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MHC class II antigen presentation by intestinal epithelial cells fine-tunes bacteria-reactive CD4 T cell responses. Mucosal Immunol 2023:S1933-0219(23)00032-6. [PMID: 37209960 DOI: 10.1016/j.mucimm.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/22/2023]
Abstract
Although intestinal epithelial cells (IECs) can express major histocompatibility complex class II (MHC II), especially during intestinal inflammation, it remains unclear if antigen presentation by IECs favours pro- or anti-inflammatory CD4+ T cell responses. Using selective gene ablation of MHC II in IECs and IEC organoid cultures, we assessed the impact of MHC II expression by IECs on CD4+ T cell responses and disease outcomes in response to enteric bacterial pathogens. We found that intestinal bacterial infections elicit inflammatory cues that greatly increase expression of MHC II processing and presentation molecules in colonic IECs. Whilst IEC MHC II expression had little impact on disease severity following Citrobacter rodentium or Helicobacter hepaticus infection, using a colonic IEC organoid-CD4+ T cell co-culture system, we demonstrate that IECs can activate antigen-specific CD4+ T cells in an MHC II-dependent manner, modulating both regulatory and effector Th cell subsets. Furthermore, we assessed adoptively transferred H. hepaticus-specific CD4+ T cells during intestinal inflammation in vivo and report that IEC MHC II expression dampens pro-inflammatory effector Th cells. Our findings indicate that IECs can function as non-conventional antigen presenting cells and that IEC MHC II expression fine-tunes local effector CD4+ T cell responses during intestinal inflammation.
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TRANSTHORACIC SHOCKS LEAD TO REGIONAL BI-VENTRICULAR DIASTOLIC DYSFUNCTION IN TERRITORIES WITH ACUTE MYOCARDIAL INJURY. J Cardiothorac Vasc Anesth 2022. [DOI: 10.1053/j.jvca.2022.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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COMPARISON OF POST-PROCESSING TECHNIQUES FOR OPTIMIZING THE QUALITY OF CARDIAC MAGNETIC RESONANCE T1 MAPPING IMAGES. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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4
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THE NON-INVASIVE ASSESSMENT OF PERIPHERAL MICROVASCULAR AND ENDOTHELIAL FUNCTION IN WOMEN WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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KS05.5.A Alterations in white matter fiber density associated with structural MRI and metabolic PET lesions following multimodal therapy in glioma patients. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In glioma patients, multimodal therapy and recurrent tumor result in local brain tissue changes, characterized by pathologic findings in structural MRI and metabolic PET images. Little is known about these different lesion types’ impact on the local white matter fiber architecture and clinical outcome.
Patients and Methods
This study included data from 121 pretreated patients (median age, 52 years; ECOG, 01) with histomolecularly characterized glioma (WHO grade IV glioblastoma, n=81; WHO grade III anaplastic astrocytoma, n=28; WHO grade III anaplastic oligodendroglioma, n=12), who had a resection, radiotherapy, alkylating chemotherapy, or combinations thereof. After a median time of 14 months (range, 1-214 months), post-therapeutic structural and metabolic findings were evaluated using anatomical MRI and O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET acquired on a 3T hybrid PET/MR scanner. Local fiber density was estimated from tractography based on highangular resolution diffusion-weighted imaging. A cohort of 121 healthy subjects selected from the 1000BRAINS study and matched for age, gender and education served as a control group.
Results
The median volume of resection cavities, contrast-enhancing regions, regions with pathologically increased FET uptake, and T2/FLAIR hyperintense regions amounted to 20.9, 7.9, 30.3, and 53.4 mL, respectively. Compared to the control group, the average local fiber density in these regions was significantly reduced (p<0.001). Resection cavities showed the highest reduction, followed by contrast-enhancing lesions and metabolically active tumors on FET PET (relative fiber density reduction, -87%, -65%, -55%, respectively). The local fiber density was inversely related (p=0.005) to the FET uptake in recurrent tumors. T2/FLAIR hyperintense lesions, either assigned to peritumoral edema in recurrent glioma or radiation-induced gliosis, had a comparable impact on reducing fiber density (48% and 41%, respectively). The total fiber loss (average fiber loss multiplied by lesion volume) associated with contrast-enhancing lesions (p=0.006) and T2/FLAIR hyperintense lesions (p=0.013) had a significant impact on the general performance status of the patients (ECOG score).
Conclusions
Our results suggest that apart from resection cavities, reduction in local fiber density is greatest in contrast-enhancing recurrent tumors, but total fiber loss induced by edema or gliosis has an equal detrimental effect on the patients’ performance due to the larger volume affected.
