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Winter K, Pfeil JM, Engmann H, Aisenbrey S, Lorenz B, Hufendiek K, Breuss H, Khattab M, Süsskind D, Kakkassery V, Lagrèze WA, Barth T, Liegl R, Bründer MC, Skevas C, Goldammer I, Glitz B, Michalewicz E, Krohne TU, Bartmann IR, Stahl A. Comparability of input parameters in the German Retina.net ROP registry and the EU-ROP registry - An exemplary comparison between 2011 and 2021. Acta Ophthalmol 2024; 102:e314-e321. [PMID: 37725047 DOI: 10.1111/aos.15753] [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: 04/19/2023] [Revised: 07/04/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE The German Retina.net ROP registry and its Europe-wide successor, the EU-ROP registry, collect data from patients treated for ROP. This analysis compares input parameters of these two registries to establish a procedure for joint analyses of different registry data using exemplary datasets from the two registries. METHODS Exemplary datasets from the two databases over a 1-year period each (German Retina.net ROP Registry, 2011, 22 infants; EU-ROP Registry, 2021, 44 infants) were compared. The parameters documented in the two databases were aligned and analysed regarding demographic parameters, treatment modalities, complications within first 24 h and retreatments. RESULTS The current analysis showed that data can be aligned for joint analyses with some adjustments within the data structure. The registry with more detailed data collection (EU-ROP) needs to be reduced regarding granularity in order to align the different registries, as the registry with lower granularity determines the level of analyses that can be performed in a comparative approach. In the exemplary datasets, we observed that the overall most common ROP severity in both registries was zone II, 3+ (2011: 70.5%; 2021: 65%), with decreasing numbers of clock hours showing preretinal neovascularisations (2011: 10-12 clock hours in 29% of cases, 2021: 4-6 clock hours in 38%). The most prevalent treatment method was laser coagulation in 2011 (75%) and anti-VEGF therapy in 2021 (86.1%). Within the anti-VEGF group, all patients were treated with bevacizumab in 2011 and with ranibizumab in 2021. Retreatment rates were comparable in 2011 and 2021. CONCLUSION Data from two different ROP registries can be aligned and jointly analysed. The analysis reveals a paradigm shift in treatment modalities, from predominantly laser to anti-VEGF, and within the anti-VEGF group from bevacizumab to ranibizumab in Germany. In addition, there was a trend towards earlier treatment in 2021.
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Affiliation(s)
- K Winter
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - J M Pfeil
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - H Engmann
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - S Aisenbrey
- Department of Ophthalmology, Vivantes Klinikum Neukoelln, Berlin, Germany
| | - B Lorenz
- Department of Ophthalmology, University Medicine Giessen and Marburg GmbH Giessen Campus, Giessen, Germany
| | - K Hufendiek
- University Eye Hospital, Hannover Medical School, Hannover, Germany
| | - H Breuss
- Department of Ophthalmology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - M Khattab
- Department of Ophthalmology, University Medical Center Goettingen, Goettingen, Germany
| | - D Süsskind
- University Eye Hospital, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - V Kakkassery
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | - W A Lagrèze
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - T Barth
- Department of Ophthalmology, University of Regensburg, Regensburg, Germany
| | - R Liegl
- Department of Ophthalmology, University Medicine Bonn, Bonn, Germany
| | - M C Bründer
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - C Skevas
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Goldammer
- Department of Ophthalmology, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - B Glitz
- Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
| | - E Michalewicz
- Department of Ophthalmology, University Hospital RWTH Aachen, Aachen, Germany
| | - T U Krohne
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - I R Bartmann
- Department of Ophthalmology, Klinikum Fulda, Faculty of Medicine/Campus Fulda, University of Marburg, Fulda, Germany
| | - A Stahl
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
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Winter K. Are tropical forests approaching critical temperature thresholds? Plant Biol (Stuttg) 2024. [PMID: 38477075 DOI: 10.1111/plb.13638] [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] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024]
Abstract
There is growing concern about the fate of tropical forests in the face of rising global temperatures. Doughty et al. (2023) suggest that an increase in air temperature beyond ∼4 °C will result in massive death of tropical forest leaves and potentially tree death. However, this prediction relies on assumptions that likely underestimate the heat tolerance of tropical leaves.
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Affiliation(s)
- K Winter
- Smithsonian Tropical Research Institute, Panama City, Republic of Panama
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Troillet A, Hildebrand J, Stoffel MH, Schwabe S, Winter K, Brehm W. Histo-morphological effects on equine synovium after arthroscopic synovectomy using two different motorized synovial resectors and two different intensities. J Equine Vet Sci 2024; 133:104988. [PMID: 38157949 DOI: 10.1016/j.jevs.2023.104988] [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: 07/12/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The purpose of the study was to determine the histo-morphological effects on villous synovium after synovectomy using two different motorized synovial resectors and two different intensities ex-vivo. Thirty-three (n = 33) equine metacarpophalangeal/metatarsophalangeal joints were used. Synovectomy was performed along the dorsomedial/dorsolateral synovium (n = 66) using two motorized synovial resectors (aggressive full radius resector, AFRR, used at two intensities: single treatment, n = 24 vs. triple treatment, n = 21 vs. aggressive meniscus side cutter, AMSC, n = 21). Arthroscopic images were evaluated blindly for resector type and intensity. Histological images were evaluated descriptive for synovial morphology and the extent of tissue loss using a microscopic scale. Scanning electron microscopy described the synovial morphology. The synovectomized areas were specific for each resector used and distinguishable from arthroscopic images. The AFRR demonstrated a clear demarcation between treated and non-treated areas and removed the stratum synoviale completely including parts of the underlying stratum fibrosum. In contrast, the AMSC showed less clear demarcation, villous scaffolds and no involvement of the stratum fibrosum. Triple intense treated AFFR samples resulted in significantly deeper lesions compared to single treatments (p = 0.037) but could not be distinguished on arthroscopic images. The morphological effects on villous synovium differ according to the resector type used. The extent of synovial tissue loss cannot be estimated from arthroscopic images but histologically. The type and use of motorized synovial resector determines the morphological alterations of the treated synovium. Arthroscopic control is considered unsuitable to control synovectomy depth.
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Affiliation(s)
- A Troillet
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 21, Leipzig 04103, Germany.
| | - J Hildebrand
- Equine Clinic, VetSuisse Faculty, University of Berne, Länggassstrasse 124, Berne 3012, Switzerland
| | - M H Stoffel
- Institute for Veterinary Anatomy, VetSuisse Faculty, University of Berne, Länggassstrasse 120, Berne 3001, Switzerland
| | - S Schwabe
- Institute for Veterinary Anatomy, VetSuisse Faculty, University of Berne, Länggassstrasse 120, Berne 3001, Switzerland
| | - K Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, Liebigstrasse 12, Leipzig 04103, Germany
| | - W Brehm
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 21, Leipzig 04103, Germany
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Faron M, Cheugoua-Zanetsie M, Tierney J, Thirion P, Nankivell M, Winter K, Yang H, Shapiro J, Vernerey D, Smithers BM, Walsh T, Piessen G, Nilsson M, Boonstra J, Ychou M, Law S, Cunningham D, de Vathaire F, Stahl M, Urba S, Valmasoni M, Williaume D, Thomas J, Lordick F, Tepper J, Roth J, Gebski V, Burmeister B, Paoletti X, van Sandick J, Fu J, Pignon JP, Ducreux M, Michiels S. Individual Participant Data Network Meta-Analysis of Neoadjuvant Chemotherapy or Chemoradiotherapy in Esophageal or Gastroesophageal Junction Carcinoma. J Clin Oncol 2023; 41:4535-4547. [PMID: 37467395 PMCID: PMC10553121 DOI: 10.1200/jco.22.02279] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/31/2023] [Accepted: 04/24/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE The optimal neoadjuvant treatment for resectable carcinoma of the thoracic esophagus (TE) or gastroesophageal junction (GEJ) remains a matter of debate. We performed an individual participant data (IPD) network meta-analysis (NMA) of randomized controlled trials (RCTs) to study the effect of chemotherapy or chemoradiotherapy, with a focus on tumor location and histology subgroups. PATIENTS AND METHODS All, published or unpublished, RCTs closed to accrual before December 31, 2015 and having compared at least two of the following strategies were eligible: upfront surgery (S), chemotherapy followed by surgery (CS), and chemoradiotherapy followed by surgery (CRS). All analyses were conducted on IPD obtained from investigators. The primary end point was overall survival (OS). The IPD-NMA was analyzed by a one-step mixed-effect Cox model adjusted for age, sex, tumor location, and histology. The NMA was registered in PROSPERO (CRD42018107158). RESULTS IPD were obtained for 26 of 35 RCTs (4,985 of 5,807 patients) corresponding to 12 comparisons for CS-S, 12 for CRS-S, and four for CRS-CS. CS and CRS led to increased OS when compared with S with hazard ratio (HR) = 0.86 (0.75 to 0.99), P = .03 and HR = 0.77 (0.68 to 0.87), P < .001 respectively. The NMA comparison of CRS versus CS for OS gave a HR of 0.90 (0.74 to 1.09), P = .27 (consistency P = .26, heterogeneity P = .0038). For CS versus S, a larger effect on OS was observed for GEJ versus TE tumors (P = .036). For the CRS versus S and CRS versus CS, a larger effect on OS was observed for women (P = .003, .012, respectively). CONCLUSION Neoadjuvant chemotherapy and chemoradiotherapy were consistently better than S alone across histology, but with some variation in the magnitude of treatment effect by sex for CRS and tumor location for CS. A strong OS difference between CS and CRS was not identified.
