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Noel NL, Abrams J, Mudafort ER, Babu A, Forbes E, Hill L, Hill CC, Valbrun TG, Osian N, Wise LA, Kuohung W. Study protocol for the implementation of Centering Patients with Fibroids, a novel group education and empowerment program for patients with symptomatic uterine fibroids. Reprod Health 2024; 21:41. [PMID: 38561795 PMCID: PMC10983732 DOI: 10.1186/s12978-024-01777-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Black women and people with uteri have utilized collectivistic and relational practices to improve health outcomes in the face of medical racism and discrimination for decades. However, there remains a need for interventions to improve outcomes of uterine fibroids, a condition that disproportionately impacts Black people with uteri. Leveraging personalized approaches alongside evidence that demonstrates the positive impact of social and peer support on health outcomes, we adapted from CenteringPregnancy, an evidence based group prenatal care intervention, for the education and empowerment of patients with uterine fibroids. METHODS The present report provides an overview of the study design and planned implementation of CPWF in cohorts at Boston Medical Center and Emory University / Grady Memorial Hospital. After receiving training from the Centering Healthcare Institute (CHI), we adapted the 10-session CenteringPregnancy curriculum to an 8-session hybrid group intervention called Centering Patients with Fibroids (CPWF). The study began in 2022 with planned recruitment of six cohorts of 10-12 participants at each institution. We will conduct a mixed methods evaluation of the program using validated survey tools and qualitative methods, including focus groups and 1:1 interviews. DISCUSSION To date, we have successfully recruited 4 cohorts at Boston Medical Center and are actively implementing BMC Cohort 5 and the first cohort at Emory University / Grady Memorial Hospital. Evaluation of the program is forthcoming.
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Affiliation(s)
- Nyia L Noel
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA.
| | - Jasmine Abrams
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Estefania Rivera Mudafort
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
| | - Anagha Babu
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Emma Forbes
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
| | | | - Cherie C Hill
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nkem Osian
- The White Dress Project, Atlanta, GA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Wendy Kuohung
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
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Wise LA, Wang TR, Ncube CN, Lovett SM, Abrams J, Boynton-Jarrett R, Koenig MR, Geller RJ, Wesselink AK, Coleman CM, Hatch EE, James-Todd T. Use of Chemical Hair Straighteners and Fecundability in a North American Preconception Cohort. Am J Epidemiol 2023; 192:1066-1080. [PMID: 37005071 PMCID: PMC10505421 DOI: 10.1093/aje/kwad079] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/04/2023] Open
Abstract
Chemical hair straighteners ("relaxers") are used by millions of North Americans, particularly women of color. Hair relaxers may contain endocrine-disrupting compounds, which can harm fertility. We evaluated the association between hair relaxer use and fecundability among 11,274 participants from Pregnancy Study Online (PRESTO), a North American preconception cohort study. During 2014-2022, participants completed a baseline questionnaire in which they reported their history of relaxer use and completed follow-up questionnaires every 8 weeks for 12 months or until pregnancy, whichever came first. We used multivariable-adjusted proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs). Relative to never use, fecundability was lower among current (FR = 0.81, 95% CI: 0.64, 1.03) and former (FR = 0.89, 95% CI: 0.81, 0.98) users of hair relaxers. FRs for first use of hair relaxers at ages <10, 10-19, and ≥20 years were 0.73 (95% CI: 0.55, 0.96), 0.93 (95% CI: 0.83, 1.04), and 0.85 (95% CI: 0.74, 0.98), respectively. Fecundability was lowest among those with longer durations of use (≥10 years vs. never: FR = 0.71, 95% CI: 0.54, 0.91) and more frequent use (≥5 times/year vs. never: FR = 0.82, 95% CI: 0.60, 1.11), but associations were nonmonotonic. In this preconception cohort study, use of chemical hair straighteners was associated with slightly reduced fecundability.
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Affiliation(s)
- Lauren A Wise
- Correspondence to Dr. Lauren A. Wise, Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118 (e-mail: )
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Bond JC, Abrams J, Wesselink AK, White KO, Rothman KJ, Wise LA. Predictors of Non-Response to a Sexual Health Survey in a North American Preconception Cohort Study. J Sex Med 2022; 19:1707-1715. [PMID: 36182572 PMCID: PMC9617790 DOI: 10.1016/j.jsxm.2022.08.199] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Refusal to participate in studies related to sexual health can compromise the internal and external validity of findings. Research examining non-response to sexual health studies has primarily focused on predictors such as specific sexual attitudes and behaviors. AIM Evaluate predictors of non-response to a supplemental sexual health survey added to a web-based cohort study, focusing on predictors that may be important in epidemiologic studies of sexual health. METHODS In March 2021, we added the "Sexual Health and Wellbeing Questionnaire" (SQ), an optional supplemental sexual health survey, to the protocol for Pregnancy Study Online , a web-based North American prospective cohort study. Eligible participants identified as female and were aged 21-45 years, actively trying to conceive, and in a relationship with a male partner. Participants completed a baseline questionnaire at enrollment and follow-up questionnaires every 8 weeks. Participants were invited to complete the SQ 30 days after baseline questionnaire completion. The analytic sample included all Pregnancy Study Online participants who enrolled between March 2021 and December 2021 and was divided into 3 mutually-exclusive groups: (i) those who completed the baseline questionnaire only (ie, did not complete a follow-up questionnaire or the SQ), (ii) those who completed at least 1 follow-up questionnaire but not the SQ, and (iii) participants who completed the SQ (with or without a follow-up questionnaire). We compared sociodemographic, medical, lifestyle, and reproductive factors across these groups. RESULTS Of the 1,491 enrolled participants, 302 (20.3%) completed the baseline questionnaire only, 259 (17.4%) completed a follow-up questionnaire but not the SQ, and 930 (62.4%) completed the SQ. Strong predictors of non-response (absolute difference in response >10% comparing SQ responders to baseline-only responders) included longer pregnancy attempt time at study entry, a history of infertility, and lower income and education. Compared with response to the follow-up questionnaire only, SQ response was lower among Hispanic/Latina participants and participants aged <25 years. CLINICAL TRANSLATION The addition of sexual health surveys to established cohort studies may be an effective way to expand epidemiologic sex research efforts. STRENGTHS & LIMITATIONS Study strengths include the prospective design, geographic heterogeneity of the cohort, and use of online methods. Our findings may not generalize to clinic-based sex research. CONCLUSION We report that in an established North American cohort study, response to the SQ exceeded 60%. We observed few strong predictors for SQ non-response among engaged participants. Bond JC, Abrams J, Wesselink AK, et al. Predictors of Non-Response to a Sexual Health Survey in a North American Preconception Cohort Study. J Sex Med 2022;19:1707-1715.
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Affiliation(s)
- Julia C Bond
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Jasmine Abrams
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA; Maternal and Child Health Center of Excellence, Boston University School of Public Health, Boston, MA, USA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Katharine O White
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Threats M, Brawner BM, Montgomery TM, Abrams J, Jemmott LS, Crouch PC, Freeborn K, Kamitani E, Enah C. A Review of Recent HIV Prevention Interventions and Future Considerations for Nursing Science. J Assoc Nurses AIDS Care 2021; 32:373-391. [PMID: 33929980 PMCID: PMC8715511 DOI: 10.1097/jnc.0000000000000246] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.
