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Triebelhorn J, Schneider J, Spinner CD, Iakoubov R, Voit F, Wagner L, Erber J, Rothe K, Berthele A, Pernpeintner V, Strauß EM, Renders L, Willmann A, Minic M, Vogel E, Christa C, Hoffmann D, Protzer U, Jeske SD. Clinical and immunological outcomes of SARS-CoV-2-infected vaccine responders, vaccine non-responders, and unvaccinated patients evaluated for neutralizing monoclonal antibody treatment at a single German tertiary care center: a retrospective cohort study with prospective follow-up. Infection 2024:10.1007/s15010-023-02171-z. [PMID: 38305828 DOI: 10.1007/s15010-023-02171-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] [Received: 09/26/2023] [Accepted: 12/27/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE This study assessed the clinical and immunological outcomes of SARS-CoV-2-infected patients with risk factors for severe disease depending on their immunological status. METHODS In this retrospective study with single follow-up visit, clinical outcome and humoral immunity was monitored in SARS-CoV-2 infected patients at risk. The results were compared based on the patients' initial immunological status: unvaccinated (UV), patients who did not develop neutralizing antibodies after vaccination (vaccine non-responders, VNR), and patients who expressed neutralizing antibodies after vaccination (vaccine responders, VR). Patients who lacked neutralizing antibodies (VNR and UV) were treated with nMABs. RESULTS In total, 113 patients at risk of severe COVID-19 consented to participate in the study. VR and UV were not admitted to the hospital. During the observation period, UVs had the highest rate of SARS-CoV-2 re-infections. Three of 41 VNRs (7.3%) were hospitalized due to severe COVID-19, with two of them having undergone iatrogenic B-cell depletion. The humoral immune response after infection was significantly lower in the VNR group than in the VR group in terms of anti-N, anti-receptor-binding domain (RBD), anti-S antibody titers, and anti-S antibody avidity. In a sub-analysis of VNR, B cell-deficient non-responders had significantly lower levels of anti-N antibodies and anti-S avidity after infection than other VNRs. CONCLUSION VNR, particularly B-cell-depleted VNR, remained at risk of hospitalization due to COVID-19. In the VR group, however, no clinical complications or severe disease were observed, despite not receiving nMAbs. Tailoring the administration of nMABs according to patient vaccination and immunological status may be advisable.
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Affiliation(s)
- J Triebelhorn
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
| | - J Schneider
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - C D Spinner
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - R Iakoubov
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - F Voit
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - L Wagner
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - J Erber
- Department of Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - K Rothe
- Institute of Medical Microbiology, Immunology and Hygiene, School of Medicine, Technical University of Munich, Munich, Germany
| | - A Berthele
- Department of Neurology, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - V Pernpeintner
- Department of Neurology, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - E-M Strauß
- Department of Neurology, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - L Renders
- Department of Nephrology, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
| | - A Willmann
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
| | - M Minic
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
| | - E Vogel
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
| | - C Christa
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
| | - D Hoffmann
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
| | - U Protzer
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
| | - S D Jeske
- Institute of Virology, School of Medicine, Technical University of Munich/Helmholtz Centre Munich, Munich, Germany
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Peipert JD, Shaunfield S, Kaiser K, Moreno PI, Fox RS, Kircher S, Mohindra N, Ip E, Zhao F, Wagner L, Cella D. Correction to: How do patients interpret and respond to a single‑item global indicator of cancer treatment tolerability? Support Care Cancer 2023; 31:489. [PMID: 37486453 PMCID: PMC10366021 DOI: 10.1007/s00520-023-07953-7] [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: 07/25/2023]
Affiliation(s)
- John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 Michigan Ave, 21st Floor, Chicago, IL, 60611, USA.
| | - Sara Shaunfield
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 Michigan Ave, 21st Floor, Chicago, IL, 60611, USA
| | - Karen Kaiser
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 Michigan Ave, 21st Floor, Chicago, IL, 60611, USA
| | - Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rina S Fox
- University of Arizona College of Nursing, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - Sheetal Kircher
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Nisha Mohindra
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Edward Ip
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Fengmin Zhao
- ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Lynne Wagner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 Michigan Ave, 21st Floor, Chicago, IL, 60611, USA
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Osann K, Wenzel L, McKinney C, Wagner L, Cella D, Fulci G, Scroggins MJ, Lankes HA, Wang V, Nephew KP, Maxwell GL, Mok SC, Conrads TP, Miller A, Birrer M. Fear of recurrence, emotional well-being and quality of life among long-term advanced ovarian cancer survivors. Gynecol Oncol 2023; 171:151-158. [PMID: 36905875 PMCID: PMC10681156 DOI: 10.1016/j.ygyno.2023.02.015] [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: 11/01/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE Although advanced stage epithelial ovarian cancer is widely considered life-threatening, 17% of women with advanced disease will survive long-term. Little is known about the health-related quality of life (QOL) of long-term ovarian cancer survivors, or how fear of recurrence might affect QOL. METHODS 58 long-term survivors with advanced disease participated in the study. Participants completed standardized questionnaires to capture cancer history, QOL, and fear of recurrent disease (FOR). Statistical analyses included multivariable linear models. RESULTS Participants averaged 52.8 years at diagnosis and had survived >8 years (mean:13.5); 64% had recurrent disease. Mean FACT-G, FACT-O, and FACT-O-TOI (TOI) scores were 90.7 (SD:11.6), 128.6 (SD:14.8), and 85.9 (SD:10.2) respectively. Compared to the U.S. population using T-scores, QOL for participants exceeded that of healthy adults (T-score (FACT-G) = 55.9). Overall QOL was lower in women with recurrent vs. non-recurrent disease though differences did not reach statistical significance (FACT-O = 126.1 vs. 133.3, p = 0.082). Despite good QOL, high FOR was reported in 27%. FOR was inversely associated with emotional well-being (EWB) (p < 0.001), but not associated with other QOL subdomains. In multivariable analysis, FOR was a significant predictor of EWB after adjusting for QOL (TOI). A significant interaction was observed between recurrence and FOR (p = 0.034), supporting a larger impact of FOR in recurrent disease. CONCLUSION QOL in long-term ovarian cancer survivors was better than the average for healthy U.S. women. Despite good QOL, high FOR contributed significantly to increased emotional distress, most notably for those with recurrence. Attention to FOR may be warranted in this survivor population.
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Affiliation(s)
- Kathryn Osann
- Department of Medicine and Program in Public Health, University of California, 839 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Lari Wenzel
- Department of Medicine and Program in Public Health, University of California, 839 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Chelsea McKinney
- Department of Medicine and Program in Public Health, University of California, 839 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Lynne Wagner
- Department of Social Sciences and Health Policy, Wake Forest University, 475 Vine Street, Winston-Salem, NC 27101, USA.
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Health System, 633 N St Clair St, Chicago, IL 60611, USA.
| | - Giulia Fulci
- GlaxoSmithKline, 1000 Winter St, Waltham, MA 02451, USA
| | - Mary J Scroggins
- International Gynecology Cancer Society, PO Box 170645, Austin, TX 78717, USA
| | - Heather A Lankes
- The GOG Foundation, Inc., Edgewater, MD 21037, USA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
| | - Victoria Wang
- Dana-Farber Cancer Institute, Department of Data Science, 450 Brookline Ave LC1052 or LC9310, Boston, MA 02215, USA.
| | - Kenneth P Nephew
- Medical Sciences Program, Indiana University School of Medicine-Bloomington, 1001 E 3rd St, Bloomington, IN, 47405, USA.
| | - George L Maxwell
- Women's Health Integrated Research Center at Inova Health System, Women's Service Line, Inova Health System, 8110 Gatehouse Rd, Falls Church, VA 22042, USA.
| | - Samuel C Mok
- Department of Gynecological Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Houston, TX 77230, USA.
| | - Thomas P Conrads
- Women's Health Integrated Research Center at Inova Health System, Women's Service Line, Inova Health System, 8110 Gatehouse Rd, Falls Church, VA 22042, USA.
| | - Austin Miller
- Roswell Park Comprehensive Cancer Center, 665 Elm St, Buffalo, NY 14203, USA.
| | - Michael Birrer
- Winthrop P. Rockefeller Cancer Institute University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205, USA.
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Henderson NL, Courtney A, Valerie L, Ingram SA, Zubkoff L, Tung N, Wagner L, Wallner LP, Wolff AC, Rocque GB. Abstract P6-05-54: "Clinical Trials are Space Travel": Moderators of Recurrence Stress among Breast Cancer Oncologists. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-05-54] [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: 03/06/2023]
Abstract
Abstract
Background: Being an oncologist means accepting that some patients will have disease recurrence despite the most expert treatments. The universality of that experience, however, does not negate the potential for decisional regret and emotional distress on the part of the physician. The broad scale movement towards treatment optimization in medicine likely complicates this experience, as enrollment in de-escalation clinical trials inevitably means that the patient will receive less than the current standard of care. The objective of this study was to assess physician perceptions of potential emotional distress and decisional regret following patient recurrence through exploring the broad range of factors that either moderate or exacerbate those experiences. Methods: Physicians who treat breast cancer in academic and community settings across the United States participated in a qualitative interview designed to assess physician perspectives regarding patient enrollment in de-escalation clinical trials. Purposive sampling techniques were utilized to construct a balanced sample (sex, time in practice) of 39 participants. A subsection of the interview schedule centered on the experiences of decisional regret and distress surrounding patient recurrence. Interviews were recorded, transcribed, and analyzed in order to identify shared themes. Two independent coders performed a content analysis, identifying and recording factors that impact the level of distress that the physician may feel. Results: Thirty-six physicians provided in depth responses regarding their experience when a patient recurs. A total of 21 factors that affected recurrence stress were identified and spanned broad categories including patient features, disease biology, the design of the clinical trial, and characteristics of the physician. All participants expressed willingness to enroll patients in de-escalation-focused clinical trials. However, approximately half of the sample indicated that the experience would be worse after enrollment in a de-escalation trial than after a traditional intensification trial, and a quarter admitted that patient recurrence after a de-escalation trial would impact their decision making regarding future patient enrollment. Individuals not likely to experience distress emphasized having a strong trial rationale, informed patient consent, and engaging in shared decision-making, while greater distress centered on the fear of “not doing enough” and the patient missing out on necessary treatment. Conclusions: Many factors contribute to the experience of physician decisional regret and emotional distress after patient recurrence. Although most physicians recognize the importance of de-escalation focused clinical trials, a significant proportion indicated a greater potential for distress following patient recurrence in such trials and offered insight into how trial design and the process of patient enrollment can be improved to minimize potential distress.
Citation Format: Nicole L. Henderson, Andrews Courtney, Lawhon Valerie, Stacey A. Ingram, Lisa Zubkoff, Nadine Tung, Lynne Wagner, Lauren P. Wallner, Antonio C. Wolff, Gabrielle B. Rocque. "Clinical Trials are Space Travel": Moderators of Recurrence Stress among Breast Cancer Oncologists [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-54.