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Affiliation(s)
- Matthieu Faron
- Oncostat, CESP, Inserm U1018, University Paris-Saclay, labeled Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
| | - Maurice Cheugoua-Zanetsie
- Oncostat, CESP, Inserm U1018, University Paris-Saclay, labeled Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
| | - Jayne Tierney
- MRC Clinical Trial Unit at UCL, London, United Kingdom
| | | | | | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA
| | - Hong Yang
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Joel Shapiro
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - B. Mark Smithers
- University of Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - Thomas Walsh
- Connolly Hospital Blanchardstown, Dublin, Ireland
| | | | - Magnus Nilsson
- Division of Surgery, Department of Clinical Science, Intervention and Technoglogy, Karolinska Institutet, Stockholm, Sweden
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Simon Law
- Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - David Cunningham
- National Institute for Health Research, Biomedical Research Centres, Royal Marsden, London, United Kingdom
| | - Florent de Vathaire
- Oncostat, CESP, Inserm U1018, University Paris-Saclay, labeled Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
| | | | | | - Michele Valmasoni
- Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Center for Esophageal Diseases, Padova, Italy
| | | | - Janine Thomas
- Princess Alexandra Hospital, Woolloongabba, Australia
| | | | - Joel Tepper
- University of North Carolina School of Medicine, Chapel Hill, NC
| | | | | | | | | | - Johanna van Sandick
- The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jianhua Fu
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Jean-Pierre Pignon
- Oncostat, CESP, Inserm U1018, University Paris-Saclay, labeled Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
| | - Michel Ducreux
- Departement d’Oncologie Médicale, Gustave Roussy, Villejuif, France
| | - Stefan Michiels
- Oncostat, CESP, Inserm U1018, University Paris-Saclay, labeled Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
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Dawson L, Winter K, Knox J, Zhu A, Krishnan S, Guha C, Kachnic L, Gillin M, Hong T, Craig T, Hosni A, Chen E, Noonan A, Koay E, Sinha R, Lock M, Ohri N, Dorth J, Moughan J, Crane C. NRG/RTOG 1112: Randomized Phase III Study of Sorafenib vs. Stereotactic Body Radiation Therapy (SBRT) Followed by Sorafenib in Hepatocellular Carcinoma (HCC) (NCT01730937). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.002] [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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Vicini F, Winter K, Freedman G, Arthur D, Hayman J, Rosenstein B, Bentzen S, Li A, Lyons J, Tomberlin J, Seaward S, Cheston S, Coster J, Anderson B, Perera F, Poppe M, Petersen I, Bazan J, Moughan J, White J. NRG RTOG 1005: A Phase III Trial of Hypo Fractionated Whole Breast Irradiation with Concurrent Boost vs. Conventional Whole Breast Irradiation Plus Sequential Boost Following Lumpectomy for High Risk Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2320] [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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Moor I, Schneider A, Niederschuh L, Winter K, Richter M. How can school-based interventions reduce health inequalities? Results from two reviews. Eur J Public Health 2022; 32:ckac129.161. [PMCID: PMC9593703 DOI: 10.1093/eurpub/ckac129.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Background Even in young people the chances to grow up healthy are unequal, depending on their socioeconomic position (SEP). In order to reduce these health inequalities, the school is an important field of action for health promotion. However, the evidence is limited regarding interventions focusing on health inequalities. Thus, the aim of the current research is to investigate 1) which school-based interventions contribute to the reduction of socio-economic inequalities in health and health behaviour of children and adolescents and 2) how and under what conditions they are successful. Methods A systematic and a realist review were conducted. Some steps of the methodological approach were used synergistically for both reviews: development of the search strategy, selection of the databases (MEDLINE, SSCI, SCIE, DoPHER and TRoPHI) and some inclusion and exclusion criteria. The search covered the years 2000-2020. The screening and subsequent steps were applied specific to each review design. Preliminary results The search resulted in 10,524 hits of which 37 publications were included for the systematic review. Most of the interventions focused on nutrition (14), followed by mental health (8) and substance use (5). The results indicate that structural preventive interventions are more likely to reduce health inequalities compared to behavioral preventive interventions. For the Realist Review 7 studies were included. Intrapersonal, interpersonal, and institutional factors were extracted that are relevant for school-based interventions focusing on adolescents with low SEP. Conclusions The systematic review showed that school-based interventions are able to reduce health inequalities, but also to increase them. Structural preventive measures seem to be helpful in increasing health equity. The Realist review identified mechanisms of interventions which help to address students with lower SEP. Key messages • The evidence regarding interventions with focus on health inequalities is limited. We present two reviews analysing what interventions are needed and how and why they work. • Structural preventive measures seem to be helpful in increasing health equity. Factors on the intrapersonal, interpersonal, and institutional level are important to address students with low SEP.
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Affiliation(s)
- I Moor
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Sociology, Medical Faculty, Halle, Germany
| | - A Schneider
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Sociology, Medical Faculty, Halle, Germany
| | - L Niederschuh
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Sociology, Medical Faculty, Halle, Germany
| | - K Winter
- Martin-Luther-University Halle-Wittenberg, Institute of Medical Sociology, Medical Faculty, Halle, Germany
| | - M Richter
- Technical University of Munich, Department of Sport and Health Sciences, Munich, Germany
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Moor I, Winter K, Markert J, Richter M. Die HBSC-Studie Sachsen-Anhalt. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753892] [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] [Indexed: 12/12/2022]
Affiliation(s)
- I Moor
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie (IMS), Halle (Saale),
Deutschland
| | - K Winter
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie (IMS), Halle (Saale),
Deutschland
| | - J Markert
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie (IMS), Halle (Saale),
Deutschland
| | - M Richter
- Technische Universität München, Lehrstuhl für
Soziale Determinanten der Gesundheit, München, Deutschland
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Winter K, Jung A, Ulrich HS, Schneider N, Brzank PJ. Belastungen, Ressourcen und Versorgungsbedarfe von ungewollt
Schwangeren mit Gewalterfahrungen in intimen Paarbeziehungen: ein Realist
Review. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753591] [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: 12/12/2022]
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11
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Runow C, Moor I, Winter K. HBSC-Studie Sachsen-Anhalt: Chancen und Herausforderungen für
die soziallagenbezogene Gesundheitsförderung in der schulischen und
kommunalen Lebenswelt. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753891] [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] [Indexed: 12/12/2022]
Affiliation(s)
- C Runow
- IKK gesund plus, Grundsatzfragen Prävention, Magdeburg,
Deutschland
| | - I Moor
- Martin-Luther-Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle, Deutschland
| | - K Winter
- Martin-Luther-Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle, Deutschland
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12
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Moor I, Winter K, Richter M. Herausforderungen und Strategien in der Rekrutierung von Schulen:
Erfahrungen der „Health Behaviour in School-aged Children
(HBSC)“ Studie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753946] [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] [Indexed: 12/12/2022]
Affiliation(s)
- I Moor
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie (IMS), Halle (Saale),
Deutschland
| | - K Winter
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie (IMS), Halle (Saale),
Deutschland
| | - M Richter
- Technische Universität München, Lehrstuhl für
Soziale Determinanten der Gesundheit, München, Deutschland
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Ulrich HS, Markert J, Jung A, Winter K, Laué M, Brzank PJ. Ressourcen, Belastungen und Versorgungsbedarfe von ungewollt
schwangeren geflüchteten und „illegalisierten“ Frauen:
ein Realist-Review. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753590] [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] [Indexed: 12/12/2022]
Affiliation(s)
- H-S Ulrich
