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Liu W, Das S, Olson RA, Baker S, Dunne EM, Chang JS, Schellenberg D, Berrang T, Hsu F, Jiang W, Mou B, Lefresne S, Tyldesley S, Liu M. Polymetastatic Recurrence-Free Survival in Patients with Repeat Oligometastases on the SABR-5 Trial. Int J Radiat Oncol Biol Phys 2023; 117:S59. [PMID: 37784532 DOI: 10.1016/j.ijrobp.2023.06.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To determine polymetastatic recurrence-free survival (PMRFS) in patients with repeat oligometastases (OM) on the SABR-5 trial. MATERIALS/METHODS SABR-5 is a prospective, multi-center trial that evaluated the safety of stereotactic ablative radiotherapy (SABR) in patients with 1-5 OM or oligoprogressive lesions. On SABR-5, patients were followed post-SABR according to standardized protocols. Patients with repeat extra-cranial OM after metastasis-directed therapy (MDT; SABR, surgery, or thermoablation) to all initial OM (including those treated before enrolment on SABR-5) were identified. Exclusion criteria included history of multiple primary malignancies and incomplete re-staging. PMRFS was defined as time from presentation of repeat oligometastases to death or presentation of 6 or more progressing metastases, leptomeningeal metastases, lymphangitic carcinomatosis, malignant ascites, or malignant pleural effusion. PMRFS, overall survival (OS), and progression-free survival (PFS) were calculated using the Kaplan-Meier method. RESULTS Seventy-six patients with repeat OM were included, of which 44 (58%) received second MDT to all OM. The most common histology in patients who received second MDT was colorectal cancer (10/44 [23%]) and in those who did not was prostate cancer (17/32 [53%]). Patients who did vs. did not receive second MDT had fewer metastases at repeat OM (mean 1.3 vs 2.2; p<0.001) and no difference in time between initial OM and repeat OM (16 vs. 17 months; p = 0.74). For patients who received second MDT, median follow-up from presentation of repeat OM was 2.6 years. Median PFS after first and second MDT were 15 months (95% CI 11-18) and 11 months (95% CI 7-17), respectively. At last follow-up, 22/44 patients (50%) were alive without polymetastatic recurrence. 3-year PMRFS and OS from presentation of repeat OM were 51% (95% CI 33-66%) and 66% (95% CI 47-79%), respectively. CONCLUSION Patients presenting with repeat OM after MDT may still have favorable 3-year PMRFS and OS, which may justify exploring aggressive local treatments in this subpopulation. Further randomized trials in this space are needed.
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Affiliation(s)
- W Liu
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - S Das
- BC Cancer Victoria, Victoria, BC, Canada
| | - R A Olson
- BC Cancer - Prince George, Prince George, BC, Canada
| | - S Baker
- BC Cancer - Surrey, Surrey, BC, Canada
| | - E M Dunne
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - J S Chang
- Department of Radiation Oncology, Gangnam Severance Hospital, Seoul, Korea, Republic of (South) Korea
| | | | - T Berrang
- BC Cancer Victoria, Victoria, BC, Canada
| | - F Hsu
- BC Cancer Abbotsford, Abbotsford, BC, Canada
| | - W Jiang
- BC Cancer - Surrey, Surrey, BC, Canada
| | - B Mou
- BC Cancer Kelowna, Kelowna, BC, Canada
| | - S Lefresne
- BC Cancer Vancouver, Vancouver, BC, Canada
| | | | - M Liu
- BC Cancer Vancouver, Vancouver, BC, Canada
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Li ZH, Kong T, Dunne EM, Liu M, Chang JS, Zhang TW, Chan M, McDermott R. Examining the Efficacy and Safety Profile of Palliative Radiotherapy Using 30 Gy in 5 Fractions. Int J Radiat Oncol Biol Phys 2023; 117:e129. [PMID: 37784686 DOI: 10.1016/j.ijrobp.2023.06.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Higher biological equivalent doses of radiotherapy (RT) can improve symptom palliation and local control in select tumor sites. However, not all patients meet criteria for treatment with stereotactic ablative radiotherapy (SABR). Furthermore, SABR is a resource intensive technique which may limit its use in many centers. The 30 Gray in 5 fractions regimen (30/5) stems from a modification of 5-fraction SABR regimens. It is a conformal, homogenous hypo-fractionated regimen that delivers higher dose than conventional palliative RT while still respecting the normal tissue constraints for 5-fraction SABR. It uses streamlined contouring and planning with less stringent requirements for immobilization and image guidance, compared to what is required for SABR. This study evaluates the clinical outcomes of patients receiving 30/5. MATERIALS/METHODS A single institution retrospective review of clinical and treatment data was performed for patients who received 30/5 from October 2020 to August 2022. Local control (LC) was calculated for all treatment courses. Distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) were calculated for all patients. Survival analyses were analyzed by the Kaplan-Meier method and curves compared by log-rank test. Univariate and multivariate analyses were performed using cox-regression analysis. RESULTS A total of 77 patients and 92 courses of 30/5 were available for analysis. The most common primary tumor was lung (44%), followed by gastrointestinal (GI; 20%), breast (10%), and genitourinary (10%). The median age of patients was 64 years (range: 37-93). The median tumor size treated was 11.4 cm^3 (range: 0.3 - 210.9 cm^3). Treatment sites included lung (31%), lymph nodes (22%), non-spine bone (20%), and spine (15%). At median follow-up of 10.1 months (mo), 25 deaths occurred. Median LC after receiving 30/5 was 18.5 mo (95% CI: 15.7-21.3 mo), median DMFS was 6.6 months (95% CI: 4.6-8.6 mo), median PFS was 6.4 mo (95% CI: 4.9-8.0 mo), and median OS was 18.1 mo (95% CI: 13.1-23.1 mo). Median time to initiating, restarting, or changing systemic therapy was 12.8 mo (95% CI: 7.6-18.0 mo). Radiosensitive (lung, prostate, breast, gynecological, and head/neck) tumors had better LC than radioresistant (GI, renal cell, sarcoma, melanoma) tumors (median 20.9 vs 12.1 mo, p < 0.02). Six grade 2 toxicities occurred (6.5% of all treatments). No grade 3 or higher toxicities occurred. CONCLUSION The 30/5 regimen is a safe, well-tolerated, and resource efficient regimen with effective local control. This may serve as a practical alternative for patients who require palliative RT but not optimal candidates for SABR. As expected, radiosensitive tumors had better local control than radioresistant tumors. Future research can further explore the safety, efficacy, and indications of 30/5 as a palliative RT option.
