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Ruddy S, Bapna M, Karnik K, Yung L, Rodriguez G, Urban C, Yoon J, Prasad N, Segal-Maurer S, Turett G. Novel case of combination antibiotic therapy for treatment of a complicated polymicrobial urinary tract infection with one organism harboring a metallo-β-lactamase (MBL) in a pregnant patient. IDCases 2024; 36:e01946. [PMID: 38646598 PMCID: PMC11031789 DOI: 10.1016/j.idcr.2024.e01946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/23/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024] Open
Abstract
Carbapenem resistance due to metallo-beta-lactamases (MBLs) is a global phenomenon and an important challenge for antibiotic therapy (Boyd et al., 2020 [1]). While previous reports have demonstrated both in vitro and in vivo synergy using the combination of ceftazidime-avibactam and aztreonam against Stenotrophomonas maltophilia, an MBL-harboring organism, this treatment strategy has not been reported during pregnancy (Mojic et al., 2017 [2], [3], Mojica et al., 2016 [4], Alexander et al., 2020 [5]). We describe a 33-year-old pregnant female with polymicrobial, bilateral pyelonephritis caused by Stenotrophomonas maltophilia and other gram-negative bacteria. The organisms were eradicated with the combination of ceftazidime-avibactam and aztreonam followed by successful delivery with no observed adverse effects in either mother or child post-partum.
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Affiliation(s)
- S. Ruddy
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - M. Bapna
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - K. Karnik
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
| | - L. Yung
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - G. Rodriguez
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Columbia University School of Nursing, New York, NY, 10032, United States of America
| | - C. Urban
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - J. Yoon
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - N. Prasad
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - S. Segal-Maurer
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- Weill Cornell Medicine, Cornell University, New York, NY 10065, United States of America
| | - G. Turett
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main St, Flushing, NY 11355, United States of America
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Catalano AA, Yoon J, Fertuzinhos S, Reisert H, Walsh H, Kosana P, Wilson M, Gisslen M, Zetterberg H, Marra CM, Farhadian SF. Neurosyphilis is characterized by a compartmentalized and robust neuroimmune response but not by neuronal injury. Med 2024; 5:321-334.e3. [PMID: 38513660 DOI: 10.1016/j.medj.2024.02.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/09/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Neurosyphilis is increasing in prevalence but its pathophysiology remains incompletely understood. This study assessed for CNS-specific immune responses during neurosyphilis compared to syphilis without neurosyphilis and compared these immune profiles to those observed in other neuroinflammatory diseases. METHODS Participants with syphilis were categorized as having neurosyphilis if their cerebrospinal fluid (CSF)-venereal disease research laboratory (VDRL) test was reactive and as having syphilis without neurosyphilis if they had a non-reactive CSF-VDRL test and a white blood cell count <5/μL. Neurosyphilis and syphilis without neurosyphilis participants were matched by rapid plasma reagin titer and HIV status. CSF and plasma were assayed for markers of neuronal injury and glial and immune cell activation. Bulk RNA sequencing was performed on CSF cells, with results stratified by the presence of neurological symptoms. FINDINGS CSF neopterin and five CSF chemokines had levels significantly higher in individuals with neurosyphilis compared to those with syphilis without neurosyphilis, but no markers of neuronal injury or astrocyte activation were significantly elevated. The CSF transcriptome in neurosyphilis was characterized by genes involved in microglial activation and lipid metabolism and did not differ in asymptomatic versus symptomatic neurosyphilis cases. CONCLUSIONS The CNS immune response observed in neurosyphilis was comparable to other neuroinflammatory diseases and was present in individuals with neurosyphilis regardless of neurological symptoms, yet there was minimal evidence for neuronal or astrocyte injury. These findings support the need for larger studies of the CSF inflammatory response in asymptomatic neurosyphilis. FUNDING This work was funded by the National Institutes of Health, grants K23MH118999 (S.F.F.) and R01NS082120 (C.M.M.).
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Affiliation(s)
- Allison A Catalano
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
| | - Jennifer Yoon
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Sofia Fertuzinhos
- Bioinformatics Support Hub, Cushing/Whitney Library, Yale School of Medicine, New Haven, CT, USA
| | - Hailey Reisert
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Hannah Walsh
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Priya Kosana
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
| | - Michael Wilson
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Magnus Gisslen
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christina M Marra
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Shelli F Farhadian
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.
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Wang M, Yoon J, Reisert H, Das B, Orlinick B, Chiarella J, Halvas EK, Mellors J, Pang AP, Barakat LA, Fikrig M, Cyktor J, Kluger Y, Spudich S, Corley MJ, Farhadian SF. HIV-1-infected T cell clones are shared across cerebrospinal fluid and blood during ART. JCI Insight 2024; 9:e176208. [PMID: 38587074 DOI: 10.1172/jci.insight.176208] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
The central nervous system HIV reservoir is incompletely understood and is a major barrier to HIV cure. We profiled people with HIV (PWH) and uninfected controls through single-cell transcriptomic and T cell receptor (TCR) sequencing to understand the dynamics of HIV persistence in the CNS. In PWH on ART, we found that most participants had single cells containing HIV-1 RNA, which was found predominantly in CD4 central memory T cells, in both cerebrospinal fluid (CSF) and blood. HIV-1 RNA-containing cells were found more frequently in CSF than blood, indicating a higher burden of reservoir cells in the CNS than blood for some PWH. Most CD4 T cell clones containing infected cells were compartment specific, while some (22%) - including rare clones with members of the clone containing detectable HIV RNA in both blood and CSF - were found in both CSF and blood. These results suggest that infected T cells trafficked between tissue compartments and that maintenance and expansion of infected T cell clones contributed to the CNS reservoir in PWH on ART.
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Affiliation(s)
- Meng Wang
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | | | | | | | | | - Jennifer Chiarella
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Elias K Halvas
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John Mellors
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alina Ps Pang
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York City, New York, USA
| | | | | | - Joshua Cyktor
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yuval Kluger
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Serena Spudich
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael J Corley
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York City, New York, USA
| | - Shelli F Farhadian
- Section of Infectious Diseases, and
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
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4
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Tejwani L, Ravindra NG, Lee C, Cheng Y, Nguyen B, Luttik K, Ni L, Zhang S, Morrison LM, Gionco J, Xiang Y, Yoon J, Ro H, Haidery F, Grijalva RM, Bae E, Kim K, Martuscello RT, Orr HT, Zoghbi HY, McLoughlin HS, Ranum LPW, Shakkottai VG, Faust PL, Wang S, van Dijk D, Lim J. Longitudinal single-cell transcriptional dynamics throughout neurodegeneration in SCA1. Neuron 2024; 112:362-383.e15. [PMID: 38016472 PMCID: PMC10922326 DOI: 10.1016/j.neuron.2023.10.039] [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: 12/15/2022] [Revised: 09/10/2023] [Accepted: 10/27/2023] [Indexed: 11/30/2023]
Abstract
Neurodegeneration is a protracted process involving progressive changes in myriad cell types that ultimately results in the death of vulnerable neuronal populations. To dissect how individual cell types within a heterogeneous tissue contribute to the pathogenesis and progression of a neurodegenerative disorder, we performed longitudinal single-nucleus RNA sequencing of mouse and human spinocerebellar ataxia type 1 (SCA1) cerebellar tissue, establishing continuous dynamic trajectories of each cell population. Importantly, we defined the precise transcriptional changes that precede loss of Purkinje cells and, for the first time, identified robust early transcriptional dysregulation in unipolar brush cells and oligodendroglia. Finally, we applied a deep learning method to predict disease state accurately and identified specific features that enable accurate distinction of wild-type and SCA1 cells. Together, this work reveals new roles for diverse cerebellar cell types in SCA1 and provides a generalizable analysis framework for studying neurodegeneration.
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Affiliation(s)
- Leon Tejwani
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06510, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA.
| | - Neal G Ravindra
- Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA; Department of Computer Science, Yale University, New Haven, CT 06510, USA
| | - Changwoo Lee
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06510, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
| | - Yubao Cheng
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - Billy Nguyen
- University of California, San Francisco School of Medicine, San Francisco, CA 94143, USA
| | - Kimberly Luttik
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06510, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
| | - Luhan Ni
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - Shupei Zhang
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - Logan M Morrison
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - John Gionco
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Yangfei Xiang
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA; Yale Stem Cell Center, Yale School of Medicine, New Haven, CT 06510, USA
| | | | - Hannah Ro
- Yale College, New Haven, CT 06510, USA
| | | | - Rosalie M Grijalva
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06510, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
| | | | - Kristen Kim
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06510, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
| | - Regina T Martuscello
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Harry T Orr
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Huda Y Zoghbi
- Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Howard Hughes Medical Institute, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hayley S McLoughlin
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109-2200, USA
| | - Laura P W Ranum
- Department of Molecular Genetics and Microbiology, Center for Neurogenetics, College of Medicine, Genetics Institute, McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA
| | - Vikram G Shakkottai
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Phyllis L Faust
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Siyuan Wang
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA; Department of Cell Biology, Yale School of Medicine, New Haven, CT 06510, USA.
| | - David van Dijk
- Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA; Department of Computer Science, Yale University, New Haven, CT 06510, USA.
| | - Janghoo Lim
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06510, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA; Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA; Yale Stem Cell Center, Yale School of Medicine, New Haven, CT 06510, USA; Program in Cellular Neuroscience, Neurodegeneration and Repair, Yale School of Medicine, New Haven, CT 06510, USA; Wu Tsai Institute, Yale School of Medicine, New Haven, CT 06510, USA.
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5
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Farhadian SF, Reisert HD, McAlpine L, Chiarella J, Kosana P, Yoon J, Spudich S. Self-Reported Neuropsychiatric Post-COVID-19 Condition and CSF Markers of Neuroinflammation. JAMA Netw Open 2023; 6:e2342741. [PMID: 37948085 PMCID: PMC10638645 DOI: 10.1001/jamanetworkopen.2023.42741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/02/2023] [Indexed: 11/12/2023] Open
Abstract
This case-control study assesses cerebrospinal fluid markers of neuroinflammation and blood-brain barrier disruption in individuals with post–COVID-19 condition who reported neuropsychiatric symptoms.