- Hochschule Nordhausen, Institut für Sozialmedizin,
Rehabilitationswissenschaften und Versorgungsforschung, Nordhausen,
Deutschland
| | - J Markert
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie (IMS), Halle (Saale),
Deutschland
| | - A Jung
- Hochschule Nordhausen, Institut für Sozialmedizin,
Rehabilitationswissenschaften und Versorgungsforschung, Nordhausen,
Deutschland
| | - K Winter
- Hochschule Nordhausen, Institut für Sozialmedizin,
Rehabilitationswissenschaften und Versorgungsforschung, Nordhausen,
Deutschland
| | - M Laué
- Hochschule Nordhausen, Institut für Sozialmedizin,
Rehabilitationswissenschaften und Versorgungsforschung, Nordhausen,
Deutschland
| | - PJ Brzank
- Hochschule Nordhausen, Institut für Sozialmedizin,
Rehabilitationswissenschaften und Versorgungsforschung, Nordhausen,
Deutschland
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Cabrit N, Faron M, Tierney J, Cheugoua-Zanetsie M, Thirion P, Cunningham D, Winter K, Fu J, Mauer M, Shapiro J, Burmeister B, Walsh T, Piessen G, Klevebro F, Ychou M, Van Der Gaast A, Law S, Stahl M, Paoletti X, Ducreux M, Michiels S. SO-5 Disease-free survival as surrogate for overall survival in neoadjuvant chemo(radio)therapy treatment of esophageal or gastro-esophageal junction carcinoma: An analysis of 4518 individual patients and 22 trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.404] [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: 11/01/2022] Open
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15
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Faron M, Cheugoua-Zanetsie M, Thirion P, Tierney J, Cunningham D, Winter K, Fu J, Mauer M, Shapiro J, Burmeister B, Walsh T, Piessen G, Klevebro F, Ychou M, Van Der Gaast A, Law S, Stahl M, van Sandick J, Pignon J, Ducreux M, Michiels S. SO-4 Individual participant data network meta-analysis (IPD-NMA) of neoadjuvant chemotherapy or chemoradiotherapy in esophageal or gastro-esophageal junction carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.403] [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: 11/01/2022] Open
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Safran HP, Winter K, Ilson DH, Wigle D, DiPetrillo T, Haddock MG, Hong TS, Leichman LP, Rajdev L, Resnick M, Kachnic LA, Seaward S, Mamon H, Diaz Pardo DA, Anderson CM, Shen X, Sharma AK, Katz AW, Salo J, Leonard KL, Moughan J, Crane CH. Trastuzumab with trimodality treatment for oesophageal adenocarcinoma with HER2 overexpression (NRG Oncology/RTOG 1010): a multicentre, randomised, phase 3 trial. Lancet Oncol 2022; 23:259-269. [PMID: 35038433 PMCID: PMC8903071 DOI: 10.1016/s1470-2045(21)00718-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Trastuzumab is a monoclonal antibody against HER2 (also known as ERBB2). The primary objective of the NRG Oncology/RTOG-1010 trial was to establish whether trastuzumab improves disease-free survival when combined with trimodality treatment (paclitaxel plus carboplatin and radiotherapy, followed by surgery) for patients with untreated HER2-overexpressing oesophageal adenocarcinoma. METHODS NRG Oncology/RTOG-1010 was an open label, randomised, phase 3 trial for which patients were accrued from 111 NRG-affiliated institutions in the USA. Eligible patients were adults (aged ≥18 years) with newly diagnosed pathologically confirmed oesophageal adenocarcinoma, American Joint Committee on Cancer 7th edition T1N1-2 or T2-3N0-2 stage disease, and a Zubrod performance status of 0-2. Patients were stratified by adenopathy (no vs yes [coeliac absent] vs yes [coeliac present ≤2 cm]) and randomly assigned (1:1) to receive weekly intravenous paclitaxel (50 mg/m2 intravenously over 1 h) and carboplatin (area under the curve 2, intravenously over 30-60 min) for 6 weeks with radiotherapy 50·4 Gy in 28 fractions (chemoradiotherapy) followed by surgery, with or without intravenous trastuzumab (4 mg/kg in week one, 2 mg/kg per week for 5 weeks during chemoradiotherapy, 6 mg/kg once presurgery, and 6 mg/kg every 3 weeks for 13 treatments starting 21-56 days after surgery). The primary endpoint, disease-free survival, was defined as the time from randomisation to death or first of locoregional disease persistence or recurrence, distant metastases, or second primary malignancy. Analyses were done by modified intention to treat. This study is registered with Clinicaltrials.gov, NCT01196390; it is now closed and in follow-up. FINDINGS 606 patients were entered for HER2 assessment from Dec 30, 2010 to Nov 10, 2015, and 203 eligible patients who were HER2-positive were enrolled and randomly assigned to chemoradiotherapy plus trastuzumab (n=102) or chemoradiotherapy alone (n=101). Median duration of follow-up was 2·8 years (IQR 1·4-5·7). Median disease-free survival was 19·6 months (95% CI 13·5-26·2) with chemoradiotherapy plus trastuzumab compared with 14·2 months (10·5-23·0) for chemoradiotherapy alone (hazard ratio 0·99 [95% CI 0·71-1·39], log-rank p=0·97). Grade 3 treatment-related adverse events occurred in 41 (43%) of 95 patients in the chemoradiotherapy plus trastuzumab group versus 52 (54%) of 96 in the chemoradiotherapy group and grade 4 events occurred in 20 (21%) versus 21 (22%). The most common grade 3 or worse treatment-related adverse events for both groups were haematological (53 [56%] of 95 patients in the chemoradiotherapy plus trastuzumab group vs 55 [57%] of 96 patients in the chemotherapy group) or gastrointestinal disorders (28 [29%] vs 20 [21 %]). 34 (36%) of 95 patients in the chemoradiotherapy plus trastuzumab group and 27 (28%) of 96 patients in the chemoradiotherapy only group had treatment-related serious adverse events. There were eight treatment-related deaths: five (5%) of 95 patients in the chemoradiotherapy plus trastuzumab group (bronchopleural fistula, oesophageal anastomotic leak, lung infection, sudden death, and death not otherwise specified), and three (3%) of 96 in the chemoradiotherapy group (two multiorgan failure and one sepsis). INTERPRETATION The addition of trastuzumab to neoadjuvant chemoradiotherapy for HER2-overexpressing oesophageal cancer was not effective. Trastuzumab did not lead to increased toxicities, suggesting that future studies combining it with or using other agents targeting HER2 in oesophageal cancer are warranted. FUNDING National Cancer Institute and Genentech.
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Kachnic LA, Winter K, Myerson RJ, Goodyear MD, Abitbol AA, Streeter OE, Augspurger ME, Schefter TE, Katz AW, Fisher BJ, Henke LE, Narayan S, Crane CH. Long-Term Outcomes of NRG Oncology/RTOG 0529: A Phase 2 Evaluation of Dose-Painted Intensity Modulated Radiation Therapy in Combination With 5-Fluorouracil and Mitomycin-C for the Reduction of Acute Morbidity in Anal Canal Cancer. Int J Radiat Oncol Biol Phys 2022; 112:146-157. [PMID: 34400269 PMCID: PMC8688291 DOI: 10.1016/j.ijrobp.2021.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 04/19/2021] [Revised: 07/28/2021] [Accepted: 08/05/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE A multi-institutional phase 2 trial assessed long-term outcomes of dose-painted intensity modulated radiation therapy (IMRT) with 5-fluorouracil (5FU) and mitomycin-C (MMC) for anal canal cancer. METHODS AND MATERIALS T2-4N0-3M0 anal cancers received 5FU (1000 mg/m2/d, 96-hour infusion) and MMC (10 mg/m2 bolus) on days 1 and 29 of dose-painted IMRT prescribed as follows: T2N0 = 42 Gy elective nodal and 50.4 Gy anal tumor planning target volumes, 28 fractions; T3-4N0-3 = 45Gy elective nodal, 50.4 Gy ≤3 cm and 54 Gy >3cm metastatic nodal and 54 Gy anal tumor planning target volumes, 30 fractions. Local-regional failures, distant metastases, and colostomy failures were assessed using the cumulative incidence method, and disease-free survival, overall survival, and colostomy-free survival were assessed using the Kaplan-Meier method. Late effects were scored using National Cancer Institute-Common Terminology Criteria for Adverse Events v3. RESULTS Of 52 patients, 54% were stage II, 25% were stage IIIA, and 21% were stage IIIB. Median follow-up was 7.9 years (min-max, 0.02-9.2 years). Local-regional failure, colostomy failures, distant metastases, overall survival, disease-free survival, and colostomy-free survival at 5 years are 16% (95% confidence interval [CI], 7%-27%), 10% (95% CI, 4%-20%), 16% (95% CI, 7%-27%), 76% (95% CI, 61%-86%), 70% (95% CI, 56%-81%), and 74% (95% CI, 59%-84%); and at 8 years they are 16% (95% CI, 7%-27%), 12% (95% CI, 5%-23%), 22% (95% CI, 12%-34%), 68% (95% CI, 53%-79%), 62% (95% CI, 47%-74%) and 66% (95% CI, 51%-77%), respectively. Eight patients experienced local-regional failure, with 5 patients having persistent disease at 12 weeks. No isolated nodal failures occurred in the microscopic elective nodal volumes. Six patients required colostomy-5 for local-regional salvage and 1 for a temporary ostomy for anorectal dysfunction. Rates of late adverse events included: 28 patients (55%) with grade 2, 8 patients (16%) with grade 3, 0 patients with grade 4, and 2 patients (4%) with grade 5 events (sinus bradycardia and myelodysplasia, possibly owing to chemotherapy). Only 11 patients reported grade 1 to 3 sexual dysfunction. CONCLUSIONS Dose-painted IMRT with 5FU/MMC for the treatment of anal canal cancer yields comparable long-term efficacy as conventional radiation cohorts. Enhanced normal tissue protection lowered rates of grade 3 and higher late effects without compromising pelvic tumor control.