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Affiliation(s)
- Z H Li
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - T Kong
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - E M Dunne
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - M Liu
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - J S Chang
- BC Cancer Vancouver, Vancouver, BC, Canada; Yonsei Cancer Center, Seoul, Korea, Republic of (South) Korea
| | - T W Zhang
- BC Cancer Vancouver, Vancouver, BC, Canada
| | - M Chan
- BC Cancer Vancouver, Vancouver, BC, Canada
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Ratnakumaran R, van As N, Khoo V, McDonald F, Tait D, Ahmed M, Taylor H, Griffin C, Dunne EM, Tree AC. Patterns of Failure After Stereotactic Body Radiotherapy to Sacral Metastases. Clin Oncol (R Coll Radiol) 2023; 35:339-346. [PMID: 36805131 DOI: 10.1016/j.clon.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
AIMS Stereotactic body radiotherapy (SBRT) is increasingly used to treat sacral metastases. We analysed our centre's local relapse rates and patterns of failure after sacral SBRT and assessed whether using the consensus contouring recommendation (CCR) may have prevented local relapse. MATERIALS AND METHODS We conducted a single-centre retrospective review of patients treated with sacral SBRT between February 2012 and December 2021. The cumulative incidence of local relapse, patterns of failure and overall survival were determined. Two investigators reviewed planning computed tomography scans and imaging at relapse to determine if local relapse was potentially preventable with a larger CCR-derived radiotherapy field. RESULTS In total, 34 patients received sacral SBRT, with doses ranging from 24 to 40 Gy over three to five fractions. The most frequently used schedule was 30 Gy in three fractions. Common primaries treated included prostate (n = 16), breast (n = 6), lung (n = 3) and renal (n = 3) cancers. The median follow-up was 20 months (interquartile range 13-55 months). The cumulative incidence of local relapse (4/34) was 2.9% (95% confidence interval 0.2-13.2), 6.3% (95% confidence interval 1.1-18.5) and 16.8% (95% confidence interval 4.7-35.4) at 6 months, 1 year and 2 years, respectively. The patterns of failure were local-only (1/34), local and distant (3/34) and distant relapse (10/34). The overall survival was 96.7% (95% confidence interval 90.5-100) and 90.6% (95% confidence interval 78.6-100) at 1 and 2 years, respectively. For prostate/breast primaries, the cumulative incidence of local relapse was 4.5% (95% confidence interval 0.3-19.4), 4.5% (95% confidence interval 0.3-19.4) and 12.5% (95% confidence interval 1.7-34.8) at 6 months, 1 and 2 years, respectively. Twenty-nine cases (85.3%) deviated from the CCR. Sacral relapse was potentially preventable if the CCR was used in one patient (2.9% of the whole cohort and 25% of the relapsed cohort). DISCUSSION We have shown excellent local control rates with sacral SBRT, which was largely planned with a margin expansion approach.
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Affiliation(s)
- R Ratnakumaran
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK.
| | - N van As
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK
| | - V Khoo
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK
| | - F McDonald
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK
| | - D Tait
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK
| | - M Ahmed
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK
| | - H Taylor
- The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - C Griffin
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, UK
| | - E M Dunne
- Department of Radiation Oncology, BC Cancer - Vancouver Centre, Vancouver, British Columbia, Canada
| | - A C Tree
- The Royal Marsden NHS Foundation Trust, Sutton, UK; Radiotherapy and Imaging Division, Institute of Cancer Research, London, UK
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4
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Dunne EM, Myrehaug S, Sahgal A. Stereotactic Body Radiotherapy for Painful Spinal Metastases - A Significant Advance in the Field of Radiation Oncology. Clin Oncol (R Coll Radiol) 2023; 35:e104-e105. [PMID: 36437160 DOI: 10.1016/j.clon.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/11/2022] [Indexed: 11/26/2022]
Affiliation(s)
- E M Dunne
- Department of Radiation Oncology, BC Cancer - Vancouver Centre, Vancouver, British Columbia, Canada.
| | - S Myrehaug
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - A Sahgal
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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5
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Dey AK, Ennis N, Cheng DM, Blokhina E, Raj A, Quinn E, Bendiks S, Palfai T, Dunne EM, Cook RL, Krupitsky E, Samet JH. Impulsivity and linkage to HIV Care among People living with HIV in St. Petersburg, Russia. AIDS Behav 2022; 26:4126-4134. [PMID: 35708831 DOI: 10.1007/s10461-022-03738-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 11/25/2022]
Abstract
This study evaluated the association between impulsivity and linkage to HIV care among Russians living with HIV recruited from an inpatient narcology hospital. Linking Infectious and Narcology Care (LINC) study participants who completed the Barratt Impulsiveness Scale (BIS) were included in these analyses. The primary independent variable was impulsivity score which was categorized as high impulsivity (BIS score > 71) vs. low impulsivity (BIS score < = 71). The primary outcome, linkage to care post recruitment, was defined as one or more HIV medical care visits at 12-month follow-up. Multiple logistic regression models were used to evaluate the association between high impulsivity and linkage to HIV care controlling for potential confounders. Participants (N = 227) were adults with a mean age of 34 years (SD = 5), and the majority were male (74%). We did not detect a significant association between impulsivity and linkage to HIV care after adjusting for respondents' age, gender, CD4 cell count, and depression score. We also found that substance use and hazardous drinking did not appear to confound the relationship. Although our study was unable to detect an association between impulsivity and linkage to HIV care, it may provide direction for future research exploring the associations between impulsivity and HIV care.
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Affiliation(s)
- Arnab K Dey
- Division of Global Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, 92093, San Diego, CA, USA.
| | | | | | - Elena Blokhina
- First St. Petersburg Pavlov State Medical University, St. Petersburg, Russia
| | - Anita Raj
- Division of Global Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, 92093, San Diego, CA, USA
| | | | | | | | | | | | - Evgeny Krupitsky
- First St. Petersburg Pavlov State Medical University, St. Petersburg, Russia.,V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - Jeffrey H Samet
- Boston University, Boston, MA, USA.,Boston Medical Center, Boston, MA, USA
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6
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Diez P, Hanna GG, Aitken KL, van As N, Carver A, Colaco RJ, Conibear J, Dunne EM, Eaton DJ, Franks KN, Good JS, Harrow S, Hatfield P, Hawkins MA, Jain S, McDonald F, Patel R, Rackley T, Sanghera P, Tree A, Murray L. UK 2022 Consensus on Normal Tissue Dose-Volume Constraints for Oligometastatic, Primary Lung and Hepatocellular Carcinoma Stereotactic Ablative Radiotherapy. Clin Oncol (R Coll Radiol) 2022; 34:288-300. [PMID: 35272913 DOI: 10.1016/j.clon.2022.02.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/21/2022] [Accepted: 02/14/2022] [Indexed: 12/25/2022]
Abstract
The use of stereotactic ablative radiotherapy (SABR) in the UK has expanded over the past decade, in part as the result of several UK clinical trials and a recent NHS England Commissioning through Evaluation programme. A UK SABR Consortium consensus for normal tissue constraints for SABR was published in 2017, based on the existing literature at the time. The published literature regarding SABR has increased in volume over the past 5 years and multiple UK centres are currently working to develop new SABR services. A review and update of the previous consensus is therefore appropriate and timely. It is hoped that this document will provide a useful resource to facilitate safe and consistent SABR practice.