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Affiliation(s)
- Megan Threats
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Bridgette M. Brawner
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Tiffany M. Montgomery
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jasmine Abrams
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Loretta Sweet Jemmott
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Pierre-Cedric Crouch
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Kellie Freeborn
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Emiko Kamitani
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Comfort Enah
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Abstract
BACKGROUND Traumatic eardrum perforation is a common presentation in otorhinolaryngologic practices and emergency clinics. A consistent management strategy (active intervention vs. watchful waiting) is, however, still lacking. OBJECTIVE In the following study, the outcome of watchful waiting is analyzed and presented. MATERIALS AND METHODS A collective of 272 patients presenting at two different specialist ENT practices within days of traumatic tympanic membrane perforation from June 2002 to March 2019 were analyzed. Treatment was non-surgical, with prospective monitoring. Whereas antibiotics were not given at all in one practice, they were given only upon signs of infection in the other practice. The outcome was evaluated retrospectively on the basis of patient files. RESULTS The collective consisted of 185 males and 87 females. Mean age was 30 years (range: 7 months to 82 years). The perforations were most commonly located in the upper anterior and lower posterior quadrants. According to Griffin grading, the size was grade I in 97%. The three most common causes were impact to the ear, barotrauma, and foreign bodies. Under a watchful waiting regimen, 95% of the patients presenting for follow-up checks showed complete closure. CONCLUSION Watchful waiting can be assessed as appropriate in traumatic eardrum perforation, provided otorhinolaryngologic follow-up is ensured. An exception is blast injury, which is now much less common in Central Europe, as this is associated with a risk of secondary cholesteatomas. In these rare cases, active treatment with surgical exploration of the middle ear including relining the perforation is indicated.
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Affiliation(s)
- D Heitmann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Braunschweig, Holwedestraße 16, 38118, Braunschweig, Deutschland
| | | | - J Abrams
- Überregionale HNO-Gemeinschaftspraxis, Hamm, Deutschland
| | - A O H Gerstner
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Braunschweig, Holwedestraße 16, 38118, Braunschweig, Deutschland.
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Hanna R, Pearlman R, Burmeister J, Dominello M, Abrams J. Adverse Effects of Total Body Irradiation: A Single Institution Analysis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer CE, Dees EC, Goetz MP, Olson JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW. Abstract GS4-07: Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs4-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Black race is associated with worse outcomes in localized hormone receptor (HR)-positive breast cancer in population-based and in clinical trial cohorts, whether using self-identified race (Albain et al. JNCI 2009 [PMID: 19584328; Sparano et al. JNCI 2012 [PMID: 22250182) or genetically-identified race (Schneider et al. J Precision Oncol 2017 [PMID: 29333527]). This disparity persists after adjustment for treatment delivery parameters (Hershman et al. JCO 2009 [PMID:19307504]). We evaluated clinicopathologic characteristics, treatment delivered and clinical outcomes in the Trial Assigning Individualized Options for Treatment (TAILORx) by race and ethnicity (Sparano et al. NEJM 2018 [PMID: 29860917]).
Methods: The analysis included 9719 evaluable TAILORx participants. The association between clinical outcomes and race (white, black, Asian, other/unknown) and ethnicity (Hispanic vs. non-Hispanic) was examined, including invasive disease-free survival (iDFS), distant relapse-free interval (DRFI), relapse-free interval (RFI), and overall survival (OS). Proportional hazards models were fit including age (5 categories), tumor size (>2 cm vs. <=2 cm), histologic grade (high vs. medium vs. low vs. unknown), continuous recurrence score (RS), race, and ethnicity in the overall population and randomized treatment arms in the RS 11-25 cohort.
Results: The study population included 8189 (84%) whites, 693 (7%) blacks, 405 (4%) Asians, and 432 (4%) with other/unknown race. Regarding ethnicity, 7635 (79%) were non-Hispanic, 889 (9%) Hispanic, and 1195 (12%) unknown. There was no significant difference in RS distribution (p=0.22) in blacks compared with whites, or in median (17 vs. 17) or mean RS (19.1 vs. 18.2). There was likewise no difference in Hispanic vs. non-Hispanic ethnicity for RS distribution (p=0.72) or median (17 vs. 17) or mean RS (18.5 vs. 18.0). Black race (39% vs. 30%) and Hispanic ethnicity (39% vs. 30%) were both associated with younger age (</=50 years) at diagnosis. The use and type of adjuvant chemotherapy and endocrine therapy, and duration of endocrine therapy, were similar in black (vs. white) and Hispanic (vs. non-Hispanic) populations. In proportional hazards models, black race (compared with white race) was associated with worse clinical outcomes in the entire population and in those with a RS 11-25 (see table). Hispanic ethnicity was generally associated with better outcomes (compared with non-Hispanic ethnicity). For the cohort with a RS of 11-25, there was no evidence for chemotherapy benefit for any racial or ethnic group.
Race (black vs.white) and clinical outcomes in proportional hazards modelsClinical endpointEntire Population (N=693 black) Hazard ratio for eventRS 11-25 (N=471 black) Hazard ratio for eveniDFS1.33 (p=0.005)1.49 (p=0.001)DRFI1.21 (p=0.28)1.60 (p=0.02)RFI1.39 (p=0.02)1.80 (p<0.001)OS1.52 (p=0.005)1.67 (p=0.003
Conclusions: In patients eligible and selected for participation in TAILORx, black women had worse clinical outcomes despite similar 21-gene assay RS results and comparable systemic therapy. This adds to an emerging body of evidence suggesting a biologic basis or other factors contributing to racial disparities in HR-positive breast cancer that requires further evaluation.
Citation Format: Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer, Jr. CE, Dees EC, Goetz MP, Olson, Jr. JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge, Jr. GW. Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS4-07.
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Affiliation(s)
- K Albain
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - RJ Gray
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Sparano
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Makower
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - KI Pritchard
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Hayes
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - CE Geyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - EC Dees
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MP Goetz
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Olson
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - T Lively
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - SS Badve
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Saphner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - LI Wagner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Whelan
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MJ Ellis
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - S Paik
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - WC Wood
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PM Ravdin
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MM Keane
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - HL Gomez
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PS Reddy
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TF Goggins
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - IA Mayer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - AM Brufsky
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DL Toppmeyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - VG Kaklamani
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JL Berenberg
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - J Abrams
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - GW Sledge
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
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Castro B, Ing L, Park Y, Abrams J, Ryan M. Addressing Noncommunicable Disease in Dominican Republic: Barriers to Hypertension and Diabetes Care. Ann Glob Health 2018; 84:625-629. [PMID: 30779509 DOI: 10.9204/aogh.2370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Noncommunicable diseases (NCDs) significantly contribute to morbidity and mortality worldwide. During medical brigades in Santo Domingo, the Dominican Aid Society of Virginia (DASV) collects data to help understand the dynamics of NCD management. This study presents findings regarding resources and barriers to NCD treatment. Methods: A cross-sectional survey study was conducted in two communities (Los Mina and Paraiso) during the 2014 DASV summer brigade. Descriptive statistics, associations, correlations as well as qualitative analyses were conducted to better understand resources and barriers to care in relation to health care coverage. RESULTS More than one third (n = 64) of 165 individuals had hypertension and/or diabetes. Thirty-seven percent (Paraiso) and 46% (Los Mina) of study participants did not have health insurance in the previous year. For those that did have insurance, 77% (P) and 89% (LM) visited a physician in the previous year. In this same group, 65% of individuals from Paraiso reported that their health insurance never covered the cost of medications while only a quarter of individuals from Los Mina indicated this. Health insurance and access to physicians and medication varied depending on the community of residence. Surveys indicated that access to affordable medications was an important issue for participants. Also, even though individuals in Los Mina were less likely to have health insurance than those in Paraiso, they were more likely to visit a physician. CONCLUSION This study contributes to a greater understanding of health care coverage and access for low-resource communities in the Dominican Republic. Health care access, insurance, and cost sharing differed between these communities, but barriers to care were common. Future investigations could focus on qualitative differences in communities' health insurance coverages and development of interventions to address obstacles to care.