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Affiliation(s)
- Shelli F. Farhadian
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Center for Brain and Mind Health, Yale University, New Haven, Connecticut
| | - Hailey D. Reisert
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
| | - Lindsay McAlpine
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Jennifer Chiarella
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Priya Kosana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Jennifer Yoon
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
| | - Serena Spudich
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
- Center for Brain and Mind Health, Yale University, New Haven, Connecticut
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Tejwani L, Jung Y, Kokubu H, Sowmithra S, Ni L, Lee C, Sanders B, Lee PJ, Xiang Y, Luttik K, Soriano A, Yoon J, Park J, Ro HH, Ju H, Liao C, Tieze SM, Rigo F, Jafar-Nejad P, Lim J. Reduction of nemo-like kinase increases lysosome biogenesis and ameliorates TDP-43-related neurodegeneration. J Clin Invest 2023; 133:e138207. [PMID: 37384409 PMCID: PMC10425213 DOI: 10.1172/jci138207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/16/2020] [Accepted: 06/28/2023] [Indexed: 07/01/2023] Open
Abstract
Protein aggregation is a hallmark of many neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). Although mutations in TARDBP, encoding transactive response DNA-binding protein 43 kDa (TDP-43), account for less than 1% of all ALS cases, TDP-43-positive aggregates are present in nearly all ALS patients, including patients with sporadic ALS (sALS) or carrying other familial ALS-causing (fALS-causing) mutations. Interestingly, TDP-43 inclusions are also present in subsets of patients with frontotemporal dementia, Alzheimer's disease, and Parkinson's disease; therefore, methods of activating intracellular protein quality control machinery capable of clearing toxic cytoplasmic TDP-43 species may alleviate disease-related phenotypes. Here, we identify a function of nemo-like kinase (Nlk) as a negative regulator of lysosome biogenesis. Genetic or pharmacological reduction of Nlk increased lysosome formation and improved clearance of aggregated TDP-43. Furthermore, Nlk reduction ameliorated pathological, behavioral, and life span deficits in 2 distinct mouse models of TDP-43 proteinopathy. Because many toxic proteins can be cleared through the autophagy/lysosome pathway, targeted reduction of Nlk represents a potential approach to therapy development for multiple neurodegenerative disorders.
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Affiliation(s)
- Leon Tejwani
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
| | - Youngseob Jung
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Hiroshi Kokubu
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sowmithra Sowmithra
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Luhan Ni
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Changwoo Lee
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
| | - Benjamin Sanders
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
| | - Paul J. Lee
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
| | - Yangfei Xiang
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
| | - Kimberly Luttik
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
| | | | | | - Junhyun Park
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
| | | | - Hyoungseok Ju
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | - Frank Rigo
- Ionis Pharmaceuticals, Carlsbad, California, USA
| | | | - Janghoo Lim
- Interdepartmental Neuroscience Program
- Department of Neuroscience, and
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut, USA
- Program in Cellular Neuroscience, Neurodegeneration and Repair, and
- Yale Stem Cell Center, Yale School of Medicine, New Haven, Connecticut, USA
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7
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Vize CJ, Kim SK, Matthews T, Macsai M, Merrell R, Hsu S, Kundu MG, Yoon J, Kennedy E, Pai M, Bain E, Lassman AB, Moazami G. A Phase 3b Study for Management of Ocular Side Effects in Patients with Epidermal Growth Factor Receptor-Amplified Glioblastoma Receiving Depatuxizumab Mafodotin. Ophthalmic Res 2023; 66:1030-1043. [PMID: 37257422 PMCID: PMC10413800 DOI: 10.1159/000531142] [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: 10/14/2021] [Accepted: 05/09/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The Understanding New Interventions with GBM ThErapy (UNITE) study was designed to assess the effect of prophylaxis for ocular side effects (OSEs) in patients with glioblastoma receiving the antibody-drug conjugate (ADC) depatuxizumab mafodotin. UNITE (NCT03419403) was a phase 3b, open-label, randomized, exploratory study performed at 18 research sites in 5 countries. METHODS The study enrolled adult patients with epidermal growth factor receptor-amplified, histologically confirmed, newly diagnosed supratentorial glioblastoma or grade IV gliosarcoma, and a Karnofsky Performance Status ≥70, receiving depatuxizumab mafodotin. All patients were administered depatuxizumab mafodotin during concurrent radiotherapy and temozolomide and with adjuvant temozolomide. Ninety patients were to be randomized (1:1:1) to OSE prophylactic treatments with each depatuxizumab mafodotin infusion: (a) standard steroid eye drops, (b) standard steroid eye drops plus vasoconstrictor eye drops and cold compress, or (c) enhanced steroids plus vasoconstrictor eye drops and cold compress. A Corneal Epitheliopathy Adverse Event (CEAE) scale was devised to capture symptoms, grade OSEs (scale of 0-5), and inform ADC dose modifications. The primary endpoint was the frequency of a required change in OSE management due to inadequate control of OSEs, defined as decline from baseline in visual acuity (using logarithm of the minimum angle of resolution [LogMAR] scale) or a Grade ≥3 CEAE event, in the worst eye in the first 8 weeks of treatment; unless otherwise specified, the treatment period refers to both the chemoradiation and adjuvant phases. RESULTS The UNITE study was stopped early after interim analysis of separate phase III trial showed no difference in survival from depatuxizumab mafodotin. Forty patients were randomized (38 received depatuxizumab mafodotin). Overall, 23 patients experienced inadequate control of OSEs that required change in OSE management within 8 weeks of treatment, with 21 (70.0%) experiencing ≥+0.3 change on LogMAR scale in baseline-adjusted visual acuity and 12 reporting a grade ≥3 CEAE. There were no definitive differences among prophylactic treatments. CONCLUSIONS The premature cessation of the study precludes definitive conclusions regarding the OSE prophylaxis strategies. No new clinically significant safety findings were noted. Despite these limitations, this study highlights the need for novel assessment tools to better understand and mitigate OSEs associated with ADCs.
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Affiliation(s)
- Colin J. Vize
- Department of Ophthalmology, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Stella K. Kim
- Department of Ophthalmology and Visual Science, University of Texas McGovern Medical School, Houston, TX, USA
| | - Tim Matthews
- Birmingham Neuro-Ophthalmology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marian Macsai
- Northshore University Health System, Glenview, IL, USA
| | - Ryan Merrell
- NorthShore University Health System, Evanston, IL, USA
| | - Sigmund Hsu
- The Vivian L. Smith Department of Neurosurgery, University of Texas McGovern Medical School, Houston, TX, USA
| | | | | | | | | | | | - Andrew B. Lassman
- Division of Neuro-Oncology, Department of Neurology and the Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA
| | - Golnaz Moazami
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
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8
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Iqbal H, Petrosyan A, Yoon J, Roytman M. A Complex Diagnosis of Ampullary Adenocarcinoma Presenting As Decompensated Cirrhosis. Cureus 2023; 15:e37566. [PMID: 37193458 PMCID: PMC10183155 DOI: 10.7759/cureus.37566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/18/2023] Open
Abstract
Neoplasms arising from the ampulla of Vater are exceedingly rare, and there is a paucity of literature regarding their diagnosis and management. Ampullary cancer typically presents with jaundice and signs of biliary obstruction. We present a case of ampullary adenocarcinoma with concomitant choledocholithiasis that proved complex and diagnostically challenging.
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Affiliation(s)
- Humzah Iqbal
- Internal Medicine, University of California, San Francisco, Fresno, USA
| | - Arpine Petrosyan
- Internal Medicine, University of California, San Francisco, Fresno, USA
| | - Jennifer Yoon
- Gastroenterology and Hepatology, University of California, San Francisco, Fresno, USA
| | - Marina Roytman
- Gastroenterology and Hepatology, University of California, San Francisco, Fresno, USA
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Kasthuri V, Laguna A, Kim N, Yoon J, Ahn S. Abstract No. 289 Modern Search Analytics: What Are Patients Asking ecan Uterine Artery Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.356] [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: 02/27/2023] Open
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Kasthuri V, Kim N, Laguna A, Yoon J, Ahn S. Abstract No. 604 Modern Search Analytics: What Are Patients Asking about Prostate Artery Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.462] [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: 02/27/2023] Open
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11
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Kasthuri V, Shamshad A, Davis M, Yoon J, Kumar S, Ahn S. Abstract No. 605 Modern Search Analytics: What Are Patients Asking about Varicocele Embolization? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.463] [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: 02/26/2023] Open
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12
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Kasthuri V, Gillette J, Zhang H, Kumar S, Yoon J, Ahn S. Abstract No. 190 Modern Search Analytics: What Are Patients Asking about Varicose Vein Ablation? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.247] [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: 02/27/2023] Open
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13
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Vescey L, Yoon J, Rice K, Davidson L, Desai M. A return to lived experiencers themselves: Participatory action research of and by psychosocial clubhouse members. Front Psychol 2023; 13:962137. [PMID: 36687812 PMCID: PMC9848492 DOI: 10.3389/fpsyg.2022.962137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/05/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Within the history of psychology and phenomenology, people with lived experience of mental illness have often served as participants in research, but far less as co-researchers themselves. There is now a growing movement focused on "participatory" research, where people with lived experience directly contribute to various stages of the research process. This article presents such a qualitative, participatory research study, led by members of a large psychosocial rehabilitation clubhouse-Fountain House in New York City-and informed by phenomenological research principles. The study focused on collaboratively assessing and improving the clubhouse program for its members. Methods A key feature of the project was the extent of lived experiencer involvement, for instance, in designing and conducting the study, and co-writing this research report. Members of Fountain House were trained in phenomenologically-informed research methods and developed a research study that focused on the quality improvement of their clubhouse program. Member researchers conducted a series of focus groups with fellow clubhouse members, generating qualitative data that were analyzed and written up by member researchers in collaboration with staff and university partners. Results Overall, study findings place emphasis on the theme of action in members' experiences-both with respect to how action, agency, and valued activity were key drivers of meaning and recovery for people facing severe mental illness, and with respect to the key component of the research process itself [i.e., participatory action research (PAR)]. Four major subthemes emerged from the study. First, findings revealed how members with mental illness experienced the clubhouse as a "new hope" and "the place for me," to counteract their experience of inactivity, stigma, depression, and hopelessness prior to that point. Second, findings showed how, as members' life goals changed, so did the precise meaning and role of Fountain House in their lives. Third, findings portrayed members' need for, and pursuit of, transformation within the clubhouse space itself to provide more opportunities for meaningful work rather than what they viewed as merely busy-work. Finally, member researchers viewed their direct participation in this project as an opportunity to actively combat stigma, to be a driver of research, and to engage in what they viewed as a generative activity. Discussion These action-oriented themes serve as a counter to the historical view of people with mental illness as merely passive experiencers of symptoms and passive recipients of mental health care. We discuss how the process and content of participatory research can help enhance the relevance of research for stakeholders' lives and contexts.
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Affiliation(s)
| | | | - Kevin Rice
- Fountain House, New York, NY, United States
| | | | - Larry Davidson
- Program for Recovery and Community Health, Yale Department of Psychiatry, New Haven, CT, United States
| | - Miraj Desai
- Program for Recovery and Community Health, Yale Department of Psychiatry, New Haven, CT, United States,*Correspondence: Miraj Desai,
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Catalano AA, Yoon J, Farhadian SF, Fertuzinhos S, Gisslen M, Zetterberg H, Marra CM, Walsh HL. 2348. Distinct cerebrospinal fluid immune proteins mark neurosyphilis. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Neurosyphilis (NS) is increasing in prevalence in the U.S. but remains challenging to diagnose, particularly in asymptomatic cases. Uncovering central nervous system (CNS) specific immune pathways may shed light on disease pathogenesis and potential biomarkers.
