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Vogel RI, Luo X, Brown K, Jewett P, Dona AC, Nagler RH, Ahmed RL, Martinson BC, Lazovich D. A UVR-sensor wearable device intervention to reduce sun exposure in melanoma survivors: Results from a randomized controlled trial. PLoS One 2023; 18:e0281480. [PMID: 36763627 PMCID: PMC9916644 DOI: 10.1371/journal.pone.0281480] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/12/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Melanoma survivors are at increased risk of developing a second primary melanoma; however, some report sub-optimal sun behaviors and sunburns. We tested the effectiveness of a wearable device with ultraviolet radiation (UVR)-sensing technology to improve sun behaviors and reduce sunburns in cutaneous melanoma survivors. MATERIALS AND METHODS We conducted a randomized controlled trial using Shade 2, a commercially available wrist device that measures UVR. The intervention group received the device and mobile application notifications about their exposure and prompts to use sunscreen. The control group received the device and a separate research mobile application without information about their exposure or notifications. Participants wore the device for 12 weeks and self-reported sun behaviors before, during, and after the intervention. The primary outcome was a composite score of sun protection behaviors at week 12. RESULTS 386 participants were randomized (186 control, 182 intervention). Most were female and 5+ years past their first melanoma diagnosis. The average age was 56 years. Most (93%) completed the study, though 40% experienced device issues. No meaningful differences were observed in self-reported sun protection behaviors at week 12 (controls 3.0±0.5 vs. intervention 2.9±0.5, p = 0.06), any sunburn during the intervention period (controls 14.4% vs. intervention 12.7%, p = 0.75), or average daily objective UVR exposure (controls median 87 vs. intervention 83 J/m2, p = 0.43). CONCLUSION Wearing a device that measured and alerted melanoma survivors to UVR exposure did not result in different sun behaviors, exposure, or sunburns relative to controls. The technology needs refinement before further attempts to assess the effectiveness of self-monitoring UVR exposure. CLINICAL TRIALS REGISTRATION NCT03927742.
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Affiliation(s)
- Rachel Isaksson Vogel
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Xianghua Luo
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Katherine Brown
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Patricia Jewett
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Allison C. Dona
- Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rebekah H. Nagler
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Hubbard School of Journalism & Mass Communication, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Rehana L. Ahmed
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Brian C. Martinson
- HealthPartners Institute, Bloomington, Minnesota, United States of America
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health System, Minneapolis, Minnesota, United States of America
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
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Lou E, Vogel RI, Hoostal S, Grad A, Monu M, Lukaszewski T, Deshpande J, Linden M, Klein M, Teoh DGK, Geller MA. Tumor stroma proportion to predict platinum chemoresistance in primary ovarian carcinomas: A prospective study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5581] [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: 11/20/2022] Open
Abstract
5581 Background: Platinum chemotherapy resistance occurs in approximately 25% of patients with ovarian carcinoma and represents a major barrier to effective care of this patient population. To date there are no effective nor validate predictive biomarkers of chemoresistance of ovarian carcinomas. We performed a prospective trial designed to enroll patients with ovarian masses suspicious for ovarian cancer, with the goal of identifying tumor-based predictive biomarkers of platinum resistance. Methods: 60 women were enrolled on the study. Tumor specimens were collected from 49 of these women with newly diagnosed pelvic masses, of which 29 were found to have histopathologically proven primary ovarian carcinoma. Of these primary malignant cases, 24 had specimens accessible for assessment of tumor-stroma proportion and data available regarding chemosensitive vs chemoresistance status via review of the medical record using a UMN IRB-approved protocol. Tumor slices were stained with H&E and also for antibodies against two microRNAs (29b and 199a) differentially expressed in ovarian cancer cell lines. Tumor-stroma proportions were assessed by two experienced pathologists blinded to chemoresistance status, with <50% stroma scored as low proportion, >50% scored as high proportion. Results: The average age of assessed patients with malignant tumors was 62. 87.5% had high-grade epithelial carcinomas. Baseline median CA-125 was 416 (range 32-2782). 80% of ovarian cancer patients with chemoresistance had tumor stroma proportions >50%; 73.7% of cancer patients with chemosensitive tumors had proportions <50% (p-value: 0.047). Expression of miR29b or 199a did not significantly correlate with chemoresistance. Conclusions: Tumor-stroma proportion is a useful predictive biomarker of platinum chemoresistance. If validated in larger datasets, it would be a relatively inexpensive and helpful tool for tailoring treatment strategies and clinical decision-making in women with ovarian cancer.
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Affiliation(s)
- Emil Lou
- University of Minnesota, Hopkins, MN
| | | | | | - Aaron Grad
- University of Minnesota, Minneapolis, MN
| | - Minnu Monu
- University of Minnesota, Minneapolis, MN
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Vogel RI, Jewett P, Messelt A, Lee H, Everson-Rose S, Hatsukami D, Geller MA, Teoh DGK, Blaes AH. Differences in quality of life and emotional health by diagnosis among women with early-stage gynecological cancers. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e23180] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23180 Background: Psychosocial outcomes have been described in women with gynecological cancers, but potential differences by diagnosis have received less attention. We sought to compare quality of life (QOL) and emotional health among early stage gynecological cancer survivors by disease location. Methods: We present baseline data from an ongoing cohort study of gynecological cancer patients treated at an academic cancer center. Measures include cancer-related QOL, emotional health and negative (post-traumatic stress disorder-PTSD) and positive (post-traumatic growth-PTG) reactions to cancer. Univariate and multivariate linear regression models (restricted to stage I or II; excluding vaginal/vulvar) explored differences in QOL and emotional health by diagnosis. Potential confounders considered for inclusion in the final models were age, stage, education, income, partner status, treatment status, and race. Results: 222 patients with early stage disease completed the survey: 56 (25.2%) ovarian, 122 (55.5) endometrial, 33 cervical (14.9%), and 11 (5%) vaginal/vulvar cancer. Cervical and vaginal/vulvar cancer patients reported greater cancer-related distress, anxiety and PTSD scores (Table). Endometrial cancer patients reported lowest PTG scores. Conclusions: Our analyses suggest early stage gynecological cancer patients face different psychosocial sequelae based on diagnosis, with worse outcomes generally being associated with younger age. Further research is needed to assess low PTG among endometrial cancer patients, since PTG is considered a potentially beneficial psychosocial outcome of cancer. [Table: see text]
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Affiliation(s)
| | | | | | - Heewon Lee
- University of Minnesota, Minneapolis, MN
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Hubbs JL, Dickson Michelson EL, Vogel RI, Rivard CL, Teoh DGK, Geller MA. Sexual quality of life after the treatment of gynecologic cancer: what women want. Support Care Cancer 2019; 27:4649-4654. [PMID: 30941579 DOI: 10.1007/s00520-019-04756-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 08/17/2018] [Accepted: 03/18/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE While the incidence of sexual dysfunction after treatment for gynecologic malignancies is well documented, few studies describe how patients want healthcare providers to address these concerns. The objective of this study was to evaluate changes in sexual function and describe patient preferences regarding healthcare provider roles in addressing and treating sexual dysfunction in gynecologic cancer survivors. METHODS Patients undergoing gynecologic cancer treatment from 2013 to 2014 at a single University-based Gynecologic Cancer clinic were surveyed using a modified Changes in Sexual Function Questionnaire (CSFQ), along with questions relating to healthcare provider interactions and preferences. RESULTS Among 277 eligible patients approached to participate, 85 (30.7%) completed the survey. The mean age was 52.2 ± 12.3 years; most were non-Hispanic White (78.8%), partnered (73.2%), had endometrial or ovarian cancer (30.6% and 44.7%, respectively), and were in surveillance (57.3%). Most women (64.7%) reported much or great sexual enjoyment 1 year prior to cancer treatment which decreased to 27.4% currently; 33.3% report only rare sexual activity. There were no statistically significant differences in mean total CSFQ scores by treatment modality. A minority wanted healthcare providers to initiate sexual health discussions (25.3%); the remaining reported not wanting sexual health addressed or preferred raising the issue themselves. The most commonly cited barrier to communication was the feeling that there are more important issues to discuss with their oncology providers (46.2%). CONCLUSIONS While gynecologic cancer patients report changes in sexual function following cancer therapy, many believe there are other issues more paramount to be addressed. Further studies are warranted to develop better strategies for addressing sexual health in women receiving treatment for gynecologic cancers.
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Affiliation(s)
- J L Hubbs
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | | | - R I Vogel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - C L Rivard
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - D G K Teoh
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA.
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Klein T, Wang W, Yu L, Wu K, Boylan KLM, Vogel RI, Skubitz APN, Wang JP. Development of a multiplexed giant magnetoresistive biosensor array prototype to quantify ovarian cancer biomarkers. Biosens Bioelectron 2018; 126:301-307. [PMID: 30445305 DOI: 10.1016/j.bios.2018.10.046] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 11/28/2022]
Abstract
In this work, we developed benchtop and handheld Giant Magnetoresistive (GMR) biosensing systems that serve as platforms for detecting a wide variety of protein biomarkers for human diseases. System development included spintronic and nanomagnetic materials, biomolecular chemistry, electronic circuitry, analog and digital signal processing, firmware programming, user interface programming on both PC and Android smartphone, communications over both USB and Bluetooth, and mechanical integration. In this work, we demonstrated the benchtop GMR biosensing system in the context of ovarian cancer assay development. The prototype system delivered the required performance in terms of high-sensitivity multiplex assays in a portable format with enough flexibility to serve as a platform for ovarian cancer and many other diseases. We achieved multiplex detection of cancer antigen 125 (CA125 II), human epididymis protein 4 (HE4), and interleukin 6 (IL6), with limits of detection (LOD) as low as 3.7 U/mL, 7.4 pg/mL, and 7.4 pg/mL, respectively.