Funding
Funded by the 1000BRAINS study (INM, Research Centre Juelich, Germany), Horizon 2020 (Grant No. 945539 (HBP SGA3; SC)), and Heinz Nixdorf Foundation.
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P17.19.B Incidence of treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma treated with cilengitide (EORTC 26071 - CENTRIC study): interim analysis. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In patients with glioblastoma, radiological recurrence of enhancing tissue after chemoradiotherapy can originate from progressive disease (PD) or from pseudoprogression/treatment-associated changes. There are no widely approved consensus criteria for treatment-associated changes. In the randomised EORTC-CENTRIC study (NCT00689221), patients with MGMT promoter-methylated glioblastoma were treated with chemoradiotherapy or chemoradiotherapy with cilengitide, an integrin inhibitor. We assessed the rate of treatment-associated changes in these groups according to the modified response assessment in neuro-oncology (RANO) criteria of 2017.
Methods
CENTRIC patients from both study arms with ≥3 follow-up MRIs were included. Preliminary PD (PPD) was defined as a ≥25% increase of the sum of perpendicular diameter (SPD) of a new or increasing lesion compared to baseline or nadir on the T1-MRI with gadolinium. Subsequent PD was defined as a second ≥25% increase of the SPD, at least 4 weeks later, or as a new lesion outside the radiation field. Treatment-associated changes were defined as stabilisation on ≥2 follow-up MRIs after PPD, each one 4 weeks later, or partial/complete regression on ≥1 follow-up MRI 4 weeks later.
Results
In total, 4,051 MRIs from 584 patients were available. This interim analysis included data on 462 patients with similar proportions in the cilengitide and control arm (50.9% and 49.1%). Due to missing MRIs or values, 128 were excluded. Of the remaining 334 patients, 157 (47%) patients showed RANO measurable disease at baseline or nadir (median SPD, 0mm2; interquartile range (IQR) 552.1 (0-552.1). After chemoradiotherapy with or without cilengitide, PPD occurred in 214 patients (64.1%) after a median time of 6.08 months after finishing radiation (IQR 11.4 (2.4-13.8), and 3.65 months after baseline or nadir (IQR 6.4 (2.1-8.5). After follow-up of these 214 patients, treatment-associated changes were diagnosed in 62 (18.6%) and PD was diagnosed in 48 (14.4%). The remaining 104 (31.1%) patients had no further follow-up MRI after PPD, mostly because a clinical decision to call PD was made. In the cilengitide group of 178 patients, 37 (20.8%) patients developed treatment-associated changes, and 23 (12.9%) patients developed PD, whereas in the control group of 156 patients, 25 (16%) patients developed treatment-associated changes, and 25 (16%) patients PD.
Conclusion
With the modified RANO criteria, the rate of treatment-associated changes was low compared to previous studies in newly diagnosed MGMT promoter-methylated glioblastoma. This rate did not change with addition of cilengitide. RANO-recommended radiological follow-up was not always awaited, which reflects clinical practice. Full data will be presented.
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FV 23 POSe EstimatoR for Cervical Dystonia (POSER-CD): Automatized assessment of clinical severity and kinematic pathosignatures of Cervical Dystonia using convolutional neural networks. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P 56 Deep learning derived quantitative Video-NystagmoGraphy using smartphone cameras: DeepVNG. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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ABSTRACTS OF THE JOINT INTERNATIONAL SYMPOSIA "VITAMIN D IN PREVENTION AND THERAPY" AND "BIOLOGIC EFFECTS OF LIGHT": 4-6 May, 2022 Schlossberg Hotel, Homburg/Saar, Germany. Anticancer Res 2022. [PMID: 35347044 DOI: 10.21873/anticanres.15702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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10
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OS06.4A Identification of T cell receptors targeting ZFTA-RELA fusion-positive ependymoma. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
The oncogenic gene fusion between ZFTA (formerly C11orf95) and RELA has in recent years been highlighted as oncogenic driver event ultimately leading to malignant transformation and progression of ependymoma. Representing a genetic hallmark in 17.6% of ependymomas, ZFTA-RELA fusion-positive tumors qualified as separate diagnostic entity in the 2016 revision of the WHO classification of CNS tumors. This tumor entity mainly occurs in pediatric patients and is characterized by poor prognosis and the lack of biology-driven therapy.