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Affiliation(s)
| | | | | | | | | | - Nadine Tung
- 6Beth Israel Deaconess Medical Center, Boston
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Cornu JN, Wagner L, Peschers U, Lamblin G, Gonzalez Enguita C, Ettore G, Torrisi G, Van Eijndhoven H, Fatton B, Furio Bernardo Z, Karsenty G, Saussine C, Ryckebusch H, Grise P. Altis™ single incision sling for female stress urinary incontinence: A multicenter, prospective post-market clinical study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00919-3] [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: 02/12/2023]
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Peipert JD, Shaunfield S, Kaiser K, Moreno PI, Fox RS, Kircher S, Mohindra N, Ip E, Zhao F, Wagner L, Cella D. How do patients interpret and respond to a single-item global indicator of cancer treatment tolerability? Support Care Cancer 2023; 31:37. [PMID: 36525100 PMCID: PMC10356672 DOI: 10.1007/s00520-022-07484-7] [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] [Received: 05/02/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is increasing interest in patient-reported measures of cancer treatment tolerability. A global measure of bother, the FACT GP5 item ("I am bothered by side effects of treatment") is potentially useful for regulatory, research, and clinical use. To understand this item's appropriateness for capturing treatment tolerability, we conducted cognitive interviews on this item with 3 samples of cancer patients. METHODS Patients with ovarian cancer (Study 1: N = 21; on treatment), lymphoma (Study 2: N = 14; on treatment), and colorectal or lung cancer (Study 3: N = 16; treatment naïve) were interviewed about GP5's understandability and relevance to their treatment side effects. What patients think about when answering GP5 was also assessed. In all studies, the interview included both structured and open-ended questions. Qualitative data were coded to extract themes and responses to structured questions were tallied. RESULTS Most patients on treatment (Studies 1 and 2) reported that the GP5 item wording is appropriate (88%) and its meaning is clear (97%). They were very confident or confident in their response (97%) and stated that GP5 was relevant to their cancer experience (97%). When answering GP5, patients considered their treatment and specific side effects. A large proportion (40%) of the treatment-naïve (Study 3) patients reported that GP5 was not relevant to their cancer treatment, and the largest proportion responded to GP5 thinking of negative side effect expectancies. CONCLUSION This study provides assurance that GP5 is a useful indicator of treatment tolerability, and is meaningful to people with cancer, especially once they have started treatment.
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Wilkinson M, Keehn RJ, Linke A, You Y, Gao Y, Alemu K, Correas A, Rosen B, Kohli J, Wagner L, Sridhar A, Marinkovic K, Müller RA. fMRI BOLD and MEG theta power reflect complementary aspects of activity during lexicosemantic decision in adolescents with ASD. Neuroimage Rep 2022; 2:100134. [PMID: 36438080 PMCID: PMC9683354 DOI: 10.1016/j.ynirp.2022.100134] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Neuroimaging studies of autism spectrum disorder (ASD) have been predominantly unimodal. While many fMRI studies have reported atypical activity patterns for diverse tasks, the MEG literature in ASD remains comparatively small. Our group recently reported atypically increased event-related theta power in individuals with ASD during lexicosemantic processing. The current multimodal study examined the relationship between fMRI BOLD signal and anatomically-constrained MEG (aMEG) theta power. Thirty-three adolescents with ASD and 23 typically developing (TD) peers took part in both fMRI and MEG scans, during which they distinguished between standard words (SW), animal words (AW), and pseudowords (PW). Regions-of-interest (ROIs) were derived based on task effects detected in BOLD signal and aMEG theta power. BOLD signal and theta power were extracted for each ROI and word condition. Compared to TD participants, increased theta power in the ASD group was found across several time windows and regions including left fusiform and inferior frontal, as well as right angular and anterior cingulate gyri, whereas BOLD signal was significantly increased in the ASD group only in right anterior cingulate gyrus. No significant correlations were observed between BOLD signal and theta power. Findings suggest that the common interpretation of increases in BOLD signal and theta power as 'activation' require careful differentiation, as these reflect largely distinct aspects of regional brain activity. Some group differences in dynamic neural processing detected with aMEG that are likely relevant for lexical processing may be obscured by the hemodynamic signal source and low temporal resolution of fMRI.
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Affiliation(s)
- M. Wilkinson
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States,Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - R.J. Jao Keehn
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - A.C. Linke
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Y. You
- Spatiotemporal Brain Imaging Laboratory, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Y. Gao
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States,Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - K. Alemu
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - A. Correas
- Spatiotemporal Brain Imaging Laboratory, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - B.Q. Rosen
- Spatiotemporal Brain Imaging Laboratory, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - J.S. Kohli
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States,Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - L. Wagner
- Spatiotemporal Brain Imaging Laboratory, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - A. Sridhar
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States
| | - K. Marinkovic
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States,Spatiotemporal Brain Imaging Laboratory, Department of Psychology, San Diego State University, San Diego, CA, United States,Radiology Department, University of California at San Diego, CA, United States
| | - R.-A. Müller
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States,Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, CA, United States,Corresponding author. San Diego State University, 6363 Alvarado Ct., Suite 103, San Diego, CA 92120, United States. (R.-A. Müller)
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Tamargo CL, Mitchell EP, Wagner L, Simon MA, Carlos RC, Giantonio BJ, Schabath MB, Quinn GP. “I need more knowledge”: Qualitative analysis of oncology providers’ experiences with sexual and gender minority patients. Front Psychol 2022; 13:763348. [PMID: 36046410 PMCID: PMC9421156 DOI: 10.3389/fpsyg.2022.763348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background While societal acceptance for sexual and gender minority (SGM) individuals is increasing, this group continues to face barriers to quality healthcare. Little is known about clinicians’ experiences with SGM patients in the oncology setting. To address this, a mixed method survey was administered to members of the ECOG-ACRIN Cancer Research Group. Materials and methods We report results from the open-ended portion of the survey. Four questions asked clinicians to describe experiences with SGM patients, reservations in caring for them, suggestions for improvement in SGM cancer care, and additional comments. Data were analyzed using content analysis and the constant comparison method. Results The majority of respondents noted they had no or little familiarity with SGM patients. A minority of respondents noted experience with gay and lesbian patients, but not transgender patients; many who reported experience with transgender patients also noted difficulty navigating the correct use of pronouns. Many respondents also highlighted positive experiences with SGM patients. Suggestions for improvement in SGM cancer care included providing widespread training, attending to unique end-of-life care issues among SGM patients, and engaging in efforts to build trust. Conclusion Clinicians have minimal experiences with SGM patients with cancer but desire training. Training the entire workforce may improve trust with, outreach efforts to, and cancer care delivery to the SGM community.
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Affiliation(s)
- Christina L. Tamargo
- Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Edith P. Mitchell
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Lynne Wagner
- Department of Social Sciences and Health Policy, Wake Forest University, Winston-Salem, NC, United States
| | - Melissa A. Simon
- Department of Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ruth C. Carlos
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
| | - Bruce J. Giantonio
- Department of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, United States
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States
- *Correspondence: Matthew B. Schabath,
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology and Population Health, NYU Grossman School of Medicine, New York, NY, United States
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Chen Z, Zhang H, George TJ, Guo Y, Prosperi M, Guo J, Braithwaite D, Wang F, Kibbe W, Wagner L, Bian J. Simulating Colorectal Cancer Trials Using Real-World Data. JCO Clin Cancer Inform 2022; 6:e2100195. [PMID: 35839432 PMCID: PMC9848597 DOI: 10.1200/cci.21.00195] [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: 12/08/2021] [Revised: 03/04/2022] [Accepted: 06/02/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Using real-world data (RWD)-based trial simulation approach, we aim to simulate colorectal cancer (CRC) trials and examine both effectiveness and safety end points in different simulation scenarios. METHODS We identified five phase III trials comparing new treatment regimens with an US Food and Drug Administration-approved first-line treatment in patients with metastatic CRC (ie, fluorouracil, leucovorin, and irinotecan) as the standard-of-care (SOC) control arm. Using Electronic Health Record-derived data from the OneFlorida network, we defined the study populations and outcome measures using the protocols from the original trials. Our design scenarios were (1) simulation of the SOC fluorouracil, leucovorin, and irinotecan arm and (2) comparative effectiveness research (CER) simulation of the control and experimental arms. For each scenario, we adjusted for random assignment, sampling, and dropout. We used overall survival (OS) and severe adverse events (SAEs) to measure effectiveness and safety. RESULTS We conducted CER simulations for two trials, and SOC simulations for three trials. The effect sizes of our simulated trials were stable across all simulation runs. Compared with the original trials, we observed longer OS and higher mean number of SAEs in both CER and SOC simulation. In the two CER simulations, hazard ratios associated with death from simulations were similar to that reported in the original trials. Consistent with the original trials, we found higher risk ratios of SAEs in the experiment arm, suggesting potentially higher toxicities from the new treatment regimen. We also observed similar SAE rates across all simulations compared with the original trials. CONCLUSION In this study, we simulated five CRC trials, and tested two simulation scenarios with several different configurations demonstrated that our simulations can robustly generate effectiveness and safety outcomes comparable with the original trials using real-world data.
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Affiliation(s)
- Zhaoyi Chen
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
- Cancer Informatics Share Resource, University of Florida Health Cancer Center, Gainesville, FL
| | - Hansi Zhang
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Thomas J. George
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - Yi Guo
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
- Cancer Informatics Share Resource, University of Florida Health Cancer Center, Gainesville, FL
| | - Mattia Prosperi
- Department of Epidemiology, College of Medicine & College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL
| | - Dejana Braithwaite
- Department of Epidemiology, College of Medicine & College of Public Health and Health Professions, University of Florida, Gainesville, FL
- Department of Surgery, College of Medicine, University of Florida, Gainesville, FL
| | - Fei Wang
- Department of Population Health Sciences, Cornell University, New York, NY
| | - Warren Kibbe
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Lynne Wagner
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jiang Bian
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
- Cancer Informatics Share Resource, University of Florida Health Cancer Center, Gainesville, FL
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Ayyad Y, Mittig W, Tang T, Olaizola B, Potel G, Rijal N, Watwood N, Alvarez-Pol H, Bazin D, Caamaño M, Chen J, Cortesi M, Fernández-Domínguez B, Giraud S, Gueye P, Heinitz S, Jain R, Kay BP, Maugeri EA, Monteagudo B, Ndayisabye F, Paneru SN, Pereira J, Rubino E, Santamaria C, Schumann D, Surbrook J, Wagner L, Zamora JC, Zelevinsky V. Evidence of a Near-Threshold Resonance in ^{11}B Relevant to the β-Delayed Proton Emission of ^{11}Be. Phys Rev Lett 2022; 129:012501. [PMID: 35841541 DOI: 10.1103/physrevlett.129.012501] [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] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/29/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
A narrow near-threshold proton-emitting resonance (E_{x}=11.4 MeV, J^{π}=1/2^{+}, and Γ_{p}=4.4 keV) was directly observed in ^{11}B via proton resonance scattering. This resonance was previously inferred in the β-delayed proton emission of the neutron halo nucleus ^{11}Be. The good agreement between both experimental results serves as a ground to confirm the existence of such exotic decay and the particular behavior of weakly bound nuclei coupled to the continuum. R-matrix analysis shows a sizable partial decay width for both, proton and α (Γ_{α}=11 keV) emission channels.