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Affiliation(s)
- Todd Klein
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Wei Wang
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Lina Yu
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kai Wu
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kristin L M Boylan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Rachel Isaksson Vogel
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Amy P N Skubitz
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA; Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jian-Ping Wang
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
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Heilmann W, Vogel RI, Pulver T, Zhao X, Shahi M, Richter J, Klein M, Chen L, Ding R, Konecny G, Winterhoff B, Ghebre R, Taran FA, Hartkopf A, Grischke EM, Walter CB, Brucker SY, Bazzaro M, Kommoss S. USP14 als potentielle Zielstruktur neuer Therapiestrategien in der Behandlung des Endometriumkarzinoms. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671034] [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: 10/28/2022] Open
Affiliation(s)
- W Heilmann
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - RI Vogel
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
- Masonic Cancer Center, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - T Pulver
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - X Zhao
- Division of Basic and Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - M Shahi
- Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - J Richter
- Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - M Klein
- Department of Pathology and Laboratory Medicine, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - L Chen
- Center for Drug Design, Academic Health Center, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - R Ding
- Center for Drug Design, Academic Health Center, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - G Konecny
- Gynecologic Oncology, Hematology & Oncology Department, UCLA Medical Center, Santa Monica, Vereinigte Staaten von Amerika
| | - B Winterhoff
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - R Ghebre
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - FA Taran
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - A Hartkopf
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - EM Grischke
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - CB Walter
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - SY Brucker
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - M Bazzaro
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
- Masonic Cancer Center, University of Minnesota, Minneapolis, Vereinigte Staaten von Amerika
| | - S Kommoss
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
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Blaes AH, Mulrooney DA, Vogel RI, Solovey A, Hebbel R, Peterson BA, Neglia JP, Biewen C, Konety SH, Duprez DA. Arterial elasticity as a risk factor for early cardiovascular disease among testicular cancer survivors treated with platinum-based chemotherapy: a cross-sectional pilot study. Vasc Health Risk Manag 2018; 14:205-211. [PMID: 30237722 PMCID: PMC6136418 DOI: 10.2147/vhrm.s151847] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Testicular cancer survivors who have received platinum-based chemotherapy are at risk for premature cardiovascular disease. The etiology of this risk is not well understood. This pilot study explores the impact of platinum-based chemotherapy on endothelial function. METHODS Testicular cancer survivors <30 years old at the time of diagnosis who received platinum-based chemotherapy between 2002 and 2012, as well as 17 similarly aged male controls, were identified. Consented subjects underwent vascular assessment using the HDI/PulseWave CR-2000 Cardiovascular Profiling System and the Endo-PAT2000 system. Biomarkers and functional test markers were compared among cases, controls, and a group of historical controls using two sided two-sampled t-tests and Wilcoxon rank-sum tests. RESULTS Thirteen survivors with a median age of 30.2 years and body mass index of 27.3 were enrolled, along with 17 healthy controls with a median age of 27.1 years and body mass index of 24.8. Median time from chemotherapy was 4.7 (range: 0.8-14) years. There was no statistical difference in reactive hyperemia peripheral arterial tonometry ratio between cases and controls (p = 0.574). There was no statistical difference in small or large artery elasticity between cases and controls (p = 0.086) or between cases and historical controls (p = 0.729). There was also no statistical difference in the blood levels of circulating endothelial cells, von Willebrand factor, and vascular cell adhesion molecules. There was a trend toward increased metabolic syndrome in cases (15%) as compared to recruited controls (6%), though this difference was not statistically significant (p = 0.565). CONCLUSION Testicular cancer survivors have no clinically significant difference in endothelial function compared to controls 4 years after the completion of chemotherapy. Further research is needed to explore the secondary modifiable causes that may contribute to the risk of premature cardiovascular disease.
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Affiliation(s)
- Anne H Blaes
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | | | | | - Anna Solovey
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | - Robert Hebbel
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | - Bruce A Peterson
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA,
| | | | - Carter Biewen
- Division of Pediatrics, University of California San Francisco, CA, USA
| | - Suma H Konety
- Division of Cardiology, University of Minnesota, MN, USA
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Vogel RI, Niendorf K, Lee H, Petzel S, Lee HY, Geller MA. A qualitative study of barriers to genetic counseling and potential for mobile technology education among women with ovarian cancer. Hered Cancer Clin Pract 2018; 16:13. [PMID: 29997716 PMCID: PMC6031189 DOI: 10.1186/s13053-018-0095-z] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/22/2018] [Indexed: 12/25/2022] Open
Abstract
Background National guidelines recommend genetic counseling for all ovarian cancer patients because up to 20% of ovarian cancers are thought to be due to hereditary cancer syndromes and effective cancer screening and prevention options exist for at-risk family members. Despite these recommendations, uptake of genetic counselling and testing is low. The goal of this study was to identify barriers to and motivators for receipt of genetic counseling along with preferences regarding potential use of a mobile application to promote genetic counseling. Methods Three focus groups were conducted including 14 women with a diagnosis of epithelial ovarian, primary peritoneal or fallopian tube cancer. Topics included understanding of genetic counseling, perceived pros and cons, preferences for receiving health information, and familiarity with mobile phone technology. Transcripts were analyzed using standard procedures of qualitative thematic text analysis and descriptive coding techniques. Results Six major themes regarding barriers to and motivators of genetic counseling and use of mobile technology in promoting genetic counseling emerged: (1) need for information, (2) relevance, (3) emotional concerns, (4) family concerns, (5) practical concerns, and (6) mobile application considerations. Conclusions These data reiterate previously reported barriers to genetic counseling as observed in other populations. Participants were supportive of the use of mobile technology for promoting uptake of genetic counseling.
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Affiliation(s)
- Rachel Isaksson Vogel
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Kristin Niendorf
- 2Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN USA
| | - Heewon Lee
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Sue Petzel
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Hee Yun Lee
- 3School of Social Work, College of Education and Human Development, University of Minnesota, Minneapolis, MN USA
| | - Melissa A Geller
- 1Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, MMC 395, 420 Delaware Street SE, Minneapolis, MN 55455 USA
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Petzel SV, Isaksson Vogel R, Cragg J, McClellan M, Chan D, Jacko JA, Sainfort F, Geller MA. Effects of web-based instruction and patient preferences on patient-reported outcomes and learning for women with advanced ovarian cancer: A randomized controlled trial. J Psychosoc Oncol 2018; 36:503-519. [PMID: 29791275 DOI: 10.1080/07347332.2018.1457125] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A randomized controlled trial was conducted of a web-based intervention to improve advanced care planning in women with ovarian cancer. A secondary analysis of 35 randomized women focused on changes in distress and knowledge about ovarian cancer through distress monitoring and information tailored to patients' cognitive coping style (monitoring, blunting). Pre-/postresults indicated the Intervention group demonstrated lower distress (p = 0.06); blunting was associated with lower depression (p = 0.04); knowledge in both groups was unchanged. Women in the Intervention vs. Control group reported their family was less likely to be upset by cancer information (p = 0.0004). This intervention reduced distress while incorporating patient preferences.
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Affiliation(s)
- Sue V Petzel
- a Masonic Cancer Center, University of Minnesota , Minneapolis , USA.,b Department of Obstetrics , Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota , Minneapolis , USA
| | - Rachel Isaksson Vogel
- a Masonic Cancer Center, University of Minnesota , Minneapolis , USA.,b Department of Obstetrics , Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota , Minneapolis , USA
| | - Julie Cragg
- c Institute for Health Informatics, University of Minnesota , Minneapolis , USA
| | - Molly McClellan
- d Department of Urology , University of Minnesota , Minneapolis , USA
| | - Daniel Chan
- e Division of Environmental Health Sciences, School of Public Health , University of Minnesota , Minneapolis , USA
| | - Julie A Jacko
- e Division of Environmental Health Sciences, School of Public Health , University of Minnesota , Minneapolis , USA
| | - François Sainfort
- a Masonic Cancer Center, University of Minnesota , Minneapolis , USA.,f Division of Health Policy and Management, School of Public Health , University of Minnesota , Minneapolis , USA
| | - Melissa A Geller
- a Masonic Cancer Center, University of Minnesota , Minneapolis , USA.,b Department of Obstetrics , Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota , Minneapolis , USA
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Blaes AH, Beckwith HC, Hebbel RP, Solovey AS, Potter D, Yee D, Petersen A, Vogel RI, Luepker RV, Duprez D. Longitudinal follow-up of endothelial function in breast cancer survivors on aromatase inhibitors (AIs). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e12525] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - David Potter
- University of Minnesota Department of Medicine, Minneapolis, MN
| | - Douglas Yee
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
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Millar A, Vogel RI, Bedell S, Ayers Looby M, Hubbs JL, Harlow BL, Ghebre R. Patterns of postpartum contraceptive use among Somali immigrant women living in Minnesota. Contracept Reprod Med 2017; 2:14. [PMID: 29201419 PMCID: PMC5683445 DOI: 10.1186/s40834-017-0041-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/06/2017] [Accepted: 02/16/2017] [Indexed: 11/16/2022] Open
Abstract
Background The postpartum period is a crucial time to provide family planning counseling and can decrease incidence of adverse reproductive outcomes. The purpose of this study was to characterize patterns of postpartum contraception and to investigate long acting reversible contraceptive (LARC) use among Somali women living in a metropolitan area of Minnesota in an effort to provide better family planning and reproductive health counseling in this growing immigrant population. Methods A retrospective chart review was conducted of Somali women who delivered between January 1, 2011 and December 31, 2014. Information was collected regarding family planning counseling provided and contraceptive methods chosen at the postpartum clinic visit. Results Of the 747 Somali women who delivered during this time period, 56.4% had no postpartum follow up visit. At the postpartum visit, 88.3% of women received family planning counseling and 80.8% chose a contraceptive method with the remainder declining. The intrauterine device (IUD) was the most popular contraceptive method, chosen by 39.7% of women. Other than parity, no statistically significant differences were observed between women who chose LARC versus other contraceptive methods. Of the women that chose a LARC, 39.4% had it placed at the time of their postpartum visit; immediate placement was statistically significantly more likely with more recent delivery, lower BMI and obstetrician as the provider type. Conclusions The IUD was the most popular method of postpartum contraception. There was a trend toward increase in LARC use with increasing parity. Same-day LARC placement was uncommon, but should be encouraged in this population given high loss to follow up rate.