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Affiliation(s)
| | | | - Yeri Park
- Virginia Commonwealth University, US
| | | | - Mark Ryan
- Virginia Commonwealth University, US
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Abstract
Introduction: Noncommunicable diseases (NCDs) significantly contribute to morbidity and mortality worldwide. During medical brigades in Santo Domingo, the Dominican Aid Society of Virginia (DASV) collects data to help understand the dynamics of NCD management. This study presents findings regarding resources and barriers to NCD treatment. Methods: A cross-sectional survey study was conducted in two communities (Los Mina and Paraiso) during the 2014 DASV summer brigade. Descriptive statistics, associations, correlations as well as qualitative analyses were conducted to better understand resources and barriers to care in relation to health care coverage. Results: More than one third (n = 64) of 165 individuals had hypertension and/or diabetes. Thirty-seven percent (Paraiso) and 46% (Los Mina) of study participants did not have health insurance in the previous year. For those that did have insurance, 77% (P) and 89% (LM) visited a physician in the previous year. In this same group, 65% of individuals from Paraiso reported that their health insurance never covered the cost of medications while only a quarter of individuals from Los Mina indicated this. Health insurance and access to physicians and medication varied depending on the community of residence. Surveys indicated that access to affordable medications was an important issue for participants. Also, even though individuals in Los Mina were less likely to have health insurance than those in Paraiso, they were more likely to visit a physician. Conclusion: This study contributes to a greater understanding of health care coverage and access for low-resource communities in the Dominican Republic. Health care access, insurance, and cost sharing differed between these communities, but barriers to care were common. Future investigations could focus on qualitative differences in communities' health insurance coverages and development of interventions to address obstacles to care.
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Affiliation(s)
| | | | - Yeri Park
- Virginia Commonwealth University, US
| | | | - Mark Ryan
- Virginia Commonwealth University, US
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Russell AG, Tolbert P, Henneman L, Abrams J, Liu C, Klein M, Mulholland J, Sarnat SE, Hu Y, Chang HH, Odman T, Strickland MJ, Shen H, Lawal A. Impacts of Regulations on Air Quality and Emergency Department Visits in the Atlanta Metropolitan Area, 1999-2013. Res Rep Health Eff Inst 2018; 2018:1-93. [PMID: 31883240 PMCID: PMC7266381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION The United States and Western Europe have seen great improvements in air quality, presumably in response to various regulations curtailing emissions from the broad range of sources that have contributed to local, regional, and global pollution. Such regulations, and the ensuing controls, however, have not come without costs, which are estimated at tens of billions of dollars per year. These costs motivate accountability-related questions such as, to what extent do regulations lead to emissions changes? More important, to what degree have the regulations provided the expected human health benefits? Here, the impacts of specific regulations on both electricity generating unit (EGU) and on-road mobile sources are examined through the classical accountability process laid out in the 2003 Health Effects Institute report linking regulations to emissions to air quality to health effects, with a focus on the 1999-2013 period. This analysis centers on regulatory actions in the southeastern United States and their effects on health outcomes in the 5-county Atlanta metropolitan area. The regulations examined are largely driven by the 1990 Clean Air Act Amendments (C). This work investigates regulatory actions and controls promulgated on EGUs: the Acid Rain Program (ARP), the NOx Budget Trading Program (NBP), and the Clean Air Interstate Rule (CAIR) - and mobile sources: Tier 2 Gasoline Vehicle Standards and the 2007 Heavy Duty Diesel Rule. METHODS Each step in the classic accountability process was addressed using one or more methods. Linking regulations to emissions was accomplished by identifying major federal regulations and the associated state regulations, along with analysis of individual facility emissions and control technologies and emissions modeling (e.g., using the U.S. Environmental Protection Agency's [U.S. EPA's] MOtor Vehicle Emissions Simulator [MOVES] mobile-source model). Regulators, including those from state environmental and transportation agencies, along with the public service commissions, play an important role in implementing federal rules and were involved along with other regional stakeholders in the study. We used trend analysis, air quality modeling, satellite data, and a ratio-of-ratios technique to investigate a critical current issue, a potential large bias in mobile-source oxides of nitrogen (NOx) emissions estimates. The second link, emissions-air quality relationships, was addressed using both empirical analyses as well as chemical transport modeling employing the Community Multiscale Air Quality (CMAQ) model. Kolmogorov-Zurbenko filtering accounting for day of the year was used to separate the air quality signal into long-term, seasonal, weekday-holiday, and short-term meteorological signals. Regression modeling was then used to link emissions and meteorology to ambient concentrations for each of the species examined (ozone [O3], particulate matter ≤ 2.5 μm in aerodynamic diameter [PM2.5], nitrogen dioxide [NO2], sulfur dioxide [SO2], carbon monoxide [CO], sulfate [SO4-2], nitrate [NO3-], ammonium [NH4+], organic carbon [OC], and elemental carbon [EC]). CMAQ modeling was likewise used to link emissions changes to air quality changes, as well as to further establish the relative roles of meteorology versus emissions change impacts on air quality trends. CMAQ and empirical modeling were used to investigate aerosol acidity trends, employing the ISORROPIA II thermodynamic equilibrium model to calculate pH based on aerosol composition. The relationships between emissions and meteorology were then used to construct estimated counterfactual air quality time series of daily pollutant concentrations that would have occurred in the absence of the regulations. Uncertainties in counterfactual air quality were captured by the construction of 5,000 pollutant time series using a Monte Carlo sampling technique, accounting for uncertainties in emissions and model parameters. Health impacts of the regulatory actions were assessed using data on cardiorespiratory emergency department (ED) visits, using patient-level data in the Atlanta area for the 1999-2013 period. Four outcome groups were chosen based on previous studies identifying associations with ambient air pollution: a combined respiratory disease (RD) category; the subgroup of RD presenting with asthma; a combined cardiovascular disease (CVD) category; and the subgroup of CVD presenting with congestive heart failure (CHF). Models were fit to estimate the joint effects of multiple pollutants on ED visits in a time-series framework, using Poisson generalized linear models accounting for overdispersion, with a priori model formulations for temporal and meteorological covariates and lag structures. Several parameterizations were considered for the joint-effects models, including different sets of pollutants and models with nonlinear pollutant terms and first-order interactions among pollutants. Use of different periods for parameter