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Affiliation(s)
- Y Ayyad
- IGFAE, Universidade de Santiago de Compostela, E-15782 Santiago de Compostela, Spain
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - W Mittig
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Tang
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Olaizola
- ISOLDE-EP, CERN, CH-1211 Geneva 23, Switzerland
| | - G Potel
- Lawrence Livermore National Lab., P.O. Box 808, Livermore, California 94550, USA
| | - N Rijal
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Watwood
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Alvarez-Pol
- IGFAE, Universidade de Santiago de Compostela, E-15782 Santiago de Compostela, Spain
| | - D Bazin
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Caamaño
- IGFAE, Universidade de Santiago de Compostela, E-15782 Santiago de Compostela, Spain
| | - J Chen
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Cortesi
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Fernández-Domínguez
- IGFAE, Universidade de Santiago de Compostela, E-15782 Santiago de Compostela, Spain
| | - S Giraud
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - P Gueye
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Heinitz
- Laboratory of Radiochemistry, Paul Scherrer Institute, Forschungsstrasse 111, 5232 Villigen PSI, Switzerland
| | - R Jain
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B P Kay
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E A Maugeri
- Laboratory of Radiochemistry, Paul Scherrer Institute, Forschungsstrasse 111, 5232 Villigen PSI, Switzerland
| | - B Monteagudo
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - F Ndayisabye
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S N Paneru
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Pereira
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Rubino
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Santamaria
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Schumann
- Laboratory of Radiochemistry, Paul Scherrer Institute, Forschungsstrasse 111, 5232 Villigen PSI, Switzerland
| | - J Surbrook
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - L Wagner
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - J C Zamora
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - V Zelevinsky
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
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Ghazal LV, Cole S, Salsman JM, Wagner L, Duan F, Gareen I, Lux L, Parsons SK, Cheung C, Loeb DM, Prasad P, Dinner S, Zebrack B. Social Genomics as a Framework for Understanding Health Disparities Among Adolescent and Young Adult Cancer Survivors: A Commentary. JCO Precis Oncol 2022; 6:e2100462. [PMID: 35772048 PMCID: PMC9259142 DOI: 10.1200/po.21.00462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Lauren V Ghazal
- Center for Improving Patient and Population Health, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Steve Cole
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - John M Salsman
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
| | - Lynne Wagner
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University, Winston-Salem, NC
| | - Fenghai Duan
- Department of Biostatistics, Brown University, Providence, RI
| | - Ilana Gareen
- Department of Epidemiology and the Center for Statistical Sciences, Brown University School of Public Health, Providence, RI
| | - Lauren Lux
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Susan K Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Cancer Center, Tufts Medical Center, Boston, MA
| | | | | | - Pinki Prasad
- Louisiana State University Health, New Orleans, LA
| | - Shira Dinner
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brad Zebrack
- Division of Cancer Control and Population Sciences, School of Social Work, Rogel Cancer Center, University of Michigan, Ann Arbor, MI
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Andrews C, Childers TC, Wiseman KD, Lawhon V, Ingram S, Smith ML, Wolff AC, Wagner L, Rocque GB. Facilitators and barriers to reducing chemotherapy for early-stage breast cancer: a qualitative analysis of interviews with patients and patient advocates. BMC Cancer 2022; 22:141. [PMID: 35120494 PMCID: PMC8815019 DOI: 10.1186/s12885-022-09189-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background As the combination of systemic and targeted chemotherapies is associated with severe adverse side effects and long-term health complications, there is interest in reducing treatment intensity for patients with early-stage breast cancer (EBC). Clinical trials are needed to determine the feasibility of reducing treatment intensity while maintaining 3-year recurrence-free survival of greater than 92%. To recruit participants for these trials, it is important to understand patient perspectives on reducing chemotherapy. Methods We collected qualitative interview data from twenty-four patients with Stage II-III breast cancer and sixteen patient advocates. Interviews explored potential barriers and facilitators to participation in trials testing reduced amounts of chemotherapy. As the COVID-19 pandemic struck during data collection, seventeen participants were asked about the potential impact of COVID-19 on their interest in these trials. Interviews were audio-recorded and transcribed, and researchers used qualitative content analysis to code for dominant themes. Results Seventeen participants (42.5%) expressed interest in participating in a trial of reduced chemotherapy. Barriers to reducing chemotherapy included (1) fear of recurrence and inefficacy, (2) preference for aggressive treatment, (3) disinterest in clinical trials, (4) lack of information about expected outcomes, (5) fear of regret, and (6) having young children. Facilitators included (1) avoiding physical toxicity, (2) understanding the scientific rationale of reducing chemotherapy, (3) confidence in providers, (4) consistent monitoring and the option to increase dosage, (5) fewer financial and logistical challenges, and (6) contributing to scientific knowledge. Of those asked, nearly all participants said they would be more motivated to reduce treatment intensity in the context of COVID-19, primarily to avoid exposure to the virus while receiving treatment. Conclusions Among individuals with EBC, there is significant interest in alleviating treatment-related toxicity by reducing chemotherapeutic intensity. Patients will be more apt to participate in trials testing reduced amounts of chemotherapy if these are framed in terms of customizing treatment to the individual patient and added benefit—reduced toxicities, higher quality of life during treatment and lower risk of long-term complications—rather than in terms of taking treatments away or doing less than the standard of care. Doctor-patient rapport and provider support will be crucial in this process. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09189-w.
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Affiliation(s)
- Courtney Andrews
- College of Arts and Sciences, University of Alabama, 1720 2nd Avenue South, Birmingham, Alabama, 35294, USA.
| | - Timothy C Childers
- University of Alabama School of Medicine, 1670 University Boulevard, Birmingham, AL, 35233, USA
| | - Kimberly D Wiseman
- Wake Forrest School of Medicine, Bowman Gray Center for Medical Education, 475 Vine St, Winston-Salem, NC, 27101, USA
| | - Valerie Lawhon
- University of Alabama School of Medicine, 1670 University Boulevard, Birmingham, AL, 35233, USA
| | - Stacey Ingram
- University of Alabama School of Medicine, 1670 University Boulevard, Birmingham, AL, 35233, USA
| | - Mary Lou Smith
- Research Advocacy Network, Park Blvd, Suite 305, Plano, TX, 6505 W75093, USA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21205, USA
| | - Lynne Wagner
- Wake Forrest School of Medicine, Bowman Gray Center for Medical Education, 475 Vine St, Winston-Salem, NC, 27101, USA
| | - Gabrielle B Rocque
- University of Alabama School of Medicine, 1670 University Boulevard, Birmingham, AL, 35233, USA
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Obeng-Gyasi S, ONeill A, Miller KD, Schneider BP, Patridge AH, Timsina LR, Sledge GW, Wagner L, Carlos RC. Abstract PO-219: The implications of genetic ancestry and allostatic load on clinical outcomes in the ECOG-ACRIN adjuvant breast cancer trial E5103. Cancer Epidemiol Biomarkers Prev 2022. [DOI: 10.1158/1538-7755.disp21-po-219] [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: 11/16/2022] Open
Abstract
Abstract
Introduction: Elevated allostatic load (AL) has been associated with poor tumor prognostic features in Black breast cancer patients and worse disease specific and overall survival among cancer patients. To date, there are no studies evaluating the relationship between genetic ancestry, allostatic load and clinical trial endpoints such as completion of chemotherapy per protocol or overall survival. Prior evaluations of the ECOG-ACRIN adjuvant breast cancer trial E5103 suggests African ancestry is associated with a worse invasive disease-free survival and lower odds of chemotherapy completion. The objective of this study is to evaluate the association of genetic ancestry and AL with trial completion per protocol and with overall survival among patients in E5103. Methods: ECOG-ACRIN E5103 was a clinical trial that compared doxorubicin and cyclophosphamide (AC) for four cycles, followed by 12 weeks of weekly paclitaxel with placebo (Arm A) to the same chemotherapy with either concurrent bevacizumab (Arm B) or with concurrent plus sequential bevacizumab (Arm C) among women with node positive or high-risk node negative HER2 negative disease. Genetic ancestry groups of African ancestry (AA), European ancestry (EA) and other ancestry (OA) were determined using genome-wide single nucleotide polymorphisms. AL, at trial entry, was comprised of the biomarkers body mass index, systolic blood pressure, diastolic blood pressure, creatinine, IL6, IL10, and TNF alpha. To calculate AL, patients were awarded a point if their biomarker value was above the 75 percentile of the study sample. Logistic regression and Cox-Proportional Hazard models (odds ratio(OR) and hazard ratio (HR) estimates with corresponding 95% confidence intervals (CI)) were used to assess association with chemotherapy completion and with overall mortality. Estimates for AL were adjusted for genetic ancestry. Results: There were 348 patients in the study. The majority of the sample was of EA (EA 80%, AA 10%, OA 10%). Median (range) of AL was 2(0-6). Patients of AA (2.1(1.3)) and EA (1.88(1.4)) had a higher mean (SD) AL score compared to OA patients (0.91(1.1). On adjusted analysis, a 1 unit increased in AL was associated with a 15% reduction in the odds of completing chemotherapy per protocol (OR 0.85, 95% CI 0.72-0.99). Additionally, a 1 unit increase in AL was associated with a 14% increase in the hazard of death (HR 1.14, 95%CI 1.02-1.29). There was no association between ancestry and chemotherapy completion (AA OR 0.95, 95%CI 0.47-1.93; OA 1.82, 95%CI 0.78-4.23; ref EA) or survival (AA HR 1.40, 95% CI 0.85-2.31), OA 0.89 (0.46-1.73; ref EA). Moreover, there was no interaction between AL and ancestry. Conclusion: Among patients enrolled in E5103, AL appeared to be a better predictor of chemotherapy completion and overall survival than genetic ancestry. These results suggest life course exposure to chronic stress has implication in clinical outcomes even within the context of equivalent access to and quality of care.
Citation Format: Samilia Obeng-Gyasi, Anne ONeill, Kathy D. Miller, Bryan P. Schneider, Ann H. Patridge, Lava R. Timsina, George W. Sledge, Lynne Wagner, Ruth C. Carlos. The implications of genetic ancestry and allostatic load on clinical outcomes in the ECOG-ACRIN adjuvant breast cancer trial E5103 [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-219.
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Affiliation(s)
| | - Anne ONeill
- 2Dana Farber Cancer Institute – ECOG-ACRIN Biostatistics Center, Boston, MA,
| | - Kathy D. Miller
- 3Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN,
| | - Bryan P. Schneider
- 3Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN,
| | | | | | | | - Lynne Wagner
- 7Wake Forest University Health sciences, Winston Salem, NC,
| | - Ruth C. Carlos
- 8University of Michigan Comprehensive Cancer Center, Ann Arbor, MI
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Kircher S, Braccio N, Gallagher K, Carlos R, Wagner L, Smith ML, Balch A, Benson AB. Meeting Patients Where They Are: Policy Platform for Telehealth and Cancer Care Delivery. J Natl Compr Canc Netw 2021; 19:1470-1474. [PMID: 34902826 DOI: 10.6004/jnccn.2021.7111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Cardot V, Campagne-Loiseau S, Roulette P, Peyrat L, Vidart A, Wagner L, Thuillier C, Klap J, Hurel S, Hermieu JF, Girard F, Even L, Donon L, Charles T, Tibi B, Bosset PO, Berrogain N, Meyer F, Cornu JN, Deffieux X. 2021 opinion from the CUROPF on THE efficacy and safety of mid-urethral slings used in women WITH urinary stress incontinence. Prog Urol 2021; 32:247-257. [PMID: 34920924 DOI: 10.1016/j.purol.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/23/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the usefulness of mid-urethral slings (MUS) in the surgical management of women presenting with urinary stress incontinence (USI) METHOD: A consensus committee of multidisciplinary experts (CUROPF) was convened and focused on PICO questions concerning the efficacy and safety of MUS surgery compared to other procedures and concerning which approach (retropubic (RP) vs transobturator (TO)) should be proposed as a first-line MUS surgery for specific subpopulations (obese; intrinsic sphincteric deficiency (ISD); elderly) RESULTS: As compared to other procedures (urethral bulking agents, traditional slings and open colposuspension), the MUS procedure should be proposed as the first-line surgical therapy (strong agreement). MUS surgery can be associated with complications and proper pre-operative informed consent is mandatory (strong agreement). Mini-slings (SIS/SIMS) should only be proposed in clinical trials (strong agreement). Both RP and TO approaches may be proposed for the insertion of MUS (strong agreement). However, if the woman is willing to accept a moderate increase in per-operative risk, the RP approach should be preferred (strong agreement) since it is associated with higher very long-term cure rates and as it is possible to completely remove the sling surgically if a severe complication occurs. The RP approach should be used for the insertion of MUS in a woman presenting with ISD (strong agreement). Either the RP or TO approach should be used for the insertion of MUS in an obese woman presenting with USI (strong agreement). In very obese women (BMI ≥35-40kg/m2), weight loss should be preferred prior to MUS surgery and bariatric surgery should be discussed (strong agreement) CONCLUSION: The current Opinion provides an appropriate strategy for both the selection of patients and the best therapeutic approach in women presenting with USI.
