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Ballesteros M, Guarque A, Ingles M, Vilanova N, Lopez M, Martin L, Jane M, Puerto L, Martinez M, De la Flor M, Vendrell J, Megia A. Prematurity and congenital malformations differ according to the type of pregestational diabetes. BMC Pregnancy Childbirth 2024; 24:335. [PMID: 38698309 PMCID: PMC11064320 DOI: 10.1186/s12884-024-06470-7] [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: 01/11/2024] [Accepted: 03/30/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is the most common metabolic disorder in pregnancy. Women with Type 2 DM seems to have no better perinatal outcomes than those with Type 1 DM. METHODS Single-center prospective cohort observational study. Pregnant women with diabetes (141 with Type 1 DM and 124 with Type 2 DM) that were followed in the university hospital between 2009 and 2021 were included in this study. Clinical data and obstetric and perinatal outcomes were collected. RESULTS As expected, women with Type 1 DM were younger and had a longer duration of diabetes than women with Type 2 DM. Obesity and chronic hypertension were higher in the group of women with Type 2 DM and their value of HbA1c in the second and third trimesters were lower than in Type 1 DM. No differences in prematurity were found, but more extreme prematurity was observed in Type 2 DM, as well as a higher rate of congenital malformations. The frequency of hypoglycemia and the weight of the newborn was higher in Type 1 DM. The maternal independent factors related to the weight of the newborn were: the glycemic control at the third trimester, the weight gain during pregnancy, and pregestational BMI. CONCLUSIONS Newborns born to mothers with Type 1 DM were larger and had a higher frequency of hypoglycemia, while congenital malformations and precocious preterm was more associated to Type 2 DM. Metabolic control, weight gain and pregestational weight were important determinants of both obstetric and neonatal complications.
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Affiliation(s)
- Monica Ballesteros
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain.
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain.
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain.
| | - A Guarque
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - M Ingles
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - N Vilanova
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - M Lopez
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - L Martin
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - M Jane
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - L Puerto
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - M Martinez
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - M De la Flor
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- Department of Obstetrics and Gynecology, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - J Vendrell
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
- Departament of Endocrinology and Nutrition, Research Unit, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - A Megia
- Department of Medicine and Surgery, Rovira i Virgili University, Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
- Departament of Endocrinology and Nutrition, Research Unit, University Hospital of Tarragona Joan XXIII, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
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Robin C, Poiroux L, Delaunay J, Seuwou P, Martin L, Démoulins E. Tele-expertise assessment of chronic wounds by advanced practice dermatology nurses. Ann Dermatol Venereol 2024; 151:103273. [PMID: 38678771 DOI: 10.1016/j.annder.2024.103273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/04/2023] [Accepted: 03/07/2024] [Indexed: 05/01/2024]
Affiliation(s)
- C Robin
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France.
| | - L Poiroux
- Direction de la recherche clinique et de l'innovation, CHU d'Angers, 49933 Angers, France
| | - J Delaunay
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France
| | - P Seuwou
- University of Northampton, Northampton, United Kingdom
| | - L Martin
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France
| | - E Démoulins
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France
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Housset M, Fayad Kazour A, Paugam C, Le Corre Y, Croue A, Martin L, Lechevalier D, Berthin C. Pruriginous vesicular eruption associated with nivolumab immunotherapy: A case of dermatitis herpetiformis. Ann Dermatol Venereol 2024; 151:103269. [PMID: 38678772 DOI: 10.1016/j.annder.2024.103269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/05/2023] [Accepted: 02/15/2024] [Indexed: 05/01/2024]
Affiliation(s)
- M Housset
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France.
| | - A Fayad Kazour
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France
| | - C Paugam
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France
| | - Y Le Corre
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France
| | - A Croue
- Department of Pathology, 4 rue Larrey, 49100 Angers, France
| | - L Martin
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France
| | - D Lechevalier
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France
| | - C Berthin
- Department of Dermatology, 4 rue Larrey, 49100 Angers, France
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Hospach T, Kallinich T, Martin L, V Kalle T, Reichert F, Girschick HJ, Hedrich CM. [Arthritis and osteomyelitis in childhood and adolescence-Bacterial and nonbacterial]. Z Rheumatol 2024:10.1007/s00393-024-01504-z. [PMID: 38653784 DOI: 10.1007/s00393-024-01504-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/25/2024]
Abstract
Bacterial arthritis and osteomyelitis are usually acute diseases, which in this way differ from the often insidious course of nonbacterial osteomyelitis; however, there is often an overlap both in less acute courses of bacterial illnesses and also in nonbacterial osteitis. The overlapping clinical phenomena can be explained by similar pathophysiological processes. In bacteria-related illnesses the identification of the pathogen and empirical or targeted anti-infectious treatment are prioritized, whereas no triggering agent is known for nonbacterial diseases. The diagnostics are based on the exclusion of differential diagnoses, clinical scores and magnetic resonance imaging (MRI). An activity-adapted anti-inflammatory treatment is indicated.
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Affiliation(s)
- T Hospach
- Zentrum für Pädiatrische Rheumatologie, Olgahospital, Klinikum Stuttgart (ZEPRAS), Kriegsbergstr 62, 70176, Stuttgart, Deutschland.
| | - T Kallinich
- Klinik für Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Charité, Universitätsmedizin Berlin, Berlin, Deutschland
| | - L Martin
- Klinik für Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Charité, Universitätsmedizin Berlin, Berlin, Deutschland
| | - T V Kalle
- Radiologisches Institut, Olgahospital, Klinikum Stuttgart, Stuttgart, Deutschland
| | - F Reichert
- Pädiatrische Infektiologie, Olgahospital, Klinikum Stuttgart, Stuttgart, Deutschland
| | - H J Girschick
- Vivantes Klinikum Friedrichshain, Berlin, Deutschland
| | - C M Hedrich
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, Großbritannien
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, Großbritannien
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5
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Yang JB, Powlovich L, Moore D, Martin L, Miller B, Nehrbas J, Tewari AR, Mata J. Transcutaneous Ablation of Lung Tissue in a Porcine Model Using Magnetic-Resonance-Guided Focused Ultrasound (MRgFUS). Tomography 2024; 10:533-542. [PMID: 38668399 PMCID: PMC11055042 DOI: 10.3390/tomography10040042] [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: 02/06/2024] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/29/2024] Open
Abstract
Focused ultrasound (FUS) is a minimally invasive treatment that utilizes high-energy ultrasound waves to thermally ablate tissue. Magnetic resonance imaging (MRI) guidance may be combined with FUS (MRgFUS) to increase its accuracy and has been proposed for lung tumor ablation/debulking. However, the lungs are predominantly filled with air, which attenuates the strength of the FUS beam. This investigation aimed to test the feasibility of a new approach using an intentional lung collapse to reduce the amount of air inside the lung and a controlled hydrothorax to create an acoustic window for transcutaneous MRgFUS lung ablation. Eleven pigs had one lung mechanically ventilated while the other lung underwent a controlled collapse and subsequent hydrothorax of that hemisphere. The MRgFUS lung ablations were then conducted via the intercostal space. All the animals recovered well and remained healthy in the week following the FUS treatment. The location and size of the ablations were confirmed one week post-treatment via MRI, necropsy, and histological analysis. The animals had almost no side effects and the skin burns were completely eliminated after the first two animal studies, following technique refinement. This study introduces a novel methodology of MRgFUS that can be used to treat deep lung parenchyma in a safe and viable manner.
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Affiliation(s)
- Jack B. Yang
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (J.B.Y.); (B.M.)
| | | | - David Moore
- Focused Ultrasound Foundation, Charlottesville, VA 22903, USA
| | - Linda Martin
- Section of Thoracic Surgery, Department of Surgery, University of Virginia, Charlottesville, VA 22903, USA;
| | - Braden Miller
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (J.B.Y.); (B.M.)
| | - Jill Nehrbas
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (J.B.Y.); (B.M.)
| | - Anant R. Tewari
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (J.B.Y.); (B.M.)
| | - Jaime Mata
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, VA 22903, USA; (J.B.Y.); (B.M.)
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6
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Bakkeren IM, Henneman L, van Vliet-Lachotzki EH, Martin L, Gitsels-van der Wal JT, Polak MG, Bekker MN, Galjaard RJH. Psychological impact of additional findings detected by genome-wide Non-Invasive Prenatal Testing (NIPT): TRIDENT-2 study. Eur J Hum Genet 2024; 32:302-308. [PMID: 38057584 PMCID: PMC10923886 DOI: 10.1038/s41431-023-01504-8] [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: 06/01/2023] [Revised: 08/01/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023] Open
Abstract
In the Netherlands, genome-wide non-invasive prenatal testing (NIPT) is offered to all pregnant women as part of the nationwide TRIDENT-2 study. Findings other than trisomy 21, 18, or 13, which are called "additional findings", are reported only on request of the pregnant woman. This study examined: (1) women's pre-test perceptions and reasons to opt for additional findings and (2) women's experiences with- and the psychological impact of being informed about an additional finding. A questionnaire, consisting of the anxiety measure State-Trait Anxiety Inventory (STAI), distress measure Impact of Event Scale (IES) and questions developed specifically for this study, was retrospectively administered to 402 women who received an additional finding. A total of 227 (56.5%) women completed the questionnaire. Most (60.2%) chose to know additional findings because they wanted as much information as possible about the health of their fetus. Almost all (92%) stated that receiving the additional finding was unexpected, a shock, and/or they were in disbelief, for 85% it caused a lot of worry. Post-test, high anxiety (STAI) levels were reported in 15.5% of women, and 7.5% reported severe distress (IES). Women who gave birth to an affected child (n = 10) experienced most psychological impact (STAI and IES). Eighty-six percent of women with a fetal aberration would opt for additional findings again, compared to 49.2% of women whose result was confined to the placenta. Pre-test counseling should focus on explaining the different results NIPT can generate. Post-test counseling should focus on guiding pregnant women through this uncertain and anxious time.
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Affiliation(s)
- Iris M Bakkeren
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Lidewij Henneman
- Department of Human Genetics and Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Linda Martin
- Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Janneke T Gitsels-van der Wal
- Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marike G Polak
- Department of Psychology, Education & Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Mireille N Bekker
- Department of Obstetrics and Gynecology, Utrecht University Medical Center, Utrecht, the Netherlands
| | - Robert-Jan H Galjaard
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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7
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Amini-Adle M, Arnault JP, Aubin F, Beneton N, Bens G, Brunet-Possenti F, Célerier P, Charles J, Crumbach L, Dalac S, Darras S, De Quatrebarbes J, Dinulescu M, Dutriaux C, Gaudy C, Gérard E, Giacchero D, Granel-Brocard F, Grange F, Jouary T, Kramkimel N, Lebbé C, Le Corre Y, Legoupil D, Lesage C, Lesimple T, Lorphelin JM, Mansard S, Martin L, Mary-Prey S, Maubec E, Meyer N, Mignard C, Montaudie H, Mortier L, Nardin C, Neidhardt Berard EM, Pagès Laurent C, Peuvrel L, Quereux G, Robert C, Saiag P, Saint-Jean M, Samimi M, Sassolas B, Scalbert C, Skowron F, Steff M, Stoebner PE, Trablesi S, Visseaux L, Zehou O, Boespflug A. The combination of ipilimumab and nivolumab is still not reimbursed for BRAF-mutated melanoma patients in France: An unacceptable medical situation that raises ethical concerns. Ann Dermatol Venereol 2024; 151:103243. [PMID: 38325268 DOI: 10.1016/j.annder.2023.103243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/06/2023] [Accepted: 09/05/2023] [Indexed: 02/09/2024]
Affiliation(s)
- M Amini-Adle
- Dermatology Department, Centre Léon Bérard, Lyon, France.