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Affiliation(s)
- Amy Millar
- University of Minnesota Department of Obstetrics, Gynecology and Women's Health, 420 Delaware St SE, MMC 395, Minneapolis, MN 55455 USA
| | - Rachel Isaksson Vogel
- University of Minnesota Department of Obstetrics, Gynecology and Women's Health, 420 Delaware St SE, MMC 395, Minneapolis, MN 55455 USA
| | - Sabrina Bedell
- University of Minnesota Department of Obstetrics, Gynecology and Women's Health, 420 Delaware St SE, MMC 395, Minneapolis, MN 55455 USA
| | - Maureen Ayers Looby
- University of Minnesota Department of Obstetrics, Gynecology and Women's Health, 420 Delaware St SE, MMC 395, Minneapolis, MN 55455 USA
| | - Jessica L Hubbs
- University of Minnesota Department of Obstetrics, Gynecology and Women's Health, 420 Delaware St SE, MMC 395, Minneapolis, MN 55455 USA
| | | | - Rahel Ghebre
- University of Minnesota Department of Obstetrics, Gynecology and Women's Health, 420 Delaware St SE, MMC 395, Minneapolis, MN 55455 USA.,Human Resources for Health Program Rwanda and Yale School of Medicine, New Haven, CT USA
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12
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Abstract
OBJECTIVE Negative pressure therapy (NPT) offers the potential to reduce infection in obese patients. The goal of this study was to explore the association between NPT use and infection after cesarean delivery among obese women. METHODS We initiated a hospital protocol wherein women with a body mass index (BMI) of 40 kg/m2 or greater who delivered after January 1, 2011 were to receive NPT following cesarean section. A retrospective comparison of surgical site infection (SSI) in women receiving the intervention to a similar group with a BMI of 40 kg/m2 or greater, a historical control group of women who delivered before January 1, 2011. Incidence of SSI was compared between time periods using logistic regression models. RESULTS A total of 233 patients in the preintervention (control) group and 234 patients in the intervention group were included in the analysis. In the control group, 23 (9.9%) developed SSI, compared with 13 (5.6%) in the intervention group. After adjustment for potential confounding factors, women in the postintervention period experienced a statistically significant reduction in SSI rates (adjusted odds ratio =0.45, 95% CI = 0.22-0.95); P = .04). CONCLUSION Implementation of a hospital protocol of NPT following cesarean delivery in obese women resulted in reduced incidence of postoperative SSI. This study suggests that using NPT after cesarean delivery in women with a BMI ≥40 kg/m2 is an efficacious method to reduce incidence of postoperative wound infections.
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Affiliation(s)
- Maureen Ayers Looby
- 1 HealthPartners Department of Obstetrics and Gynecology, St Paul, MN, USA.,2 University of Minnesota, Minneapolis, MN, USA
| | | | | | - Barbara Hyer
- 1 HealthPartners Department of Obstetrics and Gynecology, St Paul, MN, USA
| | - Kamalini Das
- 1 HealthPartners Department of Obstetrics and Gynecology, St Paul, MN, USA
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13
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Niendorf KB, Geller MA, Vogel RI, Church TR, Leininger A, Bakke A, Madoff RD. A model for patient-direct screening and referral for familial cancer risk. Fam Cancer 2017; 15:707-16. [PMID: 27350384 DOI: 10.1007/s10689-016-9912-6] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Patients at increased familial risk of cancer are sub-optimally identified and referred for genetic counseling. We describe a systematic model for information collection, screening and referral for hereditary cancer risk. Individuals from three different clinical and research populations were screened for hereditary cancer risk using a two-tier process: a 7-item screener followed by review of family history by a genetic counselor and application of published criteria. A total of 869 subjects participated in the study; 769 in this high risk population had increased familial cancer risk based on the screening questionnaire. Of these eligible participants, 500 (65.0 %) provided family histories and 332 (66.4 %) of these were found to be at high risk of a hereditary cancer syndrome, 102 (20.4 %) at moderate familial cancer risk, and 66 (13.2 %) at average risk. Three months following receipt of the risk result letter, nearly all respondents found the process at least somewhat helpful (98.4 %). All participants identified as high-risk were mailed a letter recommending genetic counseling and were provided appointment tools. After 1 year, only 13 (7.3 %) of 179 high risk respondents reported pursuit of recommended genetic counseling. Participants were willing to provide family history information for the purposes of risk assessment; however, few patients pursued recommended genetic services. This suggests that cancer family history registries are feasible and viable but that further research is needed to increase the uptake of genetic counseling.
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Affiliation(s)
- Kristin B Niendorf
- Masonic Cancer Center, University of Minnesota, 420 Delaware Street SE, MMC 450, Minneapolis, MN, 55455, USA. .,Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
| | - Melissa A Geller
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Isaksson Vogel
- Masonic Cancer Center, University of Minnesota, 420 Delaware Street SE, MMC 450, Minneapolis, MN, 55455, USA
| | - Timothy R Church
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Angela Bakke
- Maternal-Fetal Medicine Center, Burnsville, MN, USA
| | - Robert D Madoff
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
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14
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Geller MA, Petzel S, Lee H, Lee H, Niendorf K, Vogel RI. Abstract DPOC-006: mAGIC – CREATION OF A MOBILE APPLICATION TO INCREASE GENETIC COUNSELING FOR WOMEN WITH OVARIAN CANCER. Clin Cancer Res 2017. [DOI: 10.1158/1557-3265.ovcasymp16-dpoc-006] [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]
Abstract
Abstract
PURPOSE: Current guidelines published by the National Comprehensive Cancer Network and the Society of Gynecologic Oncology recommend that all women with invasive ovarian, fallopian tube, or primary peritoneal cancers receive genetic risk evaluation by a genetic counselor. Despite recommendations, physicians continue to under–refer and women under–use genetic services. This study developed the Mobile Application for Genetic Information on Cancer (mAGIC) intervention to motivate ovarian cancer survivors to undergo genetic counseling. The overall study objective was to develop and assess the feasibility and effectiveness of a theory–based intervention aimed to encourage ovarian cancer survivors to receive genetic counseling.
METHODS: Based on the Precaution Adoption Process Model and the Fogg Behavior Model for Persuasive Design, a multi–step process was used to design a 7–day mobile application intervention delivering daily text and video messaging. Content and formatting was developed by a multi–disciplinary expert team in conjunction with a Community Advisory Board and was based on focus groups with ovarian cancer patients. The final content covered the following topics: genetic counseling, genetic testing, cancer genetics and personal health, cancer genetics and my family, taking care of yourself, and preparing for a genetic counseling appointment. Usability testing was conducted to ensure the intervention was relevant and easy to use. To test the effectiveness of the intervention, a randomized control trial of 104 women with ovarian cancer, who have not previously received genetic counseling, was initiated. Participants were randomized to the mobile app intervention or control (usual care). Regardless of randomization assignment, participants received a phone call from a patient health navigator two weeks following enrollment to determine their intentions, self–efficacy, and communication with family regarding seeking genetic counseling. A three month follow–up survey of all participants measured genetic counseling uptake, stage of readiness, self–efficacy, knowledge, and distress.
RESULTS: To date, 45 of 104 women have been randomized; 39 have completed the telephone survey and 10 have completed the three month survey. No interim analyses of the primary outcomes were planned; however participant feedback has been positive.
CONCLUSIONS: Despite consensus guidelines recommending the referral of all ovarian, fallopian tube and primary peritoneal cancer patients to genetic counseling, not all patients receive the recommended genetic counseling. This mobile application provides a new tool for disseminating needed information about genetic counseling directly to women with ovarian cancer.
Citation Format: Melissa A. Geller, MD, Sue Petzel, PhD, Hee Lee, PhD, Heewon Lee, BA, Kristen Niendorf, MS, Rachel Isaksson Vogel, PhD. mAGIC – CREATION OF A MOBILE APPLICATION TO INCREASE GENETIC COUNSELING FOR WOMEN WITH OVARIAN CANCER [abstract]. In: Proceedings of the 11th Biennial Ovarian Cancer Research Symposium; Sep 12-13, 2016; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2017;23(11 Suppl):Abstract nr DPOC-006.
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Affiliation(s)
- Melissa A. Geller
- 1Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Sue Petzel
- 1Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Hee Lee
- 2School of Social Work, University of Minnesota, Minneapolis, MN
| | - Heewon Lee
- 1Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Kristen Niendorf
- 3Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota, Minneapolis, MN
| | - Rachel Isaksson Vogel
- 1Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
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15
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Teoh DGK, Vogel RI, Allen A, Blaes AH, Mason S, Nagler R, Raymond N, Talley K, Wyman J. Minnesota healthcare providers’ breast cancer screening practices at the extremes of age. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e13037] [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: 11/20/2022] Open
Abstract
e13037 Background: Breast cancer screening guidelines disagree on the age to initiate and discontinue screening. We sought to determine the age at which Minnesota providers initiate and discontinue breast cancer screening. Methods: A cross-sectional online survey of Minnesota primary care providers was conducted in 2016. The survey queried providers’ breast screening practices for average-risk women. Data were summarized using descriptive statistics and comparisons by professional characteristics were conducted using Chi-squared tests. Results: There were 805 respondents (8% of 10,392 invitees), of which 456 (56.7%) provided primary care to women and were included in the analysis. 316 (72%) were women, 193 (44%) were physicians, 50 (11%) were physician assistants (PAs), and 197 (45%) were advanced practice nurses (APNs). 85% practiced in a community setting. 38% had practiced > 20 years, and 27% had practiced < 10 years. Among respondents, 67%, 77% and 72% recommended screening mammography for women age 40-44, 45-49 and 70+ years, respectively. Compared to male providers, female providers were more likely to screen women age 40-44 years (73% vs. 49%; p < 0.0001) and 45-49 years (81% vs. 66%; p = 0.002), but there was no difference by gender for patients age 70+ years (72% vs. 74%; p = 0.89). Respondents reporting specialized interest in women’s health were more likely to screen women age 40-44 years (73% vs. 61%; p = 0.006), 45-49 years (83% vs 72%; p = 0.007) and older than age 70 years (77% vs. 69%; p = 0.04). Physicians were less likely to screen women age 40-44 and 45-49 years (57% and 71%, respectively; p = 0.001) than PAs (72%, 78%) and APNs (74%, 83%), but APNs were less likely to screen women age 70+ years (65% vs. physicians 79% vs. PAs 76%; p = 0.006). Number of years in practice was not associated with a difference in age at initiation of screening, however, increasing number of years in practice was associated with screening women age 70+ years (p = 0.02). Conclusions: Although breast cancer screening practices for average risk women vary by healthcare provider characteristics, a majority of Minnesota primary care providers initiate breast cancer screening between ages 40-49 years, and continue screening women age 70 years and older.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jean Wyman
- University of Minnesota, Minneapolis, MN
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16
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Blaes AH, Vogel RI, Raymond N, Talley K, Allen A, Nagler R, Teoh DGK, Mason S, Wyman J. Breast cancer screening practices with high-risk women: A cross-sectional survey. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.1550] [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: 11/20/2022] Open
Abstract
1550 Background: Little literature exists on primary care providers’ knowledge and preferences towards breast cancer screening for high-risk women. While guidelines recommend MRI and mammography, it is unclear how frequently these recommendations are used. Methods: This web-based survey of providers licensed to practice in Minnesota was conducted. This analysis focuses on breast cancer screening practices for high-risk women. Data were summarized using descriptive statistics; professional characteristic comparisons were conducted using Chi-squared tests. Results: 805 of 10,392 (8%) invitees completed the survey. 72.2% were female. 43.9% were physicians (20.8% internists, 71.7% family medicine, 6.3% gynecology), 11.4% physician assistants (PAs), 44.8% advanced practice registered nurses (APRNs). 84.8% were in community practice, 38% > 20 years of experience and 27.1% < 10 years. When asked how effective screening was for reducing cancer mortality in high risk women, mammography was thought to be very effective (48.8%) or effective (46.8%) in women ages 40-49 years, for women ages 50+ years, 60.8% and 35.7%, respectively. 62.4% thought breast MRI was very effective in reducing cancer mortality in high risk women. There was no difference in breast MRI recommendation based on professional background, experience or practice setting. Female practitioners, less experience, and those working in gynecology or women’s health were more likely to recommend breast MRI. A case vignette for high risk screening cancer survivors is provided (Table). Conclusions: Most primary care providers believe mammography is helpful in women at high risk for developing breast cancer. Less than half of practitioners, however, are following guideline specific recommendations of both mammography and MRI for breast cancer screening in high-risk patients. [Table: see text]
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jean Wyman
- University of Minnesota, Minneapolis, MN
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17
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Iizuka Y, Mooneyham A, Sieben A, Chen K, Maile M, Hellweg R, Schütz F, Teckle K, Starr T, Thayanithy V, Vogel RI, Lou E, Lee MK, Bazzaro M. UNC-45A is required for neurite extension via controlling NMII activation. Mol Biol Cell 2017; 28:1337-1346. [PMID: 28356421 PMCID: PMC5426848 DOI: 10.1091/mbc.e16-06-0381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 07/18/2016] [Revised: 03/15/2017] [Accepted: 03/21/2017] [Indexed: 01/13/2023] Open
Abstract
UNC-45A is a novel regulator of neuronal differentiation. UNC-45A localizes at the growth cone, binds to NMIIA and NMIIB, and is disposable for neuronal survival but is required for neurite initiation and extension via regulating NMII activation. Thus UNC-45A is a potential master regulator of a number of NMII-mediated cellular processes. UNC-45A is a highly conserved member of the UNC-45/CRO1/She4p family of proteins, which act as chaperones for conventional and nonconventional myosins. NMII mediates contractility and actin-based motility, which are fundamental for proper growth cone motility and neurite extension. The presence and role of UNC-45A in neuronal differentiation have been largely unknown. Here we demonstrate that UNC-45A is a novel growth cone–localized, NMII-associated component of the multiprotein complex regulating growth cone dynamics. We show that UNC-45A is dispensable for neuron survival but required for neurite elongation. Mechanistically, loss of UNC-45A results in increased levels of NMII activation. Collectively our results provide novel insights into the molecular mechanisms of neurite growth and define UNC-45A as a novel and master regulator of NMII-mediated cellular processes in neurons.