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Affiliation(s)
- V Cardot
- Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France
| | - S Campagne-Loiseau
- Service de gynécologie obstétrique, CHU Estaing, Clermont Ferrand, 1, place Lucie et Raymond-Aubrac, 63000 Clermont Ferrand, France
| | - P Roulette
- Service d'urologie, CH Cahors, 30, avenue de la voie Romaine, 06000 Nice, France
| | - L Peyrat
- Service d'urologie, Clinique de Turin, 13, rue de Turin, 75008 Paris, France
| | - A Vidart
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L Wagner
- Servie d'urologie, CHU Carémeau, place du Pr Robert Debré, 30029 Nîmes, France
| | - C Thuillier
- Service d'urologie, CHU Grenoble-Alpes, 38000 Grenoble, France
| | - J Klap
- Service d'urologie, hôpital Privé Claude Galien, 20, route de Boussy Saint-Antoine, 91480 Quincy sous Sénart, France
| | - S Hurel
- Service d'urologie, hôpital Européen Georges-Pompidou (AP-HP), 20, rue Leblanc, 75015 Paris, France
| | - J F Hermieu
- Service d'urologie, hôpital Bichat (AP-HP), 46, rue Henri-Huchard, 75018 Paris, France
| | - F Girard
- Service d'urologie, clinique oudinot fondation Cognacq-Jay, 2 rue Rousselet, 75007 Paris, France
| | - L Even
- Cabinet d'urologie, Espace Santé 3, 521, avenue de Rome, 83500 La Seyne-sur-Mer, France
| | - L Donon
- Service d'urologie, Polyclinique de la Côte Basque Sud, 7, rue Léonce Goyetche, 64500 Saint Jean de Luz, France
| | - T Charles
- Service d'urologie, CHU La Miletrie, 2, rue de la Milétrie, 86021 Poitiers, France
| | - B Tibi
- Service d'urologie, CH Cahors, 30, avenue de la voie Romaine, 06000 Nice, France
| | - P O Bosset
- Service d'urologie, Clinique de Turin, 13, rue de Turin, 75008 Paris, France
| | - N Berrogain
- Service d'URologie, Clinique Ambroise Pare, 387, route de Saint-Simon, 31100 Toulouse, France
| | - F Meyer
- Service d'urologie, hôpital Saint Louis (APHP), 1, avenue Claude Vellefaux, 75010 Paris, France
| | - J-N Cornu
- Service d'urologie, hôpital Charles-Nicolle, université de Rouen, 1, rue de Germont, 76000 Rouen, France
| | - X Deffieux
- Service de gynécologie obstétrique, hôpital Antoine-Béclère (APHP), 157, rue de la Porte de Trivaux, 92140 Clamart, France.
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Even L, Tibi B, Bentellis I, Treacy PJ, Berrogain N, Bosset PO, Campagne-Loiseau S, Cardot V, Charles T, Deffieux X, Donon L, Girard F, Hermieu JF, Hurel S, Klap J, Meyer F, Peyrat L, Thuillier C, Vidart A, Wagner L, Cornu JN. [Complications of mid-urethral sling - A review from the Committee for Female Urology and Pelviperineology for the French Association of Urology]. Prog Urol 2021; 31:1141-1166. [PMID: 34794867 DOI: 10.1016/j.purol.2021.09.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Placement of a mid-urethral sling is the gold standard in the surgical management of stress urinary incontinence in women in France. The cure rate of this material is no longer to be demonstrated, but the per- and post-operative complications are currently the subject of a growing controversy not only in Europe but also across the Channel and across the Atlantic, having led to the modification of operative indications. In France, recommendations are also evolving with a stricter framework for indications for surgery by multidisciplinary consultation meeting and an obligation for postoperative follow-up in the short and long term. OBJECTIVES In this context, CUROPF realized a review of the literature bringing together the available scientific evidence concerning the occurrence of per- and post-operative complications relating to the installation of mid urethral sling. The bibliographic search was carried out using the Medline database and 123 articles were selected. RESULTS Analysis of the data highlights various complications, depending on the implanted material, the patient and the indication for surgery. The retro-pubic mid urethral sling provides more bladder erosion during surgery (up to 14%), more suprapubic pain (up to 4%) and more acute urinary retention (up to 19,7%) and postoperative dysuria (up to 26%). The trans obturator mid-urethral sling is responsible for more vaginal erosion during the operation (up to 10,9%), more lower limb pain of neurological origin (up to 26,7%). The risk of developing over active bladder is similar in both procedures (up to 33%). But these risks of complications must be balanced by the strong impact of urinary incontinence surgery on the overall quality of life of these women. CONCLUSION Thus, surgical failure and long term complications exist but should not limit the surgical management of stress urinary incontinence with mid urethral tape. Women should be treated with individualized decision-making process and long-term follow -up is necessary.
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Affiliation(s)
- L Even
- Cabinet d'urologie, espace santé 3 83500 La Seyne sur Mer, clinique du Cap d'Or, 83500 La Seyne sur mer, Polyclinique Les Fleurs, 83190 Ollioules, France
| | - B Tibi
- Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
| | - I Bentellis
- Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
| | - P J Treacy
- Service d'urologie, université de Nice-Sophia Antipolis, hôpital Pasteur 2, CHU de Nice, 06000 Nice, France
| | - N Berrogain
- Clinique Ambroise-Paré, 31100 Toulouse, France
| | - P O Bosset
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - S Campagne-Loiseau
- Service de gynécologie-obstétrique, CHU Estaing, Clermont-Ferrand, France
| | - V Cardot
- Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France
| | - T Charles
- Service d'urologie, CHU La Miletrie, 86000 Poitiers, France
| | - X Deffieux
- Service de gynécologie-obstétrique, hôpital Antoine-Béclère (AP-HP), 92140 Clamart, France
| | - L Donon
- Clinique de la Côte Basque, 64100 Bayonne, France
| | - F Girard
- Service d'urologie, clinique Oudinot Fondation Cognac-Jay, 2, rue Rousselet, 75007 Paris, France
| | - J-F Hermieu
- Service d'urologie, hôpital Bichat, AP-HP, Paris, France
| | - S Hurel
- Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - J Klap
- Service d'urologie, hôpital Privé Claude Galien, 91480 Quincy-sous-Sénart, France
| | - F Meyer
- Service d'urologie, hôpital Saint-Louis, AP-HP, Paris, France
| | - L Peyrat
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - C Thuillier
- Service d'urologie, CHU Grenoble-Alpes, 38000 Grenoble, France
| | - A Vidart
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L Wagner
- Service d'urologie, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France
| | - J N Cornu
- Service d'urologie, université de Rouen, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France.
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Righini M, Droupy S, Turra N, Martin L, Blion C, Wagner L, Boukaram M, Ben Naoum K, Chevrot A. Traitement par Aquablation (Aquabeam) de l’hypertrophie prostatique symptomatique : expérience initiale. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.186] [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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Flochlay M, Peyronnet B, Lasri S, Broudeur L, Gondran-Tellier B, Karsenty G, Perrouin-Verbe M, Biardeau X, Wagner L, Bey E. Sphincter urinaire artificiel par voie robotique : comparaison préliminaire des voies d’abord antérieure et postérieure du col vésical chez les femmes présentant une incontinence urinaire à l’effort par insuffisance sphinctérienne. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ferreira GA, Wagner L, Maziero R, Ataide-Silva T, Silva NA, Bertuzzi R, Lima-Silva AE. Caffeine intake reduces sedentary time and increases physical activity predisposition in obese police officers. ACTA ACUST UNITED AC 2021; 54:e11556. [PMID: 34550274 PMCID: PMC8457682 DOI: 10.1590/1414-431x2021e11556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022]
Abstract
Sedentary time is associated with increased obesity in police officers. Caffeine intake may reduce sedentary time but it has not been extensively investigated. In the present study, the effect of caffeine ingestion on sedentary time was investigated in obese police officers. Fourteen obese police officers ingested either 5 mg/kg of caffeine or cellulose (placebo) for six days. Information on inactivity time, time spent with physical activities, self-reported perception of tiredness, and physical activity disposition was obtained daily during the intervention period. Sedentary and physical activity times were divided into two intraday periods (T1: 08:00 am-02:00 pm and T2: 02:00 pm-08:00 pm). Caffeine intake decreased the sedentary time in both T1 (79.2±2.2%) and T2 (79.1±2.5%), when compared with T2 of the placebo condition (81.1±3.6%, P<0.05). Caffeine intake also increased the time spent on light physical activities in T1 and T2 (17±2 and 18±2%), when compared with T2 of the placebo condition (16±3%, P<0.05). In addition, sedentary time increased and light physical activity time decreased from T1 to T2 in the placebo (P<0.001) but not in the caffeine condition (P=0.81). Caffeine intake had no effect on tiredness (P>0.05), but it increased the self-reported physical activity disposition compared to the placebo condition (4.5±2.7 vs 3.2±2.3 units, P<0.05). Caffeine intake reduced the sedentary time and increased the time spent on light physical activities of obese police officers, which seems to be related to a higher disposition for the practice of physical activity.
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Affiliation(s)
- G A Ferreira
- Grupo de Pesquisa em Performance Humano, Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brasil.,Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, PE, Brasil
| | - L Wagner
- Grupo de Pesquisa em Performance Humano, Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brasil
| | - R Maziero
- Grupo de Pesquisa em Performance Humano, Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brasil
| | - T Ataide-Silva
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, Brasil
| | - N A Silva
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, Brasil
| | - R Bertuzzi
- Grupo de Estudos em Desempenho Aeróbio, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A E Lima-Silva
- Grupo de Pesquisa em Performance Humano, Universidade Tecnológica Federal do Paraná, Curitiba, PR, Brasil
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Fritel X, de Tayrac R, de Keizer J, Campagne-Loiseau S, Cosson M, Ferry P, Deffieux X, Lucot JP, Wagner L, Debodinance P, Saussine C, Pizzoferrato AC, Carlier-Guérin C, Thubert T, Panel L, Bosset PO, Nkounkou E, Ramanah R, Boisramé T, Charles T, Raiffort C, Charvériat A, Ragot S, Fauconnier A. Serious complications and recurrences after pelvic organ prolapse surgery for 2309 women in the VIGI-MESH registry. BJOG 2021; 129:656-663. [PMID: 34541781 DOI: 10.1111/1471-0528.16892] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the incidence of serious complications and reoperations for recurrence after surgery for pelvic organ prolapse (POP) and compare the three most common types of repair. DESIGN Prospective cohort study using a registry. SETTING Nineteen French surgical centres. POPULATION A total of 2309 women participated between 2017 and 2019. METHODS A multivariate analysis including an inverse probability of treatment weighting approach was used to obtain three comparable groups. MAIN OUTCOME MEASURES Serious complications and subsequent reoperations for POP recurrence. RESULTS The median follow-up time was 17.6 months. Surgeries were native tissue vaginal repairs (n = 504), transvaginal mesh placements (n = 692) and laparoscopic sacropexies with mesh (n = 1113). Serious complications occurred among 52 women (2.3%), and reoperation for POP recurrence was required for 32 women (1.4%). At 1 year the cumulative weighted incidence of serious complications was 1.8% for native tissue vaginal repair, 3.9% for transvaginal mesh and 2.2% for sacropexy, and the rates for reoperation for recurrence of POP were 1.5, 0.7 and 1.1%, respectively. Compared with native tissue vaginal repair, the risk of serious complications was higher in the transvaginal mesh group (weighted hazard ratio, wHR 3.84, 95% CI 2.43-6.08) and the sacropexy group (wHR 2.48, 95% CI 1.45-4.23), whereas the risk of reoperation for prolapse recurrence was lower in both the transvaginal mesh (wHR 0.22, 95% CI 0.13-0.39) and sacropexy (wHR 0.29, 95% CI 0.18-0.47) groups. CONCLUSIONS Our results suggest that native tissue vaginal repairs have the lowest risk of serious complications but the highest risk of reoperation for recurrence. These results are useful for informing women and for shared decision making. TWEETABLE ABSTRACT Laparoscopic sacropexy had fewer serious complications than transvaginal mesh and fewer reoperations for recurrence than vaginal repair.