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Affiliation(s)
- P Diez
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK
| | - G G Hanna
- Belfast Health and Social Care Trust, Belfast, UK; Queen's University Belfast, Belfast, UK
| | - K L Aitken
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; Institute of Cancer Research, London, UK
| | - N van As
- Institute of Cancer Research, London, UK; Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Chelsea, London, UK
| | - A Carver
- Department of Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Medical Centre, Edgbaston, Birmingham, UK
| | - R J Colaco
- Department of Clinical Oncology, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - J Conibear
- Radiotherapy Department, Barts Cancer Centre, London, UK
| | - E M Dunne
- Department of Clinical Oncology, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - D J Eaton
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK; Department of Medical Physics, Guys and St Thomas' NHS Foundation Trust, London, UK; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - K N Franks
- Department of Clinical Oncology, Leeds Cancer Centre, St James's University Hospitals, Leeds, UK
| | - J S Good
- Department of Clinical Oncology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - S Harrow
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - P Hatfield
- Department of Clinical Oncology, Leeds Cancer Centre, St James's University Hospitals, Leeds, UK
| | - M A Hawkins
- Department of Medical Physics and Biomechanical Engineering, University College London, London, UK; Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Jain
- Belfast Health and Social Care Trust, Belfast, UK; Queen's University Belfast, Belfast, UK
| | - F McDonald
- Institute of Cancer Research, London, UK; Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Chelsea, London, UK
| | - R Patel
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK
| | - T Rackley
- Department of Clinical Oncology, Velindre Cancer Centre, Cardiff, UK
| | - P Sanghera
- Department of Clinical Oncology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, UK
| | - A Tree
- Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; Institute of Cancer Research, London, UK
| | - L Murray
- Department of Clinical Oncology, Leeds Cancer Centre, St James's University Hospitals, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
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7
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Donahue ML, Dunne EM, Gathright EC, DeCosta J, Balletto BL, Jamison RN, Carey MP, Scott-Sheldon LAJ. Complementary and integrative health approaches to manage chronic pain in U.S. military populations: Results from a systematic review and meta-analysis, 1985-2019. Psychol Serv 2021; 18:295-309. [PMID: 32134305 PMCID: PMC7483193 DOI: 10.1037/ser0000417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The objective of this study was to examine the efficacy of complementary and integrative health (CIH) approaches for reducing pain intensity (primary outcome) and depressive symptoms (secondary outcome) as well as improving physical functioning (secondary outcome) among U.S. military personnel living with chronic pain. Studies were retrieved from bibliographic databases, databases of funded research, and reference sections of relevant articles. Studies that (a) evaluated a CIH approach to promote chronic pain management among military personnel, (b) used a randomized controlled trial design, and (c) assessed pain intensity were included. Two coders extracted data from each study and calculated effect sizes. Discrepancies between coders were resolved through discussion. Comprehensive searches identified 12 studies (k = 15 interventions) that met inclusion criteria. CIH practices included cognitive-behavioral therapies (k = 5), positive psychology (k = 3), yoga (k = 2), acupuncture (k = 2), mindfulness-based interventions (k = 2), and biofeedback (k = 1). Across these studies, participants who received the intervention reported greater reductions in pain intensity (d+ = 0.44, 95% CI [0.21, 0.67], k = 15) compared to controls. Statistically significant improvements were also observed for physical functioning (d+ = 0.36, 95% CI [0.11, 0.61], k = 11) but not for depressive symptoms (d+ = 0.21, 95% CI [-0.15, 0.57], k = 8). CIH approaches reduced pain intensity and improved physical functioning. These approaches offer a nonpharmacological, nonsurgical intervention for chronic pain management for military personnel. Future studies should optimize interventions to improve depressive symptoms in military populations experiencing chronic pain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Marissa L. Donahue
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Eugene M. Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
| | - Emily C. Gathright
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
| | - Julie DeCosta
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Brittany L. Balletto
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Robert N. Jamison
- Pain Management Center, Brigham and Women’s Hospital, Chestnut Hill, MA
- Harvard Medical School, Boston, MA
| | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Lori A. J. Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
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8
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Carr OJJ, Vilivong K, Bounvilay L, Dunne EM, Lai JYR, Chan J, Vongsakid M, Chanthongthip A, Siladeth C, Ortika B, Nguyen C, Mayxay M, Newton PN, Mulholland K, Do LAH, Dubot-Pérès A, Satzke C, Dance DAB, Russell FM. Nasopharyngeal Pneumococcal Colonization Density is Associated with Severe Pneumonia in Young Children in the Lao PDR. J Infect Dis 2021; 225:1266-1273. [PMID: 33974708 PMCID: PMC8974848 DOI: 10.1093/infdis/jiab239] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background No studies have explored the association between pneumococcal nasopharyngeal density and severe pneumonia using the World Health Organization (WHO) 2013 definition. In Lao People’s Democratic Republic (Lao PDR), we determine the association between nasopharyngeal pneumococcal density and severe pneumonia in children. Methods A prospective observational study was undertaken at Mahosot Hospital, Vientiane, from 2014 to mid-2018. Children <5 years admitted with acute respiratory infections (ARIs) were included. Clinical and demographic data were collected alongside nasopharyngeal swabs for pneumococcal quantification by lytA real-time quantitative polymerase chain reaction. Severe pneumonia was defined using the 2013 WHO definition. For pneumococcal carriers, a logistic regression model examined the association between pneumococcal density and severe pneumonia, after adjusting for potential confounders including demographic and household factors, 13-valent pneumococcal conjugate vaccine status, respiratory syncytial virus co-detection, and preadmission antibiotics. Results Of 1268 participants with ARI, 32.3% (n = 410) had severe pneumonia and 36.9% (n = 468) had pneumococcal carriage. For pneumococcal carriers, pneumococcal density was positively associated with severe pneumonia (adjusted odds ratio, 1.4 [95% confidence interval, 1.1–1.8]; P = .020). Conclusions Among children with ARIs and pneumococcal carriage, pneumococcal carriage density was positively associated with severe pneumonia in Lao PDR. Further studies may determine if pneumococcal density is a useful marker for pneumococcal conjugate vaccine impact on childhood pneumonia.
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Affiliation(s)
- O J J Carr
- University of Tasmania, Hobart, Tasmania, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - K Vilivong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - L Bounvilay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - E M Dunne
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | | - J Chan
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - M Vongsakid
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - A Chanthongthip
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - C Siladeth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - B Ortika
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - C Nguyen
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - M Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - P N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - K Mulholland
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - L A H Do
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - A Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.,Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
| | - C Satzke
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty, Institute for Infection and Immunity, Parkville, Australia
| | - D A B Dance
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - F M Russell
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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9
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Dunne EM, Rosen RK, Rich C, Norris AL, Salmoirago-Blotcher E, Carey MP. Telephone-delivered behavioral health interventions for people living with HIV: patients' perspectives from a qualitative study. AIDS Care 2020; 33:1155-1158. [PMID: 33138622 DOI: 10.1080/09540121.2020.1838427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
People living with HIV (PLWH) often experience mental health concerns as well as difficulties with medication adherence; they also report barriers to receipt of health services. Telephone-delivered interventions can overcome some of these barriers. To obtain patients' perspectives on telephone-delivered behavioral health services, we conducted a qualitative study with patients who participated in one of two telephone-delivered interventions (mindfulness training, health coaching) in a research trial. Patients (N = 42; M age = 46 years, 50% female, 26% Black) participated in semi-structured qualitative interviews after completing the study. They identified several advantages (e.g., being able to schedule sessions more flexibly compared to in-person appointments, ease of developing rapport with interventionists) as well as occasional challenges of phone delivery (e.g., network connectivity). Overall, PLWH view telephone-delivery as a convenient and flexible method to engage in behavioral health interventions.
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Affiliation(s)
- Eugene M Dunne
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Rochelle K Rosen
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,School of Public Health, Brown University, Providence, RI, USA
| | - Carla Rich
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Alyssa L Norris
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA.,School of Public Health, Brown University, Providence, RI, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA.,School of Public Health, Brown University, Providence, RI, USA
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10
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Dunne EM, Striley CW, Mannes ZL, Asken BM, Whitehead NE, Cottler LB. Reasons for Prescription Opioid Use While Playing in the National Football League as Risk Factors for Current Use and Misuse Among Former Players. Clin J Sport Med 2020; 30:544-549. [PMID: 29933284 PMCID: PMC6310671 DOI: 10.1097/jsm.0000000000000628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Prescription opioid misuse has become a significant public health issue. Previous research has examined predictors of prescription opioid use and misuse among former National Football League (NFL) players. The present study aimed to describe how reasons for prescription opioid use while in the NFL corresponds to use and misuse in retirement. DESIGN Former NFL players reporting prescription opioid use during their playing careers (N = 336) were included in this secondary data analysis. Participants reported reasons for prescription opioid use, including pain management, use "to function," to improve mood, to reduce stress, and to aid sleep. RESULTS Among retired NFL players with exposure to prescribed pain medication during their playing career, 26.2% reported recent use of prescription opioids (past 30 days) and 73.8% reported no use. Specifically, 14.3% of retired players reported opioid use only as prescribed, whereas 11.9% reported misuse (not prescribed or use other than as prescribed). Using prescription opioids to function while in the NFL was associated with any opioid use in the past 30 days [odds ratios (OR) = 1.30, 95% CI: 1.12-1.50, P < 0.001]. Further, opioid use in the NFL to reduce stress and anxiety was associated with increased odds of past 30-day misuse of prescription opioids (OR = 1.45, 95% CI: 1.01-2.11; P = 0.048). CONCLUSIONS The present study adds to the literature on elite athletes at high risk for pain and prescription opioid use and misuse. The findings may help to identify and provide early intervention for professional athletes most at risk for misuse of prescription opioids.