Methods
Paired cerebrospinal fluid and blood were collected from participants with syphilis without neurological symptoms from 2013–2019. Participants were categorized as NS if CSF VDRL was positive and matched by RPR and date of enrollment to participants without neurosyphilis (non-NS), defined by VDRL negative and CSF WBC < 5/uL. Paired CSF and plasma were run on a 71-plex chemokine/cytokine array, high-sensitivity (SIMOA) ELISA for markers of neuronal and astrocyte injury, and ELISA for neopterin, a marker of intrathecal macrophage/microglial activation. Comparisons between NS and non-NS were made using T-tests and Wilcoxon rank-sum tests, with p-values adjusted (FDR) for multiple comparisons.
Results
24 participants were enrolled with characteristics as in Table 1. HIV status, age, race/ethnicity, and plasma RPR values did not significantly differ by group. Six cytokines were significantly (p< 0.05, FDR < 0.10) different in the CSF in NS compared to non-NS, including MIG/CXCL9, IP-10/CXCL10, macrophage-derive-chemokine (MDC), IL-8/CXCL8 and BCA-1/CXCL13, which was previously recognized as elevated in NS (Figure 1B). Neopterin, but no neuronal or astrocyte markers, was elevated in the CSF of NS versus non-NS (p < 0.001) (Figure 1A). After adjusting for multiple comparisons, there were no significant differences between markers in plasma of NS vs non-NS. Differences between NS and non-NS groups were not affected by HIV status.
Conclusion
There is a distinct and compartmentalized CNS immune response occurring in individuals with NS, as indicated by elevated markers of CNS inflammation and of key chemoattractants, the CXC family of proteins. Elevation of neopterin, but not neuronal injury markers suggest asymptomatic disease elicits an immune response without incurring neuronal damage. These immune biomarkers can provide insight into neuroinflammatory processes during asymptomatic NS and should be explored as potential CSF biomarkers of NS.
Disclosures
Magnus Gisslen, MD, PhD, Amgen: Honoraria|AstraZeneca: Advisor/Consultant|AstraZeneca: DSMB membership|Biogen: Honoraria|Gilead Sciences: Advisor/Consultant|Gilead Sciences: Honoraria|GlaxoSmithKline/ViiV: Advisor/Consultant|GlaxoSmithKline/ViiV: Honoraria|MSD: Advisor/Consultant|MSD: Honoraria|Novo Nordic: Honoraria|Novocure: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Honoraria|Sanofi: Honoraria.
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Affiliation(s)
| | | | | | | | - Magnus Gisslen
- Biomedicine, Sahlgrenska Akademy , Gothenburg, Vastra Gotaland , Sweden
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15
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Youssef I, Yoon J, Mohamed N, Zakeri K, Press RH, Chen L, Gelblum DY, McBride SM, Tsai CJ, Riaz N, Yu Y, Cohen MA, Dunn LA, Ho AL, Wong RJ, Michel LS, Boyle JO, Singh B, Kriplani A, Ganly I, Sherman EJ, Pfister DG, Fetten J, Lee NY. Toxicity Profiles and Survival Outcomes Among Patients With Nonmetastatic Oropharyngeal Carcinoma Treated With Intensity-Modulated Proton Therapy vs Intensity-Modulated Radiation Therapy. JAMA Netw Open 2022; 5:e2241538. [PMID: 36367724 PMCID: PMC9652753 DOI: 10.1001/jamanetworkopen.2022.41538] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
IMPORTANCE Patients with oropharyngeal carcinoma (OPC) treated with radiotherapy often experience substantial toxic effects, even with modern techniques such as intensity-modulated radiation therapy (IMRT). Intensity-modulated proton therapy (IMPT) has a potential advantage over IMRT due to reduced dose to the surrounding organs at risk; however, data are scarce given the limited availability and use of IMPT. OBJECTIVE To compare toxic effects and oncologic outcomes among patients with newly diagnosed nonmetastatic OPC treated with IMPT vs IMRT with or without chemotherapy. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included patients aged 18 years or older with newly diagnosed nonmetastatic OPC who received curative-intent radiotherapy with IMPT or IMRT at a single-institution tertiary academic cancer center from January 1, 2018, to December 31, 2021, with follow-up through December 31, 2021. EXPOSURES IMPT or IMRT with or without chemotherapy. MAIN OUTCOMES AND MEASURES The main outcomes were the incidence of acute and chronic (present after ≥6 months) treatment-related adverse events (AEs) and oncologic outcomes, including locoregional recurrence (LRR), progression-free survival (PFS), and overall survival (OS). Fisher exact tests and χ2 tests were used to evaluate associations between toxic effects and treatment modality (IMPT vs IMRT), and the Kaplan-Meier method was used to compare LRR, PFS, and OS between the 2 groups. RESULTS The study included 292 patients with OPC (272 [93%] with human papillomavirus [HPV]-p16-positive tumors); 254 (87%) were men, 38 (13%) were women, and the median age was 64 years (IQR, 58-71 years). Fifty-eight patients (20%) were treated with IMPT, and 234 (80%) were treated with IMRT. Median follow-up was 26 months (IQR, 17-36 months). Most patients (283 [97%]) received a dose to the primary tumor of 70 Gy. Fifty-seven of the patients treated with IMPT (98%) and 215 of those treated with IMRT (92%) had HPV-p16-positive disease. There were no significant differences in 3-year OS (97% IMPT vs 91% IMRT; P = .18), PFS (82% IMPT vs 85% IMRT; P = .62), or LRR (5% IMPT vs 4% IMRT; P = .59). The incidence of acute toxic effects was significantly higher for IMRT compared with IMPT for oral pain of grade 2 or greater (42 [72%] IMPT vs 217 [93%] IMRT; P < .001), xerostomia of grade 2 or greater (12 [21%] IMPT vs 68 [29%] IMRT; P < .001), dysgeusia of grade 2 or greater (16 [28%] IMPT vs 134 [57%] IMRT; P < .001), grade 3 dysphagia (4 [7%] IMPT vs 29 [12%] IMRT; P < .001), mucositis of grade 3 or greater (10 [53%] IMPT vs 13 [70%] IMRT; P = .003), nausea of grade 2 or greater (0 [0%] IMPT vs 18 [8%] IMRT; P = .04), and weight loss of grade 2 or greater (22 [37%] IMPT vs 138 [59%] IMRT; P < .001). There were no significant differences in chronic toxic effects of grade 3 or greater, although there was a significant difference for chronic xerostomia of grade 2 or greater (6 IMPT [11%] vs 22 IMRT [10%]; P < .001). Four patients receiving IMRT (2%) vs 0 receiving IMPT had a percutaneous endoscopic gastrostomy tube for longer than 6 months. CONCLUSIONS AND RELEVANCE In this study, curative-intent radiotherapy with IMPT for nonmetastatic OPC was associated with a significantly reduced acute toxicity burden compared with IMRT, with few chronic toxic effects and favorable oncologic outcomes, including locoregional recurrence of only 5% at 2 years. Prospective randomized clinical trials comparing these 2 technologies and of patient-reported outcomes are warranted.
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Affiliation(s)
- Irini Youssef
- Department of Radiation Oncology, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Jennifer Yoon
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Nader Mohamed
- Department of Radiation Oncology, SUNY Downstate Health Sciences University, Brooklyn, New York
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kaveh Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Linda Chen
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daphna Y. Gelblum
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sean M. McBride
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chiaojung Jillian Tsai
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nadeem Riaz
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yao Yu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc A. Cohen
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lara Ann Dunn
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alan L. Ho
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Richard J. Wong
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Loren S. Michel
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jay O. Boyle
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Bhuvanesh Singh
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anuja Kriplani
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ian Ganly
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eric J. Sherman
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David G. Pfister
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - James Fetten
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy Y. Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
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Cenko E, Bergami M, Yoon J, Van Der Schaar M, Manfrini O, Gale C, Vasiljevic Z, Stankovic G, Vavlukis M, Kedev S, Milicic D, Dorobantu M, Badimon L, Bugiardini R. Relation between sex and mortality after myocardial infarction in high-income and middle-income European countries. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The relationship between female sex and cardiovascular mortality in myocardial infarction (MI) is controversial. Most available data are from high-income countries (HIC) where baseline risk is lower and revascularization procedures are more likely, so the generalizability to other populations is unclear.
Purpose
The main goal of this study was to unravel the relation between patient-specific revascularization through percutaneous coronary intervention (PCI) and mortality among women and men.
Methods
Data were drawn from the ISACS-Archives (NCT04008173) which includes a large cohort of patients enrolled in 6 European HIC (Croatia, Italy, Lithuania, Hungary, Romania, and United Kingdom) and 7 middle-income countries (MIC; Bosnia & Herzegovina, Kosovo, Macedonia, Moldova, Montenegro, and Serbia). Participants were stratified by MI subtypes: STEMI and NSTEMI. The primary outcome was 30-day mortality. To yield unbiased sex estimates of the effects of MI on mortality we modeled covariates and outcomes by propensity score-based analytic methods. We calculated the women to men risk ratios (RRs) using weighting with estimates compared by test of interaction on the log scale.