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Affiliation(s)
- X Fritel
- Service de Gynécologie, CHU de Poitiers, Poitiers, France.,Université de Poitiers, INSERM CIC 1402, Poitiers, France
| | - R de Tayrac
- Service de Gynécologie, CHU Carémeau, Nîmes, France
| | - J de Keizer
- Université de Poitiers, INSERM CIC 1402, Poitiers, France
| | | | - M Cosson
- Service de Gynécologie, CHU de Lille, Lille, France
| | - P Ferry
- Service de Gynécologie, CH de La Rochelle, La Rochelle, France
| | - X Deffieux
- Service de Gynécologie, APHP Antoine-Béclère, Clamart, France
| | - J-P Lucot
- Service de Gynécologie, Hôpital Saint-Vincent-de-Paul, Lille, France
| | - L Wagner
- Service d'Urologie, CHU Carémeau, Nîmes, France
| | - P Debodinance
- Service de Gynécologie, CH de Dunkerque, Dunkerque, France
| | - C Saussine
- Service d'Urologie, CHU de Strasbourg, Strasbourg, France
| | | | - C Carlier-Guérin
- Service de Gynécologie, CH de Châtellerault, Châtellerault, France
| | - T Thubert
- Service de Gynécologie, CHU de Nantes, Nantes, France
| | - L Panel
- Service de Gynécologie, Clinique Beau-Soleil, Montpellier, France
| | - P-O Bosset
- Service d'Urologie, Hôpital Foch, Suresnes, France
| | - E Nkounkou
- Service de Gynécologie, CH de Béthune, Béthune, France
| | - R Ramanah
- Université de Franche-Comté, CHU de Besançon, Besançon, France
| | - T Boisramé
- Service de Gynécologie, CHU de Strasbourg, Strasbourg, France
| | - T Charles
- Service d'Urologie, CHU de Poitiers, Poitiers, France
| | - C Raiffort
- Service de Gynécologie, Groupe Hospitalier Diaconesses-Croix-Saint-Simon, Paris, France
| | - A Charvériat
- Service de Gynécologie, CHU de Poitiers, Poitiers, France
| | - S Ragot
- Université de Poitiers, INSERM CIC 1402, Poitiers, France
| | - A Fauconnier
- Service de Gynécologie, CHI Poissy-Saint-Germain, Poissy, France
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21
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Bakrim N, Chabannes É, Detree P, Balssa L, Wagner L, Kleinclauss F. [Sacral neuromodulation as treatment of non-neurological vesical emptying disorders]. Prog Urol 2021; 32:14-22. [PMID: 34332832 DOI: 10.1016/j.purol.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/05/2021] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Abstract
GOAL The goal was to evaluate the results of sacral neuromodulation (SNM) in non-neurological vesical emptying disorders. PATIENTS AND METHODS From February 2010 to October 2017, 28 patients presenting voiding symptoms or a non-obstructive chronic urine retention without neurological cause have been operated for an SNM (test phase). The test was positive in case of decreased number of proper intermittent self-catheterization (SC) or post-voiding residual urine (PVR) of at least 50 %. A 100 % positive result meant the return to a spontaneous voiding without SC with a non-significative PVR (<100ml). RESULTS The median follow-up was of 53.2±21.2 months. Twenty-four (85.7%) tests were positive, from which twenty-two (78.6%) were 100% positive. 16 (84.2%) out of 19 patients with SC had spontaneous voiding without PVR. The number of daily SC decreased from 4.6±1.5 to 0.4±1.2 in post-operative (P<0.001). The PVR was of 287.1±170.4ml vs. 30.4±48.6ml in post-operative (P<0.001). Fourteen patients (58.3%) underwent at least one chirurgical revision or a removal of material ; mainly for loss of efficiency, end of battery, electrode migration and pain on material. At the end of the follow-up, 70.8% of the responding patients had their device still efficient. CONCLUSION Results showed that SNM appears to be an efficient treatment of non-neurological emptying vesical troubles. Nevertheless, the re-operation rate was still significant. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- N Bakrim
- Service d'urologie andrologie et transplantation rénale, CHRU Minjoz, Besançon, France; Université de Franche Comte, Besançon, France.
| | - É Chabannes
- Service d'urologie andrologie et transplantation rénale, CHRU Minjoz, Besançon, France
| | - P Detree
- Service d'urologie andrologie et transplantation rénale, CHRU Minjoz, Besançon, France
| | - L Balssa
- Service d'urologie andrologie et transplantation rénale, CHRU Minjoz, Besançon, France
| | - L Wagner
- Service d'urologie andrologie, CHU Caremeau, Nîmes, France
| | - F Kleinclauss
- Service d'urologie andrologie et transplantation rénale, CHRU Minjoz, Besançon, France; Université de Franche Comte, Besançon, France; Nanomedicine Lab, Imagery and Therapeutics", EA 4662, Besancon, France
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22
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Lee HC, Ailawadhi S, Gasparetto CJ, Jagannath S, Rifkin RM, Durie BGM, Narang M, Terebelo HR, Toomey K, Hardin JW, Wagner L, Omel JL, Dhalla M, Liu L, Joshi P, Abonour R. Treatment patterns and outcomes in elderly patients with newly diagnosed multiple myeloma: results from the Connect ® MM Registry. Blood Cancer J 2021; 11:134. [PMID: 34301916 PMCID: PMC8302734 DOI: 10.1038/s41408-021-00524-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/16/2021] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Hans C Lee
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | | | | | | | - Robert M Rifkin
- Rocky Mountain Cancer Centers US Oncology Research, Denver, CO, USA
| | | | - Mohit Narang
- Maryland Oncology Hematology, US Oncology Research, Columbia, MD, USA
| | | | | | | | - Lynne Wagner
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James L Omel
- Myeloma Research Advocate/Advisor, Grand Island, NE, USA
| | | | - Liang Liu
- Bristol Myers Squibb, Princeton, NJ, USA
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23
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Charles T, De Tayrac R, Campagne-Loiseau S, Cosson M, Ferry P, Deffieux X, Lucot JP, Wagner L, Debodinance P, Saussine C, Pizzoferrato AC, Carlier-Guérin C, Thubert T, Panel L, Bosset PO, Nkounkou E, Ramanah R, Boisramé T, Raiffort C, Chavériat A, Fauconnier A, Fritel X. Serious complications and recurrences after pelvic organ prolapse surgery for 2,309 women in the VIGI-MESH registry. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00763-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Charles T, Wagner L, Campagne-Loiseau S, Ferry P, Saussine C, Cosson M, Deffieux X, Hummel M, Panel L, Lucot JP, Debodinance P, Carlier-Guérin C, Pizzoferrato AC, Vidart A, Thubert T, Ramanah R, Nkounkou E, Fauconnier A, Fritel X. Complications, revision and perceived health after surgery for stress urinary incontinence by mid urethra sling inthe VIGI-MESH register: Description and medium-term incidence for 1814 women. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Wagner L, Sestini S, Brown C, Finglas A, Francisco R, Bond S, Lampe C, Belettato C, Van Lingen C, Scarpa M. OP0277-PARE METABERN, THE EUROPEAN REFERENCE NETWORK FOR RARE HEREDITARY DISEASES: STRUCTURE, OBJECTIVES, METABOLIC RMDS AND THE ROLES OF EUROPEAN PATIENT ADVOCACY GROUPS (EPAGS). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3372] [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
Background:Inborn metabolic disorders (IMDs) currently encompass more than 1,500 diseases with new ones still to be identified1. Each of them is characterised by a genetic defect affecting a metabolic pathway. Only few of them have curative treatments, that target the respective metabolic pathway. Commonly, treatment examples include diet, substrate reduction therapies, enzyme replacement therapies, gene therapy and biologicals, enabling IMD-patient now to survive to adulthood. About 30 % of all IMDs involve the musculoskeletal system and are here referred to as rare metabolic RMDs. Generally, IMDs are very heterogenous with respect to symptoms and severity, often being systemic and affecting more children than adults. Thus, challenges include certified advanced training of adult metabolic experts, standardised transition plans, social support and development of therapies for diseases that do not have any cure yet.Objectives:Introduction of MetabERN, its structure and objectives, highlighting on the unique features and challenges of metabolic RMDs and describing the involvement of patient representation in MetabERN.Methods:MetabERN is stratified in 7 subnetworks (SNW) according to the respective metabolic pathways and 9 work packages (WP), including administration, dissemination, guidelines, virtual counselling framework, research/clinical trials, continuity of care, education and patient involvement. The patient board involves a steering committee and single point of contacts for each subnetwork and work package, respectively2. Projects include identifying the need of implementing social science to assess the psycho-socio-economic burden of IMDs, webinars on IMDs and their transition as well as surveys on the impact of COVID-193 on IMD-patients and health care providers (HCPs), social assistance for IMD-patients and analysing the transition landscape within Europe.Results:The MetabERN structure enables bundling of expertise, capacity building and knowledge transfer for faster diagnosis and better health care. Rare metabolic RMDs are present in all SNWs that require unique treatments according to their metabolic pathways. Implementation of social science to assess the psycho-socio-economic burden of IMDs is still underused. Involvement of patient representatives is essential for a holistic healthcare not only focusing on clinical care, but also on the quality of life for IMD-patients. Surveys identified unmet needs of patient care, patients having little information on national support systems and structural deficits of healthcare systems to ensure HCP can provide adequate clinical care during transition phases. These results are collected by MetabERN and forwarded to the Directorate-General for Health and Food Safety (DG SANTE) of the European Commission (EC) to be addressed further.Conclusion:MetabERN offers an infrastructure of virtual healthcare for patients with IMDs. Thus, in collaboration with ERN ReCONNET, MetabERN can assist in identifying rare metabolic disorders of RMDs to shorten the odyssey of diagnosis and advise on their respective therapies. On the other hand, MetabERN can benefit from EULAR’s longstanding experience regarding issues affecting the quality of life, all RMD patients are facing, such as pain, stiffness, fatigue, rehabilitation, maintaining work and disability claims.References:[1]IEMbase - Inborn Errors of Metabolism Knowledgebase http://www.iembase.org/ (accessed Jan 29, 2021).[2]MetabERN: European Refence Network for Hereditary Metabolic Disorders https://metab.ern-net.eu/ (accessed Jan 29, 2021).[3]Lampe, C.; Dionisi-Vici, C.; Bellettato, C. M.; Paneghetti, L.; van Lingen, C.; Bond, S.; Brown, C.; Finglas, A.; Francisco, R.; Sestini, S.; Heard, J. M.; Scarpa, M.; MetabERN collaboration group. The Impact of COVID-19 on Rare Metabolic Patients and Healthcare Providers: Results from Two MetabERN Surveys. Orphanet J. Rare Dis.2020, 15 (1), 341. https://doi.org/10.1186/s13023-020-01619-x.Acknowledgements:The authors thank the MetabERN collaboration group, the single point of contacts (SPOC) of the MetabERN patient board and the Transition Project Working Group (TPWG)Disclosure of Interests:None declared
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Rocque GB, Williams CP, Andrews C, Childers TC, Wiseman KD, Gallagher K, Tung N, Balch A, Lawhon VM, Ingram SA, Brown T, Kaufmann T, Smith ML, DeMichele A, Wolff AC, Wagner L. Patient perspectives on chemotherapy de-escalation in breast cancer. Cancer Med 2021; 10:3288-3298. [PMID: 33932097 PMCID: PMC8124110 DOI: 10.1002/cam4.3891] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 01/10/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Given excellent survival outcomes in breast cancer, there is interest in de-escalating the amount of chemotherapy delivered to patients. This approach may be of even greater importance in the setting of the COVID-19 pandemic. METHODS This concurrent mixed methods study included (1) interviews with patients and patient advocates and (2) a cross-sectional survey of women with breast cancer served by a charitable nonprofit organization. Questions evaluated interest in de-escalation trial participation, perceived barriers/facilitators to participation, and language describing de-escalation. RESULTS Sixteen patient advocates and 24 patients were interviewed. Key barriers to de-escalation included fear of recurrence, worry about decision regret, lack of clinical trial interest, and dislike for focus on less treatment. Facilitators included trust in physician recommendation, toxicity avoidance, monitoring for progression, perception of good prognosis, and impact on daily life. Participants reported that the COVID-19 pandemic made them more likely to avoid chemotherapy if possible. Of 91 survey respondents, many (43%) patients would have been unwilling to participation in a de-escalation clinical trial. The most commonly reported barrier to participation was fear of recurrence (85%). Few patients (19%) considered clinical trials themselves as a barrier to de-escalation trial participation. The most popular terminology describing chemotherapy de-escalation was "lowest effective chemotherapy dose" (53%); no patients preferred the term "de-escalation." CONCLUSIONS Fear of recurrence is a common concern among breast cancer survivors and patient advocates, contributing to resistance to de-escalation clinical trial participation. Additional research is needed to understand how to engage patients in de-escalation trials.