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Affiliation(s)
- Eugene M. Dunne
- Department of Clinical and Health Psychology, University of Florida,
Gainesville, FL
| | | | - Zachary L. Mannes
- Department of Clinical and Health Psychology, University of Florida,
Gainesville, FL
| | - Breton M. Asken
- Department of Clinical and Health Psychology, University of Florida,
Gainesville, FL
| | | | - Linda B. Cottler
- Department of Epidemiology, University of Florida, Gainesville
FL
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11
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Mannes ZL, Dunne EM, Ferguson EG, Cottler LB, Ennis N. History of opioid use as a risk factor for current use and mental health consequences among retired National Football League athletes: A 9-year follow-up investigation. Drug Alcohol Depend 2020; 215:108251. [PMID: 32916451 PMCID: PMC7590231 DOI: 10.1016/j.drugalcdep.2020.108251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many retired National Football League (NFL) athletes manage pain with opioids during their playing careers and in retirement, though the longitudinal association between opioid use and health outcomes pertinent to an NFL career are not yet known. This study aimed to assess the relationship between opioid use in 2010 and current use, depressive symptoms, and health related quality of life (HRQoL) among NFL retirees. METHODS Former NFL athletes from the Retired NFL Players Association initially recruited in 2010 for a study examining risk factors of opioid use and misuse were re-contacted (N = 89) from 2018 to 2019 and administered measures of pain, opioid use, depressive symptoms, and HRQoL. Binomial regression examined the association between 2010 opioid use with current use, moderate-severe depressive symptoms, and average and above HRQoL (physical and mental) while controlling for covariates. RESULTS Nearly 50 % of retirees using opioids in 2010 currently used. Compared to non-users, retirees who used opioids in 2010 had greater odds of current use (AOR: 3.71, 95 % CI: 1.02-13.56, p = 0.046) and experiencing moderate-severe depressive symptoms (AOR: 5.93, 95 % CI: 1.15-30.54, p = 0.033). Retirees reporting use in 2010 also evidenced lower odds of reporting average or above mental HRQoL (AOR: 0.13, 95 % CI: 0.03-0.67, p = 0.015) compared to non-users. CONCLUSIONS This study showed that among NFL retirees, early retirement opioid use predicted current use and deleterious effects on mental health, including moderate-severe depressive symptoms approximately nine years later. This investigation further supports the importance of early intervention of pain and opioid use among this population.
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Affiliation(s)
- Zachary L Mannes
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146 Gainesville, FL, 32610-0165, United States.
| | - Eugene M Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building West, Suite 309, 164 Summit Ave, Providence, RI, 02906, United States; Alpert Medical School, Brown University, Providence, RI, 02906, United States
| | - Erin G Ferguson
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, P.O. Box 100165, 1225 Center Drive, Room 3146 Gainesville, FL, 32610-0165, United States
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida P.O. Box 100231, 2004 Mowry Road, Gainesville, FL, 32610, United States
| | - Nicole Ennis
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, 32310, United States
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12
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Mannes ZL, Dunne EM, Ferguson EG, Cook RL, Ennis N. Symptoms of generalized anxiety disorder as a risk factor for substance use among adults living with HIV. AIDS Care 2020; 33:623-632. [PMID: 32835502 DOI: 10.1080/09540121.2020.1808163] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study examined the association between symptoms of generalized anxiety disorder (GAD) and substance use among 932 people living with HIV (PLWH) in Florida. PLWH completed a 45-minute questionnaire assessing demographics, symptoms of GAD and depression, and use of substances including alcohol, cigarettes, marijuana, crack/cocaine, and injection drugs. The GAD-7 measured symptoms of anxiety and participants were categorized as experiencing none/mild anxiety (score 0-9) or moderate/severe symptoms (score ≥10). Adjusted binary logistic regressions assessed the association between moderate-severe GAD symptoms and substance use while controlling for covariates, including depressive symptoms. Approximately one-third (31.4%) of the sample reported experiencing moderate/severe symptoms of GAD. After controlling for covariates, PLWH with moderate/severe symptoms of GAD had greater odds of reporting current cigarette use (AOR = 1.70, 95% CI = 1.18-2.45 p = 0.004), past 30-day hazardous alcohol consumption (AOR = 1.50, 95% CI = 1.04-2.16, p = 0.028), and past 12-month non-injection crack/cocaine use (AOR = 1.75, 95% CI = 1.13-2.69, p = 0.011) compared to PLWH reporting none/mild symptoms. Findings demonstrate that moderate/severe GAD symptoms were common among this sample of PLWH in Florida and were associated with use of cigarettes, crack/cocaine, and hazardous alcohol consumption. Future studies should explore interventions to reduce comorbid anxiety and substance use.
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Affiliation(s)
- Zachary L Mannes
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Eugene M Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.,Alpert Medical School, Brown University, Providence, RI, United States
| | - Erin G Ferguson
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Robert L Cook
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole Ennis
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, United States
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13
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Carey MP, Dunne EM, Norris A, Dunsiger S, Rich C, Rosen RK, Chan P, Salmoirago-Blotcher E. Telephone-Delivered Mindfulness Training to Promote Medication Adherence and Reduce Sexual Risk Behavior Among Persons Living with HIV: An Exploratory Clinical Trial. AIDS Behav 2020; 24:1912-1928. [PMID: 31848765 DOI: 10.1007/s10461-019-02768-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study explored whether telephone-delivered mindfulness training (MT) to promote medication adherence and reduce sexual risk behavior was feasible for and acceptable to people living with HIV. Participants (N = 42; 50% female; M age = 47.5 years) were randomized to MT or health coaching (HC). Pre- and post-intervention, and at 3-month follow-up, we assessed adherence to ART, sexual risk behavior, and hypothesized mediators; we also conducted individual interviews to obtain qualitative data. Results showed that 55% of patients assigned to MT completed ≥ 50% of the training calls compared with 86% of HC patients (p < .05). Most patients reported satisfaction with their intervention (MT = 88%, HC = 87%). Patients in MT and HC reported improvements in medication adherence, mindfulness, and sexual risk reduction as well as reductions in anxiety, depressive symptoms, perceived stress, and impulsivity over time; however, no between-groups differences were observed.
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Affiliation(s)
- Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA.
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, USA.
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, USA.
| | - Eugene M Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Alyssa Norris
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Shira Dunsiger
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, USA
| | - Carla Rich
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA
| | - Rochelle K Rosen
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, USA
| | - Philip Chan
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, USA
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO West, Suite 309, 164 Summit Avenue, Providence, RI, 02903, USA
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, USA
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14
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Japuntich SJ, Dunne EM, Krieger NH, Ryan PM, Rogers E, Sherman SE, Fu SS. Proactive Tobacco Treatment in a Behavioral Health Home. Community Ment Health J 2020; 56:328-332. [PMID: 31520255 DOI: 10.1007/s10597-019-00458-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/07/2019] [Indexed: 12/30/2022]
Abstract
Tobacco use is rarely addressed in community mental healthcare despite high patient smoking prevalence. Community mental health centers have systems in place that could be used to comprehensively address tobacco use. This study tested feasibility of, satisfaction with, and safety of proactive tobacco treatment (tobacco outreach to offer connection to tobacco cessation treatment). Behavioral health home patients who smoke were randomly assigned to usual care (UC; N = 11) or proactive care (PC; N = 9). All participants were called 3-months post-randomization for follow-up. PC patients reported high satisfaction with the program and experienced no adverse events or mental health symptom exacerbation during treatment. PC patients reported greater reductions in cigarettes per day, more quit attempts, and more cessation medication utilization than UC patients. Proactive outreach for tobacco cessation is feasible in a behavioral health home, acceptable to patients, and may reduce smoking heaviness and promote quit attempts.