RESULTS
De novo prediction of putative gene fusion-derived neoepitopes in malignant CNS diseases yielded several potential candidates suitable for screening. Of these, vaccination of A2.DR1-transgenic major histocompatibility complex (MHC)-humanized mice with in silico compiled peptide vaccines encompassing the ZFTA-RELA fusion sequence elicited robust antigen-specific CD4+-restricted immune responses. We identified ZFTA-RELA-reactive T cell clones by multiplexed Interferon-γ / Interleukin-2 recall response. Single-cell VDJ-sequencing of reactive T cells demonstrated a highly clonal T cell receptor (TCR) repertoire and shared clonotypes among all vaccinated animals. Matching TCRα/β chains have been assembled from single-cell sequencing data and cloned for functional testing of neoepitope-reactive TCR-transgenic T cells in vitro as well as in vivo using a transposon system-based immunocompetent, MHC-humanized ZFTA-RELA fusion-positive ependymoma model.
CONCLUSION
Here we identify the oncogenic ZFTA-RELA gene fusion product as a novel tumor-specific neoepitope that is recognized by MHC class II-restricted TCRs. Therapeutic efficacy of TCR-transgenic cell therapy can be further investigated using an immunocompetent MHC-humanized mouse model of ZFTA-RELA fusion-positive ependymoma. Our findings provide initial evidence for neoepitope-specific immunotherapy in pediatric CNS tumors.
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OS12.4.A MHC class II-restricted transgenic T cell receptor therapy targeting mutant capicua transcriptional repressor in experimental gliomas. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Glioma subtypes are classified according to their characteristic mutations and show a high degree of resistance to standard therapeutic interventions such as radiotherapy and alkylating chemotherapy. Some of these characteristic mutations have shown to generate immunogenic neoepitopes that can be targeted with immunotherapy. 70% of oligodendrogliomas carry capicua transcriptional repressor (CIC) inactivating mutations.
RESULTS
In a screen for potential immunogenic glioma neoepitopes we identified recurrent CIC hotspot mutations at position 215 (CICR215W/Q) expressed in a subset of oligodendrogliomas as an immunogenic major histocompatibility complex (MHC) class II-restricted neoepitopes. Peptide-based vaccination of MHC-humanized mice resulted in the generation of robust mutation-specific T cell responses against CICR215W/Q, restricted to MHC class II. Droplet-based single cell T cell receptor (TCR) sequencing from CICR215W-specific T cell lines enabled retrieval of MHC class II-restricted CICR215W-reactive TCRs. By retroviral transduction of T cells, we established a flow cytometry-based testing platform of retrieved TCRs and were able to show the top reactive TCR against CICR215W to be shared between individual mice. Using a newly developed glioma model in MHC-humanized mice induced by CRISPR-based delivery of tumor suppressor targeting guide RNAs, we show that adoptive intraventricular transfer of CICR215W-specific TCR-transgenic T cells exert anti-tumor responses against CICR215W-expressing syngeneic gliomas.
CONCLUSION
The integration of immunocompetent MHC-humanized orthotopic glioma models in the discovery of shared immunogenic glioma neoepitopes facilitates the identification and preclinical testing of HLA-restricted neoepitope-specific TCRs for locoregional TCR-transgenic T cell adoptive therapy.
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KS01.6.A Comparative analysis of the immune compartment in human glioblastoma and IDH-mutant WHO grade 4 astrocytoma reveals profound differences in microglia phenotypes. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma (GBM) are the most common primary brain tumors. If untreated the average survival is around 12–18 months. Unfortunately, despite extensive research efforts, the therapeutic options remain limited. One major aspect complicating therapeutic development is an immunosuppressive tumor microenvironment. Isocitrate dehydrogenase (IDH)-mutant, WHO grade 4 astrocytomas appear histologically indistinguishable from GBM, but show significantly longer survival times. IDH mutations lead to changes in the tumor microenvironment with accrual of the neometabolite R-2-hydroxyglutarate. Previous studies on bulk transcriptomes have shown differences in the immune compartment of both tumor entities that were linked to the differences in clinical behavior.
MATERIAL AND METHODS
We have conducted high-dimensional comparative analyses of the myeloid compartment in surgically resected human GBM and IDH-mutant WHO grade 4 astrocytomas using single-cell RNA-Sequencing and immunohistochemistry. Histologically normal brain regions from epilepsy patients were used as controls. For analysis, whole-cell suspensions were prepared from freshly resected tumors or controls. Fluorescence activated cell sorting was used for myeloid cell enrichment. Samples were processed using the high-sensitivity single-cell RNA sequencing protocol CEL-Seq2. Seurat and StemID2 algorithms were used for clustering, differential gene expression and pseudotime analysis. Protein validation was achieved using immunohistochemistry.