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Siegel EM, Ajidahun A, Berglund A, Guerrero W, Eschrich S, Putney RM, Magliocco A, Riggs B, Winter K, Simko JP, Ajani JA, Guha C, Okawara GS, Abdalla I, Becker MJ, Pizzolato JF, Crane CH, Brown KD, Shibata D. Genome-wide host methylation profiling of anal and cervical carcinoma. PLoS One 2021; 16:e0260857. [PMID: 34882728 PMCID: PMC8659695 DOI: 10.1371/journal.pone.0260857] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022] Open
Abstract
HPV infection results in changes in host gene methylation which, in turn, are thought to contribute to the neoplastic progression of HPV-associated cancers. The objective of this study was to identify joint and disease-specific genome-wide methylation changes in anal and cervical cancer as well as changes in high-grade pre-neoplastic lesions. Formalin-fixed paraffin-embedded (FFPE) anal tissues (n = 143; 99% HPV+) and fresh frozen cervical tissues (n = 28; 100% HPV+) underwent microdissection, DNA extraction, HPV genotyping, bisulfite modification, DNA restoration (FFPE) and analysis by the Illumina HumanMethylation450 Array. Differentially methylated regions (DMR; t test q<0.01, 3 consecutive significant CpG probes and mean Δβ methylation value>0.3) were compared between normal and cancer specimens in partial least squares (PLS) models and then used to classify anal or cervical intraepithelial neoplasia-3 (AIN3/CIN3). In AC, an 84-gene PLS signature (355 significant probes) differentiated normal anal mucosa (NM; n = 9) from AC (n = 121) while a 36-gene PLS signature (173 significant probes) differentiated normal cervical epithelium (n = 10) from CC (n = 9). The CC progression signature was validated using three independent publicly available datasets (n = 424 cases). The AC and CC progression PLS signatures were interchangeable in segregating normal, AIN3/CIN3 and AC and CC and were found to include 17 common overlapping hypermethylated genes. Moreover, these signatures segregated AIN3/CIN3 lesions similarly into cancer-like and normal-like categories. Distinct methylation changes occur across the genome during the progression of AC and CC with overall similar profiles and add to the evidence suggesting that HPV-driven oncogenesis may result in similar non-random methylomic events. Our findings may lead to identification of potential epigenetic drivers of HPV-associated cancers and also, of potential markers to identify higher risk pre-cancerous lesions.
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Affiliation(s)
- Erin M. Siegel
- Departments of Cancer Epidemiology, Tampa, FL, United States of America
| | - Abidemi Ajidahun
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Anders Berglund
- Biostatistics and Bioinformatics, Tampa, FL, United States of America
| | - Whitney Guerrero
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Steven Eschrich
- Biostatistics and Bioinformatics, Tampa, FL, United States of America
| | - Ryan M. Putney
- Biostatistics and Bioinformatics, Tampa, FL, United States of America
| | - Anthony Magliocco
- Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States of America
| | - Bridget Riggs
- Departments of Cancer Epidemiology, Tampa, FL, United States of America
| | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center–ACR, Philadelphia, PA, United States of America
| | - Jeff P. Simko
- UCSF Medical Center-Mount Zion, San Francisco, CA, United States of America
| | - Jaffer A. Ajani
- M D Anderson Cancer Center, Houston, TX, United States of America
| | - Chandan Guha
- Montefiore Medical Center, New York, NY, United States of America
| | - Gordon S. Okawara
- Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, ON, United States of America
| | - Ibrahim Abdalla
- Cancer Research for the Ozarks CCOP, Springfield, MO, United States of America
| | - Mark J. Becker
- Columbus Community Clinical Oncology Program, Columbus, OH, United States of America
| | - Joseph F. Pizzolato
- Mount Sinai Comprehensive Cancer Center CCOP, Miami, FL, United States of America
| | | | - Kevin D. Brown
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, United States of America
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, United States of America
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Faron M, Cheugoua-Zanetsie AM, Thirion P, Nankivell M, Winter K, Cunningham D, Van der Gaast A, Law S, Langley R, de Vathaire F, Valmasoni M, Mauer M, Roth J, Gebski V, Burmeister BH, Paoletti X, van Sandick J, Fu J, Ducreux M, Blanchard P, Tierney J, Pignon JP, Michiels S. Individual patient data meta-analysis of neoadjuvant chemotherapy followed by surgery versus upfront surgery for carcinoma of the oesophagus or the gastro-oesophageal junction. Eur J Cancer 2021; 157:278-290. [PMID: 34555647 DOI: 10.1016/j.ejca.2021.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/17/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Which neoadjuvant treatment for locally advanced thoracic oesophagus (TE) or gastro-oesophageal junction carcinoma is best remains an open question. Randomised controlled trials variously accrued patients with adenocarcinoma and squamous cell carcinoma, making strong conclusions hard to obtain. The primary objective of this individual participant data meta-analysis was to investigate the effect of neoadjuvant chemotherapy on overall survival (OS). PATIENTS AND METHODS Eligible trials should have closed to accrual before 2016 and compared neoadjuvant chemotherapy and surgery (CS) to surgery alone. All relevant published and unpublished trials were identified via searches of electronic databases, conference proceedings and clinical trial registers. The main end-point was OS. Investigators were contacted to obtain the individual patient data, which was recorded, harmonised and checked. A random-effects Cox model, stratified by trial, was used for meta-analysis and subgroup analyses were preplanned. RESULTS 16 trials were identified as eligible. Individual patient data were obtained from 12 trial and 2478 patients. CS was associated with an improved OS versus surgery, hazard ratio (HR) = 0.83 [0.72-0.96], p < 0.0001, translating to an absolute benefit of 5.7% at 5-years from 16.8% to 22.5%. Treatment effects did not vary substantially between adenocarcinoma (HR = 0.73 [0.62-0.87]) and squamous cell carcinoma (HR = 0.91 [0.76-1.08], interaction p = 0.26). A somewhat more pronounced effect was observed in gastro-oesophageal junction (HR = 0.68 [0.50-0.93]) versus TE (HR = 0.87 [0.75-1.00], interaction p = 0.07). CS was also associated with a greater disease-free survival (HR = 0.74 [0.64-0.85], p < 0.001). CONCLUSIONS Neoadjuvant chemotherapy conferred a better OS than surgery alone and should be considered in all anatomical location and histological subtypes.
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Affiliation(s)
- Matthieu Faron
- Oncostat U1018, Inserm, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France; Service de Chirurgie Viscérale Oncologique, Gustave Roussy Cancer Campus, Villejuif, France.
| | - Armel Maurice Cheugoua-Zanetsie
- Oncostat U1018, Inserm, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France; Bureau de Biostatistiques et Epidémiologie, Gustave Roussy Cancer Campus, Villejuif, France
| | | | | | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA, United States
| | - David Cunningham
- National Institute for Health Research, Biomedical Research Centres, Royal Marsden, London, UK
| | - Ate Van der Gaast
- Department of Medical Oncology, Erasmus MC, Rotterdam, the Netherlands
| | - Simon Law
- Department of Surgery, The University of Hong Kong, Hong Kong, SAR, China
| | | | - Florent de Vathaire
- Epidémiologie des Radiations U1018, Inserm, Université Paris-Saclay, Villejuif, France
| | - Michele Valmasoni
- Padova University Hospital, Center for Esophageal Diseases, Department of Surgery, Oncology and Gastroenterology, Padova, Italy
| | | | - Jack Roth
- Department of Thoracic and Cardiovascular Surgery, Division of Surgery, MD Anderson, Houston, United States
| | - Val Gebski
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
| | | | - Xavier Paoletti
- Département de Biostatistiques, Institut Curie, Paris, France
| | - Johanna van Sandick
- Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Jianhua Fu
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Michel Ducreux
- Département de Médecine Oncologique, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif France, France
| | - Pierre Blanchard
- Oncostat U1018, Inserm, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France; Département de Radiothérapie, Gustave Roussy Cancer Campus, France
| | | | - Jean-Pierre Pignon
- Oncostat U1018, Inserm, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France; Bureau de Biostatistiques et Epidémiologie, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stefan Michiels
- Oncostat U1018, Inserm, Université Paris-Saclay, Équipe Labellisée Ligue Contre le Cancer, Villejuif, France; Bureau de Biostatistiques et Epidémiologie, Gustave Roussy Cancer Campus, Villejuif, France
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Spychalski M, Włodarczyk M, Winter K. Impact of COVID-19 pandemic on endoscopic submucosal dissection outcomes in early colorectal tumours. Br J Surg 2021; 108:e224-e225. [PMID: 33713112 PMCID: PMC7989635 DOI: 10.1093/bjs/znab079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/07/2021] [Indexed: 11/14/2022]
Affiliation(s)
| | - M Włodarczyk
- Department of General and Colorectal Surgery, Medical University of Lodz, Lodz, Poland
| | - K Winter
- Center of Bowel Treatment, Brzeziny, Poland
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Körfer J, Hußtegge M, Gockel I, Monecke A, Schumacher G, Weimann A, Winter K, Bechmann I, Lordick F, Kallendrusch S. 100P Patient-derived tissue cultures of esophagogastric-junction cancer (EGJC) and gastric cancer (GC): An ex vivo model to study individual response of immunotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.589] [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: 11/27/2022] Open
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Ah Kim I, Winter K, Sperduto P, De Los Santos J, Peereboom D, Ogunleye T, Boulter D, Cho KH, Shin KH, Zoberi I, Choi S, Palmer J, Liem B, Kim YB, Anderson B, Thakrar A, Muanza T, Kim M, Choi DH, White J, Mehta M. CTNI-05. NRG ONCOLOGY / RTOG 1119: PHASE II RANDOMIZED STUDY OF WHOLE BRAIN RADIOTHERAPY / STEREOTACTIC RADIOSURGERY WITH CONCURRENT LAPATINIB IN PATIENTS WITH BRAIN METASTASES FROM HER2-POSITIVE BREAST CANCER. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.172] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Trastuzumab/pertuzumab improved outcomes for patients (pts) with HER2+ breast cancer. Increased survival coupled with limited blood-brain barrier (BBB) penetration of these agents apparently contributes to increased incidence of brain metastases (BM). Lapatinib (L) crosses the BBB and demonstrates activity against BM. Based upon pre/early clinical data, it’s hypothesized that L + whole brain radiotherapy (WBRT) or Stereotactic Radiosurgery (SRS) would improve intracranial control compared to WBRT/SRS (RT) alone. This randomized phase II trial included HER2+ breast cancer pts with ≥ 1 measurable, unirradiated parenchymal BM. Pts were randomized 1:1 to WBRT (37.5 Gy/3 weeks) or SRS +/- concurrent L (1000 mg dailyx6 weeks), andwere stratified by graded prognostic assessment (GPA), use of non-CNS penetrating anti-HER2 therapies, and previous SRS/resection. The primary endpoint was intracranial complete response (CR) rate 12weeks (wk) after RT. Secondary endpoints included objective response rate (ORR), lesion-specific response rate, CNS progression-free survival, and overall survival. 114 of 143 pts were evaluable for 12-wk CR (52 RT, 62 RT+L). Rate of grade 3 and 4 adverse events were 8% and 0% for RT and 29% and 6% for RT+L. 92% and 90% pts received concurrent and adjuvant L per protocol/acceptable variation. There were no significant differences in 12 or 4wk CR rates (p=0.97 and p=0.77); 5.8% and 0% at 12wk and 3.6% and 1.5% at 4wk for RT and RT+L, respectively. The ORR at 4 wk was 42% and 56% (p=0.059, RECIST), 40% and 58% (p=0.027, WHO) in the RT and RT+L, respectively. Although the addition of lapatinib to WBRT/SRS did not improve the 12wk CR rate, it showed meaningful clinical benefit by demonstrating a trend toward improvement of 4 wk ORR. Results of ongoing central review of MRIs using RECIST1.1, WHO and RANO-BM criteria including secondary endpointswill be reported. Support: NCI grants U10CA180868, U10CA180822, UG1CA189867, and Novartis