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Affiliation(s)
- Sandra J Japuntich
- Hennepin Healthcare Research Institute, 701 Park Ave. S.9.303, Minneapolis, MN, 55415, USA.
| | - Eugene M Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI, USA
| | - Naomi H Krieger
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | | | - Erin Rogers
- VA New York Harbor Healthcare System, New York City, NY, USA
- Department of Population Health, New York University School of Medicine, New York, NY, 10016, USA
| | - Scott E Sherman
- VA New York Harbor Healthcare System, New York City, NY, USA
- Department of Population Health, New York University School of Medicine, New York, NY, 10016, USA
| | - Steven S Fu
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, 55417, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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15
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Pender A, Dunne EM, Wong SK, Ho C, Melosky B. Canadian Lung Cancer Conference 2019. Curr Oncol 2019; 26:e578-e580. [PMID: 31548828 DOI: 10.3747/co.26.5105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The 19th Canadian Lung Cancer Conference took place 7-8 February 2019 in Vancouver, British Columbia. This annual interdisciplinary education event attracted participants from throughout Canada to review the latest advances in lung cancer care and to learn from world-renowned experts in the field. The highlights of this year's conference were perspectives about biomarkers for immunotherapy, approaches to oligoprogressive disease, and caregiver burnout.
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Affiliation(s)
- A Pender
- Medical Oncology, BC Cancer, Vancouver, BC
| | - E M Dunne
- Radiation Oncology, BC Cancer, Vancouver, BC
| | - S K Wong
- Medical Oncology, BC Cancer, Vancouver, BC
| | - C Ho
- Medical Oncology, BC Cancer, Vancouver, BC
| | - B Melosky
- Medical Oncology, BC Cancer, Vancouver, BC
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16
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Dunne EM, Norris AL, Romer D, DiClemente RJ, Vanable PA, Valois RF, Brown LK, Carey MP. Problem Solving Reduces Sexual Risk Associated with Sensation Seeking, Substance Use, and Depressive Symptoms Among African-American Adolescents. J Child Adolesc Subst Abuse 2019; 28:113-118. [PMID: 32952380 PMCID: PMC7500528 DOI: 10.1080/1067828x.2019.1610679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors. METHOD To test this hypothesis, we used data from African-American adolescents (N = 1018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial. RESULTS Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (β = 1.13, b = 0.13,
SE = 0.02, p < .001) and lower problem-solving skills (β = -0.08, b = -0.06,
SE = 0.02, p = .01). Problem-solving skills were associated with drug use prior to sex (β = 0.92, b = -0.08, SE = 0.03, p = .004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Lastly, problem solving skills mediated the association between sexual sensation seeking and drug use prior to sex, though the effect was small (β = 0.01, 95% CI: .001, .01). CONCLUSIONS Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African American adolescents.
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Affiliation(s)
- Eugene M. Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Alpert Medical School, Brown University, Providence, RI
| | - Alyssa L. Norris
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Alpert Medical School, Brown University, Providence, RI
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA
| | | | | | - Robert F. Valois
- Schools of Public Health and Medicine, University of South Carolina, Columbia, SC
| | | | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI
- Alpert Medical School, Brown University, Providence, RI
- Brown University School of Public Health, Providence, RI
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17
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Abstract
Despite advances in HIV antiretroviral medications, some patients do not achieve adequate medication adherence or suppressed viral load. The aim of this study was to identify the relationship between factors of impulsivity and medication non-adherence. It was hypothesized that impulsivity would have a direct association with non-adherence, after accounting for other known correlates. Participants included 322 HIV positive individuals (M age = 49, 56% male, 64% Black/African American). Impulsivity was measured using the Barratt Impulsiveness Scale-Brief (BIS-Brief). Factor analysis was conducted to determine if BIS-Brief resulted in a unidimensional or multi-factor solution. Results were suggestive of a two-factor solution: behavioral impulsivity and non-planning impulsivity. Structural equation modeling found non-planning impulsivity was associated with non-adherence (β = 0.18, p = 0.016), while no significant association was observed for behavioral impulsiveness. Results suggest that strategies related to planning for future consequences may be beneficial for impulsive persons with medication adherence difficulties.
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Affiliation(s)
- Eugene M Dunne
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
- Department of Psychiatry and Human Behavior, Brown University, Coro Building, Suite 309, 164 Summit Ave, Providence, RI, 02906, USA.
| | - Robert L Cook
- Departments of Epidemiology and Medicine, University of Florida, Gainesville, FL, USA
| | - Nicole Ennis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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18
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La Vincente SF, von Mollendorf C, Ulziibayar M, Satzke C, Dashtseren L, Fox KK, Dunne EM, Nguyen CD, de Campo J, de Campo M, Thomson H, Surenkhand G, Demberelsuren S, Bujinlkham S, Do LAH, Narangerel D, Cherian T, Mungun T, Mulholland EK. Evaluation of a phased pneumococcal conjugate vaccine introduction in Mongolia using enhanced pneumonia surveillance and community carriage surveys: a study protocol for a prospective observational study and lessons learned. BMC Public Health 2019; 19:333. [PMID: 30898094 PMCID: PMC6429832 DOI: 10.1186/s12889-019-6639-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 03/08/2019] [Indexed: 11/17/2022] Open
Abstract
Background Streptococcus pneumoniae causes substantial morbidity and mortality among children. The introduction of pneumococcal conjugate vaccines (PCV) has the potential to dramatically reduce disease burden. As with any vaccine, it is important to evaluate PCV impact, to help guide decision-making and resource-allocation. Measuring PCV impact can be complex, particularly to measure impact on one of the most common and significant diseases caused by the pneumococcus, namely pneumonia. Here we outline the protocol developed to evaluate the impact of 13-valent PCV (PCV13) on childhood pneumonia in Mongolia, and a number of lessons learned in implementing the evaluation that may be helpful to other countries seeking to undertake pneumonia surveillance. Methods From 2016 PCV13 was introduced in a phased manner into the routine immunisation programme with some catch-up by the Government of Mongolia. We designed an evaluation to measure vaccine impact in children aged 2–59 months with hospitalised radiological pneumonia as a primary outcome, with secondary objectives to measure impact on clinically-defined pneumonia, nasopharyngeal carriage of S. pneumoniae among pneumonia patients and in the community, and severe respiratory infection associated with RSV and/or influenza. We enhanced an existing hospital-based pneumonia surveillance system by incorporating additional study components (nasopharyngeal swabbing using standard methods, C-reactive protein, risk factor assessment) and strengthening clinical practices, such as radiology as well as monitoring and training. We conducted cross-sectional community carriage surveys to provide data on impact on carriage among healthy children. Discussion Establishing a robust surveillance system is an important component of monitoring the impact of PCV within a country. The enhanced surveillance system in Mongolia will facilitate assessment of PCV13 impact on pneumonia, with radiological confirmed disease as the primary outcome. Key lessons arising from this evaluation have included the importance of establishing a core group of in-country staff to be responsible for surveillance activities and to work closely with this team; to be aware of external factors that could potentially influence disease burden estimates; to be flexible in data collection processes to respond to changing circumstances and lastly to ensure a consistent application of the pneumonia surveillance case definition throughout the study period.