| | - J-P Arnault
- Dermatology Department, Centre Hospitalo-Universitaire, Amiens Picardie, France
| | - F Aubin
- Université de Bourgogne-Franche-Comté, Dermatology Department, Head of the Skin Cancer Unit, Centre Hospitalo-Universitaire de Besançon, Besançon, France; INSERM UMR RIGHT 1098, Besançon, France
| | - N Beneton
- Dermatology Department, Centre Hospitalier, Le Mans, France
| | - G Bens
- Dermatology Department, Centre Hospitalier, Orléans, France
| | - F Brunet-Possenti
- Dermatology Department, Centre Hospitalo-Universitaire Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Célerier
- Dermatology Department, Centre Hospitalier La Rochelle-Ré-Aunis, La Rochelle, France
| | - J Charles
- Dermatology Department, Centre Hospitalo-Universitaire, Grenoble, France
| | - L Crumbach
- Dermatology Department, Centre Léon Bérard, Lyon, France
| | - S Dalac
- Dermatology Department, Centre Hospitalo-Universitaire, Dijon, France
| | - S Darras
- Dermatology Department, Centre Hospitalier de Boulogne-sur-Mer, France
| | - J De Quatrebarbes
- Dermatology Department, Centre Hospitalier Annecy Genevois, Annecy, France
| | - M Dinulescu
- Dermatology Department, Centre Hospitalo-Universitaire, Rennes, France
| | - C Dutriaux
- Dermatology Department, Centre Hospitalo-Universitaire, Bordeaux, France
| | - C Gaudy
- Dermatology Department, Centre Hospitalo-Universitaire, Marseille, France
| | - E Gérard
- Dermatology Department, Centre Hospitalo-Universitaire, Bordeaux, France
| | | | - F Granel-Brocard
- Dermatology Department, Hôpitaux de Brabois Allée de Morvan, Vandoeuvre Les Nancy, France
| | - F Grange
- Dermatology Department, Centre Hospitalier, Valence, France
| | - T Jouary
- Dermatology Department, Hôpital François Mitterrand, Pau, France
| | - N Kramkimel
- Dermatology Department, Centre Hospitalo-Universitaire Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Lebbé
- Dermatology Department, Centre Hospitalo-Universitaire Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Y Le Corre
- Dermatology Department, Centre Hospitalo-Universitaire Angers, France
| | - D Legoupil
- Dermatology Department, Centre Hospitalo-Universitaire Régional, Brest, France
| | - C Lesage
- Dermatology Department, Hôpital Saint Eloi, Montpellier, France
| | | | - J-M Lorphelin
- Dermatology Department, Centre Hospitalo-Universitaire, Caen, France
| | - S Mansard
- Dermatology Department, Centre Hospitalo-Universitaire, Clermont Ferrand, France
| | - L Martin
- Dermatology Department, Centre Hospitalo-Universitaire, Angers, France; Groupe Ethique de la Société Française de Dermatologie, France
| | - S Mary-Prey
- Centre Hospitalo-Universitaire Saint André, Bordeaux, France
| | - E Maubec
- Dermatology Department, Centre Hospitalo-Universitaire Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - N Meyer
- Institut Universitaire du Cancer et Centre Hospitalo-Universitaire, Toulouse, France
| | - C Mignard
- Dermatology Department, Centre Hospitalo-Universitaire, Rouen, France
| | - H Montaudie
- Dermatology Department, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; INSERM U1065, Team 12, Centre Méditerranéen de Médecine Moléculaire, Université Nice Côte d'Azur, Nice, France
| | - L Mortier
- Dermatology Department, Centre Hospitalier Régional Universitaire, Lille, France
| | - C Nardin
- Université de Bourgogne-Franche-Comté et Centre Hospitalier Universitaire, Besançon, France; IINSERM UMR RIGHT 1098, Besançon, France
| | | | - C Pagès Laurent
- Institut Universitaire du Cancer et Centre Hospitalo-Universitaire, Toulouse, France
| | - L Peuvrel
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint Herblain, France
| | - Gaelle Quereux
- Dermatology Department, Centre Hospitalo-Universitaire, Nantes Université, Nantes, France; INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302, Nantes, France
| | - Caroline Robert
- Dermatology Department, Institut Gustave Roussy, Villejuif, France
| | - Philippe Saiag
- Dermatology Department, Centre Hospitalo-Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne Billancourt, France
| | - Mélanie Saint-Jean
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Saint Herblain, France
| | - M Samimi
- Dermatology Department, Centre Hospitalo-Universitaire, Tours, France
| | - B Sassolas
- Institute of Oncology & Hematology, Hôpital Morvan, Centre Hospitalier Régional Universitaire, Brest, France
| | - C Scalbert
- Dermatology Department, Centre Hospitalier Ouest Réunion, Saint Paul, Ile de la Réunion, France
| | - F Skowron
- Dermatology Department, Hôpitaux Drome Nord, Romans Sur Isère, France
| | - M Steff
- Dermatology Department, Centre Hospitalier Intercommunal Robert Ballanger, Aulnay sous-Bois, France
| | - P-E Stoebner
- Dermatology Department, Centre Hospitalo-Universitaire, Nîmes, France
| | - S Trablesi
- Dermatology Department, Centre Hospitalo-Universitaire, Grenoble, France
| | - L Visseaux
- Polyclinique Reims Bezannes, Bezannes, France
| | - O Zehou
- Dermatology Department, Centre Hospitalo-Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - A Boespflug
- Dermatology Department, Centre Hospitalier Henri Mondor, Villejuif, France
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Hoagland M, Duggar B, Hamrick J, Alonso GT, Martin L. Error traps in the perioperative management of children with type 1 diabetes. Paediatr Anaesth 2024; 34:19-27. [PMID: 37724489 DOI: 10.1111/pan.14763] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/19/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
Patients with type 1 diabetes mellitus (T1D) require insulin administration at all times to maintain euglycemia and metabolic stability. Insulin administration in the perioperative period is complicated by fasting requirements and perioperative stressors that can change the patient's insulin needs. In addition, many anesthesia providers are not familiar with insulin dosing strategies and technology, such as insulin pumps and continuous glucose monitors (CGMs), that are commonly used by patients with T1D. Errors in perioperative insulin administration can lead to hypoglycemia, hyperglycemia, and diabetic ketoacidosis. This article reviews common errors of associated with the perioperative management of patients with T1D, including failure to assess and coordinate patient care preoperatively; failure to understand diabetes management and technology; failure to monitor blood glucose and recognize dysglycemia; and failure to appropriately administer basal insulin.
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Affiliation(s)
- M Hoagland
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Colorado, Aurora, USA
| | - B Duggar
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Colorado, Aurora, USA
| | - J Hamrick
- Department of Pediatric Anesthesiology, Rady Children's Hospital, California, San Diego, USA
| | - G Todd Alonso
- Department of Endocrinology, Barbara Davis Center, University of Colorado School of Medicine, Colorado, Aurora, USA
| | - L Martin
- Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Washington, Seattle, USA
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9
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Smith AL, Smit AK, Laginha BI, Singh N, Gallo B, Martin L, Cust AE. Implementing systematic melanoma risk assessment and risk-tailored surveillance in a skin cancer focussed dermatology clinic: A qualitative study of feasibility and acceptability to patients and clinic staff. Cancer Med 2024; 13:e6976. [PMID: 38379327 PMCID: PMC10839129 DOI: 10.1002/cam4.6976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND International bodies recommend that melanoma risk assessment should be integrated into skin cancer care provision, but evidence to support implementation is lacking. AIM To explore the acceptability and feasibility of implementing personalised melanoma risk assessment and tailored patient education and skin surveillance within routine clinical care. METHODS This prospective qualitative implementation study was informed by the Theoretical Framework of Acceptability (TFA). Personalised, systematic melanoma risk assessment was implemented in the dermatology clinic at the Melanoma Institute Australia, Sydney, Australia February-May 2021. Pre- and post-implementation observations and semi-structured interviews with patients and staff were conducted (September 2020-March 2021). Observational notes and interview transcript data were analysed thematically using the TFA as a classifying framework. RESULTS A total of 37 h of observations were made, and 29 patients and 12 clinic staff were interviewed. We found that the delivery of personalised melanoma risk estimates did not impact on patient flow through the clinic. Dermatologists reported that the personalised risk information enhanced their confidence in assessing patient risk and recommending tailored surveillance schedules. Most patients reported that the risk assessment and tailored information were a beneficial addition to their care. Among patients whose risk deviated from their expectations, some reported feeling worried, confused or mistrust in the risk information, including those at lower risk who were recommended to decrease surveillance frequency. CONCLUSIONS It is feasible and acceptable to patients and clinic staff to calculate and deliver personalised melanoma risk information and tailored surveillance as part of routine clinical care within dermatology clinics.
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Affiliation(s)
- A. L. Smith
- The Daffodil CentreThe University of Sydney, a joint venture with Cancer Council NSWSydneyNew South WalesAustralia
| | - A. K. Smit
- The Daffodil CentreThe University of Sydney, a joint venture with Cancer Council NSWSydneyNew South WalesAustralia
- Melanoma Institute Australia, The University of SydneySydneyNew South WalesAustralia
- Faculty of Medicine and Health, Sydney School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - B. I. Laginha
- Australian Institute of Health Innovation, Macquarie UniversitySydneyNew South WalesAustralia
| | - N. Singh
- The Daffodil CentreThe University of Sydney, a joint venture with Cancer Council NSWSydneyNew South WalesAustralia
- Australian Institute of Health Innovation, Macquarie UniversitySydneyNew South WalesAustralia
| | - B. Gallo
- Melanoma Institute Australia, The University of SydneySydneyNew South WalesAustralia
| | - L. Martin
- Melanoma Institute Australia, The University of SydneySydneyNew South WalesAustralia
- Faculty of Medicine and HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - A. E. Cust
- The Daffodil CentreThe University of Sydney, a joint venture with Cancer Council NSWSydneyNew South WalesAustralia
- Melanoma Institute Australia, The University of SydneySydneyNew South WalesAustralia
- Faculty of Medicine and Health, Sydney School of Public HealthThe University of SydneySydneyNew South WalesAustralia
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10
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Kors J, Duprez V, Martin L, Verhoeven CJ, van Hecke A, Peerdeman SM, Kusurkar RA. Adaptation and validation of the encoding of observations using CONSUL-MCC: A self-determination theory-based tool to observe consultations in maternity care. PEC Innov 2023; 3:100219. [PMID: 37780896 PMCID: PMC10534251 DOI: 10.1016/j.pecinn.2023.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/17/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023]
Abstract
Objective During autonomy-supportive consultations, professionals use a need-supportive interaction style to facilitate patients' self-regulated behaviour. To improve maternity care professionals' need-supportive interactions, it is important to provide insights into their interaction style. No tool is currently available for measuring need-supportive interactions in maternity care. Therefore, the aim of this study was to adapt the COUNSEL-CCE to evaluate need-supportive interactions in maternity care and to validate their measurements. Methods A five-step adaptation and validation process was performed based on the guideline of Sousa and Rojjanasrirat: 1) adaptation of COUNSEL-CCE by two authors independently; 2) development of a consensus-based tool: CONSUL-MCC; 3) qualitative assessment of CONSUL-MCC; 4) pilot testing of CONSUL-MCC in the target population (N = 10) and 5) psychometric testing in the target population (N = 453). Results All indicators of the original tool remained relevant. Four items were rephrased, one indicator was added, and all examples were adapted to maternity care. The results of psychometric testing indicated good construct validity. However, the data characteristics made it impossible to prove the presumed factor structure and perform an accurate intraclass correlation. Conclusions and innovation COUNSEL-CCE proved to be a new instrument to gain insights into professionals' interactions and be applied to maternity care.
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Affiliation(s)
- Joyce Kors
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Research in Education, Amsterdam, the Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Veerle Duprez
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Linda Martin
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Corine J. Verhoeven
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Obstetrics and Gynecology, Maxima Medical Centre, Veldhoven, the Netherlands
- Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Ann van Hecke
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Saskia M. Peerdeman
- Amsterdam UMC, Department Neurosurgery, Amsterdam, the Netherlands
- Amsterdam UMC, Faculty of Medicine, Teaching and Learning Centre, Amsterdam, the Netherlands
- Amsterdam Public Health (APH), Program Quality of Care, Amsterdam, the Netherlands
| | - Rashmi A. Kusurkar
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Research in Education, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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11
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Secourgeon A, Bigot P, Martin L, Lebdai S. [Prospective controlled study evaluating teleconsultation and tele-semiology for the management of renal colic]. Prog Urol 2023; 33:1033-1040. [PMID: 37806910 DOI: 10.1016/j.purol.2023.09.025] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/16/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Physical examination appears to be a limiting factor of teleconsultation (TC). We evaluated the feasibility of self-percussion of the lumbar fossae (sPLF) and TC for simple renal colic (SRC) in comparison with a face-to-face consultation (FC). MATERIAL AND METHODS We performed a comparative prospective study in two steps. First: evaluation of the quality of an sPLF on a standardized patient in TC, without and with tutorial. Secondarily: evaluation of a TC and a FC for a SRC with a standardized patient in real conditions. Evaluation using objective clinical scores and qualitative scales by an observer, the standardized patient and the practitioner himself. RESULTS Forty-two practitioners were included in the study. In the absence of a tutorial, the sPLF was most often "poorly done". The tutorial led to a significant improvement in the quality of sPLF. There was no difference in diagnostic and therapeutic performance among senior physicians between TC and FC. The therapeutic performances of the interns were significantly lower in TC without his being aware of it. The qualitative scores were significantly lower in TC vs FC according to the practitioners, the standardized patient and the observer. CONCLUSION An sPLF is feasible but its practice should be taught. Unlike interns, senior physicians were able to perform a TC comparable to FC for the management of SRC. TC and telesemiology therefore require dedicated training and an experienced practitioner. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- A Secourgeon
- Service d'urologie, CHU d'Angers, Angers, France.
| | - P Bigot
- Service d'urologie, CHU d'Angers, Angers, France
| | - L Martin
- Service de dermatologie, CHU d'Angers, Angers, France; Centre de simulation All'Sims, CHU et Université d'Angers, Angers, France
| | - S Lebdai
- Service d'urologie, CHU d'Angers, Angers, France; Centre de simulation All'Sims, CHU et Université d'Angers, Angers, France
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12
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Sigg N, Fouquet J, Morin D, Farges D, Vrignaud S, Martin L. A survey of patients with facial angiofibromas associated with tuberous sclerosis complex: Short-, medium- and long-term efficacy and safety of topical rapamycin. Ann Dermatol Venereol 2023; 150:270-273. [PMID: 37821253 DOI: 10.1016/j.annder.2023.06.009] [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: 09/30/2021] [Revised: 04/14/2023] [Accepted: 06/22/2023] [Indexed: 10/13/2023]
Abstract
AIMS Topical rapamycin is used to reduce facial angiofibromas in patients with tuberous sclerosis (TSC). In the absence of a commercially available preparation, numerous formulations have been tested clinically, although only in the short term. METHODS The pharmacy at Angers University Hospital (France) produced a cream formulation that was administered to people presenting this genetic disease. We conducted a questionnaire-based survey among 79 patients with TSC about their perceptions regarding the short-, medium- and long-term efficacy and safety of a topical rapamycin preparation in relation to facial angiofibromas. RESULTS This formulation was very well tolerated and its efficacy was sustained over the long term with a mean treatment duration of 33 months (extremes 1-60). Efficacy was rated ≥ 8/10 by 67.1% of patients while safety was rated ≥ 8/10 by 84.8% of patients. CONCLUSION This survey supports the safety and efficacy of topical rapamycin in the short-, medium- and long-term in the treatment of facial angiofibromas in a cohort of 79 patients with TSC.
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Affiliation(s)
- N Sigg
- Dermatology Department, CRMR MAGEC Nord, Angers University Hospital, France.
| | - J Fouquet
- Dermatology Department, CRMR MAGEC Nord, Angers University Hospital, France
| | - D Morin
- Dermatology Department, CRMR MAGEC Nord, Angers University Hospital, France
| | - D Farges
- Dermatology Department, CRMR MAGEC Nord, Angers University Hospital, France
| | - S Vrignaud
- Pharmacy, Angers University Hospital, France
| | - L Martin
- Dermatology Department, CRMR MAGEC Nord, Angers University Hospital, France
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13
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Spelten E, Gitsels J, Verhoeven C, Hutton EK, Martin L. The DELIVER study; the impact of research capacity building on research, education, and practice in Dutch midwifery. PLoS One 2023; 18:e0287834. [PMID: 37906553 PMCID: PMC10617737 DOI: 10.1371/journal.pone.0287834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 06/14/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Few examples exist of research capacity building (RCB) in midwifery. As in other jurisdictions, at the turn of this century midwives in the Netherlands lagged in research-based practice. Dutch professional and academic organisations recognised the need to proactively undertake RCB. This paper describes how a large national research project, the DELIVER study, contributed to RCB in Dutch midwifery. METHODS Applying Cooke's framework for RCB, we analysed the impact of the DELIVER study on RCB in midwifery with a document analysis comprising the following documents: annual reports on research output, websites of national organizations that might have implemented research findings, National Institute for Public Health and the Environment (RIVM)), midwifery guidelines concerning DELIVER research topics, publicly available career information of the PhD students and a google search using the main research topic and name of the researcher to look for articles in public papers. RESULTS The study provided an extensive database with nationally representative data on the quality and provision of midwifery-led care in the Netherlands. The DELIVER study resulted in 10 completed PhD projects and over 60 publications. Through close collaboration the study had direct impact on education of the next generation of primary, midwifery care practices and governmental and professional bodies. DISCUSSION The DELIVER study was intended to boost the research profile of primary care midwifery. This reflection on the research capacity building components of the study shows that the study also impacted on education, policy, and the midwifery profession. As such the study shows that this investment in RCB has had a profound positive impact on primary care midwifery in the Netherlands.
