1
|
PO-1064 A Registry for Analysis of Data to Advance Personalised Therapy with MR-Linac (ADAPT-MRL). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03028-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
2
|
NEW GENES AND DISEASES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
3
|
Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Public Health 2021; 141:226-236. [PMID: 34148462 DOI: 10.1177/17579139211016077] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS The present study investigates whether loneliness and social isolation are associated with poor physical and mental health among adolescents and young adults, and whether age and gender play a role in the associations of loneliness and social isolation with mental and physical health. METHODS This study used cross-sectional self-report data from the 2017 Danish Health and Morbidity Surveys titled 'How are you?' (N = 19,890, M = 22.6 years). RESULTS Logistic regression analyses showed that loneliness and social isolation were independently associated with poor physical and mental health. Loneliness was associated with increased odds of asthma, migraine, osteoarthritis, rheumatoid arthritis, hypertension, slipped disc/back pain, tinnitus, long-term mental illness, depressive symptomatology, anxiety symptomatology and alcohol problems. Social isolation was associated with decreased odds of having migraine, osteoarthritis and alcohol problems, and an increased risk of long-term mental illness and depressive symptomatology. Small age and gender differences were detected. CONCLUSIONS In adolescents and young adults, loneliness and social isolation were associated with poor mental health and loneliness with poor physical health. These findings highlight the need for targeted prevention and intervention initiatives to alleviate loneliness and social isolation.
Collapse
|
4
|
13P Evaluating targeted next-generation sequencing (NGS) assays and reference materials for NTRK fusion detection. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
5
|
Loneliness, social isolation, and chronic disease outcomes. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Research suggests that loneliness and social isolation are serious public health concerns. However, our knowledge of the associations of loneliness and social isolation with specific chronic diseases is limited. The present prospective cohort study investigated (a) the longitudinal associations of loneliness and social isolation with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and social isolation with chronic disease, and (c) baseline psychological and behavioral explanatory factors.
Methods
Self-reported data from the 2013 Danish “How are you?” survey (N = 24,607) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013-2018).
Results
Cox proportional hazard regression analyses showed that loneliness and social isolation were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or social isolation and COPD and cancer, respectively. Likewise, loneliness and social isolation did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and social isolation had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors.
Conclusions
Loneliness and social isolation were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and social isolation with CVD and T2D were fully explained by baseline psychological and behavioral factors.
Key messages
Individuals exposed to loneliness and social isolation constitute vulnerable groups in risk of chronic disease. Psychological and behavioural factors explain the associations with chronic disease.
Collapse
|
6
|
Abstract
Abstract
Background
The present prospective cohort study investigated the association of loneliness and social isolation with healthcare utilisation in the general population over time. We also investigated the synergistic effect of loneliness and social isolation on healthcare utilisation.
Methods
Data from the 2013 Danish “How are you?' survey (n = 29,472) were combined with individual-level register data from the National Danish Patient Registry and the Danish National Health Service Registry in a 6-year follow-up period (2013-2018). Negative binomial regression analyses were performed while adjusting for baseline demographics, chronic disease, and healthcare utilisation during the follow-up period.
Results
Loneliness was significantly associated with number of GP visits (incident-rate ratio (IRR) = 1.06, 95% confidence interval (CI) [1.01, 1.13]), emergency admissions (IRR = 1.19, 95% CI [1.03, 1.37]) and number of hospital admission days (IRR = 1.32, 95% CI [1.08, 1.62]). No significant associations were found between social isolation and healthcare utilisation with one minor exception, in which social isolation was associated with less planned admissions (IRR = .88, 95% CI [.78, .99]). Finally, loneliness and social isolation demonstrated a synergistic effect on number of visits to the GP (IRR = .87, 95% CI [.78, .98]) and number of hospital admission days (IRR = .67, 95% CI [.45, .98]).
Conclusions
Our findings suggest that loneliness is a risk factor for primary and secondary healthcare utilisation, independently of social isolation, baseline demographics, chronic disease, and healthcare utilisation during the follow-up period.
Key messages
Loneliness is an independent risk factor for healthcare utilisation in the general population. Social isolation is not associated with healthcare utilisation in the general population.