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Affiliation(s)
- S F La Vincente
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia. .,Department of Paediatrics, The University of Melbourne, Melbourne, Australia. .,Telethon Kids Institute, Perth, Australia.
| | - C von Mollendorf
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - M Ulziibayar
- National Center of Communicable Diseases, Ulaanbaatar, Mongolia
| | - C Satzke
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - L Dashtseren
- National Center of Communicable Diseases, Ulaanbaatar, Mongolia
| | - K K Fox
- World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - E M Dunne
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - C D Nguyen
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - J de Campo
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Radiology, The University of Melbourne, Melbourne, Australia
| | - M de Campo
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Radiology, The University of Melbourne, Melbourne, Australia
| | - H Thomson
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - G Surenkhand
- National Center of Communicable Diseases, Ulaanbaatar, Mongolia
| | - S Demberelsuren
- World Health Organization Country Office, Ulaanbaatar, Mongolia
| | - S Bujinlkham
- National Center of Communicable Diseases, Ulaanbaatar, Mongolia
| | - L A H Do
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | | | - T Cherian
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - T Mungun
- National Center of Communicable Diseases, Ulaanbaatar, Mongolia
| | - E K Mulholland
- Pneumococcal Research Group, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,London School of Hygiene and Tropical Medicine, London, UK
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19
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Dunne EM, Balletto BL, Donahue ML, Feulner MM, DeCosta J, Cruess DG, Salmoirago-Blotcher E, Wing RR, Carey MP, Scott-Sheldon LAJ. The benefits of yoga for people living with HIV/AIDS: A systematic review and meta-analysis. Complement Ther Clin Pract 2018; 34:157-164. [PMID: 30712721 DOI: 10.1016/j.ctcp.2018.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/04/2018] [Accepted: 11/06/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND People living with HIV/AIDS (PLWHA) often experience psychological stress associated with disease management. This meta-analysis examines the benefits of yoga interventions on psychological distress among PLWHA. METHODS Included were studies that (a) evaluated a yoga intervention in PLWHA; (b) provided between-group or within-group changes; and (c) assessed a psychological, physiological, or biomedical outcome. RESULTS Seven studies sampling 396 PLWHA (M age = 42 years, SD = 5 years; 40% women) met inclusion criteria. PLWHA who received yoga interventions reported significant improvements in perceived stress (d+ = 0.80, 95% Confidence Interval [CI] = 0.53, 1.07), positive affect (d + = 0.73, 95% CI = 0.49, 0.98), and anxiety (d+ = 0.71, 95% CI = 0.27, 1.14) compared to controls. CONCLUSION Yoga is a promising intervention for stress management. However, the literature is limited by the small number of studies. Randomized controlled trials with objective measures of HIV-related outcomes are needed to further evaluate the benefits of yoga.
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Affiliation(s)
- Eugene M Dunne
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA; Alpert Medical School, Brown University, Providence, RI, USA.
| | - Brittany L Balletto
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Marissa L Donahue
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Melissa M Feulner
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Julie DeCosta
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | | | - Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA; Alpert Medical School, Brown University, Providence, RI, USA
| | - Rena R Wing
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA; Alpert Medical School, Brown University, Providence, RI, USA
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA; Alpert Medical School, Brown University, Providence, RI, USA; Brown University School of Public Health, Providence, RI, USA
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA; Alpert Medical School, Brown University, Providence, RI, USA; Brown University School of Public Health, Providence, RI, USA
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Dunne EM, Senn TE, Carey KB, Carey MP. Factors related to life satisfaction among urban African American adults receiving care at a publicly-funded sexual health clinic. PSYCHOL HEALTH MED 2017; 23:360-368. [PMID: 28778126 DOI: 10.1080/13548506.2017.1362109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Life satisfaction is linked to premature morbidity and mortality and it may be compromised for individuals living in economically-disadvantaged, urban neighborhoods. The present study explores how behavioral and social-environmental health factors are associated with life satisfaction among a sample of African American young adults. Participants (N = 307, Mage = 26.6 years, 53% male) were recruited from a publicly-funded clinic for a randomized controlled trial (RCT). Data from the baseline assessment of the RCT, which included measures of sleep, depression, anxiety, social support, alcohol and drug use problems, city stress, and life satisfaction, were used for the current study. Correlation analyses assessed bivariate associations between life satisfaction and the demographic and health-related factors. Linear regression using backward elimination determined the best fitting model of factors associated with life satisfaction. Backward elimination resulted in the following variables remaining as significantly associated with life satisfaction: age (b = -2.40, p = .017), anxiety (b = -5.32, p < .001), and social support (b = 2.89, p = .004). Feeling rested upon waking also remained in the best fitting model, although this association did not achieve statistical significance (p = .099). The results suggest that African American adults who are younger, less anxious, and report adequate social support are more likely to report satisfaction with life. These findings add to the literature aimed at examining health and social factors impacting the well-being of African Americans living in low-income, urban communities.
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Affiliation(s)
- Eugene M Dunne
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital , Providence , RI , USA
| | - Theresa E Senn
- b School of Nursing , University of Rochester , Rochester , NY , USA
| | - Kate B Carey
- c Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , RI , USA.,d Center for Alcohol and Addiction Studies , Brown University , Providence , RI , USA
| | - Michael P Carey
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital , Providence , RI , USA.,c Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , RI , USA.,e Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University , Providence , RI , USA
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21
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Manna S, Ortika BD, Dunne EM, Holt KE, Kama M, Russell FM, Hinds J, Satzke C. A novel genetic variant of Streptococcus pneumoniae serotype 11A discovered in Fiji. Clin Microbiol Infect 2017; 24:428.e1-428.e7. [PMID: 28736074 PMCID: PMC5869949 DOI: 10.1016/j.cmi.2017.06.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/13/2017] [Accepted: 06/30/2017] [Indexed: 11/26/2022]
Abstract
Objectives As part of annual cross-sectional Streptococcus pneumoniae carriage surveys in Fiji (2012–2015), we detected pneumococci in over 100 nasopharyngeal swabs that serotyped as ‘11F-like’ by microarray. We examined the genetic basis of this divergence in the 11F-like capsular polysaccharide (cps) locus compared to the reference 11F cps sequence. The impact of this diversity on capsule phenotype, and serotype results using genetic and serologic methods were determined. Methods Genomic DNA from representative 11F-like S. pneumoniae isolates obtained from the nasopharynx of Fijian children was extracted and subject to whole genome sequencing. Genetic and phylogenetic analyses were used to identify genetic changes in the cps locus. Capsular phenotypes were evaluated using the Quellung reaction and latex agglutination. Results Compared to published 11F sequences, the wcwC and wcrL genes of the 11F-like cps locus are phylogenetically divergent, and the gct gene contains a single nucleotide insertion within a homopolymeric region. These changes within the DNA sequence of the 11F-like cps locus have modified the antigenic properties of the capsule, such that 11F-like isolates serotype as 11A by Quellung reaction and latex agglutination. Conclusions This study demonstrates the ability of molecular serotyping by microarray to identify genetic variants of S. pneumoniae and highlights the potential for discrepant results between phenotypic and genotypic serotyping methods. We propose that 11F-like isolates are not a new serotype but rather are a novel genetic variant of serotype 11A. These findings have implications for invasive pneumococcal disease surveillance as well as studies investigating vaccine impact.
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Affiliation(s)
- S Manna
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
| | - B D Ortika
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - E M Dunne
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - K E Holt
- Centre for Systems Genomics, The University of Melbourne, Parkville, Victoria, Australia; Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria, Australia
| | - M Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | - F M Russell
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Centre for International Child Health, Murdoch Childrens Research Institute, Melbourne, Australia
| | - J Hinds
- Institute for Infection and Immunity, St. George's, University of London, United Kingdom; BUGS Bioscience, London Bioscience Innovation Centre, London, United Kingdom
| | - C Satzke
- Pneumococcal Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
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22
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Mannes ZL, Burrell LE, Dunne EM, Hearn LE, Whitehead NE. Contextualizing Psychosocial Determinants of Alcohol Use by Age Cohorts of Adults Living With HIV, Ages 50 and Older. J Assoc Nurses AIDS Care 2016; 28:279-288. [PMID: 28003102 DOI: 10.1016/j.jana.2016.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/21/2016] [Indexed: 11/25/2022]
Abstract
We examined the influence of age on associations between affective states, social support, and alcohol use by age cohorts. We recruited 96 older Black adults living with HIV from the southeastern United States in 2013 and 2014. Participants completed questionnaires assessing demographics, psychological function, and substance use. Hierarchical regression analyses assessed the relationship between psychosocial factors and alcohol use in a 50- to 59-year-old group, and a 60-years-and-older age group. After controlling for covariates, trait anger, state anger, and life stress were positively associated with alcohol consumption in the younger group, while social support was negatively associated with alcohol consumption in the older group. Interventions should target negative affective states in 50- to 59-year-old adults with HIV, and preserve social support for adults with HIV as they age, as such interventions will likely have an impact on these individuals' alcohol consumption and longstanding quality of life.