RESULTS
We identified profound transcriptional changes of glioma-associated microglia in GBM with respect to control brain samples. Namely, we observed a global upregulation of major histocompatibility complex associated genes in GBM across all clusters. Additionally, we identified distinct myeloid subsets with phagocytic, hypoxia-associated and chemotactic transcriptomic signatures. Pseudotime analysis finely resolved transitional cell states. These changes were dramatically attenuated in IDH-mutant WHO grade 4 astrocytomas. The myeloid cells in these tumors resembled homeostatic microglia and showed an increased expression of cytokine and chemokine genes.
CONCLUSION
Here, we present a high-dimensional transcriptomic atlas of the myeloid compartment in human GBM and IDH-mutant WHO grade 4 astrocytomas. The identified differences point towards targeted therapeutic options via the modulation of the tumor microenvironment.
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A New Approach to Myocardial Injury Adaptations: A Possible Solution for One of the Oldest Problems in Heart Surgery. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Silent Operating Theater Optimization System (SOTOS): A New Noise Reduction and Information Management System—Effects on Stress, Concentration, Well-being, and Communication of OT Crews. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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[Erratum to: Distal femur replacement in extensive defects of the distal femur in revision arthroplasty]. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2020; 32:531. [PMID: 33216150 DOI: 10.1007/s00064-020-00679-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Contrast-agent free evaluation of cardiomyopathies with T1 mapping and the new fast strain-encoded (fSENC) magnetic resonance imaging. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiomyopathies (CMP) may cause impairment of cardiac function and structure. Cardiac Magnetic Resonance Imaging (CMR) is used for analysis and risk stratification of CMP by Late Gadolinium Enhancement (LGE). However, T1 mapping (T1) and fast strain encoded (f-SENC) sequences allow contrast-free and faster exams. The aim of this study was to characterize CMP by T1 and f-SENC to develop a faster and safer CMR protocol (fast-CMR).
Methods
CMP scans from our CMR database were retrospectively analyzed. All patients were scanned at 1.5T/3T scanner. Study groups were divided as follows: Patients with normal findings, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), hypertensive heart disease (HHD) and cardiac amyloidosis. Global T1 times, longitudinal (GLS) and circumferential (GCS) strain using f-SENC of study groups were compared to healthy individuals (controls). Scan time and amount of gadolinium-based contrast agent (CA) in CMR-protocol with LGE were compared to fast-CMR.
Results
174 patients and 31 controls were recruited. T1 times, GLS and GCS were similar between controls and normal individuals. T1 times were significantly increased (p<0.05), while GLS and GCS were significantly reduced (p<0.05) in all CMR study groups compared to controls (Table 1). Using fast-CMR 21 (±6) min of scan time were saved, about 47%, and 9 (±2) ml of CA were saved per patient.
Conclusion
Normal findings could be identified by fast-CMR without contrast agent. Fast CMR might also be a useful tool to identify different forms of CMP.
Funding Acknowledgement
Type of funding source: None
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[Rare combination injury of traumatic spondylolisthesis of the lumbosacral junction and Malgaigne's C3 fracture of the pelvis : Lessons learned]. Unfallchirurg 2020; 123:890-895. [PMID: 32821978 DOI: 10.1007/s00113-020-00841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This article reports on the case of a rare combination injury of a C3 pelvic ring fracture (Malgaigne's fracture) and simultaneous unstable traumatic spondylolisthesis (Meyerding grade 2) of the lumbosacral spine. The patient had pronounced neurological deficits of the lower extremities and tearing of the thecal sac. The selected primary and secondary surgical treatment algorithm of the polytraumatized patient as well as the course are described and critically discussed on the basis of the sparsely available literature.
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The Impact of the PCMH Model on Poststroke Follow‐up Visits and Hospital Readmissions. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Expression of PD‐1 and Tim‐3 is increased in skin of patients with bullous pemphigoid and pemphigus vulgaris. J Eur Acad Dermatol Venereol 2020; 35:486-492. [DOI: 10.1111/jdv.16780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022]
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A survey on surgeon practice shows lack of consensus on the management of primary shoulder stiffness. J BIOL REG HOMEOS AG 2020; 34:59-67. Congress of the Italian Orthopaedic Research Society. [PMID: 33261257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Shoulder stiffness is a condition of painful restriction in active and passive glenohumeral range of motion, which can arise spontaneously or as consequence of a known cause. Numerous therapeutic approaches are available; however, no consensus has been reached on the best algorithm for successful treatment. The aim of this study was to investigate local practice patterns regarding management of primary shoulder stiffness. Randomized controlled trials reporting results of shoulder stiffness treatment were collected and analyzed prior to study begin. Controversial elements in the treatment of primary shoulder stiffness were identified and a survey was created and administrated to clinicians participating at an annual national congress dedicated to shoulder pathologies and their treatment. 55 completed questionnaires were collected. Physical therapy was recommended by 98% of the interviewed. The use of oral corticosteroids was considered by 58% and injections of corticosteroids by 60%. Injective therapy with local anaesthetics was considered by 56% of the clinicians and acupuncture by 36%. 38% of the interviewed did never treat shoulder stiffness surgically. Various strategies to manage shoulder stiffness have been proposed and high-level evidence has been published. Numerous controversial points and a substantial lack of consensus emerged both from literature reviews and from this survey. The treatment of shoulder stiffness should be tailored to the patient's clinical situation and the stage of its pathology, aiming primarily at identifying risk factors for recurrence, reducing pain, restoring range of motion and function and shortening the duration of symptoms.