estimates was assessed, as associations between pollutant levels and ED visits varied over the study period. A 7-pollutant, nonlinear model with pollutant interaction terms was chosen as the baseline model and fitted using pollutant and outcome data from 1999-2005 before regulations might have substantially changed the toxicity of pollutant mixtures. In separate analyses, these models were fitted using pollutant and outcome data from the entire 1999-2013 study period. Daily counterfactual time series of pollutant concentrations were then input into the health models, and the differences between the observed and counterfactual concentrations were used to estimate the impacts of the regulations on daily counts of ED visits. To account for the uncertainty in both the estimation of the counterfactual time series of ambient pollutant levels and the estimation of the health model parameters, we simulated 5,000 sets of parameter estimates using a multivariate normal distribution based on the observed variance-covariance matrix, allowing for uncertainty at each step of the chain of accountability. Sensitivity tests were conducted to assess the robustness of the results. RESULTS EGU NOx and SO2 emissions in the Southeast decreased by 82% and 83%, respectively, between 1999 and 2013, while mobile-source emissions controls led to estimated decreases in Atlanta-area pollutant emissions of between 61% and 93%, depending on pollutant. While EGU emissions were measured, mobile-source emissions were modeled. Our results are supportive of a potential high bias in mobile-source NOx and CO emissions estimates. Air quality benefits from regulatory actions have increased as programs have been fully implemented and have had varying impacts over different seasons. In a scenario that accounted for all emissions reductions across the period, observed Atlanta central monitoring site maximum daily 8-hour (MDA8h) O3 was estimated to have been reduced by controls in the summertime and increased in the wintertime, with a change in mean annual MDA8h O3 from 39.7 ppb (counterfactual) to 38.4 ppb (observed). PM2.5 reductions were observed year-round, with average 2013 values at 8.9 μg/m3 (observed) versus 19.1 μg/m3 (counterfactual). Empirical and CMAQ analyses found that long-term meteorological trends across the Southeast over the period examined played little role in the distribution of species concentrations, while emissions changes explained the decreases observed. Aerosol pH, which plays a key role in aerosol formation and dynamics and may have health implications, was typically very low (on the order of 1-2, but sometimes much lower), with little trend over time despite the stringent SO2 controls and SO42- reductions. Using health models fit from 1999-2005, emissions reductions from all selected pollution-control policies led to an estimated 55,794 cardiorespiratory disease ED visits prevented (i.e., fewer observed ED visits than would have been expected under counterfactual scenarios) - 52,717 RD visits, of which 38,038 were for asthma, and 3,057 CVD visits, of which 2,104 were for CHF - among the residents of the 5-county area over the 1999-2013 period, an area with approximately 3.5 million people in 2013. During the final two years of the study (2012-2013), when pollution-control policies were most fully implemented and the associated benefits realized, these policies were estimated to prevent 5.9% of the RD ED visits that would have occurred in the absence of the policies (95% interval estimate: -0.4% to 12.3%); 16.5% of the asthma ED visits (95% interval estimate: 7.5% to 25.1%); 2.3% of the CVD ED visits (95% interval estimate: -1.8% to 6.2%); and -.6% of the CHF ED visits (95% interval estimate: 26.3% to 10.4%). Estimates of ED visits prevented were generally lower when using health models fit for the entire 1999-2013 study period. Sensitivity analyses were conducted to show the impact of the choice of parameterization of the health models and to assess alternative definitions of the study area. When impacts were assessed for separate policy interventions, policies affecting emissions from EGUs, especially the ARP and the NBP, appeared to have had the greatest effect on prevention of RD and asthma ED visits. CONCLUSIONS This study demonstrates the effectiveness of regulations on improving air quality and health in the southeastern United States. It also demonstrates the complexities of accountability assessments as uncertainties are introduced in each step of the classic accountability process. While accounting for uncertainties in emissions, air quality-emissions relationships, and health models does lead to relatively large uncertainties in the estimated outcomes due to specific regulations, overall the benefits of regulations have been substantial.
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Affiliation(s)
- A G Russell
- Georgia Institute of Technology, Atlanta, GA
| | | | | | | | - C Liu
- Georgia Institute of Technology, Atlanta, GA
| | - M Klein
- Emory University, Atlanta, GA
| | | | | | - Y Hu
- Georgia Institute of Technology, Atlanta, GA
| | | | - T Odman
- Georgia Institute of Technology, Atlanta, GA
| | | | - H Shen
- Georgia Institute of Technology, Atlanta, GA
| | - A Lawal
- Georgia Institute of Technology, Atlanta, GA
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Chen A, Conley B, Hamilton S, Williams M, O'Dwyer P, Arteaga C, Gray R, McShane L, Li S, Rubinstein L, Patton D, Sazali K, Zwiebel J, Mitchell E, Smith M, Dragaud D, Little R, Comis R, Abrams J, Flaherty K. NCI-Molecular Analysis for Therapy Choice (NCI-MATCH) trial: A novel public-private partnership. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33006-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Claessen FMAP, Stoop N, Doornberg JN, Guitton TG, van den Bekerom MPJ, Ring D, Chauhan A, Wahegaonkar A, Shafritz A, Garcia G A, Miller A, Barquet A, Kristan A, Apard T, Armstrong A, Berner A, Jubel A, Kreis B, Babis C, Sutker B, Sears B, Nolan B, Crist B, Cross B, Wills B, Barreto C, Ekholm C, Swigart C, Oliveira Miranda C, Manke C, Zalavras C, Goldfarb C, Cassidy C, Walsh C, Jones C, Garnavos C, Young C, Moreno-Serrano C, Lomita C, Klostermann C, van Deurzen D, Rikli D, Polatsch D, Beingessner D, Drosdowech D, Eygendaal D, Patel M, Brilej D, Walbeehm E, Ballas E, Ibrahim E, Melamed E, Stojkovska Pemovska E, Hofmeister E, Hammerberg E, Kaplan F, Suarez F, Fernandes C, Lopez-Gonzalez F, Walter F, Frihagen F, Kraan G, Kontakis G, Dyer G, Kohut G, Panagopoulos G, Hernandez G, Porcellini G, Bayne G, Merrell G, DeSilva G, Della Rocca G, Bamberger H, Broekhuyse H, Durchholz H, Kodde I, McGraw I, Harris I, Pountos I, Wiater J, Choueka J, Kazanjian J, Gillespie J, Biert J, Fanuele J, Johnson J, Greenberg J, Abrams J, Hall J, Fischer J, Scheer J, Itamura J, Capo J, Braman J, Rubio J, Ortiz J, Filho J, Nolla J, Abboud J, Conflitti J, Abzug J, Patiño J, Rodríguez Roiz J, Adams J, Bishop J, Kabir K, Chivers K, Prommersberger K, Egol K, Rumball K, Dickson K, Jeray K, Poelhekke L, Campinhos L, Mica L, Borris L, Adolfsson L, Schulte L, Elmans L, Lane L, Paz L, Taitsman L, Guenter L, Austin L, Waseem M, Palmer M, Abdel-Ghany M, Richard M, Rizzo M, Pirpiris M, Di Micoli M, Bonczar M, Loebenberg M, Richardson M, Mormino M, Menon M, Soong M, Wood M, Meylaerts S, Darowish M, Nancollas M, Prayson M, Grafe M, Kessler M, Kaminaris M, Pirela-Cruz M, Mckee M, Merchant M, Tyllianakis M, Shafi M, Powell A, Shortt N, Felipe N, Parnes N, Bijlani N, Elias N, Akabudike N, Rossiter N, Lasanianos N, Kanakaris N, Brink O, van Eerten P, Paladini P, Martineau P, Appleton P, Levin P, Althausen P, Evans P, Jebson P, Krause P, Schandelmaier P, Peters A, Dantuluri P, Blazar P, Andreas P, Inna P, Quell M, Ramli R, de Bedout R, Ranade A, Ashish S, Smith R, Babst R, Omid R, Buckley R, Jenkinson R, Gilbert R, Page R, Papandrea R, Zura R, Gray R, Wagenmakers R, Pesantez R, van Riet R, Calfee R, van Helden S, Bouaicha S, Kakar S, Kaplan S, Scott F, Kaar S, Mitchell S, Rowinski S, Dodds S, Kennedy S, Beldner S, Schepers T, Guitton T, Gosens T, Baxamusa T, Taleb C, Tosounidis T, Wyrick T, Begue T, DeCoster T, Dienstknecht T, Varecka T, Mittlmeier T, Fischer T, Chesser T, Omara T, Bafus T, Siff T, Havlicek T, Sabesan V, Nikolaou V, Philippe V, Giordano V, Vochteloo A, Batson W, Hammert W, Satora W, Weil Y, Ruch D, Marsh L, Swiontkowski M, Hurwit S. Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation. J Hand Surg Am 2016; 41:e337-e341. [PMID: 27522299 DOI: 10.1016/j.jhsa.2016.07.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Received: 11/30/2015] [Revised: 04/17/2016] [Accepted: 07/13/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after operative treatment of bicolumnar distal humerus fractures. We also addressed agreement among surgeons regarding which fracture fixation will loosen or break and the influence of years in independent practice, location of practice, and so forth. METHODS A total of 232 orthopedic residents and surgeons from around the world evaluated 24 anteroposterior and lateral radiographs of distal humerus fractures on a Web-based platform to predict which implants would loosen or break. Agreement among observers was measured using the multi-rater kappa measure. RESULTS The sensitivity of prediction of failure of fixation of distal humerus fracture on radiographs was 63%, specificity was 53%, positive predictive value was 36%, the negative predictive value was 78%, and accuracy was 56%. There was fair interobserver agreement (κ = 0.27) regarding predictions of failure of fixation of distal humerus fracture on radiographs. Interobserver variability did not change when assessed for the various subgroups. CONCLUSIONS When experienced and skilled surgeons perform fixation of type C distal humerus fracture, the immediate postoperative radiograph is not predictive of fixation failure. Reoperation based on the probability of failure might not be advisable. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic III.
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Affiliation(s)
- Femke M A P Claessen
- Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Nicky Stoop
- Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Job N Doornberg
- Orthotrauma Research Center Amsterdam, University of Amsterdam Orthopaedic Residency Program, Amsterdam, The Netherlands
| | - Thierry G Guitton
- Orthotrauma Research Center Amsterdam, University of Amsterdam Orthopaedic Residency Program, Amsterdam, The Netherlands
| | | | - David Ring
- Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA.
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Abrams J, Bradley C, Geisler WS. Fixation search in natural scenes: a new role for contrast normalization. J Vis 2014. [DOI: 10.1167/14.10.1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Maxwell M, Brevard J, Abrams J, Belgrave F. What’s Color Got To Do With It? Skin Color, Skin Color Satisfaction, Racial Identity, and Internalized Racism Among African American College Students. Journal of Black Psychology 2014. [DOI: 10.1177/0095798414542299] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although skins tone perceptions influence the African American community, less is known about how skin color satisfaction differs across complexion. Employing an intersectionality framework, the current study assessed (a) the relationships between gender, self-reported skin color, skin color satisfaction, and the private regard aspect of racial identity; (b) whether skin color satisfaction moderates the relationship between perceived skin color and racial identity; and (c) whether internalized racism relates to skin color satisfaction. African American college students ( N= 191) provided their perceived skin color and completed the private regard subscale of the Multidimensional Inventory of Black Identity, the Nadanolitization Scale, and an abbreviated version of the Skin Color Satisfaction Scale. Hierarchical multiple regressions were conducted to test most hypotheses. Although skin color was not significantly associated with skin color satisfaction, skin color satisfaction moderated the relationship between perceived skin color and private regard. Darker skin African Americans high in skin color satisfaction reported higher private regard than those low in skin color satisfaction. Additionally, internalized racism significantly predicted skin color satisfaction. Psychosociological implications are discussed.
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Abrams J, Bradley C, Geisler WS. A model of detectability across the visual field. J Vis 2013. [DOI: 10.1167/13.9.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Deol A, Abrams J, Masood A, Al-Kadhimi Z, Abidi MH, Ayash L, Lum LG, Ratanatharathorn V, Uberti JP. Long-term follow up of patients proceeding to transplant using plerixafor mobilized stem cells and incidence of secondary myelodysplastic syndrome/AML. Bone Marrow Transplant 2013; 48:1112-6. [PMID: 23474805 DOI: 10.1038/bmt.2013.10] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/10/2013] [Accepted: 01/15/2013] [Indexed: 11/09/2022]
Abstract
We report the long-term follow up of 49 patients (pts) enrolled on plerixafor compassionate use protocol. Thirty-seven pts (76%) had failed one previous mobilization attempt, while 12 (24%) had failed two or more previous attempts. Using the combination of plerixafor and granulocyte colony-stimulating factor, we collected2.5 × 10(6) CD34+cells/kg in 33 pts (67%). Forty-three of the 49 pts proceeded to an auto-SCT (ASCT). The median days to WBC and platelet engraftment were 11 (range, 9-13 days) and 16 (range, 11-77 days) days post ASCT, respectively. The median WBC count, Hb and platelet counts 1 year after ASCT were 4.7 × 10(9)/L, 12.2 g/dL and 109 × 10(9)/L, respectively. With median follow up of 42 months (range <1-54 months), 21 pts had evidence of disease progression. Five pts developed myelodysplastic syndrome (MDS)/AML at median of 29 months post ASCT. The cumulative incidence of MDS/AML at 42 months was 17% (95% confidence interval, 6 to 32%). Development of secondary MDS/AML in pts proceeding to ASCT after plerixafor mobilization needs to be studied further in a larger cohort.
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Affiliation(s)
- A Deol
- Blood and Marrow SCT Program, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
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Abrams J, Carrasco M. Pre-cortical noise shapes visual performance fields. J Vis 2012. [DOI: 10.1167/12.9.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Bleeding is a main complication in ENT surgery especially in oral and nasal interventions. Based on good results in local application of tranexamic acid after dental extraction, the different possibilities of local application of tranexamic acid in ENT surgery are discussed and the current literature is presented. In our experience, the rate of secondary hemorrhage after oral and nasal interventions can be reduced considerably by local application of tranexamic acid, which means risk reduction and better compliance especially in an increasingly aging patient population. Based on our experience, the local use of tranexamic acid in ENT surgery should be the focus of future studies.
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Affiliation(s)
- J Abrams
- Belegabteilung für HNO-Heilkunde, Kopf-und Halschirurgie, Plastische Operationen, endokrine Halschirurgie, St.-Barbara-Klinik, Am Heessener Wald 1, 59073, Hamm, Deutschland.