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Affiliation(s)
- Gabrielle B Rocque
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.,Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney P Williams
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney Andrews
- UAB College of Arts and Sciences, School of Anthropology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Timothy C Childers
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Nadine Tung
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alan Balch
- Patient Advocate Foundation, Hampton, VA, USA
| | - Valerie M Lawhon
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stacey A Ingram
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thelma Brown
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tara Kaufmann
- Dell Medical School, University of Texas at Austin LiveSTRONG Cancer Institute, Austin, TX, USA
| | - Mary L Smith
- ECOG-ACRIN Cancer Research Advocates Committee, Philadelphia, PA, USA
| | - Angela DeMichele
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Lynne Wagner
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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27
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Abonour R, Rifkin RM, Gasparetto C, Toomey K, Durie BGM, Hardin JW, Terebelo HR, Jagannath S, Narang M, Ailawadhi S, Omel JL, Lee HC, Srinivasan S, Kitali A, Agarwal A, Wagner L. Effect of initial treatment on health-related quality of life in patients with newly diagnosed multiple myeloma without immediate stem cell transplant intent: results from the Connect ® MM Registry. Br J Haematol 2021; 193:93-100. [PMID: 33118614 PMCID: PMC8048460 DOI: 10.1111/bjh.17131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/04/2020] [Indexed: 12/20/2022]
Abstract
Although new multiple myeloma (MM) therapies are effective in alleviating some disease-associated symptoms (e.g. bone pain, fatigue, functional decline), they can result in additional toxicities, further impacting health-related quality of life (HRQoL). Here, we compared HRQoL and safety of lenalidomide-bortezomib-dexamethasone [RVd (n = 445)], bortezomib-melphalan-prednisone [VMP (n = 77)] and Vd or VMP (n = 588) in patients with newly diagnosed MM (NDMM) from the Connect® MM Registry, a large, USA, multicentre, prospective observational cohort study. Functional Assessment of Cancer Therapy-Multiple Myeloma subscale, EuroQol-5D overall score and Bone Pain Inventory HRQoL scores were significantly improved with RVd versus Vd/VMP. Serious adverse event rates were similar in all groups. Treatment with RVd maintained HRQoL in this real-world, largely community-based population of patients with NDMM.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Hans C. Lee
- The University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | | | | | | | - Lynne Wagner
- Wake Forest School of MedicineWinston‐SalemNCUSA
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28
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Plontke SK, Caye-Thomasen P, Strauss C, Kösling S, Götze G, Siebolts U, Vordermark D, Wagner L, Fröhlich L, Rahne T. Management of transmodiolar and transmacular cochleovestibular schwannomas with and without cochlear implantation. HNO 2021; 69:7-19. [PMID: 33044580 PMCID: PMC7862215 DOI: 10.1007/s00106-020-00919-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case series included nine patients with either primary intralabyrinthine tumors or secondary invasion of the inner ear from the internal auditory canal. The primary endpoint with CI, performed in six patients, was word recognition score at 65 dB SPL (sound pressure level). Secondary endpoints were intra- and postoperative electrophysiological parameters, impedance measures, the presence of a wave V in the electrically evoked (via the CI) auditory brainstem responses, the specifics of postoperative CI programming, and adverse events. Results Hearing rehabilitation with CI in cases of transmodiolar tumor growth could be achieved only with incomplete tumor removal, whereas tumors with transmacular growth could be completely removed. All six patients with CI had good word recognition scores for numbers in quiet conditions (80–100% at 65 dB SPL, not later than 6 to 12 months post CI activation). Four of these six patients achieved good to very good results for monosyllabic words within 1–36 months (65–85% at 65 dB SPL). The two other patients, however, had low scores for monosyllables at 6 months (25 and 15% at 65 dB SPL, respectively) with worsening of results thereafter. Conclusions Cochleovestibular schwannomas with transmodiolar and transmacular extension represent a rare entity with specific management requirements. Hearing rehabilitation with CI is a principal option in these patients. Video online The online version of this article (10.1007/s00106-020-00919-9) includes a video (2D and 3D versions) of the described surgical technique. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field, the supplementary material can be found under “Ergänzende Inhalte”. ![]()
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Affiliation(s)
- S K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - P Caye-Thomasen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - C Strauss
- Department of Neurosurgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - S Kösling
- Department of Radiation Medicine, Clinic for Radiology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - G Götze
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - U Siebolts
- Institute of Pathology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - D Vordermark
- Department of Radiation Medicine, Clinic for Radiotherapy, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle, Germany
| | - L Wagner
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - L Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - T Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
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Klap J, Campagne-Loiseau S, Berrogain N, Bosset PO, Cardot V, Charles T, Deffieux X, Donon L, Girard F, Peyrat L, Roulette P, Thuillier C, Tibi B, Vidart A, Wagner L, Hermieu JF, Cornu JN. [Vaginal LASER therapy for genito-urinary disorders: A systematic review and statement from the Committee for Female Urology and Pelviperineology of the French Association of Urology]. Prog Urol 2021; 31:634-650. [PMID: 33516611 DOI: 10.1016/j.purol.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Vaginal LASER therapy is increasingly used in the field of urogynecology, but several points remain unclear. Our goal was to produce a systematic review of available evidence and provide a critical appraisal of available data. METHODS A systematic review until march 2020 was conducted using PubMed/MEDLINE, Cochrane and Embase databases. All studies about vaginal LASER use in the field of urogynecology were included. RESULTS Forty studies have been included (8 for genitourinary syndrome of menopause, 19 for stress urinary incontinence, 3 for overactive bladder, 7 for urogenital prolapse, 3 for other indications). Data were heterogeneous, and level of evidence was weak or very weak. Few studies were comparative, and only 3 were randomized). Mild improvement of symptoms and quality of life and limited satisfaction were seen for genitourinary syndrome, stress urinary incontinence, overactive bladder and prolapse. Few adverse events were reported. However, major methodological biases were noted regarding efficacy and safety evaluation. No long-term results were available. CONCLUSIONS While Vaginal LASER therapy seem to provide encouraging results, the level of evidence supporting its use was weak, especially regarding long-term outcomes. Studies of better quality are warranted before any recommendation can be made. Current use should be limited to clinical research.
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Affiliation(s)
- J Klap
- Service d'urologie, hôpital privé Claude-Galien, 91480 Quincy-sous-Senart, France
| | - S Campagne-Loiseau
- Service de gynécologie-obstétrique, CHU d'Estaing, Clermont-Ferrand, France
| | - N Berrogain
- Clinique Ambroise-Paré, 31100 Toulouse, France
| | - P O Bosset
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - V Cardot
- Clinique de Meudon-Clamart, 3, avenue de Villacoublay, 92360 Meudon, France
| | - T Charles
- Service d'urologie, CHU de La-Miletrie, 86000 Poitiers, France
| | - X Deffieux
- Service de gynécologie-obstétrique, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France
| | - L Donon
- Clinique de la Côte Basque, 64100 Bayonne, France
| | - F Girard
- Service d'urologie, clinique Oudinot fondation Cognac-Jay, 2, rue Rousselet, 75007 Paris, France
| | - L Peyrat
- Service d'urologie, clinique Turin, 75008 Paris, France
| | - P Roulette
- Service d'urologie, centre hospitalier de Cahors, 335, rue Wilson, 46005 Cahors cedex, France
| | - C Thuillier
- Service d'urologie, CHU de Grenoble-Alpes, 38000 Grenoble, France
| | - B Tibi
- Service d'urologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine - CS 51069, 06001 Nice cedex 1, France
| | - A Vidart
- Service d'urologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France
| | - L Wagner
- Service d'urologie, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France
| | - J-F Hermieu
- Service d'urologie, hôpital Bichat, AP-HP, Paris, France
| | - J-N Cornu
- Service d'urologie, hôpital Charles-Nicolle, université de Rouen, 76000 Rouen, France.
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Schabath MB, Perez-Morales J, Sutter M, Wagner L, Simon M, Carlos RC, Giantonio BJ, Quinn GP, Mitchell EP. Abstract PO-068: Survey of healthcare providers in the ECOG-ACRIN cancer research group: Attitudes, knowledge, and practice behaviors about LGBTQ patients with cancer. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp20-po-068] [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: 11/16/2022] Open
Abstract
Abstract
INTRODUCTION: The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community is a medically underserved population that suffers from cancer disparities. To identify potential gaps in attitudes, knowledge, and institutional practices toward LGBTQ patients, we conducted a mixed-methods survey of healthcare providers in the ECOG-ACRIN Cancer Research Group. METHODS: A validated, web-based survey was administered to members of the ECOG-ACRIN Cancer Research Group in late 2019. The survey was completed by 490 healthcare providers measuring attitudes and knowledge about LGBTQ health and institutional practices regarding collection of sexual orientation and gender identity data. Results were quantified using descriptive and stratified analyses. RESULTS: Among the 490 healthcare providers that completed the survey, 77% were White, 86% were non- Hispanic, 75% were female, 81% were heterosexual, and the mean age was 46 years. Approximately 47% of the respondents were medical oncologists, 39% practiced in academic medical centers (AMCs), and 49% were from the Midwest/Northeast. As reported by prior institutional and national survey studies, there was high interest (77%) in receiving education regarding the unique health needs of LGBTQ patients, an overall limited knowledge about LGBTQ health and cancer needs, and a significant decrease from survey assessment to postsurvey assessment for confidence in knowledge for LGBT health needs. There was high agreement (71%) regarding the importance of knowing gender identity, which was contrasted with a low agreement (48%) regarding the importance of knowing sexual orientation. Stratified analyses revealed significant differences of some attitude and knowledge items. For example, when stratified by licensure/terminal degree, MD/DO vs. RN/NP/PA were significantly more willing to be listed as a LGBTQ-friendly provider (81% vs. 50%) and reported to be knowledgeable about LGB health needs (69% vs. 53%). Providers at AMCs were significantly more willing to be listed as a LGBTQ-friendly provider (71% vs.53%) believe there should be mandatory education (72% vs. 60%) regarding care of LGBQ patients versus those at non-AMCs. Having family and/or friends who are LGBTQ (vs. none) and political affiliation (conservative vs. liberal) were strong effect modifiers resulting in significant differences for 9 and 8 items, respectively.
CONCLUSION: To our knowledge, this was the first study of cancer care providers in a large cancer clinical trials research group that assessed attitudes, knowledge, and institutional practices of LGBTQ patients with cancer. Consistent with prior studies, there was limited knowledge about LGBTQ health and cancer needs, but high interest in receiving education regarding this community. New and intriguing differences for many attitude and knowledge items were revealed when we stratified the responses by licensure/terminal degree, practice setting, LGBTQ friends and/or family members, and political affiliation.
Citation Format: Matthew B. Schabath, Jaileene Perez-Morales, Megan Sutter, Lynne Wagner, Melissa Simon, Ruth C. Carlos, Bruce J. Giantonio, Gwendolyn P. Quinn, Edith P. Mitchell. Survey of healthcare providers in the ECOG-ACRIN cancer research group: Attitudes, knowledge, and practice behaviors about LGBTQ patients with cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-068.