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Increasing latrine use in rural Karnataka, India using the risks, attitudes, norms, abilities, and self-regulation approach: A cluster-randomized controlled trial. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 707:135366. [PMID: 31877399 DOI: 10.1016/j.scitotenv.2019.135366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Recent years have seen unparalleled efforts by the Swatchh Bharat Mission (SBM) to make India open defecation free. While latrine coverage has been boosted very successfully, latrine use has remained low in many areas of the country. Consequently, the aim of this study was to use robust psychological theory to develop and rigorously evaluate low-cost and scalable behaviour change interventions to promote latrine use in rural India. This study reports findings from a cluster-randomized controlled trial (N = 1945) conducted in rural Karnataka, India, from January 2017 to February 2019. The evaluated behaviour change interventions were developed using the risks, attitudes, norms, abilities, and self-regulation (RANAS) approach. Results showed that latrine use changed by more than 15% in both treatment and control arms. The intervention triggered an additional, statistically significant increase in latrine use of approximately 5% to reach 97% use at endline. The results suggest that external factors had a strong influence on latrine use, with intensive efforts by SBM likely to be among these. The added value of the campaign was to increase latrine use to almost complete uptake and to successfully tackle the most change-resistant individuals. This intervention or selected components could complement future latrine use promotion in India.
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Loudness in the Operating Room during Cardiac Surgery: Are Our Operating Rooms Quiet Enough? Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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P2718Interim study: analysis of myocardial deformation using fSENC-CMR on patients with chest pain. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In acute situations such as non-ST-elevation infarction (NSTEMI) or relevant coronary artery disease (CAD) CMR does not yet play a key role due to its lengthy protocols. fSENC is a new CMR technique which may detect subclinical signs of myocardial damage by measuring myocardial strain (change in length/ unit length). A whole-heart coverage is generated in 6 heart-beats and the information obtained is converted into a colour-coded map. fSENC does not require major post-processing, long breath-holds and the administration of contrast agents/medication.
Purpose
In this observational study fSENC is assessed in patients with chest pain and its capability to differentiate between an ischemic cause (NSTEMI, significant CAD), an underlying non-ischemic cardiac disease and non-cardiac chest pain. Additionally, we aim to identify the affected coronary arteries in the ischemic cohort. With fSENC it could be possible to successfully diagnose patients with suspected AMI in <1h after admission and also gain diagnostic information regarding the underlying pathology.
Methods
Patients with chest pain and an initial hscTnT level between 5pg/ml and 52 pg/ml are recruited. These patients then undergo an fSENC-CMR before 2nd hscTnT measurement. Additionally, a stress-induced fSENC-image is acquired (1-minute hyperventilation, followed by a single breath-hold). This breathing manoeuvre leads to an increase in oxygenation through vasodilation, therefore identifying ischemic areas. The fSENC analysis is later compared to the patient's final diagnosis and therapy.
Results
So far 50 patients have been analysed by fSENC in this observational study (26 female, aged 57±18). fSENC correctly identified 7 patients suffering from NSTEMI or significant CAD and their affected coronary arteries. 42 other patients were safely ruled-out by fSENC which was consistent with the serial hscTnT results. In 11 patients fSENC was able to detect generalized impaired myocardial deformation, implying an underlying cardiac disease (hypertrophic cardiomyopathy, myocarditis). fSENC currently exhibits a sensitivity of 100% and specificity of 97,7% for correct rule-in/-out of an ischemic cause.
Conclusions
At this stage fSENC allows correct identification of patients suffering from myocardial infarction and their affected coronary arteries. Additionally, fSENC can safely rule-out patients with chest pain but no underlying ischemic cause. This novel technique is a rapid additional diagnostic tool which assesses myocardial function non-invasively without radiation exposure.