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Taddesse A, Woldie IL, Khana P, Swerdlow PS, Chu JW, Abrams J, Abou-Samra AB. Hypogonadism in patients with sickle cell disease: central or peripheral? Acta Haematol 2012; 128:65-8. [PMID: 22678347 DOI: 10.1159/000337344] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [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: 01/16/2012] [Accepted: 02/15/2012] [Indexed: 11/19/2022]
Abstract
There is conflicting evidence in the literature on the etiology of hypogonadism in patients with sickle cell disease (SCD). A cross-sectional study was done to determine whether hypogonadism in male patients with SCD is due to primary testicular failure or secondary pituitary/hypothalamic dysfunction and assess the association between hypogonadism and serum ferritin levels. Hormonal assessment for serum concentrations of testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) was done for 34 men with SCD and their charts were reviewed for relevant clinical variables. Eight men (24%) were classified hypogonadal based on their serum testosterone levels. These men have significantly lower LH (p = 0.001) and FSH (p = 0.01) levels than normogonadal men, indicating a central etiology. There was no significant difference between hypogonadal and normogonadal men with respect to ferritin levels (p = 0.71). Our study indicates a central etiology of hypogonadism in patients with SCD. In this small study ferritin level was not significantly related to hypogonadism.
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Affiliation(s)
- A Taddesse
- Division of Endocrinology, Diabetes and Metabolism, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI 48201, USA
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Abidi M, Agarwal R, Tageja N, Ayash L, Ventimiglia M, Deol A, Al-Kadhimi Z, Lum L, Ratanatharathorn V, Abrams J, Uberti J. Melphalan 180mg/m2 Can Be Safely Administered as Conditioning Regimen Prior to an Autologous Stem Cell Transplantation in Multiple Myeloma Patients with Creatinine Clearance ≤60ml/min/1.73 m2 with Use of Palifermin for Cytoprotection: Results of a Phase I Trial. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Al-Refaie W, Parsons H, Markin A, Abrams J, Habermann E. Blood Transfusion and Cancer Surgery Outcomes: A Continued Reason for Concern. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Deol A, Abrams J, Al-Kadhimi Z, Abidi M, Ayash L, Lum L, Ratanatharathorn V, Uberti J. Stem Cell Mobilization Failures Salvaged with Plerixafor: Long Term Follow Up of Engraftment and Outcomes. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Nagasawa DT, Bergsneider M, Kelly D, Shafa B, Duong D, Ausman J, Liau L, McBride D, Yang I, Mann BS, Yabroff R, Harlan L, Zeruto C, Abrams J, Gondi V, Eickhoff J, Tome WA, Kozak KR, Mehta MP, Field KM, Drummond K, Yilmaz M, Gibbs P, Rosenthal MA, Allaei R, Johnson KJ, Hooten AJ, Kaste E, Ross JA, Largaespada DA, Johnson DR, O'Neill BP, Rice T, Zheng S, Xiao Y, Decker PA, McCoy LS, Smirnov I, Patoka JS, Hansen HM, Wiemels JL, Tihan T, Prados MD, Chang SM, Berger MS, Pico A, Rynearson A, Voss J, Caron A, Kosel ML, Fridley BL, Lachance DH, O'Neill BP, Giannini C, Wiencke JK, Jenkins RB, Wrensch MR, Xiao Y, Decker PA, Rice T, Hansen HM, Wiemels JL, Tihan T, Prados MD, Chang SM, Berger MS, Kosel ML, Fridley BL, Lachance DH, O'Neill BP, Buckner JC, Burch PA, Thompson RC, Nabors LB, Olson JJ, Brem S, Madden MH, Browning JE, Wiencke JK, Egan KM, Jenkins RB, Wrensch MR, Pereira EA, Livermore J, Alexe DM, Ma R, Ansorge O, Cadoux-Hudson TA, Johnson DR, O'Neill BP, Wang M, Dignam J, Won M, Curran W, Mehta M, Gilbert M, Terry AR, Barker FG, Leffert LR, Bateman B, Souter I, Plotkin SR, Ishaq O, Montgomery J, Terezakis S, Wharam M, Lim M, Holdhoff M, Kleinberg L, Redmond K, Kruchko C, Paker AM, Chi TL, Kamiya-Matsuoka C, Loghin ME, Lautenschlaeger T, Dedousi-Huebner V, Chakravarti A. EPIDEMIOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sandhu R, Burmeister J, Lack D, Abrams J, Konski A. Evaluation of Patient Setup Uncertainties and Effect of IGRT Shift Tolerances. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Spencer B, Miller S, Lack D, Zhao B, Abrams J, Liu Q. Biologically Equivalent Dose Volume Parameter Comparison of Common Fractionation Schemes used in HDR Brachytherapy Treatment of Cervical Cancer Patients. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Wu J, Liu S, Liu G, Dombkowski A, Abrams J, Martin-Trevino R, Wicha MS, Ethier SP, Yang ZQ. Identification and functional analysis of 9p24 amplified genes in human breast cancer. Oncogene 2011; 31:333-41. [PMID: 21666724 DOI: 10.1038/onc.2011.227] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Previously, our group identified a novel amplicon at chromosome 9p24 in human esophageal and breast cancers, and cloned the novel gene, GASC1 (gene amplified in squamous cell carcinoma 1, also known as JMJD2C/KDM4C), from this amplicon. GASC1 is a histone demethylase involved in the deregulation of histone methylation in cancer cells. In the current study, we aimed to comprehensively characterize the genes in the 9p24 amplicon in human breast cancer. We performed extensive genomic analyses on a panel of cancer cell lines and narrowed the shortest region of overlap to approximately 2 Mb. Based on statistical analysis of copy number increase and overexpression, the 9p24 amplicon contains six candidate oncogenes. Among these, four genes (GASC1 UHRF2, KIAA1432 and C9orf123) are overexpressed only in the context of gene amplification while two genes (ERMP1 and IL33) are overexpressed independent of the copy number increase. We then focused our studies on the UHRF2 gene, which has a potential involvement in both DNA methylation and histone modification. Knocking down UHRF2 expression inhibited the growth of breast cancer cells specifically with 9p24 amplification. Conversely, ectopic overexpression of UHRF2 in non-tumorigenic MCF10A cells promoted cell proliferation. Furthermore, we demonstrated that UHRF2 has the ability to suppress the expression of key cell-cycle inhibitors, such as p16(INK4a), p21(Waf1/Cip1) and p27(Kip1). Taken together, our studies support the notion that the 9p24 amplicon contains multiple oncogenes that may integrate genetic and epigenetic codes and have important roles in human tumorigenesis.