Results
The cohort consisted of 22,087 patients with MI (30.2% women). Patient outcomes varied according to the subtype of MI. Females was associated with a greater excess risk of 30-day mortality in STEMI (RR: 1.94; 95% CI: 1.71–2.21) compared with NSTEMI (RR: 1.12; 95% CI: 0.95–1.50; P interaction <0.001). Coronary revascularization reduced the incidence of death among women and men in the overall population. Despite this, the primary outcome of 30-day mortality remained higher in women than men with STEMI (RR: 2.38; 95% CI: 2.00–2.82) whereas it was comparable across sexes in patients with NSTEMI (RR: 1.21; 95% CI: 0.79–1.83; P interaction=0.002). Sex differences in mortality from STEMI were more significant in MIC compared with HIC (RRs: 2.30; 95% CI: 1.98–2.68 vs. 1.36; 95% CI: 1.05–1.75; P interaction <0.001). The sex gap in mortality was mitigated by the use of revascularization therapy (RRs: 2.05; 95% CI: 1.68–2.50 in MIC vs. 2.17; 95% CI: 1.48–3.18 in HIC; P interaction=0.40)
Conclusion
Women presenting with STEMI have worse early mortality rates than their male counterparts in both HIC and MIC even in patients undergoing revascularization. By contrast, sex differences are attenuated or no longer apparent in NSTEMI. With no information on the type of MI on admission, sex differences in early outcomes are difficult to be fully understood.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Cenko
- University of Bologna , Bologna , Italy
| | - M Bergami
- University of Bologna , Bologna , Italy
| | - J Yoon
- Google Cloud AI , Sunnyvale , United States of America
| | | | | | - C Gale
- University of Leeds , Leeds , United Kingdom
| | | | | | - M Vavlukis
- University Clinic of Cardiology , Skopje , North Macedonia
| | - S Kedev
- University Clinic of Cardiology , Skopje , North Macedonia
| | - D Milicic
- University of Zagreb School of Medicine , Zagreb , Croatia
| | - M Dorobantu
- University of Medicine and Pharmacy Carol Davila , Bucharest , Romania
| | - L Badimon
- Cardiovascular Research Center (CSIC-ICCC) , Barcelona , Spain
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Yoon J, Armstrong M, Cotton C, Mense M, Allaire N. 592 Ribosome profiling reveals distinct translation termination kinetics and efficiency between Fischer rat thyroid and human bronchial epidermal cells. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01282-6] [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: 11/07/2022]
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18
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Allaire N, Yoon J, Armstrong M, Valley H, Macadino C, Sivachenko A, Conte J, Tabak B, Bihler H, Cheng Y, Coote K, Cotton C, Mense M. 663 Modulation of cystic fibrosis transmembrane conductance regulator intron 22 alternative polyadenylation use may have therapeutic potential for the treatment of certain 3′ cystic fibrosis transmembrane conductance regulator premature termination codon variants. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01353-4] [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: 11/06/2022]
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Yoon J, Hutchinson D, Marville-Williams C, Albano M, Neves-Silva S, Purdy N, Zuk A. Case Study: The Impact of Nursing Professional Practice during the COVID-19 Pandemic at a Large Community Hospital in Canada. Nurs Leadersh (Tor Ont) 2022; 35:48-65. [PMID: 36735389 DOI: 10.12927/cjnl.2022.27003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic posed numerous challenges experienced by healthcare organizations. Nursing professional practice plays a crucial leadership role in supporting nursing staff and leaders in developing policies, parameters and philosophical approaches for delivering safe patient care. The professional practice leadership at Humber River Hospital, a large Canadian community hospital, implemented three key interventions in this hospital-based case study: (1) proactive workforce planning, (2) increased nursing student placements and (3) novel "stretch model of care" in the intensive care unit (ICU). The overall results following the implementation of these interventions resulted in substantial improvements. For example, proactive nursing workforce planning supported both a 98% reduction in agency utilization and an accelerated ICU certification program with an 84% certificate completion rate. Through innovative strategies, there was a significant increase (33-67%) in the number of nursing student placements during the first two years of the pandemic compared with previous years. Within the ICU setting, we maintained optimum ICU capacity that resulted in stronger partnership-driven relationships between nurses and physicians through an interprofessional "stretch model of care." Finally, we avoided emergency department closures and Code Orange calls during peaks of the pandemic.
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Affiliation(s)
- Jennifer Yoon
- Deputy Chief Nurse Executive, Vice President, Quality, Patient Safety and Risk, Humber River Hospital, Toronto, ON
| | - Derek Hutchinson
- Director, Professional Practice, Humber River Hospital, Toronto, ON
| | | | - Mariekris Albano
- Research and Post Discharge, Call Centre Coordinator, Humber River Hospital, Toronto, ON
| | - Susana Neves-Silva
- Manager, Central Placement Office and Simulation, School of Nursing, Toronto Metropolitan University, Toronto, ON
| | - Nancy Purdy
- Associate Professor Emeritus, Toronto Metropolitan University, Toronto, ON
| | - Aleksandra Zuk
- Assistant Professor, School of Nursing, Queen's University, Kingston, ON
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Young K, Yoon J, Getachew E, Leung B, Nguyen N, Semenov Y, Theodosakis N. 206 Tetracyclines are associated with development of new hyperpigmentation in acne patients. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.213] [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: 11/16/2022]
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21
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Getachew E, Yoon J, Young K, Leung B, Nguyen N, Mostaghimi A, Semenov Y, Theodosakis N. 674 Racial differences in melasma risk factors and treatment patterns. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.685] [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: 11/16/2022]
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22
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Youssef I, Yoon J, Mohamed N, Zakeri K, Press RH, Yu Y, Kang JJ, Wong RJ, Tuttle RM, Shaha A, Sherman E, Lee NY. Outcomes and Toxicities of Nonmedullary Thyroid Tumors Treated with Proton Beam Radiation Therapy. Int J Part Ther 2022; 9:20-30. [PMID: 36060412 PMCID: PMC9415751 DOI: 10.14338/ijpt-22-00005.1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/10/2022] [Indexed: 11/21/2022] Open
Abstract
Purpose Proton therapy is an emerging therapy for several malignancies owing to its favorable therapeutic ratio. There are very limited data on the use of proton therapy in the management of thyroid carcinoma. Our objective was to review the safety, feasibility, and outcomes of proton therapy for patients with thyroid cancer treated to the head and neck. Methods From our institution's proton database from 2012 to 2021, we identified 22 patients with thyroid cancer treated with proton beam therapy. We evaluated outcomes and toxicities. Results Median follow-up was 26 months. Of the 22 patients, 50% were female. The mean age was 65 years. Three patients had anaplastic cancer; 13, papillary carcinoma; 2, follicular carcinoma; and 2, poorly differentiated carcinoma. Forty-six percent had T4 disease. Primary targets were the central neck compartment, level VI, and upper mediastinum. Radiation dose was 60 GyRBE adjuvantly, and 70 GyRBE for gross disease (range, 6000-7600 GyRBE). Eight patients underwent upfront adjuvant radiation, and 3 received definitive radiation for unresectable disease upfront. Eleven patients received either salvage or palliative radiation. Fifty-nine percent of patients had extrathyroidal extension, and 64% of patients had gross disease in the neck before treatment. Fifty percent of patients had metastatic disease before treatment. Sixteen patients received concurrent chemotherapy, 63% of these patients received doxorubicin. For all patients, 1-year local regional recurrence (LRR) was 0%, and overall survival (OS) was 90%. Acute grade 3+ toxicities occurred in 27% of patients, the most frequent being dermatitis (27%). Three patients required a percutaneous endoscopic gastrostomy tube after radiation therapy (RT), 2 owing to progression. There were no grade 4+ toxicities. Conclusions Proton therapy for thyroid cancer appears feasible and effective with minimal toxicities. Prospective studies comparing proton therapy with intensity-modulated RT, to evaluate the clinical efficacy of using proton therapy to reduce toxicities in patients undergoing radiation for thyroid cancer, are warranted.
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Affiliation(s)
- Irini Youssef
- Department of Radiation Oncology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jennifer Yoon
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Nader Mohamed
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kaveh Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Yao Yu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jung Julie Kang
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Richard J. Wong
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R. Michael Tuttle
- Department of Endocrinology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ashok Shaha
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eric Sherman
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nancy Y. Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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23
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Farhadian SF, Lindenbaum O, Zhao J, Corley MJ, Im Y, Walsh H, Vecchio A, Garcia-Milian R, Chiarella J, Chintanaphol M, Calvi R, Wang G, Ndhlovu LC, Yoon J, Trotta D, Ma S, Kluger Y, Spudich S. HIV viral transcription and immune perturbations in the CNS of people with HIV despite ART. JCI Insight 2022; 7:e160267. [PMID: 35801589 PMCID: PMC9310520 DOI: 10.1172/jci.insight.160267] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/13/2022] [Indexed: 01/12/2023] Open
Abstract
People with HIV (PWH) on antiretroviral therapy (ART) experience elevated rates of neurological impairment, despite controlling for demographic factors and comorbidities, suggesting viral or neuroimmune etiologies for these deficits. Here, we apply multimodal and cross-compartmental single-cell analyses of paired cerebrospinal fluid (CSF) and peripheral blood in PWH and uninfected controls. We demonstrate that a subset of central memory CD4+ T cells in the CSF produced HIV-1 RNA, despite apparent systemic viral suppression, and that HIV-1-infected cells were more frequently found in the CSF than in the blood. Using cellular indexing of transcriptomes and epitopes by sequencing (CITE-seq), we show that the cell surface marker CD204 is a reliable marker for rare microglia-like cells in the CSF, which have been implicated in HIV neuropathogenesis, but which we did not find to contain HIV transcripts. Through a feature selection method for supervised deep learning of single-cell transcriptomes, we find that abnormal CD8+ T cell activation, rather than CD4+ T cell abnormalities, predominated in the CSF of PWH compared with controls. Overall, these findings suggest ongoing CNS viral persistence and compartmentalized CNS neuroimmune effects of HIV infection during ART and demonstrate the power of single-cell studies of CSF to better understand the CNS reservoir during HIV infection.
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Affiliation(s)
- Shelli F. Farhadian
- Department of Medicine, Section of Infectious Diseases, and
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ofir Lindenbaum
- Program in Applied Mathematics, and
- Interdepartmental Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Jun Zhao
- Interdepartmental Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michael J. Corley
- Department of Medicine, Division of Infectious Diseases, and
- Feil Family Brain & Mind Institute, Weill Cornell Medicine, New York, New York, USA
| | - Yunju Im
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Hannah Walsh
- Department of Medicine, Section of Infectious Diseases, and
| | - Alyssa Vecchio
- University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rolando Garcia-Milian
- Bioinformatics Support Program, Cushing/Whitney Medical Library, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer Chiarella
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Rachela Calvi
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Guilin Wang
- Yale Center for Genome Analysis, Yale University, New Haven, Connecticut, USA
| | - Lishomwa C. Ndhlovu
- Department of Medicine, Division of Infectious Diseases, and
- Feil Family Brain & Mind Institute, Weill Cornell Medicine, New York, New York, USA
| | - Jennifer Yoon
- Department of Medicine, Section of Infectious Diseases, and
| | - Diane Trotta
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Shuangge Ma
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Yuval Kluger
- Program in Applied Mathematics, and
- Interdepartmental Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Serena Spudich
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
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24
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Gandhi S, Narasimhan S, Workineh A, Mamula M, Yoon J, Krause PJ, Farhadian SF. Borrelia miyamotoi Meningoencephalitis in an Immunocompetent Patient. Open Forum Infect Dis 2022; 9:ofac295. [PMID: 35873293 PMCID: PMC9301576 DOI: 10.1093/ofid/ofac295] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/09/2022] [Indexed: 12/01/2022] Open
Abstract
Borrelia miyamotoi is an underdiagnosed cause of tick-borne illness in endemic regions and, in rare cases, causes neurological disease in immunocompetent patients. Here, we present a case of serologically confirmed Borrelia miyamotoi meningoencephalitis in an otherwise healthy patient who rapidly improved following initiation of antibiotic therapy.