Collapse
|
7
|
Abstract
Objectives: To determine the current rates of use of available image guidance modalities for large joint and bursal injections, in addition to their relationships to physician demographics.Methods: An electronic survey was sent to 3,400 members of the American Medical Society for Sports Medicine (AMSSM), examining types of guidance used for each large joint and bursal injection.Results: A total of 674 sports medicine physicians responded to the survey. Intra-articular hip and glenohumeral joint injections were more commonly performed with ultrasound guidance, while palpation-guidance was more common with all other injections. Physicians who specialized in Physical Medicine & Rehabilitation (PM&R) were more likely to use ultrasound for trochanteric bursa (p = 0.007, OR = 4.16 [1.46-11.8]), while internal medicine-, pediatrics-, and family medicine-trained physicians were more likely to use palpation guidance for at least one joint (p < 0.05). Physicians with fewer years of experience were more likely to use ultrasound for glenohumeral joint injections (p ≤ 0.002 for all age groups with less than 20 years of experience, ORs ranging from 6.3 to 9.2).Conclusion: Palpation-guidance is the most common technique used for large joint and bursal injections, other than for glenohumeral and hip joint injections. PM&R-trained physicians and those with less experience tend to use ultrasound more frequently.
Collapse
|
8
|
Abstract
Background Recognition of rare molecular subgroups is a challenge for precision oncology and may lead to tissue-agnostic approval of targeted agents. Here we aimed to comprehensively characterize the clinical, pathological and molecular landscape of RET rearranged metastatic colorectal cancer (mCRC). Patients and methods In this case series, we compared clinical, pathological and molecular characteristics of 24 RET rearranged mCRC patients with those of a control group of 291 patients with RET negative tumors. RET rearranged and RET negative mCRCs were retrieved by systematic literature review and by taking advantage of three screening sources: (i) Ignyta's phase 1/1b study on RXDX-105 (NCT01877811), (ii) cohorts screened at two Italian and one South Korean Institutions and (iii) Foundation Medicine Inc. database. Next-generation sequencing data were analyzed for RET rearranged cases. Results RET fusions were more frequent in older patients (median age of 66 versus 60 years, P = 0.052), with ECOG PS 1-2 (90% versus 50%, P = 0.02), right-sided (55% versus 32%, P = 0.013), previously unresected primary tumors (58% versus 21%, P < 0.001), RAS and BRAF wild-type (100% versus 40%, P < 0.001) and MSI-high (48% versus 7%, P < 0.001). Notably, 11 (26%) out of 43 patients with right-sided, RAS and BRAF wild-type tumors harbored a RET rearrangement. At a median follow-up of 45.8 months, patients with RET fusion-positive tumors showed a significantly worse OS when compared with RET-negative ones (median OS 14.0 versus 38.0 months, HR: 4.59; 95% CI, 3.64-32.66; P < 0.001). In the multivariable model, RET rearrangements were still associated with shorter OS (HR: 2.97; 95% CI, 1.25-7.07; P = 0.014), while primary tumor location, RAS and BRAF mutations and MSI status were not. Conclusions Though very rare, RET rearrangements define a new subtype of mCRC that shows poor prognosis with conventional treatments and is therefore worth of a specific management.
Collapse
|
9
|
307 Homozygous Biallelic KRT5 Mutations in Epidermolysis Bullosa Simplex, Including a Complete Human Keratin 5 “Knock-Out”, in Families with Extensive Consanguinity. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Adverse health behaviour increase with decreasing labour market status in a Danish population survey. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
11
|
Patient-perceived treatment burden. The first study in a general population – Denmark 2017. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
12
|
Abstract
In an attempt to elucidate if and when there is a place for abdominoperineal excision in rectal cancer, we have evaluated survival, risk of local recurrence and functional results of alternative procedures. There seems to be no difference in survival rate after intended curative surgery for rectal cancer between rectal excision and sphincter-saving resection. This is also true with respect to risk of local recurrence, except in patients with poorly differentiated Dukes’ C tumours, where the risk of significant distal intramural spread is increased. Functional results are satisfactory after low anterior resection with colorectal anastomosis, whereas coloanal anastomosis is followed by less satisfactory results especially in elderly patients. In these patients rectal excision with a permanent colostomy is probably preferable.