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HEALTHY AGING REDUCES THE MYOCARDIAL OXYGENATION RESERVE AS ASSESSED WITH OXYGENATION SENSITIVE CMR. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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339Cardiac tissue characterization in patients with wilson"s disease using cardiac magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez122.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Formulation and processability screening for the rational design of ethylene-vinyl acetate based intra-vaginal rings. Int J Pharm 2019; 564:90-97. [DOI: 10.1016/j.ijpharm.2019.04.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 10/27/2022]
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[Endoprosthetic replacement of the proximal humerus in revision shoulder arthroplasty]. OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2019; 31:115-126. [PMID: 30725115 DOI: 10.1007/s00064-019-0588-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/23/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Reconstruction of proximal humeral bone defects in the setting of shoulder revision arthroplasty by implantation of a modular humeral component. INDICATIONS Severe segmental humeral bone defects in revision total shoulder arthroplasty, after tumor resection, trauma, pathological fractures, post-infectious or after failed osteosynthesis. CONTRAINDICATIONS Acute or chronic local infections, large diaphyseal bone defects preventing adequate anchorage of the prosthesis, very short life expectancy (<3 months). SURGICAL TECHNIQUE Removal of the implant using an extended deltopectoral approach. Periarticular arthrolysis with preservation of neurovascular structures. Resection of the meta-diaphyseal bone and reconstruction of the humeral length with the help of different extension sleeves and a modular humeral component. Soft tissue management is crucial, especially with reverse shoulder arthroplasty. POSTOPERATIVE MANAGEMENT Three weeks postoperatively immobilization in a shoulder sling, active assisted movement therapy by gradual pain-adapted increase of movement, muscle coordination, and strength. RESULTS The results of 11 consecutive patients treated with a modular humeral component due to a failed shoulder arthroplasty between 2008 and 2016 were evaluated retrospectively. Mean length of reconstruction was 100 mm. Due to recurrent dislocations one patient required revision and conversion to a reverse component. No cases of aseptic loosening or periprosthetic infection were observed.
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PSXV-5 Divergent residual intake and body weight gain on ingestive behavior and diet selection by feedlot lambs. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Model for Hormonal Emergency Contraception (HEC) in cycling and mated guinea pigs - Studies with the Progesterone Receptor Modulators (PRM) Ulipristal Acetate (UPA/CDB2914) and EC317. J Steroid Biochem Mol Biol 2018; 183:152-158. [PMID: 29902513 DOI: 10.1016/j.jsbmb.2018.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/04/2018] [Accepted: 06/10/2018] [Indexed: 11/29/2022]
Abstract
UNLABELLED A guinea pig model for new HEC methods is proposed. Two targets for HEC (Hormonal Emergency Contraception), ovulation and conception (post-mating study), were investigated using adjusted PRM treatments: (a) Ovulation inhibition study: Injections on cycle days 10-17, study of ovarian histology on day 18; (b) post-mating study: Injections on cycle days 1 and 2; rate of pregnant females was recorded at autopsy on day 18. P plasma levels permitted assessment of effects on ovulation in non-conceiving animals. RESULTS (a) All controls had recently ovulated. Statistically significant anti-ovulatory effects (p < 0.05, Fisher's Exact Test) were seen at 10 mg UPA (ulipristal acetate, CDB2914) and ≥0.3 mg EC317; 100% inhibition was found for EC317 at 10, 3, and 1 mg/day. No dosage of UPA was 100% effective. (b) In post-mating studies, 16 of 30 controls were pregnant. Both PRMs (progesterone receptor modulator) exerted inhibitory effects on conception, none on imminent ovulation; 1 of 10 animals had living conceptuses after 10 mg UPA, none following 10 and 1 mg EC317/day, respectively. At pairwise comparison with controls, 10 mg was the lowest effective dosage for UPA (p < 0.05), and 1 mg for EC317 (p < 0.01). P plasma levels: Significantly lower P (p < 0.05) in subsequently pregnant vs non-pregnant controls was found on cycle day 3 or 4; this difference disappeared on day 8 or 9. This stage thus appears vulnerable to hormonal constellations and possibly PRM effects. HEC model: Effects on ovulation and conception were seen at the same dose levels of both PRM. Superior and more consistent effects of EC317 vs UPA (factor ≥10) suggest higher efficacy using EC317 for HEC.