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Mannes ZL, Burrell LE, Bryant VE, Dunne EM, Hearn LE, Whitehead NE. Loneliness and substance use: the influence of gender among HIV+ Black/African American adults 50+. AIDS Care 2015; 28:598-602. [PMID: 26654243 DOI: 10.1080/09540121.2015.1120269] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Estimates suggest 30% of adults report the highest levels of loneliness. Though men are more likely than women to use illicit substances and engage in heavy drinking, the prevalence of substance use in women is growing and their escalation toward dependence occurs more rapidly. Loneliness and substance use have greater relevance within the HIV+ population, with higher rates of substance misuse than the general population. However, the association between loneliness and substance use within HIV+ individuals remains understudied. The purpose of the present study was to test the hypothesis that there would be an association between loneliness and substance moderated by gender in HIV+ older adults. A cross-sectional study was conducted between October 2013 and January 2014. Study participants included 96 HIV-positive Black/African American men and women recruited through the University of Florida Center for HIV/AIDS Research, Education and Service (UF CARES) in Jacksonville, Florida. Participants completed an interviewer-administered assessment examining mental and behavioral health. Pearson correlations examined associations between loneliness and substance use. Binary logistic regression analyses stratified by gender examined the association between loneliness and substance use while controlling for covariates. Among women, loneliness was associated with illicit drug use, AOR = 3.37, 95% CI: 1.23-9.21, p = .018 and heavy drinking, AOR = 2.47, 95% CI: 1.07-5.71, p = .033. No significant associations were found between loneliness and illicit drug use, and heavy drinking in men. Substance use among women in this population may be linked to loneliness. Interventions should be gender specific. Further research into this association is necessary as it will likely have important clinical implications for this population.
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Affiliation(s)
- Zachary L Mannes
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
| | - Larry E Burrell
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
| | - Vaughn E Bryant
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
| | - Eugene M Dunne
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
| | - Lauren E Hearn
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
| | - Nicole Ennis Whitehead
- a Department of Clinical and Health Psychology, College of Public Health and Health Professions , University of Florida , Gainesville , FL , USA
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Dunne EM, Burrell LE, Diggins AD, Whitehead NE, Latimer WW. Increased risk for substance use and health-related problems among homeless veterans. Am J Addict 2015; 24:676-80. [PMID: 26359444 DOI: 10.1111/ajad.12289] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 07/31/2015] [Accepted: 08/28/2015] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. METHODS Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. RESULTS Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p < .001), mental health problems (OR = 4.12, 95% CI: 2.28-7.42, p < .001), and physical problems (OR = 1.83, 95% CI: 1.08-3.67, p < .01). Finally, over half of homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p < .05). CONCLUSION AND SCIENTIFIC SIGNIFICANCE Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services.
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Affiliation(s)
- Eugene M Dunne
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Larry E Burrell
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Allyson D Diggins
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - Nicole Ennis Whitehead
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
| | - William W Latimer
- Department of Health Sciences, Lehman College, City University of New York, Bronx, New York
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25
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Dunne EM, Tikkanen L, Balloch A, Gould K, Yoannes M, Phuanukoonnon S, Licciardi PV, Russell FM, Mulholland EK, Satzke C, Hinds J. Characterization of 19A-like 19F pneumococcal isolates from Papua New Guinea and Fiji. New Microbes New Infect 2015; 7:86-8. [PMID: 26339490 PMCID: PMC4547413 DOI: 10.1016/j.nmni.2015.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/25/2015] [Accepted: 06/25/2015] [Indexed: 02/03/2023] Open
Abstract
Molecular identification of Streptococcus pneumoniae serotype 19F is routinely performed by PCR targeting the wzy gene of the capsular biosynthetic locus. However, 19F isolates with genetic similarity to 19A have been reported in the United States and Brazil. We screened 78 pneumococcal carriage isolates and found six 19F wzy variants that originated from children in Papua New Guinea and Fiji. Isolates were characterized using multilocus sequence typing and opsonophagocytic assays. The 19F wzy variants displayed similar susceptibility to anti-19F IgG antibodies compared to standard 19F isolates. Our findings indicate that these 19F variants may be more common than previously believed.
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Affiliation(s)
- E M Dunne
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - L Tikkanen
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - A Balloch
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - K Gould
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - M Yoannes
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - S Phuanukoonnon
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - P V Licciardi
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - F M Russell
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - E K Mulholland
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - C Satzke
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - J Hinds
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
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26
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Dunne EM, Katz EC. Alcohol Outcome Expectancies and Regrettable Drinking-Related Social Behaviors. Alcohol Alcohol 2015; 50:393-8. [PMID: 25820611 DOI: 10.1093/alcalc/agv026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 03/03/2015] [Indexed: 11/12/2022] Open
Abstract
AIMS Research has shown that alcohol outcome expectancies are predictive of heavy alcohol consumption, which can lead to risky behavior. The purpose of the present study was to assess the incidence of various low-risk social behaviors while drinking among college students. Such social behaviors may later be regretted (referred to as regrettable social behaviors) and include electronic and in-person communications. METHODS College students (N = 236) completed measures of alcohol outcome expectancies and regrettable social behaviors. RESULTS Regrettable social behaviors were reported by 66.1% of participants, suggesting that they may occur at a much higher rate than more serious drinking-related consequences (e.g., drinking and driving, violence, etc.). Expectancies for social facilitation predicted regrettable social behavior. Further, this relationship was mediated by amount of alcohol consumed. CONCLUSION Given the high incidence, regrettable social behaviors may be effective targets in alcohol prevention programming.
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Affiliation(s)
- Eugene M Dunne
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Abstract
The study aimed to highlight the importance of interdisciplinary collaboration and the value for combining normative neuropsychological and neuroradiological measures for clinical purposes. We present the case of "CL," a 65-year-old, right-handed, Caucasian female referred for a neuropsychological evaluation of memory difficulties and depression with the rule-out of pseudodementia. A brain magnetic resonance imaging (MRI) scan was conducted within 24 hours of the neuropsychology exam. Mood measures showed elevated depression and apathy symptoms. The neuropsychological profile showed variable effort, intact comprehension but compromised confrontation naming and verbal memory deficits. Using normative references from 20 female age- and education-matched healthy control peers, CL showed significantly reduced temporal cortex thickness with reduced bilateral hippocampal, right amygdala, and right caudate volumes. Combined data were supportive of a diagnosis of semantic dementia. Examining neuropsychological profiles in combination with neuroimaging standardized metrics relative to peers improved case conceptualization. Standard measures of effort and malingering examined alone and without MRI for the diagnosis of pseudodementia have questionable validity and rationale. We additionally discuss the advantages and limitations/challenges for integrating neuropsychological assessments with normative based MRI brain metrics.