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Affiliation(s)
- Evelien Spelten
- Violet Marshman Centre for Rural Health Research, Rural Health School, La Trobe University, Melbourne, Australia
| | - Janneke Gitsels
- Amsterdam UMC location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, the Netherlands
| | - Corine Verhoeven
- Amsterdam UMC location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, the Netherlands
- Department of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, the Netherlands
| | - Eileen K. Hutton
- McMaster Midwifery Research Unit, McMaster University Hamilton, Canada
| | - Linda Martin
- Amsterdam UMC location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, the Netherlands
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14
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Gjorup CA, Pires da Silva I, Martin L, Stretch JR, Scolyer RA, Long GV, Hong A. Definitive treatment with PD-1 blockade and radiation therapy of unresected primary desmoplastic melanoma of the nose. Melanoma Res 2023; 33:422-424. [PMID: 37534694 DOI: 10.1097/cmr.0000000000000905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Two patients with primary desmoplastic melanoma of the nose were treated with definitive anti-PD-1 checkpoint inhibitor (anti-PD1) and radiation therapy. Both patients were technically resectable with partial rhinectomy but both declined for cosmetic reasons. The melanoma multidisciplinary team recommended that the patients receive PD1 blockade. The initial response to PD-1 blockade was temporary in the first case and partial in the second one. With the addition of high-dose radiotherapy, complete responses were obtained in both patients, with recurrence-free and good functional and cosmetic outcomes at a six-year and 22-month follow-up. Despite surgery being the gold standard, both cases illustrated that PD-1 blockade and radiation therapy can be a safe alternative option for desmoplastic melanoma where surgery is morbidly disfiguring.
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Affiliation(s)
| | - Ines Pires da Silva
- Melanoma Institute Australia, The University of Sydney
- Faculty of Medicine & Health, The University of Sydney
- Charles Perkins Centre, The University of Sydney
- Medical Oncology, Blacktown Hospital
| | - Linda Martin
- Melanoma Institute Australia, The University of Sydney
- The University of New South Wales
| | | | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney
- Charles Perkins Centre, The University of Sydney
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney
- Faculty of Medicine & Health, The University of Sydney
- Charles Perkins Centre, The University of Sydney
- Royal North Shore and Mater Hospitals, Medical Oncology, Sydney, Australia
| | - Angela Hong
- Melanoma Institute Australia, The University of Sydney
- Faculty of Medicine & Health, The University of Sydney
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15
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Valette C, Jonca N, Fischer J, Pernin-Grandjean J, Granier Tournier C, Diociaiuti A, Neri I, Dreyfus I, Furman M, Giehl K, Wollenberg A, Mallet S, Martin L, Martin-Santiago A, Onnis G, Broue P, Leclerc-Mercier S, Schmuth M, Sprecher E, Gruber R, Suessmuth K, Bourrat E, Komlosi K, Hill S, O'Toole EA, Schischmanoff O, Caux F, Mazereeuw-Hautier J. A retrospective study on the liver toxicity of oral retinoids in Chanarin-Dorfman syndrome. J Eur Acad Dermatol Venereol 2023; 37:e1237-e1241. [PMID: 37257069 DOI: 10.1111/jdv.19235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Affiliation(s)
- C Valette
- Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - N Jonca
- Infinity, University of Toulouse, CNRS, INSERM, Université Paul Sabatier, Toulouse, France
- Laboratoire de Biologie Cellulaire et Cytologie, Institut Fédératif de Biologie, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - J Fischer
- Institute of Human Genetics, University Medical Center, Freiburg, Germany
| | - J Pernin-Grandjean
- Infinity, University of Toulouse, CNRS, INSERM, Université Paul Sabatier, Toulouse, France
- Laboratoire de Biologie Cellulaire et Cytologie, Institut Fédératif de Biologie, Hôpital Purpan, CHU Toulouse, Toulouse, France
| | - C Granier Tournier
- Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - A Diociaiuti
- Dermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - I Neri
- Department of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - I Dreyfus
- Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - M Furman
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - K Giehl
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Wollenberg
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - S Mallet
- Department of Dermatology, University Hospital Center of Marseille, Marseille, France
| | - L Martin
- Department of Dermatology, University Hospital Center of Angers, Angers, France
| | - A Martin-Santiago
- Department of Dermatology, Hospital Universitari Son Espases, Palma, Spain
| | - G Onnis
- Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, CHU Toulouse, Toulouse, France
| | - P Broue
- Pediatric Hepatology and Reference Centre for Inborn Error of Metabolism, Children Hospital, Toulouse, France
| | - S Leclerc-Mercier
- Department of Pathology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Necker- Enfants Malades University Hospital, Paris, France
| | - M Schmuth
- Department of Dermatology, Venereology and Allergy, Medical University of Innsbruck and Karl Landsteiner Institute for Paediatric Dermatology and Rare Diseases, Innsbruck, Austria
| | - E Sprecher
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - R Gruber
- Department of Dermatology, Venereology and Allergy, Medical University of Innsbruck and Karl Landsteiner Institute for Paediatric Dermatology and Rare Diseases, Innsbruck, Austria
| | - K Suessmuth
- Department of Dermatology, University Hospital of Muenster, Muenster, Germany
| | - E Bourrat
- Department of Dermatology, Saint-Louis Hospital, Paris, France
- Department of General Paediatrics, Robert-Debré Hospital, Paris, France
| | - K Komlosi
- Institute of Human Genetics, University Medical Center, Freiburg, Germany
| | - S Hill
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust ERN-Skin, London, UK
| | - E A O'Toole
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust ERN-Skin, London, UK
| | - O Schischmanoff
- Department of Dermatology, MAGEC, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and INSERM UMR1125, Bobigny, France
| | - F Caux
- Department of Dermatology, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and INSERM UMR1125, Bobigny, France
| | - J Mazereeuw-Hautier
- Reference Centre for Rare Skin Diseases, Department of Dermatology, Larrey Hospital, CHU Toulouse, Toulouse, France
- Infinity, University of Toulouse, CNRS, INSERM, Université Paul Sabatier, Toulouse, France
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16
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Anderson EK, Baker CJ, Bertsche W, Bhatt NM, Bonomi G, Capra A, Carli I, Cesar CL, Charlton M, Christensen A, Collister R, Cridland Mathad A, Duque Quiceno D, Eriksson S, Evans A, Evetts N, Fabbri S, Fajans J, Ferwerda A, Friesen T, Fujiwara MC, Gill DR, Golino LM, Gomes Gonçalves MB, Grandemange P, Granum P, Hangst JS, Hayden ME, Hodgkinson D, Hunter ED, Isaac CA, Jimenez AJU, Johnson MA, Jones JM, Jones SA, Jonsell S, Khramov A, Madsen N, Martin L, Massacret N, Maxwell D, McKenna JTK, Menary S, Momose T, Mostamand M, Mullan PS, Nauta J, Olchanski K, Oliveira AN, Peszka J, Powell A, Rasmussen CØ, Robicheaux F, Sacramento RL, Sameed M, Sarid E, Schoonwater J, Silveira DM, Singh J, Smith G, So C, Stracka S, Stutter G, Tharp TD, Thompson KA, Thompson RI, Thorpe-Woods E, Torkzaban C, Urioni M, Woosaree P, Wurtele JS. Observation of the effect of gravity on the motion of antimatter. Nature 2023; 621:716-722. [PMID: 37758891 PMCID: PMC10533407 DOI: 10.1038/s41586-023-06527-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/06/2023] [Accepted: 08/09/2023] [Indexed: 09/29/2023]
Abstract
Einstein's general theory of relativity from 19151 remains the most successful description of gravitation. From the 1919 solar eclipse2 to the observation of gravitational waves3, the theory has passed many crucial experimental tests. However, the evolving concepts of dark matter and dark energy illustrate that there is much to be learned about the gravitating content of the universe. Singularities in the general theory of relativity and the lack of a quantum theory of gravity suggest that our picture is incomplete. It is thus prudent to explore gravity in exotic physical systems. Antimatter was unknown to Einstein in 1915. Dirac's theory4 appeared in 1928; the positron was observed5 in 1932. There has since been much speculation about gravity and antimatter. The theoretical consensus is that any laboratory mass must be attracted6 by the Earth, although some authors have considered the cosmological consequences if antimatter should be repelled by matter7-10. In the general theory of relativity, the weak equivalence principle (WEP) requires that all masses react identically to gravity, independent of their internal structure. Here we show that antihydrogen atoms, released from magnetic confinement in the ALPHA-g apparatus, behave in a way consistent with gravitational attraction to the Earth. Repulsive 'antigravity' is ruled out in this case. This experiment paves the way for precision studies of the magnitude of the gravitational acceleration between anti-atoms and the Earth to test the WEP.
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Affiliation(s)
- E K Anderson
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
| | - C J Baker
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - W Bertsche
- School of Physics and Astronomy, University of Manchester, Manchester, UK.
- Cockcroft Institute, Sci-Tech Daresbury, Warrington, UK.
| | - N M Bhatt
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - G Bonomi
- University of Brescia, Brescia and INFN Pavia, Pavia, Italy
| | - A Capra
- TRIUMF, Vancouver, British Columbia, Canada
| | - I Carli
- TRIUMF, Vancouver, British Columbia, Canada
| | - C L Cesar
- Instituto de Fisica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M Charlton
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - A Christensen
- Department of Physics, University of California at Berkeley, Berkeley, CA, USA
| | - R Collister
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Cridland Mathad
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - D Duque Quiceno
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Eriksson
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - A Evans
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - N Evetts
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Fabbri
- School of Physics and Astronomy, University of Manchester, Manchester, UK
- Accelerator and Technology Sector, CERN, Geneva, Switzerland
| | - J Fajans
- Department of Physics, University of California at Berkeley, Berkeley, CA, USA.
| | - A Ferwerda
- Department of Physics and Astronomy, York University, Toronto, Ontario, Canada
| | - T Friesen
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada
| | | | - D R Gill
- TRIUMF, Vancouver, British Columbia, Canada
| | - L M Golino
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - M B Gomes Gonçalves
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | | | - P Granum
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
| | - J S Hangst
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark.
| | - M E Hayden
- Department of Physics, Simon Fraser University, Burnaby, British Columbia, Canada
| | - D Hodgkinson
- School of Physics and Astronomy, University of Manchester, Manchester, UK
- Department of Physics, University of California at Berkeley, Berkeley, CA, USA
| | - E D Hunter
- Department of Physics, University of California at Berkeley, Berkeley, CA, USA
| | - C A Isaac
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | | | - M A Johnson
- School of Physics and Astronomy, University of Manchester, Manchester, UK
- Cockcroft Institute, Sci-Tech Daresbury, Warrington, UK
| | - J M Jones
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - S A Jones
- Van Swinderen Institute for Particle Physics and Gravity, University of Groningen, Groningen, The Netherlands
| | - S Jonsell
- Department of Physics, Stockholm University, Stockholm, Sweden
| | - A Khramov
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physics, British Columbia Institute of Technology, Burnaby, British Columbia, Canada
| | - N Madsen
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - L Martin
- TRIUMF, Vancouver, British Columbia, Canada
| | | | - D Maxwell
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - J T K McKenna
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
- School of Physics and Astronomy, University of Manchester, Manchester, UK
| | - S Menary
- Department of Physics and Astronomy, York University, Toronto, Ontario, Canada
| | - T Momose
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Mostamand
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - P S Mullan
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
- Institute for Particle Physics and Astrophysics, ETH, Zurich, Switzerland
| | - J Nauta
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | | | - A N Oliveira
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
| | - J Peszka
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
- Institute for Particle Physics and Astrophysics, ETH, Zurich, Switzerland
| | - A Powell
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada
| | - C Ø Rasmussen
- Experimental Physics Department, CERN, Geneva, Switzerland
| | - F Robicheaux
- Department of Physics and Astronomy, Purdue University, West Lafayette, IN, USA
| | - R L Sacramento
- Instituto de Fisica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M Sameed
- School of Physics and Astronomy, University of Manchester, Manchester, UK
- Accelerator Systems Department, CERN, Geneva, Switzerland
| | - E Sarid
- Soreq NRC, Yavne, Israel
- Department of Physics, Ben Gurion University, Beer Sheva, Israel
| | - J Schoonwater
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - D M Silveira
- Instituto de Fisica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - J Singh
- School of Physics and Astronomy, University of Manchester, Manchester, UK
| | - G Smith
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - C So
- TRIUMF, Vancouver, British Columbia, Canada
| | | | - G Stutter
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
- School of Mathematical and Physical Sciences, University of Sussex, Brighton, UK
| | - T D Tharp
- Physics Department, Marquette University, Milwaukee, WI, USA
| | - K A Thompson
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - R I Thompson
- TRIUMF, Vancouver, British Columbia, Canada
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada
| | - E Thorpe-Woods
- Department of Physics, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - C Torkzaban
- Department of Physics, University of California at Berkeley, Berkeley, CA, USA
| | - M Urioni
- University of Brescia, Brescia and INFN Pavia, Pavia, Italy
| | - P Woosaree
- Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada
| | - J S Wurtele
- Department of Physics, University of California at Berkeley, Berkeley, CA, USA
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17
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Mauguen C, Maruani A, Barbarot S, Abasq C, Martin L, Herbert J, Goronflot T, Gourraud PA, Happe A, Descatha A, Chrétien JM, Beuchée A, Adamski H, Dupuy A, Bouzillé G, Oger E, Droitcourt C. Factors associated with early relapse of infantile haemangioma in children treated for at least six months with oral propranolol: A case-control study using the 2014-2021 French Ouest DataHub. Ann Dermatol Venereol 2023; 150:189-194. [PMID: 37225615 DOI: 10.1016/j.annder.2023.03.007] [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: 09/29/2022] [Revised: 12/08/2022] [Accepted: 03/24/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The factors associated with early relapse of infantile haemangioma (IH) after a first course of treatment with oral propranolol for at least six months (initiated after the marketing authorization had been granted) have not previously been investigated. OBJECTIVES To identify factors associated with the risk of early relapse in children with IH treated with oral propranolol according to the current prescribing guidelines. METHODS We performed a multicentre, retrospective, case-control study, using the Ouest Data Hub database. All children treated for at least 6 months with oral propranolol for IH between 31 June 2014 and 31 December 2021, and with a follow-up visit at least three months after treatment discontinuation were included. A case was defined as relapse of IH within three months of treatment discontinuation; each case was matched for age at treatment initiation and for centre, with four (relapse-free) controls. The association between relapse and treatment or IH characteristics was expressed as an odds ratio (OR) from univariate and multivariate conditional logistic regressions. RESULTS A total of 225 children were included. Of these, 36 (16%) relapsed early. In a multivariate analysis, a deep IH component was a risk factor for early relapse [OR = 8.93; 95%CI: 1.0-78.9, p = 0.05]. A propranolol dosage level of less than 3 mg/kg/day protected against early relapse [OR = 0.11; 95%CI: 0.02-0.7, p = 0.02]. Tapering before propranolol discontinuation was not associated with a lower risk of early relapse. CONCLUSION The risk factors for late and early relapse are probably different. Investigation of the risk factors for early vs. late IH relapse is now warranted.