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Affiliation(s)
- Shiv Gandhi
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sukanya Narasimhan
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Aster Workineh
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Mark Mamula
- Section of Rheumatology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer Yoon
- Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Peter J Krause
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut, USA
| | - Shelli F Farhadian
- Correspondence: Shelli Farhadian, 135 College St, New Haven, CT 06510 ()
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25
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Yehia ZA, Yoon J, Sayan M, Kumar S, Hathout L, Kowzun M, Potdevin L, George M, Haffty BG, Ohri N. Does the Use of BioZorb ® Result in Smaller Breast Seroma Volume? Anticancer Res 2022; 42:2961-2965. [PMID: 35641254 DOI: 10.21873/anticanres.15779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 11/10/2022]
Abstract
AIM To evaluate the impact of BioZorb®, a 3D-bioabsorbable marker, on the tumor-bed boost volume and dosimetric parameters in adaptive boost planning for breast cancer. PATIENTS AND METHODS Records were reviewed for 51 breast-cancer patients who underwent breast-conserving surgery and adjuvant whole-breast irradiation between January 2017 and October 2018. Changes in lumpectomy boost volume (LBV), doses to organs at risk, toxicity and cosmesis were compared between patients with and without BioZorb® Chi-square test and paired and independent t-tests were used for comparisons of variables. RESULTS Median follow-up was 35.5 months. Mean LBV on initial CT (LBV1; 32.2 vs. 33.8 cc, p=0.74) and on boost computed tomography (CT) (LBV2; 25.3 vs. 24.8 cc, p=0.87) were similar with and without BioZorb® The mean decrease from LBV1 to LBV2 was 9.0 cc and 6.8 cc with and without BioZorb®, respectively (p=0.42). LBV1 was significantly positively correlated with a 20% reduction in LBV (p=0.02). Mean heart and lung doses on adaptive boost planning CT were slightly lower compared to initial planning CT in both groups. Acute breast pain was reported in 18/51 patients, 9 of whom had BioZorb® (p=0.24). Grade-2 pain was reported in 5/51 patients, 3 of whom had BioZorb® (p=0.11). Excellent or good cosmesis was reported in 36/41 patients. Fair cosmesis was reported in 5/41 patients, of whom 2 had BioZorb® (p=0.64). CONCLUSION BioZorb® placement does not impact the tumor-bed boost volume nor the variation of seroma volume within the period of treatment. More data and longer follow-up are needed to identify a measurable clinical impact of BioZorb® placement.
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Affiliation(s)
| | - Jennifer Yoon
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Mutlay Sayan
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, U.S.A
| | - Shicha Kumar
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Lara Hathout
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Maria Kowzun
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Lindsay Potdevin
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Mridula George
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Bruce G Haffty
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
| | - Nisha Ohri
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, U.S.A
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D'Souza A, Marshall LR, Yoon J, Kulesha A, Edirisinghe DIU, Chandrasekaran S, Rathee P, Prabhakar R, Makhlynets OV. Peptide hydrogel with self-healing and redox-responsive properties. Nano Converg 2022; 9:18. [PMID: 35478076 PMCID: PMC9046503 DOI: 10.1186/s40580-022-00309-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/06/2022] [Indexed: 06/12/2023]
Abstract
We have rationally designed a peptide that assembles into a redox-responsive, antimicrobial metallohydrogel. The resulting self-healing material can be rapidly reduced by ascorbate under physiological conditions and demonstrates a remarkable 160-fold change in hydrogel stiffness upon reduction. We provide a computational model of the hydrogel, explaining why position of nitrogen in non-natural amino acid pyridyl-alanine results in drastically different gelation properties of peptides with metal ions. Given its antimicrobial and rheological properties, the newly designed hydrogel can be used for removable wound dressing application, addressing a major unmet need in clinical care.
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Affiliation(s)
- Areetha D'Souza
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY, 13244, USA
| | - Liam R Marshall
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY, 13244, USA
| | - Jennifer Yoon
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY, 13244, USA
| | - Alona Kulesha
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY, 13244, USA
| | - Dona I U Edirisinghe
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY, 13244, USA
| | - Siddarth Chandrasekaran
- National Biomedical Center for Advanced ESR Technology, Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, 14583, USA
| | - Parth Rathee
- Department of Chemistry, University of Miami, Coral Gables, FL, 33146, USA
| | - Rajeev Prabhakar
- Department of Chemistry, University of Miami, Coral Gables, FL, 33146, USA
| | - Olga V Makhlynets
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY, 13244, USA.
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27
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Yoon J, Petrosyan A, Wang T, Ameer A. Colonic adenocarcinoma with synchronous metastasis to the pancreas: A case report and literature review. JGH Open 2022; 6:274-276. [PMID: 35475198 PMCID: PMC9021708 DOI: 10.1002/jgh3.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/04/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Jennifer Yoon
- Department of Internal Medicine University of California San Francisco California USA
| | - Arpine Petrosyan
- Department of Internal Medicine University of California San Francisco California USA
| | - Timothy Wang
- Department of Gastroenterology and Hepatology University of California San Francisco California USA
| | - Adnan Ameer
- Department of Gastroenterology and Hepatology University of California San Francisco California USA
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28
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Yoon J, Fitzgerald H, Wang Y, Wang Q, Vergalasova I, Elshaikh MA, Dimitrova I, Damast S, Li JY, Fields EC, Beriwal S, Keller A, Kidd EA, Usoz M, Jolly S, Jaworski E, Leung EW, Donovan E, Taunk NK, Chino J, Natesan D, Russo AL, Lea JS, Albuquerque KV, Lee LJ, Hathout L. Does Prophylactic Paraortic Lymph Node Irradiation Improve Outcomes in Women With Stage IIIC1 Endometrial Carcinoma? Pract Radiat Oncol 2022; 12:e123-e134. [PMID: 34822999 DOI: 10.1016/j.prro.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/23/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the impact of prophylactic paraortic lymph node (PALN) radiation therapy (RT) on clinical outcomes in patients with International Federation of Obstetrics and Gynecology 2018 stage IIIC1 endometrial cancer (EC). METHODS AND MATERIALS A multi-institutional retrospective study included patients with International Federation of Obstetrics and Gynecology 2018 stage IIIC1 EC lymph node assessment, status postsurgical staging, followed by adjuvant chemotherapy and RT using various sequencing regimens. Overall survival (OS) and recurrence-free survival (RFS) rates were estimated by the Kaplan-Meier method. Univariable and multivariable analysis were performed by Cox proportional hazard models for RFS/OS. In addition, propensity score matching was used to estimate the effect of the radiation field extent on survival outcomes. RESULTS A total of 378 patients were included, with a median follow-up of 45.8 months. Pelvic RT was delivered to 286 patients, and 92 patients received pelvic and PALN RT. The estimated OS and RFS rates at 5 years for the entire cohort were 80% and 69%, respectively. There was no difference in the 5-year OS (77% vs 87%, P = .47) and RFS rates (67% vs 70%, P = .78) between patients treated with pelvic RT and those treated with pelvic and prophylactic PALN RT, respectively. After propensity score matching, the estimated hazard ratios (HRs) of prophylactic PALN RT versus pelvic RT were 1.50 (95% confidence interval, 0.71-3.19; P = .28) for OS and 1.24 (95% confidence interval, 0.64-2.42; P = .51) for RFS, suggesting that prophylactic PALN RT does not improve survival outcomes. Distant recurrence was the most common site of first recurrence, and the extent of RT field was not associated with the site of first recurrence (P = .79). CONCLUSIONS Prophylactic PALN RT was not significantly associated with improved survival outcomes in stage IIIC1 EC. Distant metastasis remains the most common site of failure despite routine use of systemic chemotherapy. New therapeutic approaches are necessary to optimize the outcomes for women with stage IIIC1 EC.
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Affiliation(s)
- Jennifer Yoon
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Halle Fitzgerald
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Yaqun Wang
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Qingyang Wang
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | - Mohamed A Elshaikh
- Departments of Radiation Oncology, Henry Ford Cancer Institute, Detroit, Michigan
| | - Irina Dimitrova
- Departments of Gynecologic Oncology, Henry Ford Cancer Institute, Detroit, Michigan
| | - Shari Damast
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Jessie Y Li
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Emma C Fields
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Massey Cancer Center, Richmond, Virginia
| | - Sushil Beriwal
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Andrew Keller
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elizabeth A Kidd
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Melissa Usoz
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Shruti Jolly
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Elizabeth Jaworski
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Eric W Leung
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Elysia Donovan
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Neil K Taunk
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Junzo Chino
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Divya Natesan
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Andrea L Russo
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jayanthi S Lea
- Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kevin V Albuquerque
- Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Larissa J Lee
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Lara Hathout
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
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29
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Yoon J, Gu J, Martin KB. A Novel Treatment of Postpartum Depression and Review of Literature. Cureus 2022; 14:e22373. [PMID: 35371824 PMCID: PMC8938255 DOI: 10.7759/cureus.22373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/29/2022] Open
Abstract
Early-onset postpartum depression has been shown to have a unique neurobiological basis compared to major depressive disorder, implying a need for targeted treatments such as the recent Food and Drug Administration (FDA)-approved brexanolone. In this case report, a woman with a past medical history of major depressive disorder was diagnosed with postpartum depression due to worsening mood with suicidal and homicidal ideations. She was treated with vilazodone and aripiprazole with good effect after consideration of her past medication trials. Her regimen is unique in clinical practice and not reported in current literature for the treatment of postpartum depression. It may represent a safe and effective medication choice, especially in the context of current first-line treatments that have a high treatment failure rate. More research is needed to find treatments that address the unique challenges of postpartum women.
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30
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Jayachandran M, Yoon J, Wu J, Cipurko D, Quon J, Makhlynets O. Mechanistic studies of the cofactor assembly in class Ib ribonucleotide reductases and protein affinity for MnII and FeII. Metallomics 2021; 13:6413552. [PMID: 34718709 DOI: 10.1093/mtomcs/mfab062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 10/21/2021] [Indexed: 11/14/2022]
Abstract
Ribonucleotide reductase (RNR) is an essential enzyme found in all organisms. The function of RNR is to catalyze the conversion of nucleotides to deoxynucleotides. RNRs rely on metallocofactors to oxidize a conserved cysteine in the active site of the enzyme into a thiyl radical, which then initiates nucleotide reduction. The proteins required for MnIII2-Y• cluster formation in class Ib RNRs are NrdF (β-subunit) and NrdI (flavodoxin). An oxidant is channeled from the FMN cofactor in NrdI to the dimanganese center in NrdF, where it oxidizes the dimanganese center and a tyrosyl radical (Y•) is formed. Both Streptococcus sanguinis and Escherichia coli MnII2-NrdF structures have a constriction in the channel immediately above the metal site. In E. coli, the constriction is formed by the side chain of S159, whereas in the S. sanguinis system it involves T158. This serine-to-threonine substitution was investigated using S. sanguinis and Streptococcus pneumoniae class Ib RNRs but it is also present in other pathogenic streptococci. Using stopped-flow kinetics, we investigate the role of this substitution in the mechanism of MnIII2-Y• cluster formation. In addition to different kinetics observed in the studied streptococci, we found that affinity constants of NrdF for MnII and FeII are about 1 µM and the previously reported preference for MnII could not be explained by affinity only.