Collapse
|
13
|
Quality control for the first large areas of triple-GEM chambers for the CMS endcaps. EPJ WEB OF CONFERENCES 2018. [DOI: 10.1051/epjconf/201817403003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The CMS Collaboration plans to equip the very forward muon system with triple-GEM detectors that can withstand the environment of the High-Luminosity LHC. This project is at the final stages of R&D and moving to production. An unprecedented large area of several 100 m2 are to be instrumented with GEM detectors which will be produced in six different sites around the world. A common construction and quality control procedure is required to ensure the performance of each detector. The quality control steps will include optical inspection, cleaning and baking of all materials and parts used to build the detector, leakage current tests of the GEM foils, high voltage tests, gas leak tests of the chambers and monitoring pressure drop vs. time, gain calibration to know the optimal operation region of the detector, gain uniformity tests, and studying the efficiency, noise and tracking performance of the detectors in a cosmic stand using scintillators.
Collapse
|
14
|
Abstract
We present a novel application of Fiber Bragg Grating (FBG) sensors in the construction and characterisation of Micro Pattern Gaseous Detector (MPGD), with particular attention to the realisation of the largest triple (Gas electron Multiplier) GEM chambers so far operated, the GE1/1 chambers of the CMS experiment at LHC. The GE1/1 CMS project consists of 144 GEM chambers of about 0.5 m2 active area each, employing three GEM foils per chamber, to be installed in the forward region of the CMS endcap during the long shutdown of LHC in 2108-2019. The large active area of each GE1/1 chamber consists of GEM foils that are mechanically stretched in order to secure their flatness and the consequent uniform performance of the GE1/1 chamber across its whole active surface. So far FBGs have been used in high energy physics mainly as high precision positioning and re-positioning sensors and as low cost, easy to mount, low space consuming temperature sensors. FBGs are also commonly used for very precise strain measurements in material studies. In this work we present a novel use of FBGs as flatness and mechanical tensioning sensors applied to the wide GEM foils of the GE1/1 chambers. A network of FBG sensors have been used to determine the optimal mechanical tension applied and to characterise the mechanical tension that should be applied to the foils. We discuss the results of the test done on a full-sized GE1/1 final prototype, the studies done to fully characterise the GEM material, how this information was used to define a standard assembly procedure and possible future developments.
Collapse
|
15
|
RET rearrangements define an uncommon molecular subtype of metastatic colorectal cancer (mCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
16
|
High-Sensitivity Troponin Assays Predicts Structural Heart Disease on Echocardiography. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
17
|
Abstract
INTRODUCTION The purpose of the present study was to evaluate the incidence and outcome of pneumococcal infections in Greenland with special reference to serotypes. STUDY DESIGN Retrospective study of invasive pneumococcal infections in Greenland in the period 1996-2002. METHODS Cases were defined as patients with positive cultures of Streptococcus pneumoniae from blood and/or CSF received at the microbiological laboratory of Dronning Ingrids Hospital in Nuuk. Cultures were sent to Statens Serum Institut in Copenhagen for serotyping. Medical charts were reviewed. RESULTS Fifty-one cases were identified. Incidence among Inuit was 54 and among non-Inuit 17 per 100,000 per year. Twenty-one patients were in the age group 35-49 years and 20 in the age group 50-64 years. Twenty patients had meningitis (incidence 6 per 100,000). Seventeen patients died (33%). Most common serotypes were 1 (6 cases) and 12F (8 cases). Mortality rate was significantly higher among patients with 12F than among others (p<0.01). No patients wit serotype 1 died. CONCLUSION Like in Canada and Alaska, the incidence of invasive pneumococcal disease, especially meningitis, is high among the Inuit in Greenland. Young and middle-aged adults were most frequently affected. Serotype seems to be an important determinant of the outcome of invasive pneumococcal disease.