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Affiliation(s)
- In Ah Kim
- Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA, USA
| | - Paul Sperduto
- Minneapolis Radiation Oncology, Minneapolis, MN, USA
| | | | | | | | - Daniel Boulter
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kwan Ho Cho
- National Cancer Center, Goyang, Republic of Korea
| | | | - Imran Zoberi
- Washington University School of Medicine, St. Louis, MO, USA
| | - Serah Choi
- University Hospitals Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH, USA
| | | | - Ben Liem
- New Mexico Minority Underserved NCORP, Albuquerque, NM, USA
| | - Yong Bae Kim
- Yonsei University Health System-Severance Hospital, Seoul, Republic of Korea
| | | | - Anupama Thakrar
- Stroger Hospital of Cook County Minority Underserved NCORP, Chicago, IL, USA
| | | | - Michelle Kim
- University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - Doo Ho Choi
- Samsung Medical Center, Seoul, Republic of Korea
| | - Julia White
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Pietzka S, Mascha F, Winter K, Kämmerer PW, Sakkas A, Schramm A, Wilde F. Clinical Accuracy of 3D-Planned Maxillary Positioning Using CAD/CAM-Generated Splints in Combination With Temporary Mandibular Fixation in Bimaxillary Orthognathic Surgery. Craniomaxillofac Trauma Reconstr 2020; 13:290-299. [PMID: 33456700 DOI: 10.1177/1943387520949348] [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] [Indexed: 11/15/2022] Open
Abstract
Study Design The aim of this study was to evaluate the accuracy of 3-dimensional (3D)-planned maxillary positioning by using computer-assisted design (CAD)/computer-assisted manufacturing (CAM) splints combined with temporary mandibular fixation in bimaxillary orthognathic surgery. In orthognathic surgery, customized splints work sufficiently well to transfer preoperative planning into the operation site for transverse und sagittal positioning of the maxilla. The vertical positioning is more difficult due to the non-fixed mandibular reference. Therefore, the combined use of CAD/CAM splints and temporary mandibular fixation to the zygomatic region was applied for transferring the 3D-planned maxillary position into the operation site from 2012 until 2015 in our hospital. Objective In addition to the general accuracy, the precision should therefore be checked especially in the vertical plane compared to axial and sagittal plane. Methods In this retrospective study, we calculated the deviation of 5 occlusal landmarks of the maxilla in 35 consecutive patients by fusing preoperative 3D planning images and postoperative computed tomography scans after bimaxillary surgery. Results The overall median deviation of maxillary positioning between plan and surgical result was 0.99 mm. The accuracy of left-right positioning was median 0.96 mm. Anterior-posterior positioning of the maxilla showed a median accuracy of 0.94 mm. Just slightly higher values were determined for the upward-downward positioning (median 1.06 mm). Conclusions This demonstrates the predictability of maxillary positioning by using CAD/CAM splints in combination with temporary mandibular fixation in all 3 axes.
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Affiliation(s)
- S Pietzka
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Ulm, Germany.,Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Ulm, Germany
| | - F Mascha
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Ulm, Germany.,Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Ulm, Germany
| | - K Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - P W Kämmerer
- Department of Cranio-Maxillofacial Surgery, University Medical Centre Mainz, Mainz, Germany
| | - A Sakkas
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Ulm, Germany
| | - A Schramm
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Ulm, Germany.,Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Ulm, Germany
| | - F Wilde
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Ulm, Germany.,Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Ulm, Germany
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Beyer NF, Troillet A, Winter K, Brehm W, Scharner D. Diagnosis and management of cryptorchid horses – a retrospective analysis of 86 cases. PFERDEHEILKUNDE 2020. [DOI: 10.21836/pem20200303] [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: 11/27/2022]
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Troillet A, Winter K, Behrens C, Gerlach K. Retrospective analysis of endoscopic versus needle lavage in horses with traumatically injured joints and tendon sheaths. PFERDEHEILKUNDE 2020. [DOI: 10.21836/pem20200207] [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: 11/27/2022]
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De Sedas A, González Y, Winter K, Lopez OR. Seedling responses to salinity of 26 Neotropical tree species. AoB Plants 2019; 11:plz062. [PMID: 31788179 PMCID: PMC6876892 DOI: 10.1093/aobpla/plz062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 08/16/2019] [Indexed: 05/31/2023]
Abstract
Sea-level rise will result in increased salinization of coastal areas. Soil salinity is a major abiotic stress that reduces plant growth, yet tolerance to salinity varies across environmental conditions, habitats and species. To determine salinity tolerance of 26 common tropical tree species from Panama, we measured growth, gas exchange and mortality of 3-month-old seedlings subjected to weekly irrigation treatments using five seawater solutions (0 % = control, 20, 40, 60 and 90 % V/V of seawater) for ~2 months. In general, species from coastal areas were more tolerant to increased seawater concentration than inland species. Coastal species such as Pithecellobium unguis-cati, Mora oleifera, Terminalia cattapa and Thespesia populnea maintained growth rates close to those of controls at 90 % seawater. In contrast, inland species such as Minquartia guainensis, Apeiba membranacea, Ormosia coccinea and Ochroma pyramidale showed strong reductions in growth rates and high mortality. Plant height and leaf production also differed greatly between the two groups of plants. Furthermore, measurements of gas exchange parameters, i.e. stomatal conductance and maximum photosynthetic rate, were consistent with the contrasting growth responses of coastal and inland species. Our research reveals a great degree of variation in salinity tolerance among tropical tree species and demonstrates a close relationship between species habitat and the ability to thrive under increasing salt concentration in the soil, with coastal species being better adapted to withstand increased soil salinity than non-costal species.
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Affiliation(s)
- A De Sedas
- Centro de Biodiversidad y Descubrimiento de Drogas, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Ciudad del Saber, Clayton, Panamá, República de Panamá
- Department of Biotechnology, Acharya Nagarjuna University, Guntur, Andhra Pradesh, India
| | - Y González
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panamá, República de Panamá
| | - K Winter
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panamá, República de Panamá
| | - O R Lopez
- Centro de Biodiversidad y Descubrimiento de Drogas, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Ciudad del Saber, Clayton, Panamá, República de Panamá
- Smithsonian Tropical Research Institute, Balboa, Ancón, Panamá, República de Panamá
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Rivin del Campo E, Matzinger O, Haustermans K, Bosset JF, Glynne-Jones R, Winter K, Konski A, Ajani J, Peiffert D, Hannoun-Lévi JM, Puyraveau M, Chakravarthy B, Meadows H, Northover J, Collette L, Christiaens M, Maingon P. Analyse des données regroupées de paramètres de radiothérapie externe d’essais de phase II et III de chimioradiothérapie du cancer de canal anal. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bouvier C, Winter K. Findings from a new specialist remote counselling service for neuroendocrine neoplasm (NEN) patients and family members. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz256.018] [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: 11/13/2022] Open
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White J, Winter K, Cecchini R, Vicini F, Arthur D, Kuske R, Rabinovitch R, Sehkon A, Khan A, Chmura S, Shaitelman S, McCormick B, Julian T, Rogers C, Bear H, Petersen I, Gustafson G, Grossheim L, Mamounas E, Ganz P. Cosmetic Outcome from Post Lumpectomy Whole Breast Irradiation (WBI) Versus Partial Breast Irradiation (PBI) on the NRG Oncology/NSABP B39-RTOG 0413 Phase III Clinical Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.384] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kim IA, Winter K, Peereboom D, Sperduto P, De Los Santos J, Ogunleye T, Boulter D, White J, Mehta M. TRLS-09. RTOG1119: PHASE II RANDOMIZED STUDY OF WHOLE BRAIN RADIOTHERAPY / STEREOTACTIC RADIOSURGERY IN COMBINATION WITH CONCURRENT LAPATINIB IN PATIENTS WITH BRAIN METASTASIS FROM HER2-POSITIVE BREAST CANCER. Neurooncol Adv 2019. [PMCID: PMC7213269 DOI: 10.1093/noajnl/vdz014.042] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
The addition of trastuzumab to cytotoxic chemotherapy has improved outcomes for patients with HER2 positive breast cancer. Increased survival coupled with limited blood-brain barrier (BBB) penetration of trastuzumab may contribute to the increased incidence of brain metastasis in these patients. Half of these patients die of intracranial disease progression rather than extracranial disease. Therefore, strategies to improve survival must include increased CNS disease control in these patients. Lapatinib crosses the BBB and demonstrates modest activity against intracranial metastases. Based upon preclinical data and results of a phase I study, we hypothesized that lapatinib plus WBRT /SRS can improve the intracranial disease control compared to WBRT / SRS alone. A randomized phase II trial of WBRT (37.5 Gy/3 weeks) or SRS plus or minus concurrent lapatinib (daily 1000 mg for 6 weeks) was initiated. CNS penetrating HER2 targeted therapy is permitted throughout the study, but patients not on trastuzumab, pertuzumab or any other breast cancer therapy at study entry are not permitted to begin this therapy while on protocol treatment, but may begin it 24 hours after completion of protocol treatment. Eligibility includes HER2+ breast cancer with at least one measurable, unirradiated parenchymal brain metastasis. The two populations targeted for accrual include patients with 1) newly diagnosed, multiple brain metastases or 2) progressive brain metastases after stereotactic radiosurgery (SRS) or surgical resection of 1–3 metastases. Prior lapatinib is allowed. Patients are stratified by breast-specific graded prognostic assessment; use of non-CNS penetrating HER2 targeted therapy; and prior SRS or surgical resection. The primary endpoint is complete response rate in the brain 12 weeks after WBRT. Secondary endpoints include objective response rate, lesion-specific response rate, CNS progression-free survival, and overall survival. 140 of 143 target accrual have enrolled (4/22/2019).