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Affiliation(s)
- J Wu
- Breast Cancer Program, Wayne State University, Detroit, MI 48201, USA
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Nahleh ZA, Gupta R, Abrams J, Gartner EM, Reichle L. Phase II trial of biweekly gemcitabine, paclitaxel, and bevacizumab as frontline therapy for metastatic breast cancer (MBC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rosner K, Kasprzak MF, Horenstein ACJ, Thurston HL, Abrams J, Kerwin LY, Mehregan DA, Mehregan DR. Engineering a waste management enzyme to overcome cancer resistance to apoptosis: adding DNase1 to the anti-cancer toolbox. Cancer Gene Ther 2011; 18:346-57. [PMID: 21233855 DOI: 10.1038/cgt.2010.84] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cancer treatment is often complicated by resistance to conventional anti-cancer treatment and to more recently developed immunotherapy and gene therapy. These therapeutic modalities aim at activating death pathways within cancer cells. Attempts to activate the apoptotic death pathway, by overexpressing proapoptotic signals, are compromised by cancer defense mechanisms, which disrupt the apoptotic-signaling cascade downstream of the overexpressed component. Here, we describe a therapeutic option of triggering apoptosis without activating the apoptotic-signaling cascade or using the native apoptosis executioner nuclease. We have engineered Deoxyribonuclease-1 (DNase1), a waste-management enzyme, by deleting its signal peptide, adding a nuclear localization signal, and mutating its actin-binding site. Apoptosis studies and colony-forming assay for assessing cell viability were conducted in apoptosis-resistant Mel-Juso human melanoma cells. The modified DNase1 reduced cell viability by 77% relative to controls. It also induced typical microscopic features of cellular apoptosis, such as Terminal Transferase dUTP Nick-End Labeling-positive cells and DNA fragmentation. Quantification of apoptosis by Laser scanning cytometry demonstrated high-killing efficiency of 70-100%. The results suggest that this modified DNase1 can efficiently eliminate apoptosis-resistant cancer cells through apoptosis. Coupled to different tissue-specific gene expression elements, this recombinant DNase1 may serve as a platform for eliminating a variety of cancer types.
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Affiliation(s)
- K Rosner
- Laboratory for Molecular Dermatology, Program in Molecular Biology and Genetics, Barbara Ann Karmanos Cancer Institute, Detroit, MI 48201, USA.
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Hillman G, Singh-Gupta V, Al-Bashir A, Zhang H, Yunker C, Sethi S, Sarkar F, Joiner M, Abrams J, Haacke E. Imaging Sunitinib-induced Vascular Changes by DCE-MRI to Schedule Radiotherapy for Murine Renal Cell Carcinoma. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Davuluri G, Seiler C, Abrams J, Soriano AJ, Pack M. Differential effects of thin and thick filament disruption on zebrafish smooth muscle regulatory proteins. Neurogastroenterol Motil 2010; 22:1100-e285. [PMID: 20591105 PMCID: PMC3902778 DOI: 10.1111/j.1365-2982.2010.01545.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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: 01/09/2023]
Abstract
BACKGROUND The smooth muscle actin binding proteins Caldesmon and Tropomyosin (Tm) promote thin filament assembly by stabilizing actin polymerization, however, whether filament assembly affects either the stability or activation of these and other smooth muscle regulatory proteins is not known. METHODS Measurement of smooth muscle regulatory protein levels in wild type zebrafish larvae following antisense knockdown of smooth muscle actin (Acta2) and myosin heavy chain (Myh11) proteins, and in colourless mutants that lack enteric nerves. Comparison of intestinal peristalsis in wild type and colourless larvae. KEY RESULTS Knockdown of Acta2 led to reduced levels of phospho-Caldesmon and Tm. Total Caldesmon and phospho-myosin light chain (p-Mlc) levels were unaffected. Knockdown of Myh11 had no effect on the levels of either of these proteins. Phospho-Caldesmon and p-Mlc levels were markedly reduced in colourless mutants that have intestinal motility comparable with wild type larvae. CONCLUSIONS & INFERENCES These in vivo findings provide new information regarding the activation and stability of smooth muscle regulatory proteins in zebrafish larvae and their role in intestinal peristalsis in this model organism.
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Affiliation(s)
- G. Davuluri
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - C. Seiler
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - J. Abrams
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - A. J. Soriano
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - M. Pack
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA,Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Montaser-Kouhsari L, Abrams J, Carrasco M. The limit of spatial resolution varies at isoeccentric locations in the visual field. J Vis 2010. [DOI: 10.1167/9.8.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Simon MS, Shikany JM, Neuhouser ML, Rohan T, Nirmal K, Cui Y, Abrams J. Glycemic index, glycemic load, and the risk of pancreatic cancer among postmenopausal women in the women's health initiative observational study and clinical trial. Cancer Causes Control 2010; 21:2129-36. [PMID: 20711806 DOI: 10.1007/s10552-010-9632-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 08/03/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND Several reports have suggested that conditions associated with hyperinsulinemia and insulin resistance, such as diets high in carbohydrates, may influence the risk of pancreatic cancer, although results from prior studies have been mixed. METHODS We utilized data from the population-based women's health initiative (WHI) cohort to determine whether dietary factors that are associated with increased postprandial blood glucose levels are also associated with an increased risk of pancreatic cancer. The WHI included 161,809 postmenopausal women of ages 50-79, in which 332 cases of pancreatic cancer were identified over a median of 8 years of follow-up; 287 of these cases met the criteria for analysis. A validated 122-item food frequency questionnaire was used to estimate dietary glycemic load (GL), glycemic index (GI), total and available carbohydrates, fructose and sucrose. Baseline questionnaires and physical exams provided information on demographic, medical, lifestyle, and anthropometric characteristics. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between the exposures of interest and pancreatic cancer risk, with adjustment for potential confounders. RESULTS Dietary GL, GI, carbohydrates, fructose, and sucrose were not associated with increased risk of pancreatic cancer. The multivariable adjusted HR for the highest vs. the lowest quartile of GL was 0.80 (95% CI = 0.55-1.15, trend p = 0.31) and 1.13 (95% CI = 0.78-1.63, trend p = 0.94) for GI. The results remained negative when individuals with a history of diabetes were excluded. CONCLUSIONS Our results do not support the hypothesis that dietary intake of carbohydrates is associated with increased risk of pancreatic cancer.
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Affiliation(s)
- M S Simon
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, 4100 John R, 4221, HWCRC, Detroit, MI, USA.
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Anton-Erxleben K, Abrams J, Carrasco M. Attention does alter apparent contrast: Evaluating comparative and equality judgments. J Vis 2010. [DOI: 10.1167/10.7.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Stuck BA, Abrams J, de la Chaux R, Dreher A, Heiser C, Hohenhorst W, Kühnel T, Maurer JT, Pirsig W, Steffen A, Verse T. [S1 guideline on the "diagnosis and treatment of snoring in adults"]. HNO 2010; 58:272-8. [PMID: 20204310 DOI: 10.1007/s00106-010-2103-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Due to the frequency of this phenomenon and the often considerable distress caused to the affected person, competent advice, diagnosis and treatment of snoring in adults is of particular importance. The aim of this guideline is to promote high-quality medical care for patients affected by this problem. According to the three-level concept of the AWMF, it corresponds to an S1 guideline. Prior to any therapeutic intervention, relevant sleep medical history, clinical examination, as well as a mandatory objective diagnostic measure are performed. Snoring is only treated if the patient asks for it. In general, invasive methods should be viewed critically and the patient should be advised correspondingly. In the case of surgical therapy, minimally invasive techniques are preferred. Reducing body weight (in the case of overweight snorers), abstinence from alcohol, nicotine and sleep medication, as well as maintaining a healthy sleep-wake cycle can be recommended from a sleep-medicine perspective, although convincing clinical studies are not yet available. Since evidence for the effectiveness of muscle stimulation or various methods for toning and training of the muscles of the floor of mouth is not available, these methods are not recommended. Snoring can be successfully treated with the use of an intraoral device; however, careful patient selection is important. Avoiding a supine position during sleep can be helpful in some cases. Only limited data is available on the success rates of the surgical approaches and long term data is often lacking, and not all techniques have been sufficiently evaluated from a scientific point of view. Nasal surgery is only indicated if the patient suffers from nasal obstruction. Extensive data supports the effectiveness of laser-assisted resection of excessive soft palate tissue (laser-assisted uvuloplasty, LAUP). In principle, however, such resections can be performed using other techniques. Placebo-controlled studies were able to prove the effectiveness of radiofrequency surgery of the soft palate. A reduction in snoring could also be achieved in many cases by means of soft palate implants with minimal post-operative morbidity. The indication for tonsillectomy and uvulopalatopharyngoplasty should be made cautiously due to the comparatively high morbidity associated with these procedures.