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Affiliation(s)
| | | | | | - Lynne Wagner
- 3Wake Forest School of Medicine, Winston-Salem, NC,
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Charles T, Wagner L, Campagne-Loiseau S, Ferry P, Saussine C, Cosson M, Deffieux X, Hummel M, Panel L, Lucot J, Debodinance P, Carlier C, Pizzoferrato A, Vidart A, Hubert T, Ramanah R, Nkounkou E, Fauconnier A, De Tayrac R, Fritel X. Complications, révisions et qualité de vie à moyen terme après 1814 chirurgies de l’incontinence urinaire d’effort par bandelette sous-urétrale : données du registre VIGI-MESH. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cornu J, Wagner L, Ruffion A, Gamé X, Perrouin-Verbe M, Boillot B, Rock A, Marcelli F, Biardeau X, Mouton D, Capon G, Houivet E, Grise P. Neuromodulation sacrée secondaire bilatérale ou controlatérale dans l’hyperactivité vésicale en échec secondaire de neuromodulation unilatérale (NEUROBIL). Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.175] [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: 10/23/2022]
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Cornu J, Berrogain N, Bosset P, Campagne-Loiseau S, Cardot V, Charles T, Deffieux X, Donon L, Girard F, Hermieu J, Klap J, Peyrat L, Meurette G, Ragni E, Roulette P, Tibi B, Thuillier C, Vidart A, Wagner L. Réunions de concertation en pelvi-périnéologie en France : une enquête nationale auprès des urologues français. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.196] [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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Boualaoui I, Bey E, Henry de Villeneuve M, Droupy S, Wagner L. Impact médico-économique et sanitaire de l’insufflateur Airseal® : exemple de la promontofixation cœlioscopique. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wagner L, Campagne-Loiseau S, De Tayrac R, Ferry P, Deffieux X, Lucot J, Fauconnier A, De Bodinance P, Saussine C, Pizzoferrato A, Carlier C, Thubert T, Panel L, Bosset P, Nkounkou E, Ramanah R, Charles T, Bressler L, Cosson M, Fritel X. Taux de complications et de récidives après chirurgie des prolapsus des organes pelviens : résultats à moyen terme d’une étude prospective chez 2341 patientes (Registre VIGI-MESH). Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.111] [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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Ailawadhi S, Jagannath S, Lee HC, Narang M, Rifkin RM, Terebelo HR, Durie BGM, Toomey K, Hardin JW, Gasparetto CJ, Wagner L, Omel JL, He M, Yue L, Flick ED, Agarwal A, Abonour R. Association between race and treatment patterns and survival outcomes in multiple myeloma: A Connect MM Registry analysis. Cancer 2020; 126:4332-4340. [PMID: 32706404 PMCID: PMC7540439 DOI: 10.1002/cncr.33089] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 03/04/2020] [Revised: 05/04/2020] [Accepted: 05/28/2020] [Indexed: 11/10/2022]
Abstract
Background Studies have reported racial disparities in access to and use of multiple myeloma (MM) treatments between African American (AA) and White patients. Although AA patients demonstrate longer disease‐specific survival, this has not uniformly translated into improved survival over time. The association between race and treatment patterns and survival outcomes was analyzed using data from the Connect MM Registry. Methods The Connect MM Registry is a large US, multicenter, prospective observational cohort study of patients with newly diagnosed MM. Patients who received first‐line (1L) stem cell transplantation (SCT) or who did not receive SCT (non‐SCT or non–stem cell transplantation [NSCT]) were grouped by raceEffects of race and transplantation status on the use of triplet treatment were estimated using logistic regression. Results Treatment patterns in 1L (types and duration of induction, posttransplantation maintenance) were similar between AA and White patients. SCT rates in 1L (32% vs 36%) and triplet treatment use (AA: 44% for NSCT patients and 72% for SCT patients; and White: 48% for NSCT patients and 72% for SCT patients) during first induction were similar. No significant effect of race or transplantation status on 1L triplet treatment use was observed. Race was not found to be associated with survival outcomes among patients who underwent NSCT; however, AA patients who received SCT had significantly longer overall survival compared with White patients who underwent SCT (not reached vs 88.2 months; hazard ratio, 0.56; 95% CI, 0.35‐0.89 [P = .0141]). Conclusions AA and White patients were found to have similar treatment patterns in the Connect MM Registry, suggesting that both groups had equal access to health care. In this real‐world setting, AA patients received standard‐of‐care treatment, which might have contributed to better MM‐specific survival compared with White patients. Real‐world data from the mostly community‐based Connect MM Registry demonstrated that African American patients have multiple myeloma treatment patterns that are similar to those of White patients. Similar (progression‐free survival) and better (overall survival) survival outcomes are reported in African American individuals.
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Affiliation(s)
| | | | - Hans C Lee
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Robert M Rifkin
- Rocky Mountain Cancer Centers, US Oncology Research, Denver, Colorado
| | | | | | | | | | | | - Lynne Wagner
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - James L Omel
- Myeloma Research Advocate/Advisor, Grand Island, Nebraska
| | - Mia He
- Bristol-Myers Squibb, Summit, New Jersey
| | - Lihua Yue
- Bristol-Myers Squibb, Summit, New Jersey
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Shi Q, Lee JW, Wang XS, Fisch MJ, Chang VT, Wagner L, Cleeland CS. Testing Symptom Severity Thresholds and Potential Alerts for Clinical Intervention in Patients With Cancer Undergoing Chemotherapy. JCO Oncol Pract 2020; 16:e893-e901. [PMID: 32369412 PMCID: PMC7489487 DOI: 10.1200/jop.19.00403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Accepted: 03/16/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Symptom monitoring is attracting attention as a way to improve adherence to cancer therapy, reduce treatment-related toxicities, and possibly improve overall survival. How reporting thresholds affect symptom alert generation and clinical outcomes is poorly understood. PATIENTS AND METHODS We analyzed data from 38 US health care institutions collected for the prospective Eastern Cooperative Oncology Group-American College of Radiology Imaging Network E2Z02 Symptom Outcomes and Practice Patterns study. Participants were outpatients receiving chemotherapy for breast (n = 642), colorectal (n = 486), or lung cancer (n = 340) who rated symptom severity using the MD Anderson Symptom Inventory at 2 assessment points 1 month apart. Percentages of patients with pain, dyspnea, fatigue, or distress at different thresholds (score of 4-7 on a 0-10 scale) were compared. The percentage of patients whose performance status had worsened at follow-up was used to estimate risk for missing clinically important symptom data by using higher severity thresholds. RESULTS At the guideline-recommended threshold of ≥ 4, suprathreshold rates were 60% for any of the 4 symptoms at the initial survey; performance status worsened at follow-up for 27% of all patients with any symptom rated ≥ 4 at the initiate survey. When the threshold was increased to ≥ 7, approximately half of patients (51%) with worsened performance status were not identified. CONCLUSION The burden to clinicians from an alert threshold of ≥ 4 (per many current guidelines) would be substantial. However, setting higher alert thresholds may miss a large percentage of patients who need clinical intervention. These results may inform resource planning when implementing electronic symptom screening at an institutional or practice level.
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Affiliation(s)
- Qiuling Shi
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ju-Whei Lee
- ECOG-ACRIN Biostatistics Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA
| | - Xin Shelley Wang
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Victor T. Chang
- Veteran Affairs New Jersey Health Care System, East Orange, New Jersey; Rutgers New Jersey Medical School, Newark, NJ
| | - Lynne Wagner
- Wake Forest University Health Services, Winston-Salem, NC
| | - Charles S. Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX
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Henry de Villeneuve M, Boualaoui I, El Kharroubi A, Droupy S, Wagner L. [Short-term evaluation of Altis® single-incision sling in women stress urinary incontinence]. Prog Urol 2020; 30:346-352. [PMID: 32370920 DOI: 10.1016/j.purol.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Midurethral slings are the main surgical treatment of stress urinary incontinence. Altis is a minimally invasive single-incision sling system. The aim of this study is to report the safety and efficacity results during a year of follow up. MATERIALS AND METHODS This single-centre and retrospective study has been performed in a university hospital, between February 2015 and May 2018. We included women aged more than 18, complaining a stress urinary incontinence with a urethral hypermobility and positive support maneuvers, who had failed from non surgical treatment. A prospective data collection has been done at the moment of inclusion, peroperative time, at 6 weeks, 6 months and a year after the procedure. The main evaluation criteria was the cure rate at twelve months. RESULTS Thirty patients were included in our study. The mean age was 45,4±12,9 years old, the mean ICIQ-UI score was 13,5±4,06 and the median pad test was at 12g. Ninety three percent of the procedures were done as ambulatory surgery. The average operating time was at 22,2minutes. Overall, 75% of our patients were objectively cured and 14,2% were in fail of this treatment. CONCLUSION The short term results show a good efficacity and safety of this procedure. But its place remains to be defined in relation to other techniques, TVT, TOT and non-prosthetic techniques. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- M Henry de Villeneuve
- Service urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nimes, France.