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Affiliation(s)
- Megha Jayachandran
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY 13244, USA
| | - Jennifer Yoon
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY 13244, USA
| | - Jacky Wu
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY 13244, USA
| | - Denis Cipurko
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY 13244, USA
| | - Joyce Quon
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY 13244, USA
| | - Olga Makhlynets
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, NY 13244, USA
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31
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Avagyan S, Henninger JE, Mannherz WP, Mistry M, Yoon J, Yang S, Weber MC, Moore JL, Zon LI. Resistance to inflammation underlies enhanced fitness in clonal hematopoiesis. Science 2021; 374:768-772. [PMID: 34735227 DOI: 10.1126/science.aba9304] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- S Avagyan
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - J E Henninger
- Whitehead Institute for Biomedical Research, Cambridge, MA, USA
| | | | - M Mistry
- Harvard Chan Bioinformatics Core, Boston, MA, USA
| | - J Yoon
- Harvard Chan Bioinformatics Core, Boston, MA, USA
| | - S Yang
- Boston Children's Hospital, Boston, MA, USA
| | - M C Weber
- Boston Children's Hospital, Boston, MA, USA
| | - J L Moore
- Boston Children's Hospital, Boston, MA, USA
| | - L I Zon
- Boston Children's Hospital, Boston, MA, USA.,Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
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32
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Yoon J, Skach W. 612: Ribosome profiling reveals new complexities in ribosome-mediated mRNA decoding and stalling during CFTR protein synthesis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02035-x] [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: 11/25/2022]
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Cenko E, Yoon J, Van Der Schaar M, Bergami M, Manfrini O, Vasiljevic Z, Zdravkovic M, Stankovic G, Vavlukis M, Kedev S, Milicic D, Badimon L, Bugiardini R. Acute heart failure: a mechanism underscoring sex differences in outcomes following acute coronary syndromes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
It remains uncertain whether female sex is itself a strong risk factor for worse outcomes in acute coronary syndromes (ACS).
Purpose
We hypothesized that sex differences in vulnerability to heart failure after ACS may modify the association between sex and outcomes.
Methods
Data were drawn from the ISACS-Archives network of registries. The study population consisted of 87,812 patients with known time from symptom onset to hospital presentation. Participants were stratified by ACS subtypes: STEMI and NSTE-ACS Data on presenting heart failure symptoms were collected from medical record abstraction. Heart failure was categorized as Killip class >2. Time from symptom onset to hospital presentation was categorized as early (≤120 minutes) or late (>120 minutes). Primary outcome measure was 30-day mortality. Estimates were performed using a parametric balancing strategy by weighting and compared by test of interaction on the log scale.
Results
Among the study sample, 30922 (35.2%) patients were women. Patient outcomes varied according to subtype of ACS. The mortality rates at 30-days were significantly higher among women vs men in STEMI (RR:1.65; 95% CI: 1.56–1.73) compared with NSTE-ACS (RR:1.18; 95% CI: 1.09–1.28; P interaction <0.0001). Similarly, the women vs men RR of heart failure was higher in STEMI (RR: 1.24; 95% CI: 1.20–1.29) compared with NSTE-ACS (RR:1.02; 95% CI: 0.97–1.08; P interaction <0.0001). Sex difference in heart failure rates with STEMI presentation were independent (P<0.0001) of early (34.3% in women vs 24.2% in men) or late (35.5% in women vs 30.7% in men) hospital presentation. The same finding was not seen in NSTE-ACS patients. Overall, women presenting with heart failure was had higher 30-day mortality than did their male counterparts with heart failure (29.8% vs 25.5%; RR: 1.24; 95% CI: 1.17–1.31).
Conclusions
Women exhibit substantially more vulnerability to heart failure in STEMI than men: a greater percentage of women have heart failure, and women with heart failure have higher 30-day mortality than men with heart failure. This finding was not seen in NSTE-ACS. heart failure on initial assessment is a key feature to explain the sex gap in mortality after ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Cenko
- University of Bologna, Department of Internal Medicine, Section of Cardiology, Bologna, Italy
| | - J Yoon
- Google Cloud AI, Sunnyvale, United States of America
| | - M Van Der Schaar
- University of Cambridge, Cambridge Centre for Artificial Intelligence in Medicine, Department of Applied Mathematics and Th, Cambridge, United Kingdom
| | - M Bergami
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine,, Bologna, Italy
| | - O Manfrini
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine,, Bologna, Italy
| | - Z Vasiljevic
- Clinical center of Serbia and School of medicine University of Belgrade, Belgrade, Serbia
| | - M Zdravkovic
- University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | - G Stankovic
- Clinical center of Serbia and School of medicine University of Belgrade, Belgrade, Serbia
| | - M Vavlukis
- University Clinic of Cardiology, Skopje, North Macedonia
| | - S Kedev
- University Clinic of Cardiology, Skopje, North Macedonia
| | - D Milicic
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - L Badimon
- Cardiovascular Research Center (CSIC-ICCC), Barcelona, Spain
| | - R Bugiardini
- University of Bologna, Department of Experimental, Diagnostic and Specialty Medicine,, Bologna, Italy
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34
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Bergami M, Cenko E, Yoon J, Mendieta G, Kedev S, Zdravkovic M, Vasiljevic Z, Milicic D, Manfrini O, Van Der Schaar M, Gale CP, Badimon L, Bugiardini R. Statins for primary prevention among elderly men and women. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The debate about statins in primary prevention of cardiovascular (CV) disease is still alive, especially in old and very old adults.
Purpose
We undertook a propensity match-weighted cohort study to investigate whether statin treatment recommendations translate into improved cardiovascular (CV) outcomes in the current routine clinical care of the elderly.
Methods
We included in our analysis 5,619 people aged 65 years or older from the ISACS (International Survey of Acute Coronary Syndrome) Archives (NCT04008173) who presented to hospital with a first manifestation of CV disease. Participants were stratified as statin users versus nonusers and as old (65 to 75 years) versus very old (76 years or over) adults. We estimated the effects of statins on the most severe clinical manifestation of CV disease, namely ST segment elevation myocardial infarction (STEMI), using inverse probability of treatment weighting models. Estimates were compared by test of interaction on the log scale.
Results
The risk of STEMI was much lower in statin users than in nonusers in both patients aged 65 to 75 years (14.7% absolute risk reduction; relative risk [RR] ratio: 0.55, 95% CI 0.45 to 0.66) and those aged 76 years and older (13.3% absolute risk reduction; RR ratio: 0.58, 95% CI 0.46 to 0.72). Estimates were similar in patients with and without history of hypercholesterolemia (interaction test; p value= 0.2408). Proportional reductions in STEMI diminished with female sex in the old (p for interaction=0.002), but not in the very old age (p for interaction=0.26). We also observed a remarkable reduction in the risk of 30- day mortality from STEMI with statin therapy in both age groups (10.2% absolute risk reduction; RR ratio: 0.39; 95% CI 0.23 – 0.68 for patients aged 76 or over and 3.8% absolute risk reduction; RR ratio 0.37; 95% CI 0.17 – 0.82 for patients aged 65 to 75 years old; interaction test, p value=0.4570).
Conclusion
Preventive statin therapy in the elderly reduces the risk of STEMI with benefits in mortality from STEMI, irrespective of the presence of a history of hypercholesterolemia. This effect persists after the age of 76 years. Benefits are less pronounced in women.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Bergami
- University of Bologna, DIMES, Bologna, Italy
| | - E Cenko
- University of Bologna, DIMES, Bologna, Italy
| | - J Yoon
- University of California Los Angeles, Department of Electrical and Computer Engineering, Los Angeles, United States of America
| | - G Mendieta
- National Centre for Cardiovascular Research (CNIC), Madrid, Spain
| | - S Kedev
- University Clinic of Cardiology, Skopje, North Macedonia
| | - M Zdravkovic
- University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | | | - D Milicic
- University Hospital Centre Zagreb, Department for Cardiovascular Diseases, Zagreb, Croatia
| | - O Manfrini
- University of Bologna, DIMES, Bologna, Italy
| | - M Van Der Schaar
- University of California Los Angeles, Department of Electrical and Computer Engineering, Los Angeles, United States of America
| | - C P Gale
- University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, United Kingdom
| | - L Badimon
- Hospital de la Santa Creu i Sant Pau, Cardiovascular Research Program ICCC, IR-IIB Sant Pau, Barcelona, Spain
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Hur SJ, Choi Y, Yoon J, Jang J, Shin NY, Ahn KJ, Kim BS. Intraindividual Comparison between the Contrast-Enhanced Golden-Angle Radial Sparse Parallel Sequence and the Conventional Fat-Suppressed Contrast-Enhanced T1-Weighted Spin-Echo Sequence for Head and Neck MRI. AJNR Am J Neuroradiol 2021; 42:2009-2015. [PMID: 34593379 DOI: 10.3174/ajnr.a7285] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/25/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The golden-angle radial sparse parallel-volumetric interpolated breath-hold (GRASP-VIBE) sequence is a recently introduced imaging technique with high resolution. This study compared the image quality between conventional fat-suppressed T1-weighted TSE and GRASP-VIBE after gadolinium enhancement in the head and neck region. MATERIALS AND METHODS Data from 65 patients with clinical indications for head and neck MR imaging between September 2020 and January 2021 were retrospectively reviewed. Two radiologists assessed the overall image quality, overall artifacts, and image conspicuities in the oropharynx, hypopharynx, and cervical lymph nodes according to 5-point scores (best score: 5). Interobserver agreement was assessed using weighted κ statistics. The SNR and contrast-to-noise ratio were calculated and compared between the 2 sequences using a paired Wilcoxon signed rank test. RESULTS The analysis included 52 patients (mean age, 60 [SD, 14 ] years; male, 71.2% [37/52]) who were mostly diagnosed with head and neck malignancies (94.3% [50/52]). κ statistics ranged from slight agreement in cervical lymph node conspicuity (κ = 0.18) to substantial agreement in oropharyngeal mucosal conspicuity (κ = 0.80) (κ range, 0.18-0.80). Moreover, GRASP-VIBE demonstrated significantly higher mean scores in overall image quality (4.68 [SD, 0.41] versus 3.66 [SD, 0.73]), artifacts (4.47 [SD, 0.48] versus 3.58 [SD, 0.71]), oropharyngeal mucosal conspicuity (4.85 [SD, 0.41] versus 4.11 [SD, 0.79]), hypopharyngeal mucosal conspicuity (4.84 [SD, 0.34] versus 3.58 [SD, 0.81]), and cervical lymph node conspicuity (4.79 [SD, 0.32] versus 4.08 [SD, 0.64]) than fat-suppressed T1-weighted TSE (all, P < .001). Furthermore, GRASP-VIBE demonstrated a higher SNR (22.8 [SD, 11.5] versus 11.3 [SD, 5.6], P < .001) and contrast-to-noise ratio (4.7 [SD, 5.4] versus 2.3 [SD, 2.7], P = .059) than fat-suppressed T1-weighted TSE. CONCLUSIONS GRASP-VIBE provided better image quality with fewer artifacts than conventional fat-suppressed T1-weighted TSE for the head and neck regions.