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Affiliation(s)
- Yoshie Iizuka
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Ashley Mooneyham
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Andrew Sieben
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Kevin Chen
- Department of Biology, University of Maryland, Baltimore, MD 21250
| | - Makayla Maile
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Raffaele Hellweg
- Breast Unit, University of Heidelberg, 69120 Heidelberg, Germany
| | - Florian Schütz
- Breast Unit, University of Heidelberg, 69120 Heidelberg, Germany
| | - Kebebush Teckle
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Timothy Starr
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Venugopal Thayanithy
- Division of Hematology, Oncology and Transplantation, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Rachel Isaksson Vogel
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Michael K Lee
- Department of Neuroscience, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Martina Bazzaro
- Masonic Cancer Center and Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
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18
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Vogel RI, Strayer LG, Engelman L, Nelson HH, Blaes AH, Anderson KE, Lazovich D. Sun Exposure and Protection Behaviors among Long-term Melanoma Survivors and Population Controls. Cancer Epidemiol Biomarkers Prev 2017; 26:607-613. [PMID: 28254810 DOI: 10.1158/1055-9965.epi-16-0854] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 01/21/2023] Open
Abstract
Introduction: Melanoma is considered a generally preventable cancer, with excessive ultraviolet radiation (UVR) exposure being a strong causal factor. UVR exposure following a melanoma diagnosis can be modified to reduce risk of second primary melanomas. The goal of this study was to compare measures of UVR exposure and protection behaviors between long-term melanoma survivors and controls.Methods: Participants from a previously conducted case-control study were recruited for a cross-sectional survey. Melanoma cases were 25 to 59 years old at diagnosis; controls were age and sex matched. Participants were asked about UVR exposure and protection measures used in the past year, and comparisons between melanoma survivors and controls were conducted using logistic regression models, adjusting for potential confounders.Results: A total of 724 (62.0%) long-term melanoma survivors and 660 (59.9%) controls completed the follow-up survey. Melanoma survivors were significantly less likely to report high sun exposure on a typical weekday [OR, 0.72 (0.55-0.94)], sunburns [OR, 0.40 (0.30-0.53)], or indoor tanning [OR, 0.20 (0.09-0.44)] than controls; however, high sun exposure on a typical weekend day was similar. Report of optimal sun protection behaviors was higher in melanoma survivors compared with controls. However, a few melanoma survivors reported indoor tanning, 10% reported intentionally seeking sun to tan, and 20% reported sunburns.Conclusions: Although long-term melanoma survivors reported healthier UVR exposure and protection behaviors compared with controls, a sizeable proportion still reported elevated sun exposure, sunburns, and suboptimal UVR protection behaviors.Impact: Opportunities remain for improving sun protection to reduce future melanoma risk among melanoma survivors. Cancer Epidemiol Biomarkers Prev; 26(4); 607-13. ©2017 AACR.
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Affiliation(s)
- Rachel Isaksson Vogel
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota. .,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Lori G Strayer
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Leah Engelman
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Anne H Blaes
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Hematology and Oncology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kristin E Anderson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.,Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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19
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Teoh D, Halloway RN, Heim J, Vogel RI, Rivard C. Evaluation of the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator in Gynecologic Oncology Patients Undergoing Minimally Invasive Surgery. J Minim Invasive Gynecol 2017; 24:48-54. [PMID: 27789387 PMCID: PMC6614862 DOI: 10.1016/j.jmig.2016.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 09/02/2016] [Revised: 10/14/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Abstract
STUDY OBJECTIVE To evaluate the ability of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator to predict discharge to postacute care and perioperative complications in gynecologic oncology patients undergoing minimally invasive surgery (MIS). DESIGN A retrospective chart review (Canadian Task Force classification II-1). SETTING A university hospital. PATIENTS All patients undergoing MIS on the gynecologic oncology service from January 1, 2009, to December 30, 2013. INTERVENTIONS Surgical procedures were reviewed, and appropriate Common Procedural Terminology codes were assigned. Twenty-one preoperative risk factors were abstracted from the chart and entered into the ACS NSQIP surgical risk calculator. The predicted risk of discharge to postacute care and 8 additional postoperative complications were calculated and recorded. Actual postoperative complications were abstracted from the medical record. The association between the calculated risk and the actual outcome was determined using logistic regression. The ability of the calculator to accurately predict a particular event was assessed using the c-statistic and Brier score. MEASUREMENTS AND MAIN RESULTS Of the 876 patients reviewed, a majority underwent hysterectomy (71.6%), with almost half of those patients undergoing additional cancer staging procedures (34.8%). Although the calculator was a poor predictor of postoperative complications, it was a strong predictor for discharge to postacute care (c-statistic = 0.91, Brier score = 0.02) with an odds ratio of 2.31 (95% confidence interval, 1.65-3.25; p < .0001). CONCLUSION The ACS NSQIP surgical risk calculator does not accurately predict postoperative complications or length of stay in gynecologic oncology patients undergoing MIS. Although it was a strong predictor of need for discharge to postacute care, it vastly overestimated the number of patients requiring this service. Therefore, the calculator's risk score for discharge to postacute care may be considered during preoperative counseling but should not be a predictor of whether or not the patient should proceed with surgery.
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Affiliation(s)
- Deanna Teoh
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota.
| | | | - Jennifer Heim
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Isaksson Vogel
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota; Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Colleen Rivard
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, Minnesota
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20
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LeSage MG, Staley M, Muelken P, Smethells JR, Stepanov I, Vogel RI, Pentel PR, Harris AC. Abuse liability assessment of an e-cigarette refill liquid using intracranial self-stimulation and self-administration models in rats. Drug Alcohol Depend 2016; 168:76-88. [PMID: 27627814 PMCID: PMC5257285 DOI: 10.1016/j.drugalcdep.2016.08.628] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/14/2016] [Accepted: 08/22/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND The popularity of electronic cigarettes (ECs) has increased dramatically despite their unknown health consequences. Because the abuse liability of ECs is one of the leading concerns of the Food and Drug Administration (FDA), models to assess it are urgently needed to inform FDA regulatory decisions regarding these products. The purpose of this study was to assess the relative abuse liability of an EC liquid compared to nicotine alone in rats. Because this EC liquid contains non-nicotine constituents that may enhance its abuse liability, we hypothesized that it would have greater abuse liability than nicotine alone. METHODS Nicotine alone and nicotine dose-equivalent concentrations of EC liquid were compared in terms of their acute effects on intracranial self-stimulation (ICSS) thresholds, acquisition of self-administration, reinforcing efficacy (i.e., elasticity of demand), blockade of these behavioral effects by mecamylamine, nicotine pharmacokinetics and nicotinic acetylcholine receptor binding and activation. RESULTS There were no significant differences between formulations on any measure, except that EC liquid produced less of an elevation in ICSS thresholds at high nicotine doses. CONCLUSIONS Collectively, these findings suggest that the relative abuse liability of this EC liquid is similar to that of nicotine alone in terms of its reinforcing and reinforcement-enhancing effects, but that it may have less aversive/anhedonic effects at high doses. The present methods may be useful for assessing the abuse liability of other ECs to inform potential FDA regulation of those products.