| | - I Boualaoui
- Service urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nimes, France
| | - A El Kharroubi
- Service urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nimes, France
| | - S Droupy
- Service urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nimes, France
| | - L Wagner
- Service urologie, CHU de Nîmes, 4, rue du Professeur-Robert-Debré, 30029 Nimes, France
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Jagannath S, Rifkin RM, Gasparetto CJ, Toomey K, Durie BG, Hardin JW, Terebelo HR, Wagner L, Narang M, Ailawadhi S, Omel JL, Srinivasan S, He M, Ung B, Kitali A, Flick ED, Agarwal A, Abonour R. Treatment Journeys of Patients With Newly Diagnosed Multiple Myeloma (NDMM): Results From The Connect MM Registry. Clinical Lymphoma Myeloma and Leukemia 2020; 20:272-276. [DOI: 10.1016/j.clml.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 01/17/2023]
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Amy de la Bretèque M, Beauchet A, Maccari F, Ruer-Mulard M, Bastien M, Chaby G, Le Guyadec T, Estève E, Parier J, Dauendorffer JN, Barthelemy H, Géner G, Wagner L, Pfister P, Bégon E, Mery-Bossard L, Schmutz JL, Mahé E. Les patients psoriasiques vus en cabinet libéral et à l’hôpital sont-ils différents ? Ann Dermatol Venereol 2020; 147:310-312. [DOI: 10.1016/j.annder.2019.12.008] [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] [Received: 09/17/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
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Kullmann S, Wagner L, Berti K, Schneeweiss P, Veit R, Hoffmann C, Niess A, Preissl H, Häring H, Fritsche A, Weigert C, Böhm A, Heni M. P6 Exercise improves intranasal insulin mediated functional connectivity in sedentary overweight and obese adults. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fougerousse A, Maccari F, Beauchet A, Parier J, Boulard C, Becherel P, Quiles‐Tsimaratos N, Le Guyadec T, Thomas‐Beaulieu D, Halioua B, Begon E, Bastien M, Perrot J, Pallure V, Bilan P, Steff M, Pfister P, Vermersch‐Langlin A, Boyé T, Mery‐Bossard L, Maillard H, Kemula M, Girard C, Poiraud C, Monfort J, Kupfer‐Bessaguet I, Perrussel M, Lons‐Danic D, Sultan N, Lorier E, Zeitoun M, Wagner L, Gabison G, Mahé E. Factors that may influence the choice for initiating apremilast or methotrexate treatment for psoriasis in real‐world clinical setting. J Eur Acad Dermatol Venereol 2019; 33:e476-e478. [DOI: 10.1111/jdv.15804] [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: 11/27/2022]
Affiliation(s)
- A.‐C. Fougerousse
- Dermatology Department Hôpital d'Instruction des Armées Bégin Saint Mandé France
| | - F. Maccari
- Private Office La Varenne Saint Hilaire France
| | - A. Beauchet
- Department of Public Health Centre Hospitalier Universitaire Ambroise Paré APHP & UVSQ Université Paris‐Saclay Boulogne‐Billancourt France
| | - J. Parier
- Private Office La Varenne Saint Hilaire France
| | - C. Boulard
- Dermatology Department Hôpital du Havre Montivilliers France
| | - P.‐A. Becherel
- Dermatology Department Hôpital Privé d'Antony Antony France
| | | | - T. Le Guyadec
- Dermatology Department Hôpital d'Instruction des Armées Percy Clamart France
| | - D. Thomas‐Beaulieu
- Dermatology Department Centre Hospitalier Intercommunal Poissy‐Saint Germain en Laye Poissy France
| | | | - E. Begon
- Dermatology Department Hôpital René Dubos Pontoise France
| | | | - J.‐L. Perrot
- Dermatology Department Centre Hospitalier Universitaire Saint Etienne France
| | - V. Pallure
- Dermatology Department Centre Hospitalier Perpignan France
| | - P. Bilan
- Dermatology Department Centre Hospitalier Robert Ballanger Aulnay‐sous‐Bois France
| | - M. Steff
- Dermatology Department Centre Hospitalier Robert Ballanger Aulnay‐sous‐Bois France
| | | | | | - T. Boyé
- Dermatology Department Hôpital d'Instruction des Armées Sainte Anne Toulon France
| | - L. Mery‐Bossard
- Dermatology Department Centre Hospitalier François Quesnay Mantes la Jolie France
| | - H. Maillard
- Dermatology Department Centre Hospitalier Le Mans France
| | | | - C. Girard
- Dermatology Department Centre Hospitalier Universitaire Sainte Eloi Montpellier France
| | - C. Poiraud
- Dermatology Department Centre Hospitalier La Roche sur Yon France
| | - J.‐B. Monfort
- Dermatology Department Centre Hospitalier Universitaire Tenon Paris France
| | | | | | - D. Lons‐Danic
- Dermatology Department Hôpital Saint Joseph Paris France
| | - N. Sultan
- Dermatology Department Centre Hospitalier Gabriel Martin Saint‐Paul France
| | | | | | | | | | - E. Mahé
- Dermatology Department Hôpital Victor Dupouy Argenteuil France
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Ailawadhi S, Jagannath S, Narang M, Rifkin RM, Terebelo HR, Toomey K, Durie BGM, Hardin JW, Gasparetto CJ, Wagner L, Omel JL, Kumar V, Yue L, Kitali A, Agarwal A, Abonour R. Connect MM Registry as a national reference for United States multiple myeloma patients. Cancer Med 2019; 9:35-42. [PMID: 31701679 PMCID: PMC6943143 DOI: 10.1002/cam4.2656] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 06/04/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 02/06/2023] Open
Abstract
Background The Surveillance, Epidemiology, and End Results (SEER) database and National Cancer Database (NCDB) show improved overall survival (OS) in patients with multiple myeloma (MM) over the last 15 years. This analysis evaluated the validity of the largely community‐based Connect MM Registry as a national reference for MM. Methods Baseline disease characteristics and survival in US newly diagnosed MM patients were examined using the Connect MM Registry as well as SEER and NCDB databases. Baseline characteristics predictive of longer survival in Connect MM were also identified. Results As of February 2017, 3011 patients were enrolled in the Connect MM Registry; 2912 were treated. Median age at time of MM diagnosis and age range were numerically similar from 2010 to 2015 across all 3 registries; SEER had a higher representation of nonwhite racial groups than that in the other 2 registries. OS rates suggest proportionate improvement with year of diagnosis among the 3 registries. A Cox proportional hazards model suggests that younger age (<65 years) is associated with longer survival (vs ≥75; HR, 0.39; 95% confidence interval, 0.34‐0.46) in the Connect MM Registry. However, sex (HR, 0.91; P = .15) and race (black vs white; HR, 0.88; P = .21) were not associated with longer OS. Conclusions Data from the Connect MM Registry appear to be largely representative of national trends, comprehensive, and reliable representations of the national MM population. Baseline characteristics were comparable, and survival similarly improved over time among the 3 registries. ClinicalTrials.gov, identifier NCT01081028.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lynne Wagner
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James L Omel
- Myeloma Research Advocate/Advisor, Grand Island, NE, USA
| | - Vivek Kumar
- Brigham and Women's Hospital, Boston, MA, USA
| | - Lihua Yue
- Celgene Corporation, Summit, NJ, USA
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Sparano J, Gray R, Makower D, Albain K, Saphner T, Badve S, Wagner L, Mihalcioiu C, Desbiens C, Hayes D, Dees E, Geyer C, Olson J, Wood W, Lively T, Paik S, Ellis M, Abrams J, Sledge G. Clinical outcomes by chemotherapy regimen in patients with RS 26-100 in TAILORx. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Mair M, Ilhan-Mutlu A, Pajenda S, Widhalm G, Dieckmann K, Hainfellner J, Marosi C, Wagner L, Preusser M, Berghoff A. Circulating PD-L1 levels vary across brain tumour entities and are oppositely linked to survival in glioblastoma and lower grade glioma patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz243.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Terebelo HR, Abonour R, Gasparetto CJ, Toomey K, Durie BGM, Hardin JW, Jagannath S, Wagner L, Narang M, Flick ED, Srinivasan S, Yue L, Kitali A, Agarwal A, Rifkin RM. Development of a prognostic model for overall survival in multiple myeloma using the Connect ® MM Patient Registry. Br J Haematol 2019; 187:602-614. [PMID: 31382320 PMCID: PMC6899784 DOI: 10.1111/bjh.16139] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 04/05/2019] [Accepted: 06/10/2019] [Indexed: 02/02/2023]
Abstract
Median overall survival (OS) has improved for patients with newly diagnosed multiple myeloma (NDMM), but prognosis varies depending on baseline patient characteristics. Current models use data from selected clinical trial populations, which prevent application to patients in an unselected community setting that reflects routine clinical practice. Using data from the Connect® MM Registry, a large, US, multicentre, prospective observational cohort study (Cohort 1: 2009-2011; Cohort 2: 2012-2016) of 3011 patients with NDMM, we identified prognostic variables for OS via the multivariable analysis of baseline patient characteristics in Cohort 1 (n = 1493) and developed a tool to examine individual outcomes. Factors associated with OS (n = 1450 treated patients; P < 0·05) were age, del(17p), triplet therapy use, EQ-5D mobility, International Staging System stage, solitary plasmacytoma, history of diabetes, platelet count, Eastern Cooperative Oncology Group performance status and serum creatinine, which were used to create survival matrices for 3- and 5-year OS. The model was internally and externally validated using Connect MM Cohort 2 (Harrell's concordance index, 0·698), MM-015 (0·649), and the phase 3 FIRST (0·647) clinical trials. This novel prognostic tool may help inform outcomes for NDMM in the era of triplet therapy use with novel agents.
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Affiliation(s)
| | | | | | | | | | | | | | - Lynne Wagner
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | | | | | - Lihua Yue
- Celgene Corporation, Summit, NJ, USA
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Kourbanhoussen K, Cecchi M, Chevrot A, Costa P, Droupy S, Wagner L. Sphincter urinaire artificiel robot chez la femme : début d’expérience. Prog Urol 2019; 29:371-377. [DOI: 10.1016/j.purol.2019.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
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48
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Heidekrüger N, Rahne T, Wagner L. [Processing of interaural time differences in normal-hearing subjects and cochlear implant users with FSP and HDCIS coding strategy]. HNO 2019; 67:855-862. [PMID: 31201511 DOI: 10.1007/s00106-019-0699-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sound localization is necessary for social interaction and remains challenging for bilateral cochlear implant (CI) users. This study investigated the influence of fine structure processing (FSP) coding strategies on temporal accuracy and source localization. The ability to discriminate between different interaural time differences (ITD) was measured objectively and compared. MATERIALS AND METHODS Fifteen normal-hearing subjects and five CI users participated in this study. Electrophysiological recording of mismatch negativity (MMN) and psychoacoustic tests with headphones and loudspeakers were conducted to measure and compare the discrimination of ITDs. RESULTS In normal-hearing subjects the discrimination threshold for ITD was 83-117 µs. Localization ability in a free sound field was below the limit of resolution. A significant MMN was measured. CI users showed a mean angle detection error of more than 30° and a discrimination threshold between 1100 and 2100 µs. Due to artifacts, no clear MMN component could be recorded. CONCLUSION This study shows that MMN can be used as an objective measure of ITD discrimination in normal-hearing participants. An indication that improvements in directional hearing can be achieved with the transfer of fine structure could not be provided by this study.
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Affiliation(s)
- N Heidekrüger
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Universitätsmedizin Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
| | - T Rahne
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Universitätsmedizin Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
| | - L Wagner
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Halle (Saale), Universitätsmedizin Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
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49
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Riemer M, Wagner L, Seeger S, Tchirikov M, Seliger G. Die RedCar-Risk Studie: Ergebnisse einer Pilotstudie zur Senkung des kardiovaskulären Risikos von Frauen nach Präeklampsie oder HELLP-Syndrom. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1692047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- M Riemer
- Klinik für Geburtshilfe, KH St. Elisabeth und St. Barbara, Halle
| | - L Wagner
- Universitätsklinik für Geburtshilfe und Pränatalmedizin, UKH, Halle
| | - S Seeger
- Klinik für Geburtshilfe, KH St. Elisabeth und St. Barbara, Halle
| | - M Tchirikov
- Universitätsklinik für Geburtshilfe und Pränatalmedizin, UKH, Halle
| | - G Seliger
- Universitätsklinik für Geburtshilfe und Pränatalmedizin, UKH, Halle
- Zentrum für Reproduktionsmedizin und Andrologie, UKH, Halle
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50
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Scheinost S, Lu J, Wagner L, Huellein J, Walther T, Sellner L, Theocharides A, Bornhäuser B, Kühn M, Kindler T, Florence Nguyen-Khac F, Crespo Maull M, Bosch F, Manz M, Bourquin J, Dietrich S, Huber W, Zenz T. THE LANDSCAPE OF DRUG PERTURBATION EFFECTS IN LEUKEMIA AND LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.87_2629] [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: 11/11/2022]
Affiliation(s)
- S. Scheinost
- Molecular Therapy n Haematology and Oncology; NCT; Heidelberg Germany
| | - J. Lu
- Genome Biology; EMBL; Heidelberg Germany
| | - L. Wagner
- Molecular Therapy n Haematology and Oncology; NCT; Heidelberg Germany
| | | | - T. Walther
- Molecular Therapy n Haematology and Oncology; NCT; Heidelberg Germany
| | - L. Sellner
- Molecular Therapy n Haematology and Oncology; NCT; Heidelberg Germany
| | - A. Theocharides
- Medical Oncology and Haematology; University Hospital Zürich; Zürich Switzerland
| | - B. Bornhäuser
- Pediatric Oncology; Childrens’ Hospital Zürich; Zürich Switzerland
| | - M. Kühn
- Haematology and Oncology; University Hospital Mainz; Mainz Germany
| | - T. Kindler
- Haematology and Oncology; University Hospital Mainz; Mainz Germany
| | | | - M. Crespo Maull
- Haematology; Vall d'Hebron Institute of Oncology (VHIO); Barcelona Spain
| | - F. Bosch
- Haematology; Vall d'Hebron Institute of Oncology (VHIO); Barcelona Spain
| | - M. Manz
- Medical Oncology and Haematology; University Hospital Zürich; Zürich Switzerland
| | - J. Bourquin
- Pediatric Oncology; Childrens’ Hospital Zürich; Zürich Switzerland
| | - S. Dietrich
- Molecular Therapy n Haematology and Oncology; NCT; Heidelberg Germany
| | - W. Huber
- Genome Biology; EMBL; Heidelberg Germany
| | - T. Zenz
- Medical Oncology and Haematology; University Hospital Zürich; Zürich Switzerland
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