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Affiliation(s)
- S-J Hur
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y Choi
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Yoon
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J Jang
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - N-Y Shin
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K-J Ahn
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - B-S Kim
- From the Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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36
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Kim J, Kim DH, Jee H, Hwang J, Yoon J. Type B valvular and supravalvular pulmonic stenosis with aberrant pre-pulmonic right coronary artery diagnosed by non-electrocardiography-gated, multislice computed tomography in a Boston terrier. J Vet Cardiol 2021; 38:12-17. [PMID: 34689048 DOI: 10.1016/j.jvc.2021.09.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
Pulmonic stenosis (PS) is a common congenital heart disease in dogs. It may be associated with an aberrant coronary artery (CA) in brachycephalic breeds. If present, a CA anomaly must be identified before pulmonic valvuloplasty. A 1.7-year-old Boston terrier was referred for a grade V/VI systolic heart murmur and exercise intolerance. Echocardiography revealed combined type B valvular and supravalvular PS; an aberrant CA was also suspected. Non-electrocardiography (ECG)-gated, 160-multislice computed tomographic angiography (CTA) confirmed severe right ventricular wall hypertrophy, a hypoplastic pulmonic valve annulus, and severe supravalvular PS with a marked main pulmonary artery bulge; a single left coronary ostium with an anomalous pre-pulmonic right CA was also identified. Surgical correction with pulmonic valvuloplasty and pulmonary artery patch angioplasty under cardiopulmonary bypass was planned. The patient died intraoperatively due to profound hypotension after weaning from extracorporeal circulation. However, this is the first case report in which type B valvular and supravalvular PS with an aberrant pre-pulmonic right CA was diagnosed by non-ECG-gated, 160-multislice CTA in a Boston terrier, showing a similar level of image quality to ECG-gated CTA. Thus, in PS cases, high-slice CTA may be helpful to determine if CA anomalies are present and to establish a therapeutic plan.
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Affiliation(s)
- J Kim
- Helix Animal Medical Center, Seoul, 06546, South Korea; College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, South Korea
| | - D-H Kim
- College of Veterinary Medicine, Chungnam National University, Daejeon, 34134, South Korea
| | - H Jee
- Helix Animal Medical Center, Seoul, 06546, South Korea
| | - J Hwang
- Helix Animal Medical Center, Seoul, 06546, South Korea
| | - J Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, South Korea.
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37
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Pham K, Wu Y, Turett G, Prasad N, Yung L, Rodriguez GD, Segal-Maurer S, Urban C, Yoon J. Edwardsiella tarda, a rare human pathogen isolated from a perihepatic abscess: Implications of transient versus long term colonization of the gastrointestinal tract. IDCases 2021; 26:e01283. [PMID: 34527514 PMCID: PMC8433271 DOI: 10.1016/j.idcr.2021.e01283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/05/2021] [Accepted: 09/05/2021] [Indexed: 11/25/2022] Open
Abstract
Although gastroenteritis is the most commonly described manifestation of Edwardsiella tarda infection, the pathogenesis and transient or long-term colonization of the gastrointestinal tract of this organism in human disease is not clear. We describe a rare manifestation of E. tarda infection in a perihepatic abscess in the setting of a patient with perforated cholecystitis and its successful eradication following antibiotic treatment.
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Affiliation(s)
- K Pham
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - Y Wu
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - G Turett
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - N Prasad
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - L Yung
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
| | - G D Rodriguez
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,Columbia University School of Nursing, Columbia University, NY 10032, USA
| | - S Segal-Maurer
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,Weill Cornell Medicine, Cornell University, NY 10065, USA
| | - C Urban
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,Weill Cornell Medicine, Cornell University, NY 10065, USA
| | - J Yoon
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA.,The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11355, USA
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38
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Lee KW, Park J, Oh DY, Kim S, Sabanathan D, Kim T, Kim M, Yoon J, Lee H, Park S, Paeng K, Ock CY. 977P Interim results of phase I dose escalation study of YBL-006: A novel anti-PD-1 monoclonal antibody in advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1361] [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: 11/28/2022] Open
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Thompson LL, Yoon J, Chang MS, Polyakov NJ, Pan CX, Chen ST, Wei EX, Charrow AP. Advanced care planning, code status and end-of-life care in patients with bullous pemphigoid. Br J Dermatol 2021; 185:1246-1247. [PMID: 34184254 DOI: 10.1111/bjd.20606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- L L Thompson
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - J Yoon
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - M S Chang
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - N J Polyakov
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - C X Pan
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - S T Chen
- Department of Dermatology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
| | - E X Wei
- Department of Dermatology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
| | - A P Charrow
- Department of Dermatology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA
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40
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Thompson L, Li E, Krasnow N, Chang M, Said J, Molina G, Polyakov N, Yoon J, Dee E, Huang K, Blum A, Kuchroo J, Hinton A, Reynolds K, Chen S. Effect of dermatological consultation on survival in patients with checkpoint inhibitor‐associated cutaneous toxicity. Br J Dermatol 2021; 185:627-635. [DOI: 10.1111/bjd.20074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023]
Affiliation(s)
- L.L. Thompson
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - E.B. Li
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - N.A. Krasnow
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - M.S. Chang
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - J.T. Said
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - G.E. Molina
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - N.J. Polyakov
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - J. Yoon
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - E.C. Dee
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - K. Huang
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - A.E. Blum
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - J.R. Kuchroo
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - A.N. Hinton
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - K.L. Reynolds
- Department of Medicine Division of Hematology and Oncology Massachusetts General Hospital Cancer Center and Harvard Medical School Boston MA USA
| | - S.T. Chen
- Department of Dermatology Massachusetts General Hospital and Harvard Medical School Boston MA USA
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41
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Jeon Y, Min G, Park S, Park S, Yoon J, Lee S, Cho B, Eom K, Kim Y, Min C, Lee J, Cho S. Efficacy of ex vivo purging with CD34 positive selection during autologous stem cell transplantation in peripheral T-cell lymphomas. Cytotherapy 2021. [DOI: 10.1016/s1465324921003807] [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: 11/29/2022]
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42
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Pendyala P, Goglia AG, Mattes MD, Grann A, Huang D, Wagman RT, Yehia ZA, Yoon J, Ennis RD. Impact of the Coronavirus Disease of 2019 Pandemic on Radiation Oncology Clinical Decision Making in a High-Prevalence Environment. Adv Radiat Oncol 2021; 6:100680. [PMID: 33686375 PMCID: PMC7929864 DOI: 10.1016/j.adro.2021.100680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This study aimed to define how the coronavirus disease of 2019 (COVID-19) pandemic affected the role, timing, and delivery of radiation therapy (RT) in a high-prevalence region at the height of the initial U.S. outbreak. METHODS AND MATERIALS We performed a retrospective review of all patients seen at 3 radiation oncology departments within the Rutgers Robert Wood Johnson Barnabas Health system in New Jersey during the initial COVID-19 surge. The primary endpoints were to define and quantify COVID-related, radiation-specific care changes, and identify predictive factors of experiencing COVID-related care changes. RESULTS A total of 545 patients with cancer were seen during the study period, 99 of whom (18.1%) experienced ≥1 COVID-related care change. RT delays were the most common, accounting for 51.5% of all care changes. Physician-directed delays accounted for 41.2% of RT delays, and patient fears, COVID testing, and access barriers were responsible for 27.5%, 17.6%, and 13.7%, respectively. Patient age (P = .040), intent of treatment (P = .047), and cancer type (P < .001) were significantly associated with experiencing a COVID-related care change, as we found that older, curative intent and patients with rectal cancer were more likely to experience care changes. On multivariate analysis, patient age remained significant when controlling for treatment intent and cancer type. CONCLUSIONS Our study provides a perspective on how care was adapted to protect patients with cancer during a pandemic while maximizing disease control. The positive correlation between age and likelihood of care changes may reflect extra precaution taken with older patients given their vulnerability to severe COVID illness. The lower observed likelihood of COVID-related care changes among patients undergoing palliative RT may reflect either the more urgent needs addressed by palliative RT or simply be logistical, because palliative radiation is often delivered in short courses with less exposure risk. Assessing adaptations others have implemented and monitoring how they affect patient outcomes will be crucial.
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Affiliation(s)
- Praveen Pendyala
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | | | - Alison Grann
- Robert Wood Johnson Barnabas Health, Livingston, New Jersey
| | - David Huang
- Robert Wood Johnson Barnabas Health, Livingston, New Jersey
| | | | | | - Jennifer Yoon
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Ronald D. Ennis
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
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43
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Ho JK, Gui B, Yoon J, Zhang Q, Manne SL, Jabbour SK. Influence of Caregiver Presence During Physician Office Visits on Patients Undergoing Chemoradiation Therapy for Esophageal Cancer. Adv Radiat Oncol 2021; 6:100649. [PMID: 33912737 PMCID: PMC8071720 DOI: 10.1016/j.adro.2021.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose Although the association of marital status with outcomes for patients with cancer has been widely studied, the mechanisms underpinning the protective effect of marriage are still not fully understood. The social support that marriage imparts is often discussed as an explanation for why patients with cancer who are married have better outcomes. Social support has been difficult to objectively quantify. Accompaniment of the patient at physician visits may be more meaningful than marital status itself. This study investigated the effect of caregiver presence at physician visits on treatment tolerance and outcome in patients undergoing chemoradiation therapy (CRT) for esophageal cancer. Methods and Materials Patients who received a diagnosis of esophageal cancer who underwent CRT from January 1, 2005, to January 1, 2016, as part of their curative-intent management were retrospectively reviewed. Data collected included the patients’ marital status, caregiver presence at each physician visit, baseline performance status, serum albumin values and leukocyte values throughout treatment, patient weight values throughout treatment, tumor response to therapy, and overall survival. Patients were divided into 2 groups based on frequency of caregiver presence at physician visits (<50% or ≥50% of visits). Using χ2 tests, Wilcoxon rank sum tests, and log-rank tests, the patients’ characteristics, treatment tolerance and treatment outcome, and overall survival, respectively, were compared. Results In total, 35 of 59 patients were defined as having frequent caregiver presence at physician visits (≥50% of all documented visits), whereas 24 patients were categorized as having infrequent caregiver accompaniment. No significant difference in performance status or weight loss before the diagnosis of esophageal cancer was found. Patients who had frequent caregiver presence at physician visits maintained body weight better than those who had infrequent caregiver presence (median weight loss of 2.7 kg compared with 4.9 kg; P = .04). There was no difference in overall survival between the 2 groups. Conclusions Although patients with esophageal cancer undergoing CRT who had frequent caregiver presence at physician visits were not found to have an overall survival benefit, they had less weight loss, which may confer favorable treatment tolerance and maintenance of nutritional status during cancer treatment.
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Affiliation(s)
- Joseph K. Ho
- Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Bin Gui
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, New Jersey
| | - Jennifer Yoon
- Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Quan Zhang
- First People’s Hospital of Huaian, Huaian, China
| | - Sharon L. Manne
- Rutgers Cancer Institute of New Jersey, Department of Population Science, New Brunswick, New Jersey
| | - Salma K. Jabbour
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, New Jersey
- Corresponding author: Salma Jabbour, MD
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Abstract
Testicular choriocarcinomas comprise less than 1% of all testicular tumors and are often highly vascular with early hematogenous metastasis. Choriocarcinoma syndrome (CS) is a rare entity distinguished by diffuse tumor burden and often fatal bleeding from metastatic sites. Most reported cases describe pulmonary hemorrhage secondary to initiation of chemotherapy. We present a fatal case of a young, previously healthy male with overwhelming gastrointestinal bleeding as the presenting sign of CS. Our case demonstrates that CS should be considered in the differential diagnosis for refractory anemia due to gastrointestinal hemorrhage in a young male with a testicular mass.