Collapse
|
18
|
RXDX-105 demonstrates anti-tumor efficacy in multiple preclinical cancer models driven by molecular alterations in RET or BRAF oncogenes. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32685-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
19
|
Entrectinib, a highly potent pan-Trk, ROS1, and ALK inhibitor, has broad-spectrum, histology-agnostic anti-tumor activity in molecularly defined cancers. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32678-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
20
|
Improved efficacy response attributed to diagnostic selection – Interim results of the phase 1 experience from ALKA-372-001. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.86] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
21
|
Abstract
The anal sphincter muscles consist of the circular internal and external sphincters together with the sling-shaped associated puborectalis muscle. Ten men, 10 women with no vaginal deliveries, and 10 women with one or more vaginal deliveries were studied with anal endosonography using a 7 MHz multiplanar endoprobe. The thickness of the internal sphincter and the thickness, length, and cross-sectional area of the external sphincter were measured and related to age, sex, and parity. Reproducibility was assessed by similar measurements on different days in 10 volunteers. Anal sphincter size was the same in men and women and was not affected by the number of child births. Internal sphincter muscle thickness increased with age. Anal manometry and electromyography with an anal sponge were performed in all volunteers but the results did not correlate to any of the anal sphincter dimensions. Our conclusion is that although there are some limitations, endosonography can be used to determine the size of the anal sphincter muscles.
Collapse
|
22
|
Abstract
Cineradiographic defaecography combined with measurement of the anorectal angle and descent of the pelvic floor is proposed. The method used in 73 women gave valuable information in 48 patients who complained of anal incompetence, rectal tenesmus, and chronic constipation. In these patients, high and low rectal intussusception, rectocele, and pathologic movement of the pelvic floor were detected. Some of these phenomena could only be diagnosed by the radiologic method here described. Quantitations of the anorectal angle and descent of the pelvic floor placed the group with constipation halfway between normal individuals and those with anal incompetence. The value of this finding is discussed. Recent improvements in anorectal surgery often make videodefaecography decisive for the choice of the optimal operative method. Therefore, videodefaecography together with measurement of the anorectal angle and pelvic floor descent is recommended whenever anorectal surgery for correction of functional disturbances is contemplated.
Collapse
|
23
|
Abstract
Anal endosonography, including measurements of anal sphincter size, was performed in 16 patients with obstructed defecation. The findings were compared with those at defecography and anal manometry. Patients with rectocele and intussusception had a normal endosonographic appearance. One patient with puborectalic spasm had normal sonography. There was no correlation between sphincter size and anal manometry. The external sphincter muscle was thicker and the cross-sectional area larger in patients with obstructed defecation than in healthy controls (p < 0.05). Two patients with sphincter spasm and impaired rectal emptying at defecography had clearly thickened internal sphincters which may be the cause of their defecatory disorder. Three patients with previous anal dilatation or hemorrhoidectomy had sphincteric defects. Anal endosonography may be considered in patients with obstructed defecation to identify patients with internal sphincter hypertrophy.
Collapse
|
24
|
What hides behind the MASC: clinical response and acquired resistance to entrectinib after ETV6-NTRK3 identification in a mammary analogue secretory carcinoma (MASC). Ann Oncol 2016; 27:920-6. [PMID: 26884591 PMCID: PMC4843186 DOI: 10.1093/annonc/mdw042] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/21/2016] [Indexed: 01/05/2023] Open
Abstract
Here, we describe the dramatic response of a patient with an ETV6-NTRK3-driven mammary analogue secretory carcinoma to treatment with a pan-Trk inhibitor, and the development of acquired resistance linked to a novel NTRK3 mutation that interferes with drug binding. This case emphasizes how molecular profiling can identify therapies for rare diseases and dissect mechanisms of drug resistance. Background Mammary analogue secretory carcinoma (MASC) is a recently described pathologic entity. We report the case of a patient with an initial diagnosis of salivary acinic cell carcinoma later reclassified as MASC after next-generation sequencing revealed an ETV6-NTRK3 fusion. Patients and methods This alteration was targeted with the pan-Trk inhibitor entrectinib (Ignyta), which possesses potent in vitro activity against cell lines containing various NTRK1/2/3 fusions. Results A dramatic and durable response was achieved with entrectinib in this patient, followed by acquired resistance that correlated with the appearance of a novel NTRK3 G623R mutation. Structural modeling predicts that this alteration sterically interferes with drug binding, correlating to decreased sensitivity to drug inhibition observed in cell-based assays. Conclusions This first report of clinical activity with TrkC inhibition and the development of acquired resistance in an NTRK3-rearranged cancer emphasize the utility of comprehensive molecular profiling and targeted therapy for rare malignancies (NCT02097810).