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Affiliation(s)
- C Mauguen
- Department of Dermatology, CHU Rennes, 35000 Rennes, France.
| | - A Maruani
- University of Tours, INSERM 1246-SPHERE, Department of Dermatology, Tours University Hospital, F-37000 Tours, France; Dermatology Department and Reference Centre for Rare Diseases and Vascular Malformations (MAGEC), Tours University Hospital, 37000 Tours, France
| | - S Barbarot
- Department of Dermatology, CHU Nantes and INSERM CIC 004, 44000 Nantes, France
| | - C Abasq
- Department of Dermatology, Brest University Hospital, 29200 Brest, France
| | - L Martin
- Department of Dermatology, Angers University Hospital, 4, rue Larrey, 49933 Angers, France
| | - J Herbert
- Clinical Data Centre, Public Health and Prevention Unit, Tours University Hospital, 37044 Tours, France
| | - T Goronflot
- Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, 44000 Nantes, France
| | - P-A Gourraud
- Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, 44000 Nantes, France
| | - A Happe
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
| | - A Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 49000 Angers, France
| | - J-M Chrétien
- Clinical Research Department, Angers University Hospital, 49000 Angers, France
| | - A Beuchée
- Department of Neonatalogy, Rennes University Hospital, Rennes, France
| | - H Adamski
- Department of Dermatology, CHU Rennes, 35000 Rennes, France
| | - A Dupuy
- Department of Dermatology, CHU Rennes, 35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
| | - G Bouzillé
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, 35000 Rennes, France
| | - E Oger
- Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, 35000 Rennes, France
| | - C Droitcourt
- Department of Dermatology, CHU Rennes, 35000 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000 Rennes, France
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18
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Gavalda M, Lorenzo A, Vilchez H, Gimenez S, Calvo C, Martin L, Riera M. Skin lesions by Scedosporium apiospermum and Nocardia pulmonary infection in an oncologic patient: a case report. BMC Infect Dis 2023; 23:523. [PMID: 37559001 PMCID: PMC10413544 DOI: 10.1186/s12879-023-08484-6] [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: 04/23/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Fungal infections, other than candidiasis and aspergillosis, are an uncommon entity. Despite this, emerging pathogens are a growing threat. In the following case report, we present the case of an immunocompromised patient suffering from two serious opportunistic infections in the same episode: the first of these, Nocardia multilobar pneumonia; and the second, skin infection by Scedosporium apiospermum. These required prolonged antibacterial and antifungal treatment. CASE PRESENTATION This case is a 71-year-old oncological patient admitted for recurrent pneumonias that was diagnosed for Nocardia pulmonary infection. Nervous system involvement was discarded and cotrimoxazole was started. Haemorrhagic skin ulcers in the lower limbs appeared after two weeks of hospital admission. We collected samples which were positive for Scedosporium apiospermum and we added voriconazole to the treatment. As a local complication, the patient presented a deep bruise that needed debridement. We completed 4 weeks of intravenous treatment with slow improvement and continued with oral treatment until the disappearance of the lesions occurs. CONCLUSIONS Opportunistic infections are a rising entity as the number of immunocompromised patients is growing due to more use of immunosuppressive therapies and transplants. Clinicians must have a high suspicion to diagnose and treat them. A fluid collaboration with Microbiology is necessary as antimicrobial resistance is frequent.
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Affiliation(s)
- M Gavalda
- Internal Medicine, Hospital Universitari Son Espases, Palma, Spain.
- Hospital Universitari Son Espases, Valldemossa Road 79, Palma de Mallorca, Spain.
| | - A Lorenzo
- Internal Medicine, Hospital Universitari Son Espases, Palma, Spain
| | - H Vilchez
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Palma, Spain
- Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, 07120, Spain
| | - S Gimenez
- Oncology. Hospital Universitari Son Espases, Palma, Spain
| | - C Calvo
- Pathology Department, Hospital Universitari Son Espases, Palma, Spain
| | - L Martin
- Internal Medicine, Hospital Universitari Son Espases, Palma, Spain
| | - M Riera
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Palma, Spain
- Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, 07120, Spain
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19
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Rickard WDA, Sun X, Aleshin M, Martin L, Kracica M, Oldfield D, Fougerouse D, Reddy S, Saxey DW. Application of FIB-ToF-SIMS to the Search for and Characterisation of Enriched Uranium Particles. Microsc Microanal 2023; 29:528-529. [PMID: 37613266 DOI: 10.1093/micmic/ozad067.248] [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] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
| | - Xiao Sun
- John de Laeter Centre, Curtin University, Perth, Australia
| | - M Aleshin
- Centre for Microscopy, Characterisation and Analysis, UWA, Perth, Australia
| | - L Martin
- Centre for Microscopy, Characterisation and Analysis, UWA, Perth, Australia
| | - Masturina Kracica
- Australian Nuclear Science and Technology Organisation, Sydney, Australia
| | - Daniel Oldfield
- Australian Nuclear Science and Technology Organisation, Sydney, Australia
| | - Denis Fougerouse
- School of Earth and Planetary Sciences, Curtin University, Perth, Australia
| | - Steven Reddy
- School of Earth and Planetary Sciences, Curtin University, Perth, Australia
| | - David W Saxey
- John de Laeter Centre, Curtin University, Perth, Australia
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20
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Bou-Samra P, Muhammad N, Chang A, Karsalia R, Azari F, Kennedy G, Stummer W, Tanyi J, Martin L, Vahrmeijer A, Smith B, Rosenthal E, Wagner P, Rice D, Lee A, Abdelhafeez A, Malek MM, Kohanbash G, Barry Edwards W, Henderson E, Skjøth-Rasmussen J, Orosco R, Gibbs S, Farnam RW, Shankar L, Sumer B, Kumar ATN, Marcu L, Li L, Greuv V, Delikatny EJ, Lee JYK, Singhal S. Intraoperative molecular imaging: 3rd biennial clinical trials update. J Biomed Opt 2023; 28:050901. [PMID: 37193364 PMCID: PMC10182831 DOI: 10.1117/1.jbo.28.5.050901] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/18/2023]
Abstract
Significance This third biennial intraoperative molecular imaging (IMI) conference shows how optical contrast agents have been applied to develop clinically significant endpoints that improve precision cancer surgery. Aim National and international experts on IMI presented ongoing clinical trials in cancer surgery and preclinical work. Previously known dyes (with broader applications), new dyes, novel nonfluorescence-based imaging techniques, pediatric dyes, and normal tissue dyes were discussed. Approach Principal investigators presenting at the Perelman School of Medicine Abramson Cancer Center's third clinical trials update on IMI were selected to discuss their clinical trials and endpoints. Results Dyes that are FDA-approved or currently under clinical investigation in phase 1, 2, and 3 trials were discussed. Sections on how to move benchwork research to the bedside were also included. There was also a dedicated section for pediatric dyes and nonfluorescence-based dyes that have been newly developed. Conclusions IMI is a valuable adjunct in precision cancer surgery and has broad applications in multiple subspecialties. It has been reliably used to alter the surgical course of patients and in clinical decision making. There remain gaps in the utilization of IMI in certain subspecialties and potential for developing newer and improved dyes and imaging techniques.
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Affiliation(s)
- Patrick Bou-Samra
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Najib Muhammad
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Austin Chang
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Ritesh Karsalia
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Feredun Azari
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Gregory Kennedy
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Walter Stummer
- University of Muenster, Department of Neurosurgery, Muenster, Germany
| | - Janos Tanyi
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Linda Martin
- University of Virginia, School of Medicine, Charlottesville, Virginia, United States
| | | | - Barbara Smith
- Harvard University, School of Medicine, Boston, Massachusetts, United States
| | - Eben Rosenthal
- Stanford University, School of Medicine, Stanford, California, United States
| | - Patrick Wagner
- Allegheny Health Network, Pittsburgh, Pennsylvania, United States
| | - David Rice
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Amy Lee
- Seattle’s Children’s Hospital, Seattle, Washington, United States
| | | | - Marcus M. Malek
- Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Gary Kohanbash
- The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | | | - Eric Henderson
- Dartmouth College, Geisel School of Medicine, Hanover, New Hampshire, United States
| | | | - Ryan Orosco
- The University of New Mexico Medical Center, Albuquerque, New Mexico
| | - Summer Gibbs
- Oregon Health & Science University, Knight Cancer Institute, School of Medicine, Portland, Oregon, United States
| | | | - Lalitha Shankar
- National Institute of Health, Bethesda, Maryland, United States
| | - Baran Sumer
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Anand T. N. Kumar
- Harvard University, School of Medicine, Boston, Massachusetts, United States
| | - Laura Marcu
- University of California Davis, School of Medicine, Sacramento, California, United States
| | - Lei Li
- California Institute of Technology, Pasadena, California, United States
| | - Victor Greuv
- University of Illinois at Urbana-Champaign, Urbana-Champaign, United States
| | - Edward J. Delikatny
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - John Y. K. Lee
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Sunil Singhal
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Address all correspondence to Sunil Singhal,
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21
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Kumar A, Choudhary R, Potter A, Mathey-Andrews C, Ugalde P, Martin L, Yang CF. 129P Adjuvant therapy for T3 non-small cell lung cancer with additional intrapulmonary nodules. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00384-2] [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: 04/03/2023]
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22
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Lannoo L, van der Meij KRM, Bekker MN, De Catte L, Deckers S, Devriendt K, Roggen N, Galjaard RJH, Gitsels-van der Wal J, Macville MVE, Martin L, Sistermans EA, Van Calsteren K, Van Keirsbilck J, Crombag N, Henneman L. A cross-country comparison of pregnant women's decision-making and perspectives when opting for non-invasive prenatal testing in the Netherlands and Belgium. Prenat Diagn 2023; 43:294-303. [PMID: 36740754 DOI: 10.1002/pd.6329] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Netherlands and Belgium have been among the first countries to offer non-invasive prenatal testing (NIPT) as a first-tier screening test. Despite similarities, differences exist in counseling modalities and test uptake. This study explored decision-making and perspectives of pregnant women who opted for NIPT in both countries. METHODS A questionnaire study was performed among pregnant women in the Netherlands (NL) (n = 587) and Belgium (BE) (n = 444) opting for NIPT, including measures on informed choice, personal and societal perspectives on trisomy 21, 18 and 13 and pregnancy termination. RESULTS Differences between Dutch and Belgian women were shown in the level of informed choice (NL: 83% vs. BE: 59%, p < 0.001), intention to terminate the pregnancy in case of confirmed trisomy 21 (NL: 51% vs. BE: 62%, p = 0.003) and trisomy 13/18 (NL: 80% vs. BE: 73%, p = 0.020). More Belgian women considered trisomy 21 a severe condition (NL: 64% vs. BE: 81%, p < 0.001). Belgian women more frequently indicated that they believed parents are judged for having a child with trisomy 21 (BE: 42% vs. NL: 16%, p < 0.001) and were less positive about quality of care and support for children with trisomy 21 (BE: 23% vs. NL: 62%, p < 0.001). CONCLUSION Differences in women's decision-making regarding NIPT and the conditions screened for may be influenced by counseling aspects and country-specific societal and cultural contexts.