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P3.12-03 Targeting DLL3 with AMG 757, a BiTE® Antibody Construct, and AMG 119, a CAR-T, for the Treatment of SCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1826] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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P04.62 The oncometabolite R-2-Hydroxyglutarate suppresses the innate immune microenvironment of IDH1-mutated gliomas via aryl hydrocarbon receptor signaling. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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New insights into risk evaluation of heart failure with preserved ejection fraction using MRI. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Vasoreactivity during apnea in coronary artery stenosis swine model. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Der Einfluss von Selbstwirksamkeit und resilientem Coping auf die Lebensqualität bei Krebspatienten. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1668058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Return to work and living healthy after head and neck cancer (RELIANCE): Pilot results of a randomized controlled trial. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Klinische Basisuntersuchung des Kniegelenkes. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2018. [DOI: 10.1055/s-0043-125093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Zielsetzung Die erfolgreiche Behandlung von Kniegelenkserkrankungen erfordert eine exakte Diagnose. Neben einer differenzierten Anamneseerhebung stellt die klinische Untersuchung dabei den wichtigsten Bestandteil in der Diagnostik von Kniegelenkserkrankungen dar.
Methode Das vorliegende Video erklärt die gängigen Provokationstests und Funktionsprüfungen, die in der Basisuntersuchung des Kniegelenkes zum Einsatz kommen. Neben der generellen Inspektion und Palpation liegt der Fokus hierbei auf den einzelnen Regionen Patella, Menisken, Kreuzbändern und Kollateralbändern.
Schlussfolgerung Der vorliegende Basisuntersuchungsgang ermöglicht eine strukturierte Herangehensweise an klinische Problemstellungen und kann, ergänzt um weitere spezifische und individuelle Tests eine gute Grundlage für die Diagnostik von Kniegelenkserkrankungen darstellen.
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Abstract
Zusammenfassung
Zielsetzung Die erfolgreiche Behandlung von Schultererkrankungen erfordert eine exakte Diagnose. Neben einer differenzierten Anamneseerhebung stellt die klinische Untersuchung dabei den wichtigsten Bestandteil in der Diagnostik dar.
Methode Das vorliegende Video erklärt die gängigen Funktionsprüfungen und Provokationstests, die in der Basisuntersuchung der Schulter zum Einsatz kommen. Neben der Inspektion und Palpation liegt der Fokus hierbei auf den einzelnen Provokations- und Funktionstests.
Schlussfolgerung Der vorliegende Basisuntersuchungsgang ermöglicht eine strukturierte Herangehensweise an klinische Problemstellungen und kann, ergänzt um weitere spezifische und individuelle Tests, eine gute Grundlage für die Diagnostik von Schultererkrankungen darstellen.
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LapTrain: multi-modality training curriculum for laparoscopic cholecystectomy-results of a randomized controlled trial. Surg Endosc 2018; 32:3830-3838. [PMID: 29435758 DOI: 10.1007/s00464-018-6110-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/07/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Multiple training modalities for laparoscopy have different advantages, but little research has been conducted on the benefit of a training program that includes multiple different training methods compared to one method only. This study aimed to evaluate benefits of a combined multi-modality training program for surgical residents. METHODS Laparoscopic cholecystectomy (LC) was performed on a porcine liver as the pre-test. Randomization was stratified for experience to the multi-modality Training group (12 h of training on Virtual Reality (VR) and box trainer) or Control group (no training). The post-test consisted of a VR LC and porcine LC. Performance was rated with the Global Operative Assessment of Laparoscopic Skills (GOALS) score by blinded experts. RESULTS Training (n = 33) and Control (n = 31) were similar in the pre-test (GOALS: 13.7 ± 3.4 vs. 14.7 ± 2.6; p = 0.198; operation time 57.0 ± 18.1 vs. 63.4 ± 17.5 min; p = 0.191). In the post-test porcine LC, Training had improved GOALS scores (+ 2.84 ± 2.85 points, p < 0.001), while Control did not (+ 0.55 ± 2.34 points, p = 0.154). Operation time in the post-test was shorter for Training vs. Control (40.0 ± 17.0 vs. 55.0 ± 22.2 min; p = 0.012). Junior residents improved GOALS scores to the level of senior residents (pre-test: 13.7 ± 2.7 vs. 18.3 ± 2.9; p = 0.010; post-test: 15.5 ± 3.4 vs. 18.8 ± 3.8; p = 0.120) but senior residents remained faster (50.1 ± 20.6 vs. 25.0 ± 1.9 min; p < 0.001). No differences were found between groups on the post-test VR trainer. CONCLUSIONS Structured multi-modality training is beneficial for novices to improve basics and overcome the initial learning curve in laparoscopy as well as to decrease operation time for LCs in different stages of experience. Future studies should evaluate multi-modality training in comparison with single modalities. TRIAL REGISTRATION German Clinical Trials Register DRKS00011040.