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Affiliation(s)
- MG LeSage
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN,Department of Medicine, University of Minnesota, Minneapolis, MN,Department of Psychology, University of Minnesota, Minneapolis, MN, 55455
| | - M Staley
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - P Muelken
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN
| | - JR Smethells
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN,Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55455
| | - I Stepanov
- Masonic Cancer, Center University of Minnesota, Minneapolis, MN
| | - RI Vogel
- Masonic Cancer Center Biostatistics and Bioinformatics Core ,University of Minnesota Minneapolis, MN
| | - PR Pentel
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN,Department of Medicine, University of Minnesota, Minneapolis, MN
| | - AC Harris
- Department of Medicine, Minneapolis Medical Research Foundation, Minneapolis, MN,Department of Medicine, University of Minnesota, Minneapolis, MN,Department of Psychology, University of Minnesota, Minneapolis, MN, 55455
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21
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Allen A, Vogel RI, Meier E, Anderson A, Jensen J, Severson HH, Hatsukami D. Gender differences in snus versus nicotine gum for cigarette avoidance among a sample of US smokers. Drug Alcohol Depend 2016; 168:8-12. [PMID: 27610935 PMCID: PMC5215723 DOI: 10.1016/j.drugalcdep.2016.08.624] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/12/2016] [Accepted: 08/17/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Women are more susceptible to the harmful effects of cigarette smoking. Thus, identifying effective harm reduction approaches for women is necessary. The goal of this project was to examine gender differences in response to snus versus nicotine gum for cigarette avoidance, as a means of harm reduction. METHODS Participants were randomly assigned to use snus or nicotine gum as a method to avoid cigarette smoking. Participants attended clinic visits to receive study product, as well as provide biological samples to assess smoking avoidance and biomarkers and report on use of study product and cigarettes. A secondary analysis comparing men and women by randomization to study product was conducted. RESULTS Participants (n=391; 47% women) were randomized into the snus group (n=196; 45% women) and the gum group (n=195; 49% women). Men used more snus whereas women used more gum (p=0.02). During treatment, men in the snus group had higher total nicotine equivalent values whereas women did not vary by group (p=0.03). Overall, fewer men in the snus group completely avoided cigarettes compared to men in the gum group (e.g., continuous abstinence at Week 12: odds ratio=0.43, 95% confidence interval=0.20-0.93). Among women, there were no differences by randomization in cigarette avoidance. CONCLUSIONS Despite a number of gender differences in response to snus versus nicotine gum, these data suggest that snus may not be an optimal harm reduction approach for either gender.
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Affiliation(s)
- Alicia Allen
- University of Minnesota, Family Medicine and Community Health, Minneapolis, MN, United States; University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States.
| | - Rachel Isaksson Vogel
- University of Minnesota, Gynecologic Oncology, Minneapolis, MN, United States,University of Minnesota, Masonic Comprehensive Cancer Center – Biostatistics and Bioinformatics Core, Minneapolis, MN, United States
| | - Ellen Meier
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | - Amanda Anderson
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | - Joni Jensen
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | | | - Dorothy Hatsukami
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States,University of Minnesota, Psychiatry, Minneapolis, MN, United States
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22
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Heilmann W, Vogel RI, Pulver T, Zhao X, Shahi M, Richter J, Klein M, Chen L, Ding R, Konecny G, Winterhoff BJN, Ghebre R, Taran FA, Hartkopf A, Grischke EM, Walter C, Brucker SY, Bazzaro M, Kommoss S. USP14 als prognostisch relevanter Biomarker und potentieller Kandidat für eine medikamentöse Behandlung der Endometriumkarzinompatientin mit hohem Risiko. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593265] [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] Open
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23
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Law EK, Sieuwerts AM, LaPara K, Leonard B, Starrett GJ, Molan AM, Temiz NA, Vogel RI, Meijer-van Gelder ME, Sweep FCGJ, Span PN, Foekens JA, Martens JWM, Yee D, Harris RS. The DNA cytosine deaminase APOBEC3B promotes tamoxifen resistance in ER-positive breast cancer. Sci Adv 2016; 2:e1601737. [PMID: 27730215 PMCID: PMC5055383 DOI: 10.1126/sciadv.1601737] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/31/2016] [Indexed: 05/27/2023]
Abstract
Breast tumors often display extreme genetic heterogeneity characterized by hundreds of gross chromosomal aberrations and tens of thousands of somatic mutations. Tumor evolution is thought to be ongoing and driven by multiple mutagenic processes. A major outstanding question is whether primary tumors have preexisting mutations for therapy resistance or whether additional DNA damage and mutagenesis are necessary. Drug resistance is a key measure of tumor evolvability. If a resistance mutation preexists at the time of primary tumor presentation, then the intended therapy is likely to fail. However, if resistance does not preexist, then ongoing mutational processes still have the potential to undermine therapeutic efficacy. The antiviral enzyme APOBEC3B (apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like 3B) preferentially deaminates DNA C-to-U, which results in signature C-to-T and C-to-G mutations commonly observed in breast tumors. We use clinical data and xenograft experiments to ask whether APOBEC3B contributes to ongoing breast tumor evolution and resistance to the selective estrogen receptor modulator, tamoxifen. First, APOBEC3B levels in primary estrogen receptor-positive (ER+) breast tumors inversely correlate with the clinical benefit of tamoxifen in the treatment of metastatic ER+ disease. Second, APOBEC3B depletion in an ER+ breast cancer cell line results in prolonged tamoxifen responses in murine xenograft experiments. Third, APOBEC3B overexpression accelerates the development of tamoxifen resistance in murine xenograft experiments by a mechanism that requires the enzyme's catalytic activity. These studies combine to indicate that APOBEC3B promotes drug resistance in breast cancer and that inhibiting APOBEC3B-dependent tumor evolvability may be an effective strategy to improve efficacies of targeted cancer therapies.
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Affiliation(s)
- Emily K. Law
- Howard Hughes Medical Institute, University of Minnesota, Minneapolis, MN 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Anieta M. Sieuwerts
- Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, 3015 GE Rotterdam, Netherlands
| | - Kelly LaPara
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Brandon Leonard
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Gabriel J. Starrett
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Amy M. Molan
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Nuri A. Temiz
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Rachel Isaksson Vogel
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Marion E. Meijer-van Gelder
- Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, 3015 GE Rotterdam, Netherlands
| | - Fred C. G. J. Sweep
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Paul N. Span
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - John A. Foekens
- Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, 3015 GE Rotterdam, Netherlands
| | - John W. M. Martens
- Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, 3015 GE Rotterdam, Netherlands
| | - Douglas Yee
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Reuben S. Harris
- Howard Hughes Medical Institute, University of Minnesota, Minneapolis, MN 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
- Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
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Ojo-Fati O, Thomas JL, Vogel RI, Ogedegbe O, Jean-Louis G, Okuyemi KS. Predictors of Adherence to Nicotine Replacement Therapy (Nicotine Patch) Among Homeless Persons Enrolled in a Randomized Controlled Trial Targeting Smoking Cessation. J Fam Med 2016; 3:1079. [PMID: 28580456 PMCID: PMC5453676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Adherence to smoking cessation treatment is generally low, especially among socio-economically disadvantaged groups including individuals experiencing homelessness and those with mental illnesses. Despite the high smoking rates in homeless populations (~70%) no study to date has systematically examined predictors of adherence to nicotine replacement therapy (NRT) in this population. OBJECTIVE The aim of this secondary analysis was to identify predictors of adherence to NRT in a smoking cessation trial conducted among homeless smokers. METHODS Secondary analysis of data from a randomized controlled trial enrolling 430 persons who were homeless and current cigarette smokers. Participants were assigned to one of the two study conditions to enhance smoking cessation: Motivational Interviewing (MI; 6 sessions of MI + 8 weeks of NRT) or Standard Care (Brief advice to quit+ 8 weeks of NRT). The primary outcome for the current analysis was adherence to NRT at end of treatment (8 weeks following randomization). Adherence was defined as a total score of zero on a modified Morisky adherence scale). Demographic and baseline psychosocial, tobacco-related, and substance abuse measures were compared between those who did and did not adhere to NRT. RESULTS After adjusting for confounders, smokers who were depressed at baseline (OR=0.58, 95% CI, 0.38-0.87, p=0.01), had lower confidence to quit (OR=1.10, 95% CI, 1.01-1.19, p=0.04), were less motivated to adhere (OR=1.04, 95% CI, 1.00-1.07, p=0.04), and were less likely to be adherent to NRT. Further, age of initial smoking was positively associated with adherence status (OR= 0.83, 95% CI, 0.69-0.99, p=0.04). CONCLUSION These results suggest that smoking cessation programs conducted in this population may target increased adherence to NRT by addressing both depression and motivation to quit. TRIAL REGISTRATION clinicaltrials.gov: NCT00786149.
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Affiliation(s)
- O Ojo-Fati
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA
| | - J L Thomas
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - R I Vogel
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, USA
| | - O Ogedegbe
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - G Jean-Louis
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - K S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
- Program in Health Disparities Research, University Of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
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25
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Rizzardi AE, Zhang X, Vogel RI, Kolb S, Geybels MS, Leung YK, Henriksen JC, Ho SM, Kwak J, Stanford JL, Schmechel SC. Quantitative comparison and reproducibility of pathologist scoring and digital image analysis of estrogen receptor β2 immunohistochemistry in prostate cancer. Diagn Pathol 2016; 11:63. [PMID: 27401406 PMCID: PMC4940862 DOI: 10.1186/s13000-016-0511-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 01/26/2016] [Accepted: 07/01/2016] [Indexed: 12/02/2022] Open
Abstract
Background Digital image analysis offers advantages over traditional pathologist visual scoring of immunohistochemistry, although few studies examining the correlation and reproducibility of these methods have been performed in prostate cancer. We evaluated the correlation between digital image analysis (continuous variable data) and pathologist visual scoring (quasi-continuous variable data), reproducibility of each method, and association of digital image analysis methods with outcomes using prostate cancer tissue microarrays (TMAs) stained for estrogen receptor-β2 (ERβ2). Methods Prostate cancer TMAs were digitized and evaluated by pathologist visual scoring versus digital image analysis for ERβ2 staining within tumor epithelium. Two independent analysis runs were performed to evaluate reproducibility. Image analysis data were evaluated for associations with recurrence-free survival and disease specific survival following radical prostatectomy. Results We observed weak/moderate Spearman correlation between digital image analysis and pathologist visual scores of tumor nuclei (Analysis Run A: 0.42, Analysis Run B: 0.41), and moderate/strong correlation between digital image analysis and pathologist visual scores of tumor cytoplasm (Analysis Run A: 0.70, Analysis Run B: 0.69). For the reproducibility analysis, there was high Spearman correlation between pathologist visual scores generated for individual TMA spots across Analysis Runs A and B (Nuclei: 0.84, Cytoplasm: 0.83), and very high correlation between digital image analysis for individual TMA spots across Analysis Runs A and B (Nuclei: 0.99, Cytoplasm: 0.99). Further, ERβ2 staining was significantly associated with increased risk of prostate cancer-specific mortality (PCSM) when quantified by cytoplasmic digital image analysis (HR 2.16, 95 % CI 1.02–4.57, p = 0.045), nuclear image analysis (HR 2.67, 95 % CI 1.20–5.96, p = 0.016), and total malignant epithelial area analysis (HR 5.10, 95 % CI 1.70–15.34, p = 0.004). After adjusting for clinicopathologic factors, only total malignant epithelial area ERβ2 staining was significantly associated with PCSM (HR 4.08, 95 % CI 1.37–12.15, p = 0.012). Conclusions Digital methods of immunohistochemical quantification are more reproducible than pathologist visual scoring in prostate cancer, suggesting that digital methods are preferable and especially warranted for studies involving large sample sizes. Electronic supplementary material The online version of this article (doi:10.1186/s13000-016-0511-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anthony E Rizzardi
- Department of Pathology, University of Washington, 908 Jefferson Street, Room 2NJB244, Seattle, WA, 98104, USA.,Department of Pathology, University of Washington, 300 Ninth Ave, Research & Training Building, Room 421, Seattle, WA, 98104, USA
| | - Xiaotun Zhang
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Rachel Isaksson Vogel
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Suzanne Kolb
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Milan S Geybels
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yuet-Kin Leung
- Divison of Environmental Genetics and Molecular Toxicology, University of Cincinnati, Cincinnati, OH, USA.,Center for Environmental Genetics, Cincinnati Cancer Institute, University of Cincinnati, Cincinnati, OH, USA.,Department of Environmental Health, Cincinnati Cancer Institute, University of Cincinnati, Cincinnati, OH, USA
| | - Jonathan C Henriksen
- Department of Pathology, University of Washington, 908 Jefferson Street, Room 2NJB244, Seattle, WA, 98104, USA
| | - Shuk-Mei Ho
- Divison of Environmental Genetics and Molecular Toxicology, University of Cincinnati, Cincinnati, OH, USA.,Center for Environmental Genetics, Cincinnati Cancer Institute, University of Cincinnati, Cincinnati, OH, USA.,Department of Environmental Health, Cincinnati Cancer Institute, University of Cincinnati, Cincinnati, OH, USA
| | - Julianna Kwak
- Department of Pathology, University of Washington, 908 Jefferson Street, Room 2NJB244, Seattle, WA, 98104, USA
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Stephen C Schmechel
- Department of Pathology, University of Washington, 908 Jefferson Street, Room 2NJB244, Seattle, WA, 98104, USA.