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Affiliation(s)
- Lore Lannoo
- Department of Obstetrics and Gynaecology, Fetomaternal Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Karuna R M van der Meij
- Department of Human Genetics, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mireille N Bekker
- Department of Obstetrics and Gynaecology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Luc De Catte
- Department of Obstetrics and Gynaecology, Fetomaternal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Sarah Deckers
- Department of Obstetrics and Gynaecology, Fetomaternal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Koenraad Devriendt
- Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Nele Roggen
- Department of Obstetrics and Gynaecology, AZ Imelda, Bonheiden, Belgium
| | - Robert-Jan H Galjaard
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janneke Gitsels-van der Wal
- Department of Midwifery Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - Merryn V E Macville
- Department of Clinical Genetics, GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Linda Martin
- Department of Midwifery Science, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, The Netherlands
| | - Erik A Sistermans
- Department of Human Genetics, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynaecology, Fetomaternal Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | | | - Neeltje Crombag
- Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Lidewij Henneman
- Department of Human Genetics, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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23
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Martin L, Chang M, Miller S, Gupta A, Kishore S, Kothary N. Abstract No. 78 Association of Bilirubin and Overall Survival in Veterans who Receive Radioembolization for Hepatocellular Carcinoma Treatment. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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24
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Villalobos V, Betancor D, Pastor-Vargas C, Martin L, Cuesta J, Rodríguez Del Río P, Escudero C. Pistachio Allergens: The Long Journey Between Mother and Daughter. J Investig Allergol Clin Immunol 2023; 33:64-65. [PMID: 35332872 DOI: 10.18176/jiaci.0806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V Villalobos
- Allergy Department, Niño Jesús University Children´s Hospital, Madrid, Spain.,Allergy Department, Fundación Jiménez Díaz, Madrid, Spain
| | - D Betancor
- Allergy Department, Niño Jesús University Children´s Hospital, Madrid, Spain.,Allergy Department, Fundación Jiménez Díaz, Madrid, Spain
| | - C Pastor-Vargas
- Biochemistry and Molecular Biology Department, Universidad Complutense de Madrid, Madrid, Spain.,RETIC ARADyAL, Instituto de Salud Carlos III, Madrid, Spain
| | - L Martin
- Foundation for Biomedical Research and Innovation, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J Cuesta
- Allergy Department, Fundación Jiménez Díaz, Madrid, Spain.,IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - P Rodríguez Del Río
- Allergy Department, Niño Jesús University Children´s Hospital, Madrid, Spain.,FIB Niño Jesús, Madrid, Spain.,IIS La Princesa, Madrid, Spain
| | - C Escudero
- Allergy Department, Niño Jesús University Children´s Hospital, Madrid, Spain.,FIB Niño Jesús, Madrid, Spain.,IIS La Princesa, Madrid, Spain
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25
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Ho S, Carriker A, Sieg K, Martin L, Marklin GF. Uncovering new potentials: Screening for donor infectious disease serologies in less than 1 hour. Am J Transplant 2023:S1600-6135(23)00286-1. [PMID: 36758750 DOI: 10.1016/j.ajt.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/09/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Affiliation(s)
- Sam Ho
- Gift of Hope Organ and Tissue Donor Network, Itasca, Illinois, USA; Mid-America Transplant, St Louis, Missouri, USA; Center for Organ Recovery and Education, Pittsburgh, Pennsylvania, USA; College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
| | | | - Kristin Sieg
- Gift of Hope Organ and Tissue Donor Network, Itasca, Illinois, USA
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26
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Ho G, Smith A, Cust AE, Melhoranse-Gouveia B, Collgros H, Martin L, Guitera P. Reflectance confocal microscopy in Australia: Perspectives on barriers to implementation and uptake. Australas J Dermatol 2023; 64:e109-e111. [PMID: 36412240 DOI: 10.1111/ajd.13954] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Genevieve Ho
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Australia.,Faculty of Medicine, University of New South Wales, New South Wales, Sydney, Australia
| | - Andrea Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Anne E Cust
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia.,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Bruna Melhoranse-Gouveia
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Australia
| | - Helena Collgros
- Faculty of Medicine and Health, University of Sydney, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, New South Wales, Sydney, Australia
| | - Linda Martin
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, New South Wales, Sydney, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Australia.,Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, New South Wales, Sydney, Australia
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Johnson E, Ford J, Perera SAU, Nashed N, Lovick S, Mulkerrin S, Bryant E, Martin L. 1215 IMPROVING THE QUALITY OF ANTICIPATORY CARE PLANNING FOR PATIENTS WITH RECURRENT ASPIRATION PNEUMONIA. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Recurrent episodes of aspiration pneumonia (RAP) are a significant problem in frail patients leading to high re-hospitalization and mortality. Anticipatory care planning (ACP) enables improved quality of life and end of life care. We reviewed the assessment, ACP discussions and communication with Primary Care in these patients.
Methods
We used a PDSA methodology, reviewing 116 patients with RAP referred to Speech and Language Therapy (SLT) in Elderly Medicine wards over six months, including the winter. Educational interventions were implemented. An illustrative case and pre-intervention results were presented at an online hospital-wide seminar and subsequently at an online departmental medical staff teaching session. Post-intervention analysis of 10 patients with RAP admitted over two summer months was conducted. The second round of interventions included departmental induction teaching for newly rotated doctors and creating an electronic ACP document (RAP ACP) for inclusion within the medical record.
Results
Baseline data was collected from 116 patients (mean age 85, 47% female). After the educational interventions, data was collected from 10 patients (mean age 88, 70% female). Data is being collected from winter months after the second intervention. This will be available before the conference. Baseline data demonstrated the need for improvements in documentation of Mental Capacity Assessment (MCA) specific to feeding (21.5%), ACP completion (26.7%) and flagging patients suitable for the Gold Standards Framework (GSF) on discharge (15%). Following educational interventions, there was a substantial improvement in MCA documentation (80%). Furthermore, there was a marked improvement in the completion of ACP discussions (70%). Communication of patients eligible for GSF was similar (14.2%) post-intervention.
Conclusions
Educational interventions substantially improved the quality of individualised care provided to patients with RAP. Mortality was high in both groups, yet documentation of eligibility for GSF was low, prompting further interventions targeting discharge communication.
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Affiliation(s)
- E Johnson
- North West Anglia NHS Foundation Trust Dept of Medicine for the Elderly,
| | - J Ford
- Cambridge University Hospital Dept of Medicine for the Elderly,
| | - S A U Perera
- Cambridge University Hospital Dept of Medicine for the Elderly,
| | - N Nashed
- Cambridge University Hospital Dept of Medicine for the Elderly,
| | - S Lovick
- Cambridge University Hospital Dept of Medicine for the Elderly,
| | - S Mulkerrin
- Cambridge University Hospital Dept of Speech and Language Therapy,
| | - E Bryant
- Cambridge University Hospital Dept of Speech and Language Therapy,
| | - L Martin
- Cambridge University Hospital Pharmacy Department,
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Aguilhon S, Nawel A, Dupasquier V, Delbaere Q, Max R, Sartre A, Duroux E, Martin L, Pasquié JL, Chapet N, Roubille F. Telemonitoring of heart failure: State of the art at the University Hospital of Montpellier. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.083] [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: 12/31/2022]
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Tao Y, Biau J, Sun XS, Sire C, Martin L, Alfonsi M, Prevost JB, Modesto A, Lafond C, Tourani JM, Miroir J, Kaminsky MC, Coutte A, Liem X, Chautard E, Vauleon E, Drouet F, Ruffier A, Ramee JF, Waksi G, Péchery A, Wanneveich M, Guigay J, Aupérin A, Bourhis J. Pembrolizumab versus cetuximab concurrent with radiotherapy in patients with locally advanced squamous cell carcinoma of head and neck unfit for cisplatin (GORTEC 2015-01 PembroRad): a multicenter, randomized, phase II trial. Ann Oncol 2023; 34:101-110. [PMID: 36522816 DOI: 10.1016/j.annonc.2022.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/01/2022] [Accepted: 10/13/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND To evaluate potential synergistic effect of pembrolizumab with radiotherapy (RT) compared with a standard-of-care (SOC) cetuximab-RT in patients with locally advanced-squamous cell carcinoma of head and neck (LA-SCCHN). PATIENTS AND METHODS Patients with nonoperated stage III-IV SCC of oral cavity, oropharynx, hypopharynx, and larynx and unfit for receiving high-dose cisplatin were enrolled. Patients received once-daily RT up to 69.96 Gy in 33 fractions with weekly cetuximab (cetuximab-RT arm) or 200 mg Q3W pembrolizumab during RT (pembrolizumab-RT arm). The primary endpoint was locoregional control (LRC) rate 15 months after RT. To detect a difference between arms of 60%-80% in 15-month LRC, inclusion of 66 patients per arm was required to achieve a power of at least 0.85 at two-sided significance level of 0.20. RESULTS Between May 2016 and October 2017, 133 patients were randomized to cetuximab-RT (n = 66) and pembrolizumab-RT (n = 67). Two patients (one in each arm) were not included in the analysis (a consent withdrawal and a progression before treatment start). The median age was 65 years (interquartile range 60-70 years), 92% were smokers, 60% were oropharynx (46% of oropharynx with p16+) and 75% were stage IV. Median follow-up was 25 months in both arms. The 15-month LRC rate was 59% with cetuximab-RT and 60% with pembrolizumab-RT ]odds ratio 1.05, 95% confidence interval (CI) 0.43-2.59; P = 0.91]. There was no significant difference between arms for progression-free survival (hazard ratio 0.85, 95% CI 0.55-1.32; P = 0.47) and for overall survival (hazard ratio 0.83, 95% CI 0.49-1.40; P = 0.49). Toxicity was lower in the pembrolizumab-RT arm than in the cetuximab-RT arm: 74% versus 92% patients with at least one grade ≥3 adverse events (P = 0.006), mainly due to mucositis, radiodermatitis, and rash. CONCLUSION Compared with the SOC cetuximab-RT, pembrolizumab concomitant with RT did not improve the tumor control and survival but appeared less toxic in unfit patients with LA-SCCHN.
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Affiliation(s)
- Y Tao
- Gustave-Roussy Institute, Villejuif, France
| | - J Biau
- Centre Jean Perrin, Clermont Ferrand, France
| | - X S Sun
- Hôpital Nord Franche-Comté, Montbéliard and CHU Besançon, Montbéliard, France
| | - C Sire
- Centre Hospitalier de Bretagne Sud, Lorient, France
| | - L Martin
- Clinique des Ormeaux, Le Havre, France
| | - M Alfonsi
- Clinique Sainte Catherine, Avignon, France
| | | | - A Modesto
- Institut Claudius Regaud, Toulouse, France
| | - C Lafond
- Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - J M Tourani
- Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - J Miroir
- Centre Jean Perrin, Clermont Ferrand, France
| | - M C Kaminsky
- Institut de Cancérologie de Lorraine, Nancy, France
| | - A Coutte
- Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - X Liem
- Centre Oscar Lambret, Lille, France
| | - E Chautard
- Centre Jean Perrin, Clermont Ferrand, France
| | - E Vauleon
- Centre Eugène Marquis, Rennes, France
| | - F Drouet
- Clinique Mutualiste de l'estuaire, Saint-Nazaire, France
| | - A Ruffier
- Gustave-Roussy Institute, Villejuif, France; Clinique Victor Hugo-Centre Jean Bernard, Le Mans, France
| | - J F Ramee
- Centre Hospitalier Départemental de Vendée, La Roche sur Yon, France
| | | | | | | | - J Guigay
- Centre Antoine Lacassagne, FHU OncoAge, University Côte d'Azur, Nice, France
| | - A Aupérin
- Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France
| | - J Bourhis
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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Wu H, Kumar M, Fray E, Siliciano R, Smedley J, Meyers G, Maziarz R, Burwitz B, Stanton J, Sacha J, Weber W, Waytashek C, Boyle C, Bateman K, Reed J, Hwang J, Shriver-Munsch C, Northrup M, Armantrout K, Price H, Robertson-LeVay M, Uttke S, Junell S, Moats C, Bochart R, Sciurba J, Bimber B, Sullivan M, Dozier B, MacAllister R, Hobbs T, Martin L, Siliciano J, Axthelm M. OP 6.7 – 00044 Long-term ART-free SIV Remission Following Allogeneic Hematopoietic Cell Transplantation in Mauritian Cynomolgus Macaques. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100252] [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: 12/24/2022] Open
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31
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Dietrich E, Grimaux X, Martin L, Samimi M. Etiological diagnosis of macroglossia: Systematic review and diagnostic algorithm. Ann Dermatol Venereol 2022; 149:228-237. [PMID: 36229262 DOI: 10.1016/j.annder.2022.03.011] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/10/2021] [Accepted: 03/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The objective of this literature review was to list the different etiologies of macroglossia reported in the literature, to identify characteristics that might guide diagnosis, and to create a diagnostic algorithm. METHODS The bibliographic search was carried out between October 2019 and July 2020 in the PubMed research base using the keywords "macroglossia" (MESH) and/or "tongue enlargement". RESULTS Of the 1711 references identified, 615 articles were excluded, and 1096 abstracts were reviewed. We classified the different etiologies identified according to their mechanism and whether they were congenital or acquired. The etiologies are divided into the following categories: genetic malformation syndromes, non-syndromic congenital malformations, endocrinopathies, neuromuscular diseases, storage disorders, infectious, inflammatory, traumatic, and iatrogenic diseases. CONCLUSION Based on this review, we propose a diagnostic algorithm for macroglossia according to the characteristics described. The most common diagnoses among acquired causes were amyloidosis (13.7%), endocrinopathies (8.8%), myopathies (4%) and tongue tumors (6.7%). The most common congenital causes were aneuploidy, lymphatic malformations, and Beckwith-Wiedemann syndrome, which is the main cause of congenital macroglossia, even if it appears isolated.
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Affiliation(s)
- E Dietrich
- Dermatology Department, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49000 Angers, France.
| | - X Grimaux
- Dermatology Department, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49000 Angers, France
| | - L Martin
- Dermatology Department, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49000 Angers, France
| | - M Samimi
- Dermatology Department, Centre Hospitalier Universitaire de Tours, 2 boulevard Tonnellé, 37000 Tours, France
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32
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Lahuna C, Defendi F, Bouillet L, Boccon-Gibod I, Leblond V, Launay D, Cathébras P, Brihaye B, Armengol G, Aubineau M, Gondran G, Ly K, Gayet S, Desblache J, Martin L, Arsène M, Olivier F, Delphine G. Angiœdèmes bradykiniques par déficit acquis en C1-inhibiteur, associés aux gammapathies monoclonales de signification indéterminée : caractéristiques d’une cohorte nationale française. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.031] [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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Robert J, Marchand A, Mazereeuw-Hautier J, Boccara O, Martin L, Chiaverini C, Beneton N, Vabres P, Balguerie X, Plantin P, Bessis D, Barbarot S, Dadban A, Droitcourt C, Samimi M, Morel B, Caille A, Maruani A, Leducq S. Quality of life of children with capillary malformations of the lower limbs: Evolution and associated factors. Data from the French national paediatric cohort, CONAPE. Ann Dermatol Venereol 2022; 149:271-275. [PMID: 35810006 DOI: 10.1016/j.annder.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/16/2022] [Accepted: 03/30/2022] [Indexed: 01/19/2023]
Affiliation(s)
- J Robert
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France
| | - A Marchand
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France
| | - J Mazereeuw-Hautier
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), Hospital Larrey, University Hospital Center of Toulouse, 31059 Toulouse Cedex 9, France
| | - O Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), France Université Paris, Paris-centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, 75015 Paris, France
| | - L Martin
- Department of Dermatology, University Hospital Center of Angers, 49000 Angers, France
| | - C Chiaverini
- Department of Dermatology, University Hospital Center of Nice, 06000 Nice, France
| | - N Beneton
- Department of Dermatology, Hospital Center of le Mans, 72000 Le Mans, France
| | - P Vabres
- Department of Dermatology, University Hospital Center of Dijon, Reference center for genodermatoses and rare skin diseases (MAGEC), 21000 Dijon, France
| | - X Balguerie
- Department of Dermatology, University Hospital Center of Rouen, 76000 Rouen, France
| | - P Plantin
- Department of Dermatology, Hospital Center of Quimper, 29000 Quimper, France
| | - D Bessis
- Department of Dermatology, University Hospital Center of Montpellier, 34000 Montpellier, France
| | - S Barbarot
- Department of Dermatology, University Hospital Center of Nantes, 44000 Nantes, France
| | - A Dadban
- Department of Dermatology, University Hospital Center of Amiens, 80000 Amiens, France
| | - C Droitcourt
- Department of Dermatology, University Hospital Center of Rennes, 35000 Rennes, France
| | - M Samimi
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France
| | - B Morel
- CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Department of Pediatric Radiology, 37000 Tours, France
| | - A Caille
- CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France
| | - A Maruani
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France
| | - S Leducq
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France.