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Affiliation(s)
- B A Stuck
- Universitäts-HNO-Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim.
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Nahleh ZA, Abrams J, Bhargava A, Nirmal K, Graff JJ. Outcome of patients with nonmetastatic breast cancer receiving nitrogen-containing bisphosphonates: A comparative analysis from the Metropolitan Detroit Cancer Surveillance System (MDCSS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abidi MH, Tageja N, Al-Kadhimi ZS, Abrams J, Cronin S, Ventimiglia M, Ayash LJ, Lum LG, Ratanatharathorn V, Uberti JP. Phase I dose-escalation trial of high-dose melphalan (M) with palifermin (P) for cytoprotection followed by autologous stem cell transplantation (ASCT) for myeloma (MM) patients with normal renal function (NRF). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gasparetto C, Sanchorawala V, Snyder RM, Matous J, Terebelo HR, Janakiraman N, Mapara MY, Webb C, Abrams J, Zonder JA. Use of melphalan (M)/dexamethasone (D)/bortezomib in AL amyloidosis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tageja N, Al-Kadhimi ZS, Cronin S, Abrams J, Ventimiglia M, Lum LG, Ayash LJ, Ratanatharathorn V, Uberti JP, Abidi MH. Phase I dose-escalation (DE) trial of high-dose melphalan (M) with palifermin (P) for cytoprotection followed by autologous stem cell transplantation (ASCT) for myeloma (MM) patients with abnormal renal function (AbRF). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e18560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abidi M, Ratanatharathorn V, Abrams J, Ibrahim R, Cronin S, Al-Kadhimi Z, Lum L, Ventimiglia M, Ayash L, Uberti J. Aprepitant (AP) For Prevention Of Nausea And Vomiting Secondary To High-Dose Cyclophosphamide (Cy) Administered To Patients Undergoing Autologous (A) Peripheral Blood Progenitor Cell (Pbpc) Mobilization: Final Results Of A Phase Ii Trial. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abidi M, Woldie I, Goveas R, Ratanatharathorn V, Al-Kadhimi Z, Abrams J, Ayash L, Lum L, Uberti J. Reviewing The Status Of Backup Hematopoietic Stem Cells (HSC) Banking For Multiple Myeloma (MM) Patients Who Are Eligible For Autologous Hematopoietic Stem Cells Transplant (AHSCT) In This Poor Economy. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hjerpe E, Abrams J, Becker DR. Socioeconomic Barriers and the Role of Biomass Utilization in Southwestern Ponderosa Pine Restoration. ECOL RESTOR 2009. [DOI: 10.3368/er.27.2.169] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Elevated plasma homocysteine levels have recently been implicated as a new risk factor for coronary artery disease. In this article, homocysteine metabolism, secondary causes of elevated plasma homocysteine, and the potential mechanism of vascular damage in hyperhomocysteinemia are briefly reviewed. The current clinical evidence implicating hyperhomocysteinemia as a risk factor for coronary artery disease, as well as the data regarding the effects of B vitamin supplementation on homocysteine concentrations, are also reviewed. The current recommendation of the authors is to treat patients with known coronary artery disease or those who are considered to be at high risk for coronary artery disease with 400 microg of folate supplementation. Until prospective clinical trial data become available, this approach appears to be a safe and effective way to approach this patient population.
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Affiliation(s)
- A U Chai
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
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Abstract
Cardiologists must become more involved in discussing and recommending hormone replacement in post-menopausal women with established coronary artery disease, and those individuals at high risk of coronary events. A large amount of epidemiologic and observational data, as well as new research in vascular biology, strongly support the benefits of estrogen on the development and progression of coronary atherosclerosis. While breast and uterine cancer are valid concerns, selected high-risk women with and without established coronary disease should be counseled by an informed cardiologist to consider hormone replacement therapy.
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Affiliation(s)
- J Abrams
- Department of Cardiology, University of New Mexico, Albuquerque, USA
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Kwon JS, Abrams J, Sugimoto A, Carey MS. Is adjuvant therapy necessary for Stage IA and IB uterine papillary serous carcinoma and clear cell carcinoma after surgical staging? Int J Gynecol Cancer 2008; 18:820-4. [PMID: 17892450 DOI: 10.1111/j.1525-1438.2007.01082.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [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: 11/28/2022] Open
Abstract
Adjuvant therapy of early-stage uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC) is controversial. We conducted a prospective cohort study to evaluate outcomes of patients with early-stage UPSC or CCC who were followed without adjuvant therapy after complete surgical staging. From 2000 to 2006, we evaluated all consecutive patients with stage IA/IB UPSC or CCC who had surgical staging by a gynecological oncologist at the London Health Sciences Centre, Canada. Follow-up consisted of history and physical examination every 3 months for 2 years, then every 6 months for the next 3 years. Primary outcome measure was 2-year disease-free survival. There were 22 evaluable patients. Mean patient age was 63.4 years. Median number of pelvic and para-aortic lymph nodes resected was 15 (range 2-39) and 4 (range 0-12), respectively. Thirteen had UPSC, seven had CCC, and two had both UPSC and CCC. Nine had stage IA and 13 had stage IB disease. Median follow-up was 25 months (range 6-72). Only one patient has recurred (stage IB UPSC, isolated vault recurrence 10 months after surgery), but she is well 9 months after receiving pelvic radiotherapy and vault brachytherapy. Two-year disease-free survival was 95%. These results suggest that adjuvant therapy may not be necessary for stage IA and IB UPSC and CCC after surgical staging. Further prospective evaluation of different adjuvant therapy practices is required for early-stage UPSC and CCC, which may be useful in the design of future clinical trials.
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MESH Headings
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Clear Cell/radiotherapy
- Adenocarcinoma, Clear Cell/surgery
- Adult
- Aged
- Aged, 80 and over
- Cohort Studies
- Cystadenocarcinoma, Papillary/mortality
- Cystadenocarcinoma, Papillary/pathology
- Cystadenocarcinoma, Papillary/radiotherapy
- Cystadenocarcinoma, Papillary/surgery
- Cystadenocarcinoma, Serous/mortality
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/radiotherapy
- Cystadenocarcinoma, Serous/surgery
- Female
- Follow-Up Studies
- Humans
- Lymph Node Excision
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Staging/methods
- Radiotherapy, Adjuvant/methods
- Recurrence
- Survival Analysis
- Uterine Neoplasms/mortality
- Uterine Neoplasms/pathology
- Uterine Neoplasms/radiotherapy
- Uterine Neoplasms/surgery
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Affiliation(s)
- J S Kwon
- Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, Texas 77230-1439, USA.
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