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Glasgow M, Vogel RI, Burgart J, Argenta P, Dusenbery K, Geller MA. Long term follow-up of a phase II trial of multimodal therapy given in a "sandwich" method for stage III, IV, and recurrent endometrial cancer. Gynecol Oncol Res Pract 2016; 3:6. [PMID: 27408749 PMCID: PMC4940984 DOI: 10.1186/s40661-016-0027-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 05/19/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Our objective was to determine if previously reported overall survival (OS) and progression-free survival (PFS) rates are maintained long term following multimodal therapy for advanced and recurrent endometrial cancer and to assess the lymphedema rates associated with this therapy. METHODS Women with advanced-stage or recurrent endometrial cancer were recruited between 9/2004 and 6/2009 to our previously published Phase II trial. Patients received intravenous docetaxel (75 mg/m2) and carboplatin (AUC = 6) every 3 weeks for 3 cycles before and after radiation therapy. Patient outcomes were updated in July 2014. Data abstracted included presence of lymphedema, disease progression, and death. OS and PFS estimates at 5 years were calculated using Kaplan-Meier methods. RESULTS Of the 41 patients enrolled, 10 (24 %) had stage IIIA and 21 (51 %) had stage IIIC disease; 32 (78 %) had endometrioid histology; and 35 (85 %) completed the protocol. With a median follow-up of 5 years, 15 of 41 patients have died. The Kaplan-Meier estimate and 95 % CI for OS at 5 years was 70 % (53-82 %). Excluding the two patients with recurrent disease at enrollment, 15 of 39 patients progressed or died during follow-up. The Kaplan-Meier estimate and 95 % CI for PFS at 5 years was 66 % (48-78 %). Fifteen patients (37 %) had medical record documentation of lymphedema following treatment. CONCLUSIONS After additional follow-up, OS and PFS estimates remain high and in-field recurrences low following "sandwich" therapy. The "sandwich" method remains efficacious for women with stage III-IV or recurrent endometrial cancer.
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Affiliation(s)
- Michelle Glasgow
- />Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN USA
| | - Rachel Isaksson Vogel
- />Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN USA
- />Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN USA
| | | | - Peter Argenta
- />Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN USA
| | | | - Melissa A. Geller
- />Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN USA
- />University of Minnesota, MMC 395, 420 Delaware St. SE, Minneapolis, MN 55445 USA
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Watson AP, Peterson BA, Lee CKK, Baxstrom K, Vogel RI, Blaes AH. Evaluation of chemotherapy tolerability for breast cancer patients who have received radiation as treatment for a prior Hodgkin lymphoma. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e21572] [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: 11/20/2022] Open
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28
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Hatsukami DK, Vogel RI, Severson HH, Jensen JA, O'Connor RJ. Perceived Health Risks of Snus and Medicinal Nicotine Products. Nicotine Tob Res 2016; 18:794-800. [PMID: 26386473 PMCID: PMC5896824 DOI: 10.1093/ntr/ntv200] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 04/03/2015] [Accepted: 09/01/2015] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Perceived health risk (PHR) of a tobacco product may influence both uptake and continued use. In this study, we examined PHRs of snus and medicinal nicotine using the PHR scale and the relationship of PHR responses to use of these products in smokers seeking an alternative to smoking. METHODS Smokers were randomly assigned to snus or to medicinal nicotine for a period of 12 weeks and asked to only use the assigned product. The PHR scale involves rating the extent of perceived risk of a product for different diseases and was given at baseline and weeks 4 and 12 during treatment. Relationships between PHR scale scores and study attrition, compliance with only using the product, and continued use of the product after treatment were determined. RESULTS Response to the PHR scale showed no significant differences between the snus and medicinal nicotine for perceived risks for lung cancer, emphysema, and bronchitis. However, significant differences were observed for other cancers, heart disease, stroke and risk for addiction, particularly after product use, with higher scores among those assigned to snus. Scores on the PHR scale were not related to any of the trial outcome variables. CONCLUSIONS Among smokers seeking an alternative to smoking in a clinic setting, PHR of a product changes after product use but may not be related to product use patterns. IMPLICATIONS PHRs of snus or medicinal nicotine in smokers assigned to these products become more accurate after product use. PHR does not appear to be associated with patterns of product use; rather satisfaction with a product is a better indicator as to whether a smoker is compliant with only using the product or continues to use the product.
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Affiliation(s)
- Dorothy K Hatsukami
- Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN;
| | - R I Vogel
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Herb H Severson
- Department of Psychology, Oregon Research Institute, Eugene, OR
| | - Joni A Jensen
- Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
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Abstract
IMPORTANCE In the United States and Minnesota, melanoma incidence is rising more steeply among women than men younger than 50 years. To our knowledge, no study has examined age- and sex-specific associations between indoor tanning and melanoma to determine if these trends could be due to greater indoor tanning use among younger women. OBJECTIVE To examine associations between indoor tanning and melanoma among men and women younger than 50 years. DESIGN, SETTING, AND PARTICIPANTS Population-based case-control study conducted in Minnesota of 681 patients (465 [68.3%] women) diagnosed as having melanoma between 2004 and 2007, and 654 controls (446 [68.2%] women), ages 25 to 49 years. EXPOSURE Indoor tanning, defined as any use, first age of use, and total sessions. MAIN OUTCOMES AND MEASURES Crude and adjusted odds ratios (ORs) and 95% CIs were calculated for melanoma in relation to indoor tanning exposure for men and women by diagnosis or reference age (<30, 30-39, 40-49 years). Sex-specific associations for indoor tanning and melanoma by anatomic site were examined. RESULTS Compared with women aged 40 to 49 years, women younger than 40 years initiated indoor tanning at a younger age (16 vs 25 years, P < .001) and reported more frequent indoor tanning (median number of sessions, 100 vs 40, P < .001). Women younger than 30 years were 6 times more likely to be in the case than the control group if they tanned indoors (crude OR, 6.0; 95% CI, 1.3-28.5). Odds ratios were also significantly elevated among women, ages 30 to 49 years (adjusted OR, 3.5; 95% CI, 1.2-9.7 for women 30-39 years; adjusted OR, 2.3; 95% CI, 1.4-3.6 for women 40-49 years); a dose response was observed among women regardless of age. Among men, results by age were inconsistent. The strongest OR for indoor tanning by anatomic site was for melanomas arising on the trunk of women (adjusted OR, 3.7; 95% CI, 1.9-7.2). CONCLUSIONS AND RELEVANCE Indoor tanning is a likely factor for the steeper increase in melanoma rates in the United States among younger women compared with men, given the timing of when women initiated indoor tanning relative to diagnosis. The melanoma epidemic can be expected to continue unless indoor tanning is restricted and reduced.
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Affiliation(s)
- DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, Minneapolis
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | | | - Martin A. Weinstock
- Center for Dermatoepidemiology, VA Medical Center, Providence, Rhode Island
- Department of Dermatology, Rhode Island Hospital, Providence
- Departments of Dermatology and Epidemiology, Brown University, Providence, Rhode Island
| | - Heather H. Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - Rehana L. Ahmed
- Masonic Cancer Center, University of Minnesota, Minneapolis
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, Albuquerque
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque
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Rivard C, Nahum R, Slagle E, Duininck M, Isaksson Vogel R, Teoh D. Evaluation of the performance of the ACS NSQIP surgical risk calculator in gynecologic oncology patients undergoing laparotomy. Gynecol Oncol 2016; 141:281-286. [PMID: 26899020 DOI: 10.1016/j.ygyno.2016.02.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/10/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the ability of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) surgical risk calculator to predict complications in gynecologic oncology patients undergoing laparotomy. METHODS A chart review of patients who underwent laparotomy on the gynecologic oncology service at a single academic hospital from January 2009 to December 2013 was performed. Preoperative variables were abstracted and NSQIP surgical risk scores were calculated. The risk of any complication, serious complication, death, urinary tract infection, venous thromboembolism, cardiac event, renal complication, pneumonia and surgical site infection were correlated with actual patient outcomes using logistic regression. The c-statistic and Brier score were used to calculate the prediction capability of the risk calculator. RESULTS Of the 1094 patients reviewed, the majority were <65years old (70.9%), independent (95.2%), ASA class 1-2 (67.3%), and overweight or obese (76.1%). Higher calculated risk scores were associated with an increased risk of the actual complication occurring for all events (p<0.05). The calculator performed best for predicting death (c-statistic=0.851, Brier=0.008), renal failure (c-statistic=0.752, Brier=0.015) and cardiac complications (c-statistic=0.708, Brier=0.011). The calculator did not accurately predict most complications. CONCLUSIONS The NSQIP surgical risk calculator adequately predicts specific serious complications, such as postoperative death and cardiac complications. However, the overall performance of the calculator was worse for gynecologic oncology patients than reported in general surgery patients. A tailored prediction model may be needed for this patient population.