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Bove C, Baldock RA, Champigneulle O, Martin L, Bennett CL. Fluoroquinolones - Old drugs, putative new toxicities. Expert Opin Drug Saf 2022; 21:1365-1378. [DOI: 10.1080/14740338.2022.2147924] [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: 11/18/2022]
Affiliation(s)
- Cecilia Bove
- Department of Biological Sciences, York College of Pennsylvania, 441 Country Club Road, York, PA, USA
| | - Robert A. Baldock
- School of Pharmacy and Biomedical Science, University of Portsmouth, St. Michael’s Building, White Swan Road, Portsmouth, PO1 2DT, UK
| | - Oscar Champigneulle
- University of South Carolina Schools of Pharmacy and Engineering and the SmartState Center for Medication Safety and Efficacy, Columbia, SC, USA
| | - Linda Martin
- University of South Carolina Schools of Pharmacy and Engineering and the SmartState Center for Medication Safety and Efficacy, Columbia, SC, USA
| | - Charles L Bennett
- University of South Carolina Schools of Pharmacy and Engineering and the SmartState Center for Medication Safety and Efficacy, Columbia, SC, USA
- Beckman Research Institute (BRI) of City of Hope and the Department of Comparative Medicine and Evidence Based Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Kors J, de la Croix A, Martin L, Verhoeven CJM, Bakker P, Peerdeman SM, Kusurkar RA. Autonomy-supportive decision-making in maternity care during prenatal consultations: a qualitative interaction analysis. BMJ Open 2022; 12:e063463. [PMID: 36385034 PMCID: PMC9670942 DOI: 10.1136/bmjopen-2022-063463] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify mechanisms of autonomy-supportive consultation (ASC) that maternity care professionals use during decision-making in prenatal consultations. DESIGN This study was a descriptive, qualitative analysis of professional-patient interactions in maternity care, using concepts and analytic procedures of conversation analysis. SETTING The prenatal consultations took place in hospitals and midwifery practices in the Netherlands. This study was part of a larger project. For the current study, we selected prenatal consultations concerning three topics in which patients make their own choices. PARTICIPANTS The first author invited the patient who was waiting in the waiting room. Participants were not selected a priori. MAIN OUTCOME MEASURES The main outcome measures were mechanisms of ASC. RESULTS We selected 20 consultations which were conducted by 20 different professionals. We found eight mechanisms in the professional-patient interaction which were categorised into three overarching themes. The first theme, 'Lightheartedness', comprises the interactional mechanisms 'minimising language' and 'humour'. The theme 'Orientation to agreement' describes how professionals and patients seem to be oriented towards demonstrating agreement and mutual understanding. The last theme, 'Offering information and options', describes the professional formally giving factual information almost completely without verbal interaction between the professional and the patient. CONCLUSION The results of this study show that the model of ASC can be enriched by adding minimising language and humour to the mechanisms that can be used to fulfil the psychological need 'relatedness'. Second, our results show that professionals use only few mechanisms to meet the patients' psychological needs 'competence' and 'autonomy'. They mainly use information giving to meet patients' need competence. To meet patients' need for autonomy, the professionals keep all options open. This suggests that professionals could pay more attention to other mechanisms to meet patients' needs for 'competence' and 'autonomy'.
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Affiliation(s)
- Joyce Kors
- Faculty of Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Anne de la Croix
- Faculty of Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Linda Martin
- Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Corine J M Verhoeven
- Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Midwifery, School of Health Sciences, University of Nottingham, Nottingham, Nottinghamshire, UK
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, Netherlands
| | - Petra Bakker
- Department of Obstetrics and Gynaecology, Amsterdam UMC Locatie Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Saskia M Peerdeman
- Faculty of Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Center for Evidence Based Education, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Rashmi A Kusurkar
- Faculty of Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Welsh P, Byrne H, Costa-Scharplatz M, Fonseca AF, Itani T, Farries G, Zabiby AA, Narasimham S, Martin L, Sattar N. The burden of coronary revascularization associated with lipoprotein(a) in patients with atherosclerotic cardiovascular disease: data from the UK Biobank. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Elevated lipoprotein(a) [Lp(a)] is an inherited, independent, and causal risk factor for atherosclerotic cardiovascular disease (ASCVD). In a previous analysis of 30,510 ASCVD patients from UK Biobank, adjusted models showed a 100 nmol/L (≈50 mg/dL) difference in Lp(a) was associated with a 19% (95% CI 14–23%) higher risk of coronary revascularization (Welsh P, 2022).
Purpose
To determine the absolute risk for coronary revascularization in an ASCVD population with elevated versus normal Lp(a) levels.
Methods
This was an observational, retrospective study including 32,537 patients from UK Biobank with an ASCVD diagnosis (CHD, cerebrovascular or peripheral arterial disease). Absolute risk (AR) of coronary revascularization (number of coronary revascularizations per 100-person-years) was reported in patients with normal (<65 nmol/L ≈ 30 mg/dL; n=22,257) and elevated (≥150 nmol/L ≈ 70 mg/dL; n=5,204) Lp(a) levels across two time periods: within the first year of ASCVD diagnosis, and using all available follow-up data (median 4.7 years). Lp(a) was measured in an accredited single laboratory using a method standardized to WHO/IFCC reference material. The AR was also calculated for various subgroups within the ASCVD population.
Results
Within the first year after ASCVD diagnosis, 628 (12.07%) of the population with elevated Lp(a) underwent coronary revascularization compared to 1,787 (8.03%) with normal Lp(a). Those with elevated Lp(a) had a higher AR (14.00 per 100-person-years, 95% CI 13.02–14.99; p<0.001) than those with normal Lp(a) (9.34; 95% CI 8.92–9.76). This also held in a subgroup with myocardial infarction (MI; n=9,588), AR of 18.98 (95% CI 16.95–21.01) in those with elevated Lp(a) (n=1,571) vs. AR of 13.02 (95% CI 12.16–13.89) in those with normal Lp(a) (n=6,441) (p<0.001). AR of coronary revascularization within the first year of ASCVD diagnosis was also greater in participants with family history of CV disease (p<0.001) and premature CV disease (<60 years of age) (p<0.001). When using all available follow-up, AR of coronary revascularization was higher in participants with elevated versus normal Lp(a) in the ASCVD population (3.79 vs 2.55; p<0.001) and across all subgroups.
Conclusion
Elevated Lp(a) in patients with ASCVD was associated with increased risk of coronary revascularization in the first year (and subsequently), including those with a prior MI, premature CV disease, or family history of CV disease. Lp(a) testing in ASCVD patients can therefore aid estimations for the risk of revascularization, and thus the targeting of additional therapies to lower such risks.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Welsh
- Institute of Cardiovascular and Medical Sciences , Glasgow , United Kingdom
| | - H Byrne
- Novartis Pharma AG , Dublin , Ireland
| | | | | | - T Itani
- Novartis Pharma AG , Basel , Switzerland
| | - G Farries
- Novartis Pharma AG , Dublin , Ireland
| | | | | | - L Martin
- Novartis Pharmaceuticals UK Limited , London , United Kingdom
| | - N Sattar
- Institute of Cardiovascular and Medical Sciences , Glasgow , United Kingdom
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Kahles F, Mertens R, Diebold S, Arrivas MC, Moellmann J, Steitz J, Mirzaei Y, Sandoval D, Martin L, Schuerholz T, Koch A, Tacke F, Drucker DJ, Marx N, Lehrke M. GLP-2 as an indicator and modulator of acute inflammation improves cardiac function and survival in sepsis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
GLP-1 and GLP-2 (glucagon-like peptide-1/2) are gut hormones secreted in response to food. While GLP-1 controls glucose metabolism, GLP-2 is a local gut growth factor regulating intestinal nutrient absorption. GLP-2 has been found to be upregulated in patients with colitis. We hypothesize that beyond its local intestinal function GLP-2 might be involved in systemic immune responses.
Methods and results
To analyze whether GLP-2 secretion is modulated by the immune system, we measured circulating GLP-2 levels in 2 clinical cohorts. In the first cohort (n=34) GLP-2 levels increased over time following cardiac surgery as an inflammatory stimulus. In the second cohort 223 patients with sepsis had a 3.9 fold increase of GLP-2 plasma levels vs. 53 healthy controls (3.0 ng/mL vs. 11.4 ng/mL; p<0.001). High GLP-2 levels were associated with markers of inflammation (IL-6, PCT, CRP), septic cardiomyopathy (NT-proBNP) and independently predicted mortality in humans with sepsis. Induction of sepsis in mice by endotoxin or cecal ligation puncture strongly increased GLP-2 levels independent from food intake. By injecting various proinflammatory cytokines and inducing sepsis in IL1R−/− and IL6−/− mice we identified that inflammation upregulates GLP-2 secretion through IL-6. To identify the source of GLP-2 secretion under inflammation, we induced sepsis in Gcg−/− mice lacking endogenous GLP-2 production with a tissue-specific reactivation of Gcg in gut L-cells (GcgRAΔvilCre) or pancretic alpha cells (GcgRAΔPDX1-Cre). We observed sepsis-induced GLP-2 secretion to be derived from the pancreas and not from the gut. Additional in-vitro and ex-vivo approaches revealed that IL-6 directly activates GLP-2 secretion from pancreatic alpha cells. Gcg−/− mice lacking GLP-2 production and Glp2r−/− mice show aggravated sepsis indicating that endogenous upregulation of GLP-2 is protective. Finally, we analyzed whether inflammatory upregulation of GLP-2 has immunomodulatory relevance. We administered GLP-2 or saline as control per central jugular vein catheter mice who underwent CLP. GLP-2 treatment improved LV-contractility (dp/dtmax) in septic cardiomyopathy (control 7361 vs. GLP-2 9500 mmHg/s; p<0.01), inhibited sepsis-induced hypotension and reduced mortality (p=0.018). Mechanistically GLP-2 reduced myeloid immune cell infiltration into heart and liver tissue and decreased proinflammatory cytokine levels in various organs and the blood (TNF-α, IL-6 and IL-1β). After broad GLP-2 receptor profiling we found maximum mRNA expression in gut tissues with no expression on immune cells. By further mechanistic studies we found GLP-2 to protect against sepsis-induced gut barrier dysfunction.
Conclusions
Here we identified a counter-regulatory control system in which IL-6 derived upregulation of GLP-2 secretion limits excessive innate immune responses and protects against sepsis. These findings might open new avenues for the treatment of patients with inflammatory diseases.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): European Foundation for the Study of Diabetes, European Research Area Network on Cardiovascular Diseases (ERA-CVD and BMBF), Deutsche Forschungsgemeinschaft (DFG)
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Affiliation(s)
- F Kahles
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - R Mertens
- University Hospital of Heidelberg, Department of Cardiology, Angiology, and Pneumology , Heidelberg , Germany
| | - S Diebold
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - M C Arrivas
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - J Moellmann
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - J Steitz
- RWTH University Hospital Aachen, Institute for Laboratory Animal Science , Aachen , Germany
| | - Y Mirzaei
- RWTH University Hospital Aachen, Institute for Laboratory Animal Science , Aachen , Germany
| | - D Sandoval
- University of Michigan, School of Public Health, University of Michigan , Ann Arbor , United States of America
| | - L Martin
- RWTH University Hospital Aachen, Department of Intensive Care and Intermediate Care , Aachen , Germany
| | - T Schuerholz
- RWTH University Hospital Aachen, Department of Intensive Care and Intermediate Care , Aachen , Germany
| | - A Koch
- RWTH University Hospital Aachen, Department of Gastroenterology , Aachen , Germany
| | - F Tacke
- RWTH University Hospital Aachen, Department of Gastroenterology , Aachen , Germany
| | - D J Drucker
- Mount Sinai Hospital of the University Health Network, Lunenfeld-Tanenbaum Research Institute , Toronto , Canada
| | - N Marx
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
| | - M Lehrke
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine , Aachen , Germany
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van Prooyen Schuurman L, van der Meij K, van Ravesteyn N, Crombag N, van der Wal JG, Kooij C, Martin L, Peters I, Polak M, van Vliet‐Lachotzki E, Galjaard R, Henneman L. Factors involved in the decision to decline prenatal screening with non‐invasive prenatal testing (NIPT). Prenat Diagn 2022; 43:467-476. [PMID: 36109868 DOI: 10.1002/pd.6242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT). METHOD A questionnaire study was conducted among 219 pregnant women in the Netherlands who had declined prenatal screening with NIPT (TRIDENT-2 study). Respondents were selectively recruited from three hospitals and 19 midwifery practices, primarily located in or near socioeconomically disadvantaged neighborhoods. 44.3% of the respondents were of non-Western ethnic origin and 64.4% were religious. RESULTS Most respondents (77.2%) found the decision to decline NIPT easy to make, and 59.8% had already made the decision before information about NIPT was offered. These respondents were more often religious, multigravida, and had adequate health literacy. The main reasons to decline NIPT were "I would never terminate my pregnancy" (57.1%) and "every child is welcome" (56.2%). For 16.9% of respondents, the out-of-pocket costs (175 euros) played a role in the decision, and the women in this group were more often nonreligious, primigravida, and had inadequate health literacy. CONCLUSION The primary factors involved in the decision to decline NIPT were related to personal values and beliefs, consistent with autonomous choice. Out-of-pocket costs of NIPT hinder equal access for some pregnant women.