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Affiliation(s)
- J J Tanner
- a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL 32610 , USA
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28
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Abstract
BACKGROUND Recent studies have reported high rates of Trichomonas vaginalis among middle age and older adults. Though trichomoniasis risk factors in this age cohort remain largely unknown, illicit drug use has been associated with increased incidence of sexually transmitted infections (STIs). The number of mid-older adults using illicit drugs has increased significantly in recent years suggesting the need to understand the relationship between drug use and STIs in this age cohort. OBJECTIVES This study examined the relationship between drug use, sexual-risk behaviors, and biologically confirmed T. vaginalis in a sample of mid-older and younger adults who reported recent drug use. METHODS The cross-sectional design examined the relationship between past 6-month drug use, sexual risk-behaviors, and PCR-confirmed T. vaginalis in 264 adults age 18-64 who were recruited from Baltimore, Maryland. These relationships were also explored in the age-stratified sample among those 18-44 years ("younger") and individuals 45+ years ("mid-older"). RESULTS Trichomoniasis prevalence did not differ significantly between younger (18.8%) and mid-older (19.1%) adults. Mid-older adults that tested positive for T. vaginalis were more likely to have used marijuana and crack in the past 6 months. Among younger adults, there were no associations between trichomoniasis and past 6-month drug use and sexual-risk behavior. CONCLUSIONS/IMPORTANCE Age- and drug-related immune decline is hypothesized to contribute to increase susceptibility to T. vaginalis in mid-older adults. Broad screening for trichomoniasis, particularly among older adults who are often not regarded as at risk for STIs, is needed to control this often asymptomatic infection.
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Affiliation(s)
- Lauren E Hearn
- a Clinical and Health Psychology , University of Florida , Gainesville , Florida , USA
| | | | - Eugene M Dunne
- a Clinical and Health Psychology , University of Florida , Gainesville , Florida , USA
| | - William W Latimer
- b School of Health Sciences , Human Services and Nursing, Lehman College , CUNY , Bronx, New York , USA
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Dunne EM, Hearn LE, Rose JJ, Latimer WW. ADHD as a risk factor for early onset and heightened adult problem severity of illicit substance use: an accelerated gateway model. Addict Behav 2014; 39:1755-8. [PMID: 25123341 DOI: 10.1016/j.addbeh.2014.07.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/03/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
The primary aims of the present study were to assess ADHD history as a risk factor for earlier initiation and current use of licit and illicit substances among a sample of drug using adults. It was hypothesized that ADHD history would accelerate the Gateway Theory of drug use. Participants included 941 drug-using African American and Caucasian individuals in Baltimore, Maryland. The sample consisted of 124 (13.2%) participants who reported a history of ADHD and 817 (86.8%) who reported no history of ADHD. The accelerated gateway hypothesis was supported, as a history of self-reported ADHD was significantly associated with younger ages of initiation for alcohol, cigarettes, marijuana, and cocaine use. Participants with a history of ADHD were also more likely to engage in recent HIV-risk behavior, such as injection drug use and needle sharing. This study provides compelling data in support of an accelerated gateway model for substance use related to ADHD history and increased problem severity in adulthood. Targeted substance use prevention and intervention may be beneficial for those with ADHD.
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30
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Dunne EM, Freedlander J, Coleman K, Katz EC. Impulsivity, expectancies, and evaluations of expected outcomes as predictors of alcohol use and related problems. Am J Drug Alcohol Abuse 2013; 39:204-10. [PMID: 23721536 DOI: 10.3109/00952990.2013.765005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND While the association between outcome expectancies and drinking is well documented, few studies have examined whether evaluations of expected outcomes (outcome evaluations) moderate that association. OBJECTIVES The present study tested the hypotheses that outcome evaluations moderate the outcome expectancy-drinking association and that outcome expectancies mediate the association between impulsive personality and drinking. METHODS College students (N = 201; 55.5% female) enrolled in a mid-sized metropolitan university completed measures assessing outcome expectancies and evaluations, alcohol consumption, and drinking-related problems. RESULTS Consistent with study hypotheses, expectation of negative outcomes predicted lower levels of drinking, but only when these outcomes were evaluated as highly aversive. However, impulsivity was found to be a far stronger predictor of both drinking and related problems than were outcome expectancies or evaluations. CONCLUSION The association between negative expectancy and drinking was moderated by negative evaluation, such that individuals who both expected that negative outcomes were likely to occur and who judged such outcomes as highly undesirable consumed significantly fewer drinks per week. Impulsivity was found to be a strong predictor of both alcohol consumption and alcohol-related problems.
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Affiliation(s)
- Eugene M Dunne
- Department of Psychology, Towson University, Towson, MD 21252, USA
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31
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John M, Dunne EM, Licciardi PV, Satzke C, Wijburg O, Robins-Browne RM, O'Leary S. Otitis media among high-risk populations: can probiotics inhibit Streptococcus pneumoniae colonisation and the risk of disease? Eur J Clin Microbiol Infect Dis 2013; 32:1101-10. [PMID: 23512465 DOI: 10.1007/s10096-013-1858-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 03/05/2013] [Indexed: 01/23/2023]
Abstract
Otitis media is the second most common infection in children and the leading cause for seeking medical advice. Indigenous populations such as the Inuits, indigenous Australians and American Indians have a very high prevalence of otitis media and are considered to be high-risk populations. Streptococcus pneumoniae, one of the three main bacterial causes of otitis media, colonises the nasopharynx prior to disease development. In high-risk populations, early acquisition of high bacterial loads increases the prevalence of otitis media. In these settings, current treatment strategies are insufficient. Vaccination is effective against invasive pneumococcal infection but has a limited impact on otitis media. Decreasing the bacterial loads of otitis media pathogens and/or colonising the nasopharynx with beneficial bacteria may reduce the prevalence of otitis media. Probiotics are live microorganisms that offer health benefits by modulating the microbial community and enhancing host immunity. The available data suggest that probiotics may be beneficial in otitis media. This review discusses the potential use of probiotics to reduce pathogen colonisation and decrease the prevalence of otitis media, providing justification for further investigation.
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Affiliation(s)
- M John
- Department of Otolaryngology, The University of Melbourne, Parkville, VIC, Australia.
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32
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Abstract
College students across the U.S. engage in nonmedical use of prescription stimulants (NMUPS) at increasing rates. While it has been found that use is frequently motivated by a belief that stimulants will act as a study aid, little is known about predictors of NMUPS. The present study addressed impulsivity, outcome expectancies, and evaluations of expected outcomes as predictors of NMUPS in a sample of 206 college students at a mid-Atlantic university. Approximately 26.1% of students endorsed past year NMUPS. Results indicated an increased likelihood of self-reported NMUPS was associated with increases in lack of premeditation, sensation seeking, positive expectancies and positive evaluations. Moreover, the extent to which participants believed that potential negative consequences were more severe was associated with a decreased likelihood of NMUPS. The current study suggests that impulsive personality, outcome expectancies, and evaluations of expected outcomes are important predictors of NMUPS among college students. Future research should consider other potential predictors of NMUPS in order to inform the development of prevention strategies.
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33
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Brown AG, Ross FM, Dunne EM, Steel CM, Weir-Thompson EM. Evidence for a new tumour suppressor locus (DBM) in human B-cell neoplasia telomeric to the retinoblastoma gene. Nat Genet 1993; 3:67-72. [PMID: 8490658 DOI: 10.1038/ng0193-67] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Roughly 25% of human B-cell chronic lymphocytic leukaemias (CLL) are characterized by a chromosomal lesion involving 13q14. This region contains the retinoblastoma gene (RB1). We have used a variety of techniques to determine whether RB1 or some other locus is the critical region in 11 cases of low grade B-cell malignancy (mainly CLL), all with deletions or translocations involving 13q14. In all cases, except the one with minimal disease, there was deletion or a structural lesion in the region of D13S25, with at least 4 cases showing homozygous disruption. We conclude that D13S25 lies close to a tumour suppressor locus whose inactivation contributes to the initiation or progression of low grade B-cell malignancy. This locus is located at least 530 kilobases telomeric to RB1.
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MESH Headings
- Alleles
- Animals
- Blotting, Southern
- Chromosomes, Human, Pair 13
- Electrophoresis, Gel, Pulsed-Field
- Genes, Retinoblastoma
- Genes, Tumor Suppressor
- Humans
- Hybrid Cells
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Mice
- Telomere
- Tumor Cells, Cultured
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Affiliation(s)
- A G Brown
- MRC Human Genetics Unit, Western General Hospital, Edinburgh, Scotland, UK
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