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Affiliation(s)
- In Ah Kim
- Seoul National University, Seoul, Republic of Korea
| | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA, USA
| | | | - Paul Sperduto
- Ridgeview Regional Radiation Oncology, Saint Louis Park, MN, USA
| | | | - Tomi Ogunleye
- Northside Hospital Cancer Institute, Atlanta, GA, USA
| | - Daniel Boulter
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Julia White
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Siegmund B, Winter K, Meyer-Marcotty P, Rustemeyer J. Alloplastic reconstruction of the temporomandibular joint for rehabilitation of function and pain reduction. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wilde F, Aigeldinger S, Sakkas A, Pietzka S, Winter K, Schramm A, Mascha F. In-vitro study concerning reconstruction accuracy of mandibular reconstructions with CAD/CAM reconstruction plates and comparison with standard hand-bended plates. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Winter K, Pugh SL. An investigator's introduction to statistical considerations in clinical trials. Urol Oncol 2019; 37:305-312. [PMID: 30926221 DOI: 10.1016/j.urolonc.2018.12.025] [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: 05/19/2018] [Revised: 12/22/2018] [Accepted: 12/25/2018] [Indexed: 11/26/2022]
Abstract
The purpose of this paper is to provide an introduction for investigators to many of the statistical considerations for clinical trials that will aid in their collaborations with statisticians for clinical trial research endeavors and when reading the clinical trials literature. The purpose of this paper is not to turn a physician into a statistician, that takes formal training and education, as well as day in and day out immersion in the statistical design and analysis of clinical trials, hence statistician as a profession. Successful clinical trials, not to be confused with only positive clinical trials, are ones that are well designed to answer the trial question, well conducted, and appropriately reported and published, regardless of the results. Physicians and statisticians each play integral roles in the realm of clinical trials and successful clinical trials are the result of collaborations between physicians and statisticians from the beginning of an idea through the manuscript publication.
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Affiliation(s)
- Kathryn Winter
- NRG Oncology Statistics and Data Management Center, ACR, Philadelphia, PA.
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center, ACR, Philadelphia, PA
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ScharnerD, Gittel C, Böttcher D, Winter K, Blaue D, Schedlbauer C, Vervuert I, Brehm W. Ultrasonographic evaluation of the linea alba before and after laparotomy in horses. PFERDEHEILKUNDE 2019. [DOI: 10.21836/pem20190105] [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: 11/27/2022]
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Bruner D, Moughan J, Prestidge B, Sanda M, Bice W, Michalski J, Ibbott G, Amin M, Catton C, Donavanik V, Gay H, Brachman D, Frank S, Rosenthal S, Matulonis U, Sadeghi A, Winter K, Sandler H, Papagikos M. Patient Reported Outcomes of NRG Oncology/RTOG 0232: A Phase III Study Comparing Combined External Beam Radiation and Transperineal Interstitial Permanent Brachytherapy with Brachytherapy Alone in Intermediate Risk Prostate Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chmura S, Winter K, Salama J, Robinson C, Pisansky T, Borges V, Al-Hallaq H, Matuszak M, Park S, Gonzalez V, Hasan Y, Bazan J, Wong P, Yoon H, Horton J, Gan G, Milano M, Sigurdson E, Moughan J, White J. Phase I Trial of Stereotactic Body Radiation Therapy (SBRT) to Multiple Metastatic Sites: A NRG Oncology Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.187] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Köhler B, Allgeier S, Bartschat A, Guthoff RF, Bohn S, Reichert KM, Stachs O, Winter K, Mikut R. [In vivo imaging of the corneal nerve plexus : From single image to large scale map]. Ophthalmologe 2018; 114:601-607. [PMID: 28283769 DOI: 10.1007/s00347-017-0464-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The sub-basal nerve plexus (SNP) of the cornea provides the possibility of in vivo and non-invasive examination of peripheral nerve structures by corneal confocal microscopy (CCM). Thus morphological alterations of the SNP can be directly detected and quantified. A single CCM image is insufficient for a well-founded diagnosis because of the inhomogeneous distribution of the nerve fibers; therefore, there is a demand for techniques for large area imaging of the SNP. This article provides an overview of published approaches to the problem. Current developmental work at the Karlsruhe Institute of Technology and the University of Rostock Eye Clinic is expected to lead to a simplified handling of the technology and a further improvement in the image quality.
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Affiliation(s)
- B Köhler
- Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Kaiserstraße 12, 76131, Karlsruhe, Deutschland.
| | - S Allgeier
- Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Kaiserstraße 12, 76131, Karlsruhe, Deutschland
| | - A Bartschat
- Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Kaiserstraße 12, 76131, Karlsruhe, Deutschland
| | - R F Guthoff
- Universitätsaugenklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - S Bohn
- Universitätsaugenklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - K-M Reichert
- Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Kaiserstraße 12, 76131, Karlsruhe, Deutschland
| | - O Stachs
- Universitätsaugenklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - K Winter
- Institut für Anatomie, Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - R Mikut
- Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Kaiserstraße 12, 76131, Karlsruhe, Deutschland
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Ahrberg AB, Horstmeier C, Berner D, Brehm W, Gittel C, Hillmann A, Josten C, Rossi G, Schubert S, Winter K, Burk J. Effects of mesenchymal stromal cells versus serum on tendon healing in a controlled experimental trial in an equine model. BMC Musculoskelet Disord 2018; 19:230. [PMID: 30021608 PMCID: PMC6052633 DOI: 10.1186/s12891-018-2163-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/28/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Mesenchymal stromal cells (MSC) have shown promising results in the treatment of tendinopathy in equine medicine, making this therapeutic approach seem favorable for translation to human medicine. Having demonstrated that MSC engraft within the tendon lesions after local injection in an equine model, we hypothesized that they would improve tendon healing superior to serum injection alone. METHODS Quadrilateral tendon lesions were induced in six horses by mechanical tissue disruption combined with collagenase application 3 weeks before treatment. Adipose-derived MSC suspended in serum or serum alone were then injected intralesionally. Clinical examinations, ultrasound and magnetic resonance imaging were performed over 24 weeks. Tendon biopsies for histological assessment were taken from the hindlimbs 3 weeks after treatment. Horses were sacrificed after 24 weeks and forelimb tendons were subjected to macroscopic and histological examination as well as analysis of musculoskeletal marker expression. RESULTS Tendons injected with MSC showed a transient increase in inflammation and lesion size, as indicated by clinical and imaging parameters between week 3 and 6 (p < 0.05). Thereafter, symptoms decreased in both groups and, except that in MSC-treated tendons, mean lesion signal intensity as seen in T2w magnetic resonance imaging and cellularity as seen in the histology (p < 0.05) were lower, no major differences could be found at week 24. CONCLUSIONS These data suggest that MSC have influenced the inflammatory reaction in a way not described in tendinopathy studies before. However, at the endpoint of the current study, 24 weeks after treatment, no distinct improvement was observed in MSC-treated tendons compared to the serum-injected controls. Future studies are necessary to elucidate whether and under which conditions MSC are beneficial for tendon healing before translation into human medicine.