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Affiliation(s)
- Jennifer Yoon
- Internal Medicine, University of California San Francisco Fresno, Fresno, USA
| | - Steve Hu
- Gastroenterology and Hepatology, University of California San Francisco Fresno, Fresno, USA
| | | | - Kandarp K Shah
- Gastroenterology and Hepatology, Community Medical Center, Fresno, USA
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45
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Khan S, Urban C, Singh V, Liu D, Segal-Maurer S, Parmar Y, Yoon J. Novel double beta-lactam therapy for Granulicatella adiacens infective endocarditis. IDCases 2021; 24:e01082. [PMID: 33850724 PMCID: PMC8039821 DOI: 10.1016/j.idcr.2021.e01082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 11/18/2022] Open
Abstract
Granulicatella adiacens, a nutritionally variant streptococci (NVS) is a well described organism associated with endocarditis. Previously communicated cases have documented the use of double beta-lactam therapy with ampicillin and ceftriaxone to treat patients with infective endocarditis due to Enterococcus faecalis and Streptocossus pneumoniae. We describe the first case of Granulicatella adiacens infective endocarditis in a patient successfully treated with the combination of intravenous ampicillin and ceftriaxone and document their synergistic activity.
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Affiliation(s)
- S. Khan
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - C. Urban
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
- Weill Cornell Medical College, Cornell University, NY, 10065, USA
- Corresponding author at: The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA.
| | - V. Singh
- Department of Pathology, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - D. Liu
- Department of Pathology, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - S. Segal-Maurer
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
- Weill Cornell Medical College, Cornell University, NY, 10065, USA
| | - Y. Parmar
- Department of Cardiology, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
| | - J. Yoon
- The Dr. James J. Rahal, Jr. Division of Infectious Diseases, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY, 11355, USA
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46
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Vize CJ, Kim SK, Matthews T, Macsai M, Merrell R, Hsu S, Kundu MG, Yoon J, Kennedy E, Pai M, Bain E, Lassman AB, Moazami G. Dysregulation of miR-637 Is Involved in the Development of Retinopathy in Hypertension Patients and Serves a Regulatory Role in Retinol Endothelial Cell Proliferation. Ophthalmic Res 2021; 66:1-7. [PMID: 33530086 PMCID: PMC10413800 DOI: 10.1159/000514915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND MicroRNAs play an important role in the proliferation and migration of retinal endothelial cells in patients with hypertension and hypertensive retinopathy (HR). This study aimed to investigate the clinical value of miR-637 in HR and its role in retinal endothelial cell proliferation and migration. METHODS A total of 126 subjects were recruited for the study, including 42 patients with hypertension (male/female 25/17), 42 healthy individuals (male/female 20/22), and 42 cases with HR (male/female 20/22). Except SBP and DBP, there was no significant difference in other indexes among the three groups. Quantitative real-time PCR was used to detect the expression of miR-637. The receiver operating curve (ROC) was used for diagnosis value analysis. Logistic regression analysis was used to evaluate the relationship between miR-637 and HR. CCK-8 and Transwell were used to detect the effect of miR-637 on the proliferation and migration of human umbilical vein endothelial cells. RESULTS Compared with hypertensive patients, HR patients had the lowest expression of miR-637. The area under the curve of miR-637 detected by the ROC curve method is 0.892, which has the ability to distinguish hypertension and HR patients. Logistic regression analysis showed that miR-637 was an independent influencing factor in HR. Cell experiment results showed that overexpression of miR-637 significantly inhibited cell proliferation and migration, while downregulation of miR-637 had the opposite effect. Luciferase analysis showed that STAT3 was the target gene of miR-637. CONCLUSION Our data indicate that miR-637 is a potential noninvasive marker for patients with HR. The action of miR-637 on STAT3 may inhibit the proliferation and migration of retinal endothelial cells, providing a possible target for the treatment of HR.
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Affiliation(s)
- Colin J. Vize
- Department of Ophthalmology, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Stella K. Kim
- Department of Ophthalmology and Visual Science, University of Texas McGovern Medical School, Houston, TX, USA
| | - Tim Matthews
- Birmingham Neuro-Ophthalmology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Marian Macsai
- Northshore University Health System, Glenview, IL, USA
| | - Ryan Merrell
- NorthShore University Health System, Evanston, IL, USA
| | - Sigmund Hsu
- The Vivian L. Smith Department of Neurosurgery, University of Texas McGovern Medical School, Houston, TX, USA
| | | | | | | | | | | | - Andrew B. Lassman
- Division of Neuro-Oncology, Department of Neurology and the Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, NY, USA
| | - Golnaz Moazami
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
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47
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Bañez C, Gelmi S, Bansil N, Drebit R, Solomon S, Yoon J, Burkoski V, Collins B, Hall T. Applying local context to design and implement patient room whiteboards. BMJ Open Qual 2021; 10:bmjoq-2019-000907. [PMID: 33419734 PMCID: PMC7798407 DOI: 10.1136/bmjoq-2019-000907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 10/27/2020] [Accepted: 12/17/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Carleene Bañez
- Healthcare Safety and Risk Management, Healthcare Insurance Reciprocal of Canada, Toronto, Ontario, Canada
| | - Stefano Gelmi
- Healthcare Safety and Risk Management, Healthcare Insurance Reciprocal of Canada, Toronto, Ontario, Canada
| | - Nikki Bansil
- Quality and Patient Safety, Humber River Hospital, Toronto, Ontario, Canada
| | - Rachel Drebit
- Simulation Program Corporate Education, St Michael's Hospital, Toronto, Ontario, Canada
| | - Shirley Solomon
- Research, Quality and Patient Safety, Humber River Hospital, Toronto, Ontario, Canada
| | - Jennifer Yoon
- Professional Practice, Quality and Patient Safety, Humber River Hospital, Toronto, Ontario, Canada
| | - Vanessa Burkoski
- Chief Nursing Executive, Humber River Hospital, Toronto, Ontario, Canada
| | - Barbara Collins
- President and CEO, Humber River Hospital, Toronto, Ontario, Canada
| | - Trevor Hall
- Vice President, Healthcare Safety and Risk Management, Healthcare Insurance Reciprocal of Canada, Toronto, Ontario, Canada
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48
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Mall EM, Rotte N, Yoon J, Sandhowe-Klaverkamp R, Röpke A, Wistuba J, Hübner K, Schöler HR, Schlatt S. A novel xeno-organoid approach: exploring the crosstalk between human iPSC-derived PGC-like and rat testicular cells. Mol Hum Reprod 2020; 26:879-893. [PMID: 33049038 DOI: 10.1093/molehr/gaaa067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/11/2020] [Indexed: 02/06/2023] Open
Abstract
Specification of germ cell-like cells from induced pluripotent stem cells has become a clinically relevant tool for research. Research on initial embryonic processes is often limited by the access to foetal tissue, and in humans, the molecular events resulting in primordial germ cell (PGC) specification and sex determination remain to be elucidated. A deeper understanding of the underlying processes is crucial to describe pathomechanisms leading to impaired reproductive function. Several protocols have been established for the specification of human pluripotent stem cell towards early PGC-like cells (PGCLC), currently representing the best model to mimic early human germline developmental processes in vitro. Further sex determination towards the male lineage depends on somatic gonadal cells providing the necessary molecular cues. By establishing a culture system characterized by the re-organization of somatic cells from postnatal rat testes into cord-like structures and optimizing efficient PGCLC specification protocols, we facilitated the co-culture of human germ cell-like cells within a surrogate testicular microenvironment. Specified conditions allowed the survival of rat somatic testicular and human PGCLCs for 14 days. Human cells maintained the characteristic expression of octamer-binding transcription factor 4, SRY-box transcription factor 17, and transcription factor AP-2 gamma and were recovered from the xeno-organoids by cell sorting. This novel xeno-organoid approach will allow the in vitro exploration of early sex determination of human PGCLCs.
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Affiliation(s)
- E M Mall
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - N Rotte
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany.,Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - J Yoon
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - R Sandhowe-Klaverkamp
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - A Röpke
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - J Wistuba
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - K Hübner
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - H R Schöler
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany.,Medical Faculty, University of Münster, Münster, Germany
| | - S Schlatt
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany
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49
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Yoon J, Barton MJ, St John JA, Ekberg JAK, Khan A, Redmond M. Anterior skull base olfactory tumours, which is what? A case report and review. J Clin Neurosci 2020; 81:1-5. [PMID: 33222894 DOI: 10.1016/j.jocn.2020.09.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 07/29/2020] [Accepted: 09/06/2020] [Indexed: 11/17/2022]
Abstract
Intracranial schwannomas not originating from cranial nerves are rare. In this paper, we report a case of a 50-year-old male who presented with worsening headaches, diplopia and nausea over two years. Radiological imaging revealed a large tumour arising from the olfactory groove region with a preoperative diagnosis of olfactory groove meningioma (OGM). Intraoperatively, the tumour originated from the region of the attachment of the falx to the crista galli. The patient recovered without complication and histopathology reported an unexpected diagnosis of WHO Grade 1 schwannoma. However, as olfactory groove schwannomas (OGSs) cannot be distinguished from olfactory ensheathing cell tumours (OECTs), it is possible that the tumour could have been either an OGS or an OECT. Distinguishing between OGSs, OECTs and OGMs preoperatively is difficult. OGMs exhibit distinct histopathological features from OGSs/OECTs, however, OGSs and OECTs currently cannot be distinguished from each other. Here, we review the literature to discuss the differentiating features and cellular origins of these three tumours.
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Affiliation(s)
- J Yoon
- Neurosurgery Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - M J Barton
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan, QLD, Australia
| | - J A St John
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - J A K Ekberg
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, Australia
| | - A Khan
- Anatomical Pathology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - M Redmond
- Neurosurgery Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia; Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
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50
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Thompson LL, Chang MS, McCormack L, Polyakov N, Yoon J, Song H, Huang JT, Chen ST. Patterns of cutaneous immune-related adverse events in adults and children with advanced sarcoma: a retrospective cohort study. Br J Dermatol 2020; 184:363-365. [PMID: 32894776 DOI: 10.1111/bjd.19540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022]
Affiliation(s)
- L L Thompson
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - M S Chang
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - L McCormack
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,University of Massachusetts Medical School, Worcester, MA, USA
| | - N Polyakov
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - J Yoon
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - H Song
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,Harvard Combined Dermatology Residency Program, Harvard Medical School, Boston, MA, USA
| | - J T Huang
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - S T Chen
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA.,Department of Dermatology, Harvard Medical School, Boston, MA, USA
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