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Affiliation(s)
- Lisanne van Prooyen Schuurman
- Department of Clinical Genetics Erasmus MC, University Medical Center Rotterdam Rotterdam the Netherlands
- Department of Public Health, Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands
| | - Karuna van der Meij
- Department of Human Genetics Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam the Netherlands
- Amsterdam Reproduction and Development research institute Amsterdam the Netherlands
| | - Nicolien van Ravesteyn
- Department of Public Health, Erasmus MC University Medical Center Rotterdam Rotterdam the Netherlands
| | - Neeltje Crombag
- Department of Development and Regeneration Cluster Woman and Child Biomedical Sciences KU Leuven Leuven Belgium
- Department of Obstetrics and Gynaecology UMC Utrecht, University Medical Center Utrecht Utrecht the Netherlands
| | - Janneke Gitsels van der Wal
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Caroline Kooij
- Midwifery and Ultrasound Centre "Verloskundigen Vida" Amsterdam the Netherlands
| | - Linda Martin
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Ingrid Peters
- Department of Quality and Patient Care Erasmus MC, University Medical Center Rotterdam Rotterdam the Netherlands
| | - Marike Polak
- Department of Psychology Education and Child Studies (DPECS), Erasmus University Rotterdam Rotterdam the Netherlands
| | | | - Robert‐Jan Galjaard
- Department of Clinical Genetics Erasmus MC, University Medical Center Rotterdam Rotterdam the Netherlands
| | - Lidewij Henneman
- Department of Human Genetics Amsterdam UMC location Vrije Universiteit Amsterdam Amsterdam the Netherlands
- Amsterdam Reproduction and Development research institute Amsterdam the Netherlands
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Pham F, Boespflug A, Duru G, Phan A, Poulalhon N, Weiler L, Tanaka M, Lallas A, Ogata D, Davaine AC, Bahadoran P, Balguerie X, Kamińska-Winciorek G, Tromme I, Correia O, Kim MB, Marghoob AA, Linda Martin, Guitera P, Meziane M, Miquel J, Mun JH, Argenziano G, Bessis D, Bourke J, Mijuskovic Z, Chiaverini C, Corven-Benoit C, Droitcourt C, Skowron F, Marque M, Zalaudek I, Rosendahl C, Moreno-Ramirez D, Vabres P, Haenssle H, Malvehy J, Puig S, Robert C, Schopf TR, Scope A, Dalle S, Thomas L. Dermatoscopic and clinical features of congenital or congenital-type nail matrix nevi: A multicenter prospective cohort study by the International Dermoscopy Society. J Am Acad Dermatol 2022; 87:551-558. [PMID: 35104588 PMCID: PMC10035057 DOI: 10.1016/j.jaad.2022.01.028] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 01/03/2022] [Accepted: 01/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Congenital nail matrix nevi (NMN) are difficult to diagnose because they feature clinical characteristics suggestive of adult subungual melanoma. Nail matrix biopsy is difficult to perform, especially in children. OBJECTIVE To describe the initial clinical and dermatoscopic features of NMN appearing at birth (congenital) or after birth but before the age of 5 years (congenital-type). METHODS We conducted a prospective, international, and consecutive data collection in 102 hospitals or private medical offices across 30 countries from 2009 to 2019. RESULTS There were 69 congenital and 161 congenital-type NMNs. Congenital and congenital-type NMN predominantly displayed an irregular pattern of longitudinal microlines (n = 146, 64%), reminiscent of subungual melanoma in adults. The distal fibrillar ("brush-like") pattern, present in 63 patients (27.8%), was more frequently encountered in congenital NMN than in congenital-type NMN (P = .012). Moreover, congenital NMN more frequently displayed a periungual pigmentation (P = .029) and Hutchinson's sign (P = .027) than did congenital-type NMN. LIMITATIONS Lack of systematic biopsy-proven diagnosis and heterogeneity of clinical and dermatoscopic photographs. CONCLUSION Congenital and congenital-type NMN showed worrisome clinical and dermatoscopic features similar to those observed in adulthood subungual melanoma. The distal fibrillar ("brush-like") pattern is a suggestive feature of congenital and congenital-type NMN.
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Affiliation(s)
- Félix Pham
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France
| | - Amélie Boespflug
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France
| | | | - Alice Phan
- Nephrology-Rheumatology-Dermatology Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Nicolas Poulalhon
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Laura Weiler
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Masaru Tanaka
- Department of Dermatology, Saitama Medical University, Japan
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Dai Ogata
- Department of Dermatologic oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | | | - Philippe Bahadoran
- Centre Hospitalier Universitaire Nice, Department of Dermatology, Université Nice Côte d'Azur, Nice, France
| | - Xavier Balguerie
- Department of Dermatology, Rouen University Medical Center, Rouen, France
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Gliwice Branch, Poland
| | - Isabelle Tromme
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Osvaldo Correia
- Centro Dermatologia Epidermis, Instituto CUF and Faculty of Medicine of University of Porto, Porto, Portugal
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University Medical Research Institute, Pusan National University, Busan, Korea
| | - Ashfaq A Marghoob
- Memorial Sloan Kettering Skin Cancer Center, Hauppauge, New York, USA
| | - Linda Martin
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Mariame Meziane
- Department of Dermatology, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V university, Rabat, Morocco
| | - Juliette Miquel
- Unit of Pediatric Dermatology, Saint-Pierre University Hospital, Saint-Pierre, la Réunion, France
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Napoli, Italy
| | - Didier Bessis
- Service de Dermatologie, Hôpital Saint-Eloi et Hôpital Universitaire de Montpellier, Montpellier, France
| | - Johnny Bourke
- Dermatology Department, South Infirmary-Victoria University Hospital, Cork, Ireland
| | - Zeljko Mijuskovic
- Department of Dermatology and Venereology,School of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Christine Chiaverini
- Department of Dermatology, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | - Catherine Droitcourt
- Department of Dermatology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - François Skowron
- Service de dermatologie, Hôpitaux Drôme Nord, Romans sur Isère, Romans sur Isère, France
| | - Myriam Marque
- Department of Dermatology, Caremeau Hospital, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Iris Zalaudek
- Department of Dermatology, Medical University of Trieste, Trieste, Italy
| | - Cliff Rosendahl
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Pierre Vabres
- Centre de Référence MAGEC, Service de Dermatologie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Holger Haenssle
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karl Universität, Heidelberg, Germany
| | - Josep Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Caroline Robert
- Department of Medicine, Dermatology Service, Gustave Roussy and Paris-Saclay University, INSERM U981, Villejuif, France
| | - Thomas R Schopf
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Alon Scope
- The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Stéphane Dalle
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France
| | - Luc Thomas
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France.
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Bourhis J, Le Tourneau C, Calderon B, Martin L, Sire C, Pointreau Y, Ramee JF, Coutte A, Boisselier P, Kaminsky-Forrett MC, Delord JP, Clatot F, Sun X, Villa J, Magne N, Elicin O, Damstrup L, Gollmer K, Crompton P, Tao Y. LBA33 5-year overall survival (OS) in patients (pts) with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) treated with xevinapant + chemoradiotherapy (CRT) vs placebo + CRT in a randomized, phase II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.030] [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] Open
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Alghamdi H, Sanderson D, Carmichael L, Cresswell A, Martin L. The use of portable OSL and IRSL measurements of NaCl in low dose assessments following a radiological or nuclear emergency. Front Public Health 2022; 10:969829. [PMID: 36111193 PMCID: PMC9468860 DOI: 10.3389/fpubh.2022.969829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
During recovery phases following a nuclear or radiological incident analyses of doses received by members of the public and responders are often required. Several methods have been investigated for use at different timescales after the incident, including assessments based on measurements of materials present at the time of the incident. Common salt has previously been shown to have potential for retrospective dosimetry in the mGy dose range using laboratory instrumentation. This preliminary study investigates the use of portable instruments, with unprepared commercially sourced salt, in dose ranges below 100 μGy. Responses from pulsed IRSL and portable OSL instruments were compared. For OSL measurements, detection limits of 7 μGy have been demonstrated, with detection limits of 30-340 μGy for the other instruments investigated. Dose responses in the 0-500 μGy range were determined for the most sensitive systems, which show a linear response over this dose range with a non-zero intercept representing doses received from environmental sources since manufacture of the salt. For use as a dosimeter, methods of removing or accounting for inherited signals will be required in this low dose range. The results demonstrate that salt has considerable potential for use in retrospective dosimetry below 100 μGy, and that measurements can be conducted with portable OSL instruments.
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Fitzgerald S, Sanderson D, Cresswell A, Martin L. Using Infra-red stimulated luminescence and phototransferred thermoluminescence to investigate electron trapping and charge transport in feldspars. RADIAT MEAS 2022. [DOI: 10.1016/j.radmeas.2022.106817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Filuta A, Amezcua P, Chang W, Biagini J, Kroner J, He H, Grashel B, Almasri C, Martin L, Palumbo J, Khurana Hershey G, Sherenian M. LB1033 Thrombin contributes to atopic dermatitis pathogenesis and staphylococcus aureus skin colonization in children. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.1071] [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: 10/17/2022]
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Bennett CL, Olivieri N, Hoque S, Aboulafia D, Ventrone A, Lubaczewski C, Dong B, Schooley B, Witherspoon BJ, Ray PS, Hrushesky WJ, Restaino J, Thomsen HS, Mangano D, Mora-Mangano C, McKoy JM, Schoen M, Knopf K, Martin L, Rosen S. Davids versus Goliaths: Pharma and academia threats to individual scientists and clinicians. The Journal of Scientific Practice and Integrity 2022. [DOI: 10.35122/001c.36564] [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: 12/12/2022] Open
Abstract
Background We previously described experiences of clinicians who published adverse drug reaction reports. We now report on threats and intimidations leveled against clinicians and scientists who received publicly documented threats after communicating safety, efficacy, or data integrity findings contrary to corporate interests. Methods Data on threats and intimidations were obtained from transcripts of governmental hearings or agencies, university-affiliated reports, media interviews, and investigative journalism articles. Content and timing of threats and intimidation, subsequent harms, numbers of persons seriously injured or who died from individual toxicities, financial payments from sponsors related to safety, efficacy, or data integrity concerns, and civil settlements and criminal findings were evaluated. Findings Twenty-six individuals who communicated safety, efficacy, or data integrity concerns were targets of threats and intimidation from corporate employees (twenty-three individuals) or regulatory personnel (three). Seventeen individuals identified instances where pharmaceutical sponsors submitted fraudulent data in support of regulatory approval of a drug or device. Scientist and clinician communications were followed by drug/device withdrawals (fourteen drugs/devices), black box warnings (six drugs), withdrawal of a sponsor’s application for regulatory approval (one device), and delay of approval of a sponsor’s application for regulatory approval (one drug). Actions mainly occurred after persons communicated with pharmaceutical employees (fourteen). Intimidation efforts by corporate personnel included threats of lawsuits (eighteen individuals), hiring private investigators (nine), and public disparagement at conferences (eleven). Related intimidation efforts carried out by academia or regulatory agency superiors included threats of: loss of positions (six), loss of grant funding (two), delays in decisions regarding tenure (two); or reassignment to a low-level position (one). Academic harms included lost: hospital or university appointments (nine and six, respectively), grant funding (two), chairperson title of an international clinical trial group (one), and journal editorial board position (one). Corporate harms included payment of $1 million to defense attorneys in three cases filed against clinicians. Interpretation Threats and intimidation carried out by corporate employees and/or academic supervisors followed public communication of concerns regarding patient safety, drug efficacy, or data integrity, including instances where sponsors were identified as having submitted fraudulent data to regulatory or government agencies. Consideration should be given to filing criminal charges against pharmaceutical executives who are discovered by scientists or clinicians to have knowingly submitted fraudulent data to regulatory or governmental agencies, rather than causing the scientists and clinicians who submit such reports to risk losing their reputations and occupations.