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Affiliation(s)
- A B Ahrberg
- Department of Orthopedics, Traumatology and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany. .,Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
| | - C Horstmeier
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.,Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.,University Equine Hospital, University of Leipzig, Leipzig, Germany
| | - D Berner
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, London, UK
| | - W Brehm
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.,Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.,University Equine Hospital, University of Leipzig, Leipzig, Germany
| | - C Gittel
- University Equine Hospital, University of Leipzig, Leipzig, Germany
| | - A Hillmann
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.,Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany
| | - C Josten
- Department of Orthopedics, Traumatology and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - G Rossi
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - S Schubert
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.,Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.,Institute of Veterinary Physiology, University of Leipzig, Leipzig, Germany
| | - K Winter
- University Equine Hospital, University of Leipzig, Leipzig, Germany.,Institute of Anatomy, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - J Burk
- Translational Center for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.,Saxon Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany.,Institute of Veterinary Physiology, University of Leipzig, Leipzig, Germany.,Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
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Michalski JM, Moughan J, Purdy J, Bosch W, Bruner DW, Bahary JP, Lau H, Duclos M, Parliament M, Morton G, Hamstra D, Seider M, Lock MI, Patel M, Gay H, Vigneault E, Winter K, Sandler H. Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial. JAMA Oncol 2018; 4:e180039. [PMID: 29543933 DOI: 10.1001/jamaoncol.2018.0039] [Citation(s) in RCA: 203] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance Optimizing radiation therapy techniques for localized prostate cancer can affect patient outcomes. Dose escalation improves biochemical control, but no prior trials were powered to detect overall survival (OS) differences. Objective To determine whether radiation dose escalation to 79.2 Gy compared with 70.2 Gy would improve OS and other outcomes in prostate cancer. Design, Setting, and Participants The NRG Oncology/RTOG 0126 randomized clinical trial randomized 1532 patients from 104 North American Radiation Therapy Oncology Group institutions March 2002 through August 2008. Men with stage cT1b to T2b, Gleason score 2 to 6, and prostate-specific antigen (PSA) level of 10 or greater and less than 20 or Gleason score of 7 and PSA less than 15 received 3-dimensional conformal radiation therapy or intensity-modulated radiation therapy to 79.2 Gy in 44 fractions or 70.2 Gy in 39 fractions. Main Outcomes and Measures Time to OS measured from randomization to death due to any cause. American Society for Therapeutic Radiology and Oncology (ASTRO)/Phoenix definitions were used for biochemical failure. Acute (≤90 days of treatment start) and late radiation therapy toxic effects (>90 days) were graded using the National Cancer Institute Common Toxicity Criteria, version 2.0, and the RTOG/European Organisation for the Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme, respectively. Results With a median follow-up of 8.4 (range, 0.02-13.0) years in 1499 patients (median [range] age, 71 [33-87] years; 70% had PSA <10 ng/mL, 84% Gleason score of 7, 57% T1 disease), there was no difference in OS between the 751 men in the 79.2-Gy arm and the 748 men in the 70.2-Gy arm. The 8-year rates of OS were 76% with 79.2 Gy and 75% with 70.2 Gy (hazard ratio [HR], 1.00; 95% CI, 0.83-1.20; P = .98). The 8-year cumulative rates of distant metastases were 4% for the 79.2-Gy arm and 6% for the 70.2-Gy arm (HR, 0.65; 95% CI, 0.42-1.01; P = .05). The ASTRO and Phoenix biochemical failure rates at 5 and 8 years were 31% and 20% with 79.2 Gy and 47% and 35% with 70.2 Gy, respectively (both P < .001; ASTRO: HR, 0.59; 95% CI, 0.50-0.70; Phoenix: HR, 0.54; 95% CI, 0.44-0.65). The high-dose arm had a lower rate of salvage therapy use. The 5-year rates of late grade 2 or greater gastrointestinal and/or genitourinary toxic effects were 21% and 12% with 79.2 Gy and 15% and 7% with 70.2 Gy (P = .006 [HR, 1.39; 95% CI, 1.10-1.77] and P = .003 [HR, 1.59; 95% CI, 1.17-2.16], respectively). Conclusions and Relevance Despite improvements in biochemical failure and distant metastases, dose escalation did not improve OS. High doses caused more late toxic effects but lower rates of salvage therapy. Trial Registration clinicaltrials.gov Identifier: NCT00033631.
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Affiliation(s)
| | - Jennifer Moughan
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | - James Purdy
- University of California Davis School of Medicine, Sacramento
| | - Walter Bosch
- Imaging and Radiation Oncology Core Group, St Louis, Missouri
| | | | - Jean-Paul Bahary
- Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal, Quebec, Canada
| | - Harold Lau
- Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | | | | | - Gerard Morton
- Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada
| | - Daniel Hamstra
- University of Michigan Medical Center, Ann Arbor.,now with William Beaumont Oakland University Medical School, Dearborn, Michigan
| | | | | | - Malti Patel
- McMaster University, Juravinski Cancer Center, Hamilton, Ontario, Canada
| | - Hiram Gay
- Washington University, St Louis, Missouri
| | | | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
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Suntharalingam M, Winter K, Ilson D. Questions About a Clinical Trial Evaluating the Addition of Cetuximab to Definitive Chemoradiation Therapy With Paclitaxel and Cisplatin for Patients With Esophageal Cancer—Reply. JAMA Oncol 2018; 4:888-889. [DOI: 10.1001/jamaoncol.2018.0242] [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] [Indexed: 11/14/2022]
Affiliation(s)
- Mohan Suntharalingam
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | - David Ilson
- Memorial Sloan Kettering Cancer Center, New York, New York
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Holtum JAM, Hancock LP, Edwards EJ, Winter K. Crassulacean acid metabolism in the Basellaceae (Caryophyllales). Plant Biol (Stuttg) 2018; 20:409-414. [PMID: 29369469 DOI: 10.1111/plb.12698] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 01/22/2018] [Indexed: 06/07/2023]
Abstract
C4 and crassulacean acid metabolism (CAM) have evolved in the order Caryophyllales many times but neither C4 nor CAM have been recorded for the Basellaceae, a small family in the CAM-rich sub-order Portulacineae. 24 h gas exchange and day-night changes in titratable acidity were measured in leaves of Anredera baselloides exposed to wet-dry-wet cycles. While net CO2 uptake was restricted to the light period in well-watered plants, net CO2 fixation in the dark, accompanied by significant nocturnal increases in leaf acidity, developed in droughted plants. Plants reverted to solely C3 photosynthesis upon rewatering. The reversible induction of nocturnal net CO2 uptake by drought stress indicates that this species is able to exhibit CAM in a facultative manner. This is the first report of CAM in a member of the Basellaceae.
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Affiliation(s)
- J A M Holtum
- College of Science and Engineering, James Cook University, Townsville, Qld, Australia
- Smithsonian Tropical Research Institute, Panama City, Panama
| | - L P Hancock
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI, USA
| | - E J Edwards
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
| | - K Winter
- Smithsonian Tropical Research Institute, Panama City, Panama
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Regine WF, Winter K, Abrams RA, Safran H, Kessel IL, Chen Y, Fugazzi JA, Donnelly ED, DiPetrillo TA, Narayan S, Plastaras JP, Gaur R, Delouya G, Suh JH, Meyer JE, Haddock MG, Didolkar MS, Padula GDA, Johnson D, Hoffman JP, Crane CH. Postresection CA19-9 and margin status as predictors of recurrence after adjuvant treatment for pancreatic carcinoma: Analysis of NRG oncology RTOG trial 9704. Adv Radiat Oncol 2018; 3:154-162. [PMID: 29904740 PMCID: PMC6000159 DOI: 10.1016/j.adro.2018.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 12/30/2022] Open
Abstract
Purpose NRG Oncology RTOG 9704 was the first adjuvant trial to validate the prognostic value of postresection CA19-9 levels for survival in patients with pancreatic carcinoma. The data resulting from this study also provide information about predictors of recurrence that may be used to tailor individualized management in this disease setting. This secondary analysis assessed the prognostic value of postresection CA19-9 and surgical margin status (SMS) in predicting patterns of disease recurrence. Methods and materials This multicenter cooperative trial included participants who were enrolled as patients at oncology treatment sites in the United States and Canada. The study included 451 patients analyzable for SMS, of whom 385 were eligible for postresection CA19-9 analysis. Postresection CA19-9 was analyzed at cut points of 90, 180, and continuously. Patterns of disease recurrence included local/regional recurrence (LRR) and distant failure (DF). Multivariable analyses included treatment, tumor size, and nodal status. To adjust for multiple comparisons, a P value of ≤ .01 was considered statistically significant and > .01 to ≤ .05 to be a trend. Results For CA19-9, 132 (34%) patients were Lewis antigen-negative (no CA19-9 expression), 200 (52%) had levels <90, and 220 (57%) had levels <180. A total of 188 patients (42%) had negative margins, 152 (34%) positive, and 111 (25%) unknown. On univariate analysis, CA19-9 cut at 90 was associated with increases in LRR (trend) and DF. Results were similar at the 180 cut point. SMS was not associated with an increase in LRR on univariate or multivariate analyses. On multivariable analysis, CA19-9 ≥ 90 was associated with increased LRR and DF. Results were similar at the 180 cut point. Conclusions In this prospective evaluation, postresection CA19-9 was a significant predictor of both LRR and DF, whereas SMS was not. These findings support consideration of adjuvant radiation therapy dose intensification in patients with elevated postresection CA19-9.