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Bacterial Infiltration of Structural Heart Valve Disease. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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The Influence of Dynamically Regulated, Intermittently Regulated Active Chest Drainage Units Compared to Conventional Vacuum-Driven Systems on the Early Postoperative Outcome after Cardiac Surgery. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Erratum to “Cancer-related Fatigue in Adolescents and Young Adults: A Systematic Review of the Literature” [Crit. Rev. Oncol. Hematol. 118 (2017) 63–69]. Crit Rev Oncol Hematol 2017; 120:10-12. [DOI: 10.1016/j.critrevonc.2017.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Cancer-related fatigue in adolescents and young adults: A systematic review of the literature. Crit Rev Oncol Hematol 2017; 118:63-69. [PMID: 28917270 DOI: 10.1016/j.critrevonc.2017.08.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 08/03/2017] [Accepted: 08/18/2017] [Indexed: 11/15/2022] Open
Abstract
Adolescents and young adults with cancer (AYA) represent a specific age cohort dealing with the disease in a stage of life characterized by development, upheavals, and establishment. The aim of this study was to point out the state of research on how AYA are affected by cancer-related fatigue (CRF). RESULTS Twelve articles were included. CRF was found to be higher in AYA than in either of the comparison groups, healthy peers and older cancer patients. Most included studies did not measure CRF with multidimensional, fatigue-specific instruments. CONCLUSION We found a gap in research concerning CRF in AYA. The existing findings suggest that CRF is a significant issue for AYA cancer patients. However, less is known about the prevalence, severity, and impact of CRF in AYA, and their treatment. This should be considered in future research, and risk and prevention factors should be ascertained. Multidimensional and fatigue-specific measuring tools should be used to do this.
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A novel BCMA/CD3 bispecific T-cell engager for the treatment of multiple myeloma induces selective lysis in vitro and in vivo. Leukemia 2017; 31:2278. [PMID: 28751764 DOI: 10.1038/leu.2017.219] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This corrects the article DOI: 10.1038/leu.2016.388.
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One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psychooncology 2017; 27:75-82. [DOI: 10.1002/pon.4464] [Citation(s) in RCA: 243] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 01/09/2023]
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OS10.2 R-2-Hydroxyglutarate shapes the immune microenvironment in IDH1-mutant gliomas. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chronic Infection of Stenotic Aortic Valves with Staphylococcus aureus: Implications for Perioperative Treatment? Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Introduction Minimally invasive operative techniques are being used increasingly in gynaecological surgery. The expansion of the laparoscopic operation spectrum is in part the result of improved imaging. This study investigates the practical advantages of using 3D cameras in routine surgical practice. Materials and Methods Two different 3-dimensional camera systems were compared with a 2-dimensional HD system; the operating surgeon's experiences were documented immediately postoperatively using a questionnaire. Results Significant advantages were reported for suturing and cutting of anatomical structures when using the 3D compared to 2D camera systems. There was only a slight advantage for coagulating. The use of 3D cameras significantly improved the general operative visibility and in particular the representation of spacial depth compared to 2-dimensional images. There was not a significant advantage for image width. Depiction of adhesions and retroperitoneal neural structures was significantly improved by the stereoscopic cameras, though this did not apply to blood vessels, ureter, uterus or ovaries. Conclusion 3-dimensional cameras were particularly advantageous for the depiction of fine anatomical structures due to improved spacial depth representation compared to 2D systems. 3D cameras provide the operating surgeon with a monitor image that more closely resembles actual anatomy, thus simplifying laparoscopic procedures.
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Treosulfan for advanced breast cancer in a heavily pre-treated patient - a case report. EUR J GYNAECOL ONCOL 2017; 38:115-117. [PMID: 29767877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Treatment of metastatic breast cancer experienced significant improvement in the past decades by introduction of highly effective therapies, but survival still remains poor. Nonetheless, in some patients, long-term survival can be achieved by sequent endocrine and chemotherapy treatment, although toxicity and resistance eventually occur, until no further suitable and approved therapies remain. If further therapy is needed, therapist may be forced to consider treatients which are promising but not approved, such as the alkylating agent treosulfan, which is approved for the treatment of ovarian cancer only. Thus, relevant clinical data on its use in human breast cancer are lacking. CASE REPORT The authors report the case of a 49-yeAr-old woman with heavily pre-treated, metastatic breast cancer, who experienced complete remission of pulmonary and soft tissue metastases while under treatment with treosulfan. Treatment was generally well-tolerated. CONCLUSION Treosulfan might be an effective and well-tolerated treatment even in heavily pre-treated patients with metastatic breast cancer.
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Preclinical characterization of an EGFRvIII/CD3 specific BiTE® antibody construct for the treatment of glioblastoma multiforme. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32884-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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