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Affiliation(s)
- Charles L. Bennett
- The City of Hope National Cancer Institute Designated Comprehensive Center, Duarte, California; The SONAR project of the University of South Carolina, College of Pharmacy
| | | | - Shamia Hoque
- The SONAR project of the University of South Carolina
| | | | - Anne Ventrone
- The SONAR project of the University of South Carolina
| | | | - Betty Dong
- The University of California at San Francisco
| | | | | | - Paul S. Ray
- The SONAR project of the University of South Carolina
| | | | - John Restaino
- The SONAR project of the University of South Carolina
| | | | | | | | | | - Martin Schoen
- Saint Louis University; Washington University, School of Medicine
| | - Kevin Knopf
- The SONAR project of the University of South Carolina
| | - Linda Martin
- The SONAR project of the University of South Carolina
| | - Steven Rosen
- The City of Hope National Cancer Institute Designated Comprehensive Center, Duarte, California; The SONAR project of the University of South Carolina, College of Pharmacy
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DI Iorio M, Cook C, Vanni K, Patel N, D’silva K, Fu X, Wang J, Prisco L, Kowalski E, Zaccardelli A, Martin L, Qian G, Hsu T, Wallace Z, Sparks J. POS1234 DMARD DISRUPTION, INCREASED DISEASE ACTIVITY, AND PROLONGED SYMPTOM DURATION AFTER ACUTE COVID-19 AMONG PATIENTS WITH RHEUMATIC DISEASE: A PROSPECTIVE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSystemic autoimmune rheumatic disease (SARD) patients may be at risk for disease flare and prolonged symptom duration after COVID-19, perhaps related to DMARD disruption and immune activation.ObjectivesTo describe DMARD disruption and identify differences in SARD activity among patients with and without prolonged COVID-19 symptom duration.MethodsWe identified all SARD patients with confirmed COVID-19 at the Mass General Brigham healthcare system in Boston, USA; prospective recruitment is ongoing. Surveys were used to collect demographics, clinical characteristics, DMARD disruption, COVID-19 course, and SARD disease activity before and after COVID-19. The survey included validated instruments measuring disease activity, pain, fatigue, functional status, and respiratory quality of life. Prolonged symptom duration was defined as COVID-19 symptoms lasting ≥28 days. We compared differences in patient-reported measures between those with and without prolonged symptoms.ResultsWe analyzed survey responses from 174 COVID-19 survivors with SARDs (mean age 52±16 years, 81% female, 80% White). The most common SARDs were RA (40%) and SLE (14%). Fifty-one percent of the 127 respondents on any DMARD reported a disruption to their regimen at COVID-19 onset (Figure 1). Among individual DMARDs, 56-77% were reported to have any change, except for hydroxychloroquine (23%) and rituximab (46%). SARD flare after COVID-19 was reported by 41% of respondents (Table 1). Patient global assessment of SARD activity was worse after COVID-19 (mean 7.6±2.3 before vs. 6.6±2.9 after COVID-19, p<0.001). Prolonged symptom duration was reported by 45% of participants. Those with prolonged symptoms had a higher initial COVID-19 symptom count (median 7 vs. 4, p<0.001) and were more likely to be hospitalized for COVID-19 (28% vs. 17%, p=0.001). Respondents experiencing prolonged symptom duration had higher disease activity on RAPID3 (p=0.007) as well as more pain (p<0.001) and fatigue (p=0.03) compared to those without prolonged symptoms.Table 1.Acute COVID-19 course, SARD flare/activity, and patient-reported outcomes among COVID-19 survivors with SARDs.All COVID-19 survivors with SARDs (n=174)Prolonged symptom duration ≥28 days (n=78)No prolonged symptom duration/(n=96)p-value (prolonged vs. not)Acute COVID-19 courseCOVID-19 symptom duration, days, median [IQR]14 [9, 29]46 [30, 65]11 [7, 14]<0.0001Initial symptom count, median [IQR]6 [3, 8]7 [6, 9]4 [2, 7]<0.001Hospitalized, n (%)38 (22)22 (28)16 (17)0.001SARD flare/activitySelf-reported SARD flare after COVID-19, n (%)71 (41)38 (49)33 (34)0.15Disease activity by RAPID3, median [IQR]9 [4, 14]11.2 [6, 16]7 [3, 13]0.0067RAPID3 categorical score, n (%)0.13Remission (0)11 (7)4 (5)7 (7)Near remission (0.3-1.0)23 (14)5 (7)18 (19)Low severity (1.3-2.0)26 (15)10 (14)16 (17)Moderate severity (2.3-4.0)55 (33)27 (36)28 (29)High severity (4.3-10.0)54 (32)28 (38)26 (27)Patient-reported outcomesPain by SF-MPQ, median [IQR]2 [1, 2]2 [1, 2]1 [0, 2]0.0008Fatigue by FSI, median [IQR]53 [27, 84]66 [31, 91.5]43 [26, 76]0.031mHAQ, median [IQR]0.125 [0, 0.38]0.25 [0, 0.75]0.125 [0, 0.38]0.11Respiratory quality of life by SGRQ, global [IQR]15 [4, 29]16 [4, 36]10 [4, 26]0.49RAPID3, Routine Assessment of Patient Index Data 3; SF-MPQ, Short-form McGill Pain Questionnaire; FSI, Fatigue Symptom Inventory; mHAQ, modified Health Assessment Questionnaire; SGRQ, Saint George’s Respiratory Questionnaire.Figure 1.Frequency of baseline DMARD use and proportion with any disruption at COVID-19 onset.ConclusionDMARD disruption, SARD flare, and prolonged symptoms were common in this prospective study of COVID-19 survivors with SARDs. Those with prolonged COVID-19 symptom duration, defined as ≥28 days, had higher SARD activity, more pain, and more fatigue compared to those without prolonged symptoms. These findings suggest that post-acute sequelae of COVID-19 may have a large impact on underlying SARD activity and quality of life.Disclosure of InterestsMichael Di Iorio: None declared, Claire Cook: None declared, Kathleen Vanni: None declared, Naomi Patel Consultant of: Receives consulting fees from FVC Health unrelated to this work., Kristin D’Silva: None declared, Xiaoqing Fu: None declared, Jiaqi Wang: None declared, Lauren Prisco: None declared, Emily Kowalski: None declared, Alessandra Zaccardelli: None declared, Lily Martin: None declared, Grace Qian: None declared, Tiffany Hsu: None declared, Zachary Wallace Consultant of: Receives consulting fees from Viela Bio, Zenas BioPharma, and MedPace unrelated to this work., Grant/research support from: Receives research support from Bristol-Myers Squibb and Principia/Sanofi., Jeffrey Sparks Consultant of: Receives consultant fees from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Gilead, Inova Diagnostics, Janssen, Optum, and Pfizer unrelated to this work., Grant/research support from: Receives research support from Bristol Myers Squibb.
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Samson M, Genet C, Corbera-Bellalta M, Greigert H, Ramon A, Gerard C, Cladiere C, Gabrielle P, Creuzot-Garcher C, Tarris G, Martin L, Audia S, Cid M, Bonnotte B. Une nouvelle thérapie pour l’artérite à cellules géantes : les cellules monocytaires immunosuppressives (HuMoSC). Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rehman A, Tariq S, Kumar J, Martin L, Bannon C, Duffy T, Murphy E, Stack J, Barry M, Murphy CL. POS0661 MAJOR COST SAVINGS ASSOCIATED WITH BIOLOGIC DOSE REDUCTION IN PATIENTS WITH INFLAMMATORY ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAnti-TNF drugs have dramatically improved the management of inflammatory arthritis (IA).Although the introduction of biosimilars have reduced the cost, chronic use of biologic agentshas a high impact on healthcare expenditure. This study evaluated the cost effectiveness of adose reduction strategy for the most commonly used anti- TNF drugs over a period of 10 yearsin patients with IA in remission.ObjectivesThe purpose of this study was to explore whether patients with Inflammatory Arthritis (IA) (Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS) would remain in remission after 10 year period, following a reduction in biologic dosing frequency and to calculate the cost savings associated with dose reduction.MethodsThis prospective, non-blinded, non-randomised study was commenced in 2010. Patientswith IA, Rheumatoid arthritis (RA),ankylosing spondylitis (AS) and Psoriatic arthritis (PsA)who were in remission as defined by disease activity indices (DAS28<2.6, BASDAI<4), andwere offered Anti TNF dose reduction. Patients on etanercept were reduced from 50mgweekly to fortnightly, adalimumab 40mg once monthly instead of fortnightly. Patients wereassessed for disease activity at 1, 4 and 10 years following reduction in dosingfrequency.Cost saving was calculated by deducting the total annual cost of the biologicagent used over 10 years compared with the cost if the dosing interval had not changed.ResultsSeventy nine patients with inflammatory arthritis in remission were recruited. 57% had rheumatoid arthritis (n=45), 13% psoriatic arthritis (n=10) and 30% ankylosing spondylitis (n=24). 57% (n=45) were taking etanercept and 43% (n=34) adalimumab. The percentage of patients who maintained dose reduction at 10 years was 9% (n=7). Of the total 48 patients who were successfully dose reduced at year 1 (n=42), (69%, n=29) were able to maintain the dose reduction up to 4 years and 9% (n=7) maintained this dose reduction up to year 10. The estimated cost saving was €4,928 per patient per year. Estimated cost savings for 7 patients on reduced dose was €344,952.88 over 10 years.ConclusionAnti TNF dose reduction strategy in patients with IA results in substantial cost savings. Implementation of a dose reduction strategy while monitoring of disease activity reduces the financial impact of the use of biologic therapies. Further studies should be done to identify which patients are more likely to remain in remission while on dose reduction.References[1]Bonafede MM, Gandra SR, Watson C, Princic N, Fox KM. Cost per treated patient for etanercept, adalimumab, and infliximab across adult indications: a claims analysis. Adv Ther. 2012 Mar;29(3):234-48. doi: 10.1007/s12325-012-0007-y. Epub 2012 Mar 9. PMID: 22411424.[2]Joaquín Borrás-Blasco, Antonio Gracia-Pérez, J Dolores Rosique-Robles, MD Elvira Casterá & F Javier Abad (2014) Clinical and economic impact of the use of etanercept 25 mg once weekly in rheumatoid arthritis, psoriatic arthropathy and ankylosing spondylitis patients, Expert Opinion on Biological Therapy, 14:2, 145-150, DOI: 10.1517/14712598.2014.868433[3]Carter CT, Changolkar AK, Scott McKenzie R. Adalimumab, etanercept, and infliximab utilization patterns and drug costs among rheumatoid arthritis patients. J Med Econ. 2012;15(2):332-9. doi: 10.3111/13696998.2011.649325. Epub 2012 Jan 6. PMID: 22168788.Disclosure of InterestsNone declared
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Greigert H, Ramon A, Gerard C, Ciudad M, Cladiere C, Genet C, Arnould L, Creuzot-Garcher C, Martin L, Tarris G, Audia S, Cid MC, Bonnotte B, Samson M. POS0252 MYOFIBROBLASTS MAINTAIN Th1 and Tc1 POLARIZATIONS IN GIANT CELL ARTERITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundGiant cell arteritis (GCA) is a large-vessel vasculitis mainly involving the aorta and cranial arteries. It is the most frequent vasculitis in adults over 50 years. When they are stimulated by interferon-gamma (IFN-γ), vascular smooth muscle cells (VSMC) contribute to GCA pathogenesis by producing chemokines triggering the recruitment of pro-inflammatory T cells and monocytes (1).ObjectivesCurrent knowledge about the interaction between resident cells of the vascular wall (VSMC, myofibroblasts [MF]) and immune cells is limited. The aim of our research was to better characterize the interactions between VSMC, MF and T cells in GCA.MethodsFresh fragments of temporal artery biopsies (TAB) performed at Dijon university hospital (France) were prospectively sent to our research unit. Fresh sections of positive and negative TAB were fixed and embedded in optimal cutting temperature OCT and stored at -80°C. Then, cryostat sections were fixed, permeabilized, blocked and incubated with primary antibodies (anti-alpha smooth muscle actin [α-SMA], anti-myosin heavy chain 11 [MHC11], anti-Desmin, anti CD90, anti-CD45, anti-HLA-DR, anti-phospho STAT1 [pSTAT1] and anti-pSTAT3) and secondary antibodies for confocal microscopy analyses. Fresh sections of healthy TAB were embedded in MATRIGEL and covered by DMEM to obtain vascular cells in culture. Cells were treated with trypsina-EDTA between each passage. Vascular cells were used after 4-7 doubling passages. Cells were analyzed by immunofluorescence, flow cytometry and RT-PCR and their proliferation was evaluated by impedancemetry (iCELLigence system). Peripheral blood mononuclear cells (PBMC) and vascular cells thus obtained were co-cultured for 7 days in different conditions. Vascular cells were cultured in the presence or absence of IFN-γ and tumor necrosis factor alpha (TNF-α) or interleukin-6 (IL-6) and soluble receptor of IL-6 for 72 hours. When cells reached confluence, they were cultured alone or with allogenic PBMC activated with anti-CD3/CD28 microbeads. After 7 days of culture, cells were separated with a treatment with EDTA and studied by flow cytometry.ResultsConfocal microscopy analyses of GCA arteries showed that neointima was mainly composed of myofibroblasts (MF) (α-SMA+Desmin+MHC11lowCD90+) in contact with CD45+ cells and that MF expressed HLA-DR, the phosphorylated form of STAT1 (pSTAT1) and in a lesser extent pSTAT3, strongly suggesting the activation of the IFN-γ signaling pathway rather than the IL-6 pathway. The phenotype of cultured vascular cells isolated from fresh TAB was consistent with MF. When MF were exposed to IFN-γ and TNF-α in vitro, their proliferation capacity decreased and their levels of expression of HLA-DR and CD86 increased (median fluorescence intensity [MFI] from 0 to 57 [p=0.03] and from 34 to 103 [p=0.03], respectively). In addition, co-cultures of MF and activated PBMC revealed that MF maintained the polarization of T cells into Th1 and Tc1 cells (p≤0.001) and to a lesser extent into Th17 and Tc17 cells (p=0.03). This effect was even more significant when MF were previously exposed to IFN-γ and TNF-α but not when they were exposed to IL-6.ConclusionOur results show that myofibroblasts are present in the neointima of GCA patients and that these MF activate signaling pathways indicative of IFN-γ exposure. Moreover, these MF, especially when exposed to IFN-γ, maintain the polarization of T cells into Th1 and Tc1 cells, which contributes to amplify the production of IFN-γ and thus initiate a pro-inflammatory amplification loop that likely participates in vascular inflammation and remodelling.References[1]Corbera-Bellalta M, Planas-Rigol E, Lozano E, Terrades-Garcia N, Alba MA, Prieto-Gonzalez S, et al. Blocking interferon gamma reduces expression of chemokines CXCL9, CXCL10 and CXCL11 and decreases macrophage infiltration in ex vivo cultured arteries from patients with giant cell arteritis. Ann Rheum Dis 2016;75:1177-86.Disclosure of InterestsNone declared
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Koopmanschap I, Martin L, Gitsels - van der Wal JT, Suurmond J. Counselling for prenatal anomaly screening to migrant women in the Netherlands: An interview study of primary care midwives’ perceived barriers with client–midwife communication. Eur J Midwifery 2022; 6:29. [PMID: 35633755 PMCID: PMC9118623 DOI: 10.18332/ejm/147911] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/27/2022] [Accepted: 03/31/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Large ethnic inequalities exist in the prenatal screening offer, counselling, informed decision-making, and uptake of prenatal anomaly tests. More insight into midwives’ experiences with offering prenatal counselling to migrant women may provide better insight into the origins and consequences of these ethnic inequalities. METHODS We conducted interviews with 12 midwives certified as counsellors for prenatal anomaly screening for women they identified as migrants. Interviews were analyzed using thematic analysis. RESULTS Midwives reported most difficulties in communicating with women of ‘non-western migrant background’, which include first- and second-generation migrants from Africa, Latin-America, Asia, and Turkey. They experienced barriers in communication related to linguistics, health literacy, sociocultural and religious differences, with midwife stereotyping affecting all three aspects of counselling: health education, decision-making support, and the client–midwife relation. Health education was difficult because of language barriers and low health-literacy of clients, decision-making support was hampered by sociocultural and religious midwife–client differences, and client–midwife relations were under pressure due to sociocultural and religious midwife–client differences and midwife stereotyping. CONCLUSIONS Barriers to optimal communication seem to contribute to suboptimal counselling, especially for women of ‘non-western migrant background’. Client–midwife communication thus potentially adds to the ethnic disparities observed in the offer of and informed decision-making about prenatal anomaly screening in the Netherlands. The quality of prenatal counselling for women from all ethnic backgrounds might be improved by addressing linguistic, health literacy, sociocultural and religious barriers in future training and continuing education of prenatal counsellors.
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Affiliation(s)
- Isabel Koopmanschap
- Amsterdam University Medical Center, Department of Public and Occupational Health, University of Amsterdam, Amsterdam, Netherlands
| | - Linda Martin
- Department of Midwifery Science, Academy Midwifery Amsterdam and Groningen (AVAG), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Janneke T. Gitsels - van der Wal
- Department of Midwifery Science, Academy Midwifery Amsterdam and Groningen (AVAG), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jeanine Suurmond
- Amsterdam University Medical Center, Department of Public and Occupational Health, University of Amsterdam, Amsterdam, Netherlands
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P. Pinto R, Martin L, Ramos A, Conceição M, R. da Costa R, Vaz-Velho M. Feeding and housing boars after puberty without castration allows
for good performance and low boar taint. J Anim Feed Sci 2022. [DOI: 10.22358/jafs/148234/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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