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Affiliation(s)
- Colleen Rivard
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, United States
| | - Rebi Nahum
- Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Elizabeth Slagle
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, United States
| | - Megan Duininck
- Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Rachel Isaksson Vogel
- Biostatistics and Bioinformatics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Deanna Teoh
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN, United States.
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Vogel RI, Coughlin K, Scotti A, Iizuka Y, Anchoori R, Roden RBS, Marastoni M, Bazzaro M. Simultaneous inhibition of deubiquitinating enzymes (DUBs) and autophagy synergistically kills breast cancer cells. Oncotarget 2016; 6:4159-70. [PMID: 25784654 PMCID: PMC4414179 DOI: 10.18632/oncotarget.2904] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [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: 10/01/2014] [Accepted: 12/11/2014] [Indexed: 01/23/2023] Open
Abstract
Breast cancer is one of the leading causes of cancer death among women in the United States. Patients expressing the estrogen and progesterone receptor (ER and PR) and human epidermal growth factor 2 (HER-2) tumor markers have favorable prognosis and efficacious therapeutic options. In contrast, tumors that are negative for these markers (triple-negative) have a disproportionate share of morbidity and mortality due to lack of a validated molecular target. Deubiquitinating enzymes (DUBs) are a critical component of ubiquitin-proteasome-system degradation and have been shown to be differentially expressed and activated in a number of cancers, including breast, with their aberrant activity linked to cancer prognosis and clinical outcome. We evaluated the effect of the DUB inhibitors b-AP15 and RA-9 alone and in combination with early- and late-stage lysosomal inhibitors on cell viability in a panel of triple negative breast cancer (TNBC) cell lines. Our results indicate small-molecule DUB inhibitors have a profound effect on TNBC viability and lead to activation of autophagy as a cellular mechanism to compensate for ubiquitin-proteasome-system stress. Treatment with sub-optimal doses of DUB and lysosome inhibitors synergistically kills TNBC cells. This supports the evaluation of DUB inhibition, in combination with lysosomal inhibition, as a therapeutic approach for the treatment of TNBC.
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Affiliation(s)
| | - Kathleen Coughlin
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alessandra Scotti
- Department of Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Yoshie Iizuka
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ravi Anchoori
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
| | - Richard B S Roden
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.,Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - Mauro Marastoni
- Department of Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Martina Bazzaro
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota, Minneapolis, Minnesota, USA
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McClellan MA, Karumur RP, Vogel RI, Petzel SV, Cragg J, Chan D, Jacko JA, Sainfort F, Geller MA. Designing an Educational Website to Improve Quality of Supportive Oncology Care for Women with Ovarian Cancer: An Expert Usability Review and Analysis. Int J Hum Comput Interact 2016; 32:297-307. [PMID: 27110082 PMCID: PMC4838192 DOI: 10.1080/10447318.2016.1140528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A broad-based research team developed a Health Insurance Portability and Accountability Act (HIPAA)-compliant educational website for women with ovarian cancer to improve the quality of supportive oncology care. Prior to a randomized clinical trial of the website, initial usability testing was implemented to evaluate the website. The initial review found that 165/247 checklist items had sufficient information to allow for evaluation with the website achieving an overall score of 63%. By category, lowest scores were for the Home Page, Task Orientation, Page Layout & Visual Design, and Help, Feedback & Error Tolerance. Major issues thought to potentially impede actual usage were prioritized in redevelopment and the second usability review, conducted by the same expert, saw an improvement in scores. Incorporating usability concepts from the start of development, fulfilling the positive expectations of end-users and identifying technical and personal factors that optimize use may greatly enhance usage of health websites.
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Affiliation(s)
| | - Raghav Pavan Karumur
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, USA
| | | | - Sue V. Petzel
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Julie Cragg
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Chan
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Julie A. Jacko
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - François Sainfort
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Melissa A. Geller
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
- Department of Obstetrics, Gynecology and Women’s Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
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Hermanson DL, Bendzick L, Pribyl L, McCullar V, Vogel RI, Miller JS, Geller MA, Kaufman DS. Induced Pluripotent Stem Cell-Derived Natural Killer Cells for Treatment of Ovarian Cancer. Stem Cells 2015; 34:93-101. [PMID: 26503833 DOI: 10.1002/stem.2230] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/21/2015] [Indexed: 12/15/2022]
Abstract
Natural killer (NK) cells can provide effective immunotherapy for ovarian cancer. Here, we evaluated the ability of NK cells isolated from peripheral blood (PB) and NK cells derived from induced pluripotent stem cell (iPSC) to mediate killing of ovarian cancer cells in a mouse xenograft model. A mouse xenograft model was used to evaluate the intraperitoneal delivery of three different NK cell populations: iPSC-derived NK cells, PB-NK cells that had been activated and expanded in long-term culture, and overnight activated PB-NK cells that were isolated through CD3/CD19 depletion of PB B and T cells. Bioluminescent imaging was used to monitor tumor burden of luciferase expressing tumor lines. Tumors were allowed to establish prior to administering NK cells via intraperitoneal injection. These studies demonstrate a single dose of any of the three NK cell populations significantly reduced tumor burden. When mice were given three doses of either iPSC-NK cells or expanded PB-NK cells, the median survival improved from 73 days in mice untreated to 98 and 97 days for treated mice, respectively. From these studies, we conclude iPSC-derived NK cells mediate antiovarian cancer killing at least as well as PB-NK cells, making these cells a viable resource for immunotherapy for ovarian cancer. Due to their ability to be easily differentiated into NK cells and their long-term expansion potential, iPSCs can be used to produce large numbers of well-defined NK cells that can be banked and used to treat a large number of patients including treatment with multiple doses if necessary.
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Affiliation(s)
- David L Hermanson
- Department of Medicine (Division of Hematology, Oncology, and Transplant), University of Minnesota, Minneapolis, Minnesota, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Laura Bendzick
- Department of Medicine (Division of Hematology, Oncology, and Transplant), University of Minnesota, Minneapolis, Minnesota, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lee Pribyl
- Department of Obstetrics, Gynecology, and Women's Health (Division of Gynecologic Oncology), University of Minnesota, Minneapolis, Minnesota, USA
| | - Valarie McCullar
- Department of Medicine (Division of Hematology, Oncology, and Transplant), University of Minnesota, Minneapolis, Minnesota, USA
| | - Rachel Isaksson Vogel
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeff S Miller
- Department of Medicine (Division of Hematology, Oncology, and Transplant), University of Minnesota, Minneapolis, Minnesota, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology, and Women's Health (Division of Gynecologic Oncology), University of Minnesota, Minneapolis, Minnesota, USA
| | - Dan S Kaufman
- Department of Medicine (Division of Hematology, Oncology, and Transplant), University of Minnesota, Minneapolis, Minnesota, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA
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Meier E, Isaksson Vogel R, O'Connor RJ, Severson HH, Shields PG, Hatsukami DK. Preference for Flavored Noncombustible Nicotine Products Among Smokers Motivated to Switch From Cigarettes. Nicotine Tob Res 2015; 18:892-3. [PMID: 26610935 DOI: 10.1093/ntr/ntv259] [Citation(s) in RCA: 9] [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] [Received: 03/30/2015] [Accepted: 11/13/2015] [Indexed: 11/13/2022]
Affiliation(s)
- Ellen Meier
- Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Herb H Severson
- Department of Psychology, Oregon Research Institute, Eugene, OR
| | | | - Dorothy K Hatsukami
- Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN Masonic Comprehensive Cancer Center, University of Minnesota, Minneapolis, MN;
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Ji Y, Vogel RI, Lou E. Temozolomide treatment of pituitary carcinomas and atypical adenomas: systematic review of case reports. Neurooncol Pract 2015; 3:188-195. [PMID: 27551432 DOI: 10.1093/nop/npv059] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Pituitary carcinomas (PC) and atypical pituitary adenomas (APA) are rare variants of pituitary tumors for which no evidence-based treatment currently exists. We sought to determine whether temozolomide represents an effective chemotherapeutic option for patients with PC and APA. METHODS A systematic review was performed using all published cases of PC and APA treated with temozolomide, and for which information on treatment regimen, clinical response, and survival could be identified. The primary goal of this analysis was to describe overall survival and progression-free survival among PC and APA patients after temozolomide treatment. Secondary goals included assessment of response rate and biomarkers of response. RESULTS We identified 57 cases and obtained follow-up data on 54 patients (31 APA and 23 PC) for analysis. Estimates of 5-year progression-free survival and overall survival were 21.9% and 57.4% for patients with APA and 36.1% and 56.2% for patients with PC. Among those who responded to temozolomide, overall survival was marginally statistically significantly greater for patients on long-term temozolomide therapy compared with those who were not (5-year overall survival 91.7% vs 54.1%, P = .08); Progression-free survival results were similar but not statistically significant. The objective response rate was 48.4% for patients with APA and 65.2% for patients with PC. Stable disease occurred in 29% of APA and 17.4% of PC patients. Neither histology nor expression of Ki-67 correlated with response; however, negative O6-methylguanine-DNA methyltransferase staining was strongly related to response to temozolomide in patients with APA (P < .001). CONCLUSIONS Temozolomide is an effective treatment of both PC and APA, and long-term treatment can be considered for particularly aggressive cases.
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Affiliation(s)
- Yan Ji
- Division of Hematology, Oncology and Transplantation , University of Minnesota , Minneapolis, MN (Y.J., E.L.); Masonic Cancer Center, Biostatistics and Bioinformatics , University of Minnesota , Minneapolis, MN (R.I.V.)
| | - Rachel Isaksson Vogel
- Division of Hematology, Oncology and Transplantation , University of Minnesota , Minneapolis, MN (Y.J., E.L.); Masonic Cancer Center, Biostatistics and Bioinformatics , University of Minnesota , Minneapolis, MN (R.I.V.)
| | - Emil Lou
- Division of Hematology, Oncology and Transplantation , University of Minnesota , Minneapolis, MN (Y.J., E.L.); Masonic Cancer Center, Biostatistics and Bioinformatics , University of Minnesota , Minneapolis, MN (R.I.V.)