Collapse
|
25
|
GH safety workshop position paper: a critical appraisal of recombinant human GH therapy in children and adults. Eur J Endocrinol 2016; 174:P1-9. [PMID: 26563978 PMCID: PMC4674592 DOI: 10.1530/eje-15-0873] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/11/2015] [Indexed: 01/10/2023]
Abstract
Recombinant human GH (rhGH) has been in use for 30 years, and over that time its safety and efficacy in children and adults has been subject to considerable scrutiny. In 2001, a statement from the GH Research Society (GRS) concluded that 'for approved indications, GH is safe'; however, the statement highlighted a number of areas for on-going surveillance of long-term safety, including cancer risk, impact on glucose homeostasis, and use of high dose pharmacological rhGH treatment. Over the intervening years, there have been a number of publications addressing the safety of rhGH with regard to mortality, cancer and cardiovascular risk, and the need for long-term surveillance of the increasing number of adults who were treated with rhGH in childhood. Against this backdrop of interest in safety, the European Society of Paediatric Endocrinology (ESPE), the GRS, and the Pediatric Endocrine Society (PES) convened a meeting to reappraise the safety of rhGH. The ouput of the meeting is a concise position statement.
Collapse
|
26
|
A clinical audit of in-hospital echocardiography in heart failure. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
27
|
CTCA availability does not lead to inappropriate referrals - insights from the Waitemata District Health Board experience from 2011. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Characteristics of inpatients with heart failure selected for cardiologist-directed care at North Shore Hospital. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
29
|
The three distinct roles of CT coronary angiography in chest pain diagnostic pathways – the Waitemata District Health Board experience. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
CTCA in the elderly - gatekeeper to invasive angiography or wasted effort? Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
31
|
The impact of age, clinical status, and population demographics on length of stay associated with heart failure admissions: A comparison of two hospitals. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
32
|
436 Monitoring activity of RXDX-101 in Phase 1/2 patients using a pharmacodynamic assay for TrkA activation. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
33
|
A Novel Illusion Reveals Fundamental Differences in the Binocular Integration of Achromatic and Chromatic Information. J Vis 2014. [DOI: 10.1167/14.10.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
34
|
P9.3 LOWER SUBENDOCARDIAL VIABILITY RATIO IN DIABETIC WOMEN–CONTRIBUTING TO THE ABROGATED CARDIOPROTECTIVE EFFECT OF FEMALE GENDER IN DIABETES? Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
35
|
Elevated Lipoprotein (a) level is more predictive of coronary atheroma burden than family history in intermediate and high risk- implications for screening algorithms. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
36
|
Perception and action are driven by a common representation of spatial features. J Vis 2013. [DOI: 10.1167/13.9.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
37
|
1012Prognostic Value of Adenosine Stress Cardiac Magnetic
Resonance Imaging in Patients with Known Coronary. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet070t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
38
|
Significant Radiation Dose Reduction Using Iterative Reconstruction in the 320-Slice CT Coronary Angiography System – Importance of Body Habitus. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
39
|
CT Coronary Angiography is a Useful Diagnostic Test Following Equivocal Exercise Stress ECG in Troponin-negative Chest Pain. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
40
|
Abstract PD06-03: Development of a highly reproducible clinical test for Ki67 using AQUA technology. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-pd06-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The measurement of Ki67 is showing promise in the management of breast cancer patients. It has shown potential for prognosis and as a chemotherapeutic response predictor, and also has a role in multivariate assessment of residual risk. However, the advancement in clinical testing has been arduous due to a lack of clinically validated scoring and/or cutpoints to guide clinicians. Standardization of Ki67 scoring is hindered by inter-laboratory variability in analysis of Ki67 in clinically relevant whole tissue sections, which are complicated not only by the subjective measurement required for IHC but also by heterogeneous expression due to biological variation and inconsistent fixation. In our diagnostic laboratory, we observed a significant amount of variability in the assessment of Ki67 using manual IHC scoring for percentage of positively stained nuclei. To attempt to reduce the variations in Ki67 assessment in clinically relevant specimens, our laboratory investigated the use of image analysis methods. Fluorescence immunohistochemistry (FIHC) coupled with the AQUA® technology has been established as a diagnostic test using image analysis and has been shown to eliminate much of the variation introduced in typical visual assessment.