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Affiliation(s)
| | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | | | | | - Ivan L Kessel
- University of Texas Medical Branch, Galveston, Texas
| | - Yuhchyau Chen
- University of Rochester Medical Center, Rochester, New York
| | - James A Fugazzi
- Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio
| | | | | | - Samir Narayan
- Michigan Cancer Research Consortium CCOP, Ann Arbor, Michigan
| | - John P Plastaras
- University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | | | - Guila Delouya
- Centre Hospitalier de l'Université de Montréal-Notre Dame, Montreal, Quebec
| | - John H Suh
- Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | | | | | | | | | - Christopher H Crane
- The University of Texas MD Anderson Cancer Center, Houston, Texas.,Memorial Sloan Kettering Cancer Center, New York, New York
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Gerlach K, Winter K, Zeller S, Kafka UCM. Nuclear scintigraphic retrospective study of the C6/7 articular facets of the equine cervical spine. PFERDEHEILKUNDE 2018. [DOI: 10.21836/pem20180405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Walliser J, Walliser U, Blaß S, Offhaus J, Winter K, Gerlach K. Relation of coffin bone and pastern bone length to thickness of dorsal hoof wall in horses with respect to radiographic projection. PFERDEHEILKUNDE 2018. [DOI: 10.21836/pem20180502] [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: 11/27/2022]
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Suntharalingam M, Winter K, Ilson D, Dicker AP, Kachnic L, Konski A, Chakravarthy AB, Anker CJ, Thakrar H, Horiba N, Dubey A, Greenberger JS, Raben A, Giguere J, Roof K, Videtic G, Pollock J, Safran H, Crane CH. Effect of the Addition of Cetuximab to Paclitaxel, Cisplatin, and Radiation Therapy for Patients With Esophageal Cancer: The NRG Oncology RTOG 0436 Phase 3 Randomized Clinical Trial. JAMA Oncol 2017; 3:1520-1528. [PMID: 28687830 DOI: 10.1001/jamaoncol.2017.1598] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance The role of epidermal growth factor receptor (EGFR) inhibition in chemoradiation strategies in the nonoperative treatment of patients with esophageal cancer remains uncertain. Objective To evaluate the benefit of cetuximab added to concurrent chemoradiation therapy for patients undergoing nonoperative treatment of esophageal carcinoma. Design, Setting, and Participants A National Cancer Institute (NCI) sponsored, multicenter, phase 3, randomized clinical trial open to patients with biopsy-proven carcinoma of the esophagus. The study accrued 344 patients from 2008 to 2013. Interventions Patients were randomized to weekly concurrent cisplatin (50 mg/m2), paclitaxel (25 mg/m2), and daily radiation of 50.4 Gy/1.8 Gy fractions with or without weekly cetuximab (400 mg/m2 on day 1 then 250 mg/m2 weekly). Main Outcomes and Measures Overall survival (OS) was the primary endpoint, with a study designed to detect an increase in 2-year OS from 41% to 53%; 80% power and 1-sided α = .025. Results Between June 30, 2008, and February 8, 2013, 344 patients were enrolled. This analysis used all data received at NRG Oncology through April 12, 2015. Sixteen patients were ineligible, resulting in 328 evaluable patients, 159 in the experimental arm and 169 in the control arm. Patients were well matched between the treatment arms for patient and tumor characteristics: 263 (80%) with T3 or T4 disease, 215 (66%) N1, and 62 (19%) with celiac nodal involvement. Incidence of grade 3, 4, or 5 treatment-related adverse events at any time was 71 (46%), 35 (23%), or 6 (4%) in the experimental arm and 83 (50%), 28 (17%), or 2 (1%) in the control arm, respectively. A clinical complete response (cCR) rate of 81 (56%) was observed in the experimental arm vs 92 (58%) in the control arm (Fisher exact test, P = .66). No differences were seen in cCR between treatment arms for either histology (adenocarcinoma or squamous cell). Median follow-up for all patients was 18.6 months. The 24- and 36-month local failure for the experimental arm was 47% (95% CI, 38%-57%) and 49% (95% CI, 40%-59%) vs 49% (95% CI, 41%-58%) and 49% (95% CI, 41%-58%) for the control arm (HR, 0.92; 95% CI, 0.66-1.28; P = .65). The 24- and 36-month OS rates for the experimental arm were 45% (95% CI, 37%-53%) and 34% (95% CI, 26%-41%) vs 44% (95% CI, 36%-51%) and 28% (95% CI, 21%-35%) for the control arm (HR, 0.90; 95% CI, 0.70-1.16; P = .47). Conclusions and Relevance The addition of cetuximab to concurrent chemoradiation did not improve OS. These phase 3 trial results point to little benefit to current EGFR-targeted agents in an unselected patient population, and highlight the need for predictive biomarkers in the treatment of esophageal cancer. Trial Registration clinicaltrials.gov Identifier: NCT00655876.
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Affiliation(s)
| | - Kathryn Winter
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | - David Ilson
- Memorial Sloan-Kettering Cancer Center, New York City, New York
| | - Adam P Dicker
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Lisa Kachnic
- Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - André Konski
- The Chester County Hospital, West Chester, Pennsylvania
| | - A Bapsi Chakravarthy
- Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Harish Thakrar
- MBCCOP, John H. Stroger Jr Hospital of Cook County, Chicago, Illinois
| | - Naomi Horiba
- University of Maryland Medical System, Baltimore.,Food and Drug Administration, Bethesda, Maryland
| | - Ajay Dubey
- Department of Oncology, USON-Texas, Bedford, Texas
| | - Joel S Greenberger
- Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Adam Raben
- Christiana Care Health Services Inc, CCOP, Newark, Delaware
| | | | - Kevin Roof
- Southeast Cancer Control Consortium Inc, CCOP, Winston Salem, North Carolina
| | | | | | - Howard Safran
- Brown University Oncology Group, Providence, Rhode Island
| | - Christopher H Crane
- Memorial Sloan-Kettering Cancer Center, New York City, New York.,University of Texas MD Anderson Cancer Center, Houston
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Magliocco A, Moughan J, Simko J, Efstathiou J, Gray P, Hagan M, Kaufman D, Tester W, Zietman A, McCarthy S, Hartford A, Patel A, Rosenthal S, McGowan D, Greenberg R, Schwartz M, Augspurger M, Keech J, Winter K, Shipley W. The Impact of MRE11 in Nuclear to Cytoplasmic Ratio on Outcomes in Muscle Invasive Bladder Cancer: an Analysis of NRG/RTOG 8802, 8903, 9506, 9706, 9906, and 0233. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Winter K, Winter K, Hofmann F, Thierfelder K, Heinemann V, Hesse N, Baumann A, Reiser M, Sommer W, D'Anastasi M. Empirische Bestimmung volumetrischer Grenzwerte gemäß RECIST 1.1 zur Beurteilung des Therapieansprechens bei Lebermetastasen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600427] [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] [Indexed: 10/19/2022]
Affiliation(s)
- K Winter
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - K Winter
- Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - F Hofmann
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - K Thierfelder
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - V Heinemann
- Klinikum der Ludwig-Maximilians-Universität München, Medizinische Klinik und Poliklinik III, München
| | - N Hesse
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - A Baumann
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - M Reiser
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - W Sommer
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
| | - M D'Anastasi
- Klinikum der Ludwig-Maximilians-Universität München, Institut für Klinische Radiologie, München
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Baumann A, Winter K, Garthe T, Thäns N, Bock J, Schindler R, Bischoff B, Trumm C, Reiser M, Schwarz F. Systolische Akquisition bei High-Pitch CT-Angiografien zur TAVI-Planung – Wie gut gelingt das und wann besser nicht? ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600229] [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] [Indexed: 10/19/2022]
Affiliation(s)
- A Baumann
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - K Winter
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - T Garthe
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - N Thäns
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - J Bock
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - R Schindler
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - B Bischoff
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - C Trumm
- Institut für Klinische Radiologie, LMU München, Campus Großhadern, Radiologie, München
| | - M Reiser
- Institut für Klinische Radiologie, LMU München, Radiologie, München
| | - F Schwarz
- Klinik für Diagnostische Radiologie und Neuroradiologie, Radiologie, Augsburg
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Mascha F, Wilde F, Winter K, Heufelder M, Pietzka S, Schramm A. Precision analysis of wafer-less positioning of the maxilla using patient-specific guides and implants in orthognathic surgery. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.561] [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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Winter K, Scheibe P, Guthoff RF, Allgeier S, Stachs O. [Morphometric characterization of the subbasal nerve plexus : Detection and analysis of networks of nerve fibers]. Ophthalmologe 2017; 114:608-616. [PMID: 28224218 DOI: 10.1007/s00347-017-0465-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Confocal laser scanning microscopy is a versatile tool in medical research and enables noninvasive in vivo imaging of the corneal subbasal nerve plexus. The aim of this work is to provide a structured overview about the detection and quantification of nerve fibers of the subbasal nerve plexus from images acquired by confocal laser scanning microscopy. Relevant steps are explained and potential factors influencing the quality of the results are pointed out. Information obtained from the quantification of subbasal nerve fiber structure can be potentially used as clinical parameters in the context of diagnostics and therapy control of diabetic neuropathy.
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Affiliation(s)
- K Winter
- Institut für Anatomie, Medizinische Fakultät, Universität Leipzig, Liebigstr. 13, 04103, Leipzig, Deutschland.
| | - P Scheibe
- Sächsischer Inkubator für Klinische Translation (SIKT) Leipzig, Universität Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, 04103, Deutschland
| | - R F Guthoff
- Universitätsaugenklinik, Universitätsmedizin Rostock, Doberaner Str. 140, Rostock, 18057, Deutschland
| | - S Allgeier
- Institut für Angewandte Informatik, Karlsruher Institut für Technologie, Hermann-von-Helmholtz-Platz 1, Eggenstein-Leopoldshafen, 76344, Deutschland
| | - O Stachs
- Universitätsaugenklinik, Universitätsmedizin Rostock, Doberaner Str. 140, Rostock, 18057, Deutschland
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