Materials and methods: FIHC, based on the SP6 antibody clone, was used with AQUA technology to assess Ki67 expression as measured by percentage of positively stained nuclei. Results were compared to manually scored IHC results generated using the commonly used anti-Ki67 MIB1 antibody. IHC interpretation was performed by three pathologists on the same slides.
Results: The Ki67 assay using FIHC and AQUA technology was validated for use in a CLIA environment. Inter-reader variability by IHC was first demonstrated on whole tissues (Average difference in percent positive nuclei was 18% and ranged from 0–50%). This was further assessed on tissue microarrays, which mitigate the heterogeneity component of the tissue and resulted in the same high inter-reader variability (average percent difference was 18%). A significant correlation was observed for Ki67 percent positivity between AQUA and IHC in TMAs (Spearman: r = 0.88, p < 0.0001). FIHC staining and scoring for Ki67 positivity by AQUA resulted in a 3-fold reduced variation compared to IHC and manual reads (6% variation). Using clinically relevant whole tissue sections, the accuracy of Ki67 measurement by AQUA was compared to IHC performed by an outside laboratory and resulted in a significant correlation between the two methods (Spearman: r=0.78, p < 0.0001). The inter-instrument scoring variability by FIHC of a subset of the whole tissue specimens was substantially reduced compared to manual reads (Average difference in percentage of positive nuclei was 2%).
Discussion: The use of image analysis has been shown to be of significant value in expression assessment due to increased objectivity and the potential for broader standardization. We have demonstrated that the use of advanced image analysis when coupled with fluorescence immunohistochemistry can produce a system with greatly improved precision over traditional IHC methods in clinically relevant samples. These results indicate that image analysis of Ki67 is advantageous over manual IHC in clinical diagnostic assessment.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr PD06-03.
Collapse
|
41
|
Abstract PD02-01: Her2 expression measured by AQUA analysis on BCIRG-005 and BCIRG-006 predicts the benefit of Herceptin therapy. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-pd02-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: There have been disparate results reported in breast cancer testing for HER2 assessment as measured by protein expression or DNA amplification, yet both tests are routinely used to prescribe the drug Herceptin (trastuzumab, Genentech, So San Francisco, CA). Typically, immunohistochemistry (IHC) staining intensity of 3+ or FISH copy ratio of ≥2.0 are used to establish the cutoff between a negative and a positive result. However, it is unclear whether positivity is correlated with differential response to therapy. We used Automated Quantitative Analysis (AQUA) and a fluorescent immunohistochemical assay to measure HER2 expression in cases scored by central laboratory FISH and also receiving Herceptin therapy. The intentions of the study were two-fold: first, to provide further validation of the AQUA technology as applied to the clinical measurement of HER2 expression in breast cancer and second, to examine the potential of drug response stratification within those patients that are considered positive.
Methods: AQUA fluorescence IHC staining was performed on a multi-cohort tissue microarray (TMA) set. The assay was constructed in the Genoptix CLIA laboratory per ASCO/CAP guidelines and with a cutpoint that was validated against IHC (with FISH reflex). The trial specimens tested were from the BCIRG-005/006 studies. BCIRG-005 had n=1544 cases all assessed as FISH- while the 006 cohort had n=1477 cases all assessed as FISH+. Disease free survival (DFS) was used as the variable in subsequent modeling and analysis.
Results: The BCIRG 005 and 006 cohorts, examined in aggregate, allowed for an initial examination of agreement relationships between HER2 levels as assessed by AQUA scoring and HER2 levels as assessed by central lab FISH. Results indicated a 77% negative agreement, a 97% positive agreement and an 87% overall concordance agreement for a total of n=3021 cases. Additional Cox modeling of the patients that were enrolled as FISH+ and stratified for those who did or did not receive Herceptin treatment demonstrated a significant overall hazard ratio (HR = 0.75, CI=0.60,0.93) and when stratified for response to Herceptin, cases determined to be positive by AQUA showed significant benefit from treatment (HR = 0.66, CI = 0.52,0.85) in contrast to those who were scored as negative by AQUA that did demonstrate benefit from therapy (HR = 1.19, CI=0.71,1.97).
Conclusions: Analysis of the cases in this study originally determined to be HER2+ by FISH indicates that AQUA may improve predictions of which patients will benefit from Herceptin therapy.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr PD02-01.
Collapse
|
42
|
Factors Which Predict Individuals Whose Coronary Arteries are “Old Before Their Time”: The Value of Computed Tomographic (CT) Calcium Score Testing. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
43
|
Factors Which Predict Individuals Whose Coronary Arteries are “Old Before Their Time”: The Value of Computed Tomographic (Ct) Calcium Score Testing. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
44
|
Prognostic Value of Stress Perfusion Imaging with Cardiac MRI. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
45
|
Incorporating CT Coronary Angiography in the Acute Chest Pain Pathway—An Efficient Model of Resource Utilization. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
46
|
Basic mechanisms of visual attention are normal in Asperger's syndrome. J Vis 2011. [DOI: 10.1167/11.11.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
47
|
Lipoprotein (a) Levels Independently Predict Elevated Coronary Calcium Score in Those at Intermediate or High Risk of a Cardiovascular Event—Implications for Screening Algorithms. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.03.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
48
|
A Family History of CVS Disease is Associated with more Chance of a Calcium Score Above the Ninetieth age and Gender-matched Centile: Implications for CVS Risk Assessment. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
49
|
Convalescent Cardiac MRI in Apical Ballooning—Not All Are Normal! Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
50
|
Abstract PD10-08: Quantitative and Standardized Measurement of Estrogen Receptor Predicts Response to Radiation Therapy in Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-pd10-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: It has been repeatedly demonstrated that ER-positive patients have a significantly increased response to tamoxifen, however, continuous association between relative risk and quantitative ER expression has yet to be fully established. Additionally, although it has been hypothesized that estrogen receptor positivity and tamoxifen treatment may play a role in radiation therapeutic response, an assessment of whether quantitative levels of ER predict response to radiation therapy has yet to be determined. Materials and Methods: Fluorescence immunohistochemistry with AQUA® technology was used to quantitatively assess ER expression on a cohort (n = 568) of retrospectively collected breast cancer specimens from patients treated with tamoxifen (20mg) ± radiotherapy (RT). Staining, image acquisition and AQUA analysis was performed at two independent sites using two different standardized digital pathology platforms. AQUA technology is a completely standardized and objective platform with minimized operator interaction that provides tumor-specific, quantitative and continuous expression score data.
Results: A comparison between completely independent sample staining and quantitative assessment at two sites showed highly significant correlation, with AQUA score values approaching unity (Pearson's R=0.94; linear slope = 0.999) and indistinguishable means (p=0.93). Assessment of the same tissue slides on two different instrument platforms (HistoRx PM2000 v. Aperio Scanscope FL) also showed highly significant correlation (Pearson's R=0.95; linear slope = 1.01; p = 0.89). Continuous ER AQUA scores showed a highly significant association with 5-year disease-free survival by itself (HR = 0.80 (95%CI: 0.70-0.91); p=0.001) and when put into a model with nodal status and tumor size (HR=0.80 (95%CI: 0.68 — 0.94); p=0.006). The cohort was then divided at the median AQUA score representing relative low and high ER expressing patients. The low ER expressing group showed significant benefit from RT for 5-year disease-free survival (HR = 0.56 (95%CI: 0.32-0.95); p=0.03) and maintained significance at the 10% level when nodal status and tumor size were adjusted for in the model (HR = 0.60 (95%CI: 0.32 — 1.10); p=0.097). In contrast, the high ER expressing group showed no benefit (HR = 0.81 (95%CI: 0.43-1.52); p=0.51) for radiation treatment. No benefit for either group was observed for 15-year overall survival. Discussion: Taken together, these data demonstrate that quantification of ER, beyond simple positive/negative characterization, could provide valuable predictive information for the treatment of breast cancer, specifically for predicting a group more likely to respond to radiation therapy and sparing patients from a potentially harmful treatment. These data will need further validation on an independent cohort designed to differentiate radiation response. Furthermore, these data indicate that true quantification of ER expression provides a continuous recurrence risk assessment for patients being treated with tamoxifen. Because these data are standardized across sites and imaging platforms, misclassification of patients is significantly reduced as compared to the current standard by which ER expression is determined.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD10-08.
Collapse
|