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Rivard C, Vogel RI, Teoh D. Effect of Intraperitoneal Bupivacaine on Postoperative Pain in the Gynecologic Oncology Patient. J Minim Invasive Gynecol 2015; 22:1260-5. [PMID: 26216095 PMCID: PMC4631626 DOI: 10.1016/j.jmig.2015.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 05/28/2015] [Revised: 07/15/2015] [Accepted: 07/16/2015] [Indexed: 01/15/2023]
Abstract
STUDY OBJECTIVE To evaluate if the administration of intraperitoneal bupivacaine decreased postoperative pain in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery. DESIGN Retrospective cohort study (Canadian Task Force classification II-3). SETTING University-based gynecologic oncology practice operating at a tertiary medical center. PATIENTS All patients on the gynecologic oncology service undergoing minimally invasive surgery between September 2011 and June 2013. INTERVENTIONS Starting August 2012, intraperitoneal administration of .25% bupivacaine was added to all minimally invasive surgeries. These patients were compared with historical control subjects who had surgery between September 2011 and July 2012 but did not receive intraperitoneal bupivacaine. MEASUREMENTS AND MAIN RESULTS One-hundred thirty patients were included in the study. The patients who received intraperitoneal bupivacaine had lower median narcotic use on the day of surgery and the first postoperative day compared with those who did not receive intraperitoneal bupivacaine (day 0: 7.0 mg morphine equivalents vs 11.0 mg, p = .007; day 1: .3 mg vs 1.7 mg, p = .0002). The median patient-reported pain scores were lower on the day of surgery in the intraperitoneal bupivacaine group (2.7 vs 3.2, p = .05) CONCLUSIONS: The administration of intraperitoneal bupivacaine was associated with improved postoperative pain control in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery and should be further evaluated in a prospective study.
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Affiliation(s)
- Colleen Rivard
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Isaksson Vogel
- Biostatistics and Bioinformatics, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Deanna Teoh
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota.
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Khariwala SS, Le B, Pierce BHG, Vogel RI, Chipman JG. Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course. Surg Infect (Larchmt) 2015; 17:100-5. [PMID: 26501794 DOI: 10.1089/sur.2015.131] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Free tissue reconstruction has become the standard of care for most major defects in the head and neck. Surgical site infection (SSI) can lead to vessel thrombosis and eventual flap loss. The use of antibiotics after free tissue reconstruction has not been studied in the current environment of heightened bacterial antibiotic resistance. We compared the use of short-term and longer-term antibiotics in a series of patients receiving free tissue reconstructions. METHODS A retrospective review was performed of 147 patients receiving 149 free flaps who were treated with either short-course (≤2 d; n = 149 [43%]) or long-course (>2 d; n = 85 [57%])) post-operative antibiotics from 2009 to 2014. The outcomes examined were infection, return to the operating room, length of hospital stay, and patient death up to six weeks post-surgery. In addition, risk factors associated with SSI were explored. RESULTS Surgical site infection, flap dehiscence, flap loss, and length of stay were not different in the two groups. However, those receiving long-course antibiotics had a significantly higher rate of pneumonia (24.7% vs. 10.9%; p = 0.03), although they had a lower rate of urinary tract infection (0.0% vs 9.4%, respectively; p = 0.01). Body mass index remained a statistically significant risk factor in the multivariable analysis (p = 0.005). CONCLUSION Prolonged antibiotic use after free flap reconstruction of head and neck defects does not appear to prevent SSI better than short-course treatment in this population. Moreover, long-course antibiotic use was associated with a higher risk of pneumonia.
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Affiliation(s)
- Samir S Khariwala
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Minnesota , Minneapolis, Minnesota
| | - Bin Le
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Minnesota , Minneapolis, Minnesota
| | - Brendan H G Pierce
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Minnesota , Minneapolis, Minnesota
| | - Rachel Isaksson Vogel
- 2 Masonic Cancer Center, Biostatistics and Bioinformatics Core, University of Minnesota , Minneapolis, Minnesota
| | - Jeffrey G Chipman
- 3 Department of Surgery, University of Minnesota , Minneapolis, Minnesota
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Iizuka Y, Cichocki F, Sieben A, Sforza F, Karim R, Coughlin K, Isaksson Vogel R, Gavioli R, McCullar V, Lenvik T, Lee M, Miller J, Bazzaro M. UNC-45A Is a Nonmuscle Myosin IIA Chaperone Required for NK Cell Cytotoxicity via Control of Lytic Granule Secretion. J Immunol 2015; 195:4760-70. [PMID: 26438524 DOI: 10.4049/jimmunol.1500979] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/06/2015] [Indexed: 11/19/2022]
Abstract
NK cell's killing is a tightly regulated process under the control of specific cytoskeletal proteins. This includes Wiskott-Aldrich syndrome protein, Wiskott-Aldrich syndrome protein-interacting protein, cofilin, Munc13-4, and nonmuscle myosin IIA (NMIIA). These proteins play a key role in controlling NK-mediated cytotoxicity either via regulating the attachment of lytic granules to the actin-based cytoskeleton or via promoting the cytoskeletal reorganization that is requisite for lytic granule release. UNC-45A is a highly conserved member of the UNC-45/CRO1/She4p family of proteins that act as chaperones for both conventional and nonconventional myosin. Although we and others have shown that in lower organisms and in mammalian cells NMIIA-associated functions, such as cytokinesis, cell motility, and organelle trafficking, are dependent upon the presence of UNC-45A, its role in NK-mediated functions is largely unknown. In this article, we describe UNC-45A as a key regulator of NK-mediated cell toxicity. Specifically we show that, in human NK cells, UNC-45A localize at the NK cell immunological synapse of activated NK cells and is part of the multiprotein complex formed during NK cell activation. Furthermore, we show that UNC-45A is disposable for NK cell immunological synapse formation and lytic granules reorientation but crucial for lytic granule exocytosis. Lastly, loss of UNC-45A leads to reduced NMIIA binding to actin, suggesting that UNC-45A is a crucial component in regulating human NK cell cytoskeletal dynamics via promoting the formation of actomyosin complexes.
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Affiliation(s)
- Yoshie Iizuka
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Frank Cichocki
- Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455
| | - Andrew Sieben
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Fabio Sforza
- Department of Life Sciences and Biotechnology, University of Ferrara, 44121 Ferrara, Italy; and
| | - Razaul Karim
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455
| | - Kathleen Coughlin
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Rachel Isaksson Vogel
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455
| | - Riccardo Gavioli
- Department of Life Sciences and Biotechnology, University of Ferrara, 44121 Ferrara, Italy; and
| | - Valarie McCullar
- Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455
| | - Todd Lenvik
- Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455
| | - Michael Lee
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455
| | - Jeffrey Miller
- Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455
| | - Martina Bazzaro
- Department of Obstetrics, Gynecology and Women's Heath, University of Minnesota Twin Cities, Minneapolis, MN 55455;
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Abstract
Objective Intrahepatic cholestasis of pregnancy (ICP) is a rare liver disorder, usually manifesting in the third trimester and associated with increased perinatal morbidity and mortality. The hallmark laboratory abnormality in ICP is elevated fasting serum bile acids; however, there are limited data on whether a nonfasting state affects a pregnant woman's total bile acids. This study assesses fasting and nonfasting bile acid levels in 10 healthy pregnant women after a standardized glucose load to provide insight into the effects of a glucose load on bile acid profiles. Study Design Pilot prospective cohort analysis of serum bile acids in pregnant women. A total of 10 healthy pregnant women from 28 to 32 weeks' gestation were recruited for the study before undergoing a glucose tolerance test. Total serum bile acids were collected for each subject in the overnight fasting state, and 1 and 3 hours after the 100-g glucose load. Results There was a statistically significant difference between fasting versus 3-hour values. There was no statistically significant difference between fasting versus 1-hour and 1-hour versus 3-hour values. Conclusion There is a difference between fasting and nonfasting total serum bile acids after a 100-g glucose load in healthy pregnant women.
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Affiliation(s)
- April Adams
- Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota
| | - Katherine Jacobs
- Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Isaksson Vogel
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Virginia Lupo
- Department of Obstetrics and Gynecology, Hennepin County Medical Center, Minneapolis, Minnesota
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Rivard CL, Slagle EA, Nahum R, Vogel RI, Teoh D. Evaluation of the NSQIP Surgical Risk Calculator to Predict Complications in Gynecologic Oncology Patients Undergoing Laparotomy. J Am Coll Surg 2015. [DOI: 10.1016/j.jamcollsurg.2015.07.226] [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: 11/26/2022]
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Hutchins J, Delaney D, Vogel RI, Ghebre RG, Downs LS, Carson L, Mullany S, Teoh D, Geller MA. Ultrasound guided subcostal transversus abdominis plane (TAP) infiltration with liposomal bupivacaine for patients undergoing robotic assisted hysterectomy: A prospective randomized controlled study. Gynecol Oncol 2015; 138:609-13. [PMID: 26056753 DOI: 10.1016/j.ygyno.2015.06.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/04/2015] [Accepted: 06/05/2015] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Optimal pain control after major surgery contributes to a patient's recovery and satisfaction. The use of liposomal bupivacaine in subcostal transversus abdominis plane (TAP) blocks for postoperative pain control after robot assisted abdominal surgery has yet to be studied. METHODS We conducted a prospective randomized controlled observer-blinded study comparing bilateral subcostal TAP blocks with bupivacaine to bilateral subcostal TAP blocks with liposomal bupivacaine. These were performed prior to the patient undergoing robot assisted hysterectomy. The patients' pain scores, opioid use, side effects, and satisfaction were followed for 72h after injection. RESULTS Total opioid use in the first 72h after injection was significantly decreased in the group that received liposomal bupivacaine compared to bupivacaine. Patients in the liposomal bupivacaine group had significantly lower maximal pain scores at all time periods studied as well as decreased incidence of nausea/vomiting. There was a trend toward decreased length of stay in the liposomal bupivacaine group. CONCLUSION Subcostal TAP blocks with liposomal bupivacaine decreased the total opioid requirement for the first 72h after robot assisted hysterectomy when compared to subcostal TAP blocks with bupivacaine.
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Affiliation(s)
- Jacob Hutchins
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Delaney
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Isaksson Vogel
- Masonic Cancer Center Biostatistics and Bioinformatics, University of Minnesota, Minneapolis, MN, USA
| | - Rahel G Ghebre
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Levi S Downs
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Linda Carson
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Sally Mullany
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Deanna Teoh
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA.
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Hecht SS, Carmella SG, Kotandeniya D, Pillsbury ME, Chen M, Ransom BWS, Vogel RI, Thompson E, Murphy SE, Hatsukami DK. Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers. Nicotine Tob Res 2015; 17:704-9. [PMID: 25335945 PMCID: PMC4481723 DOI: 10.1093/ntr/ntu218] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 09/30/2014] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are rapidly increasing in popularity but little information is available on their potential toxic or carcinogenic effects. METHODS Twenty-eight e-cigarette smokers who had not smoked tobacco cigarettes for at least 2 months provided urine samples which were analyzed by validated methods for a suite of toxicant and carcinogen metabolites including 1-hydroxypyrene (1-HOP), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), 3-hydroxypropylmercapturic acid (3-HPMA), 2-hydroxypropylmercapturic acid (2-HPMA), 3-hydroxy-1-methylpropylmercapturic acid (HMPMA), S-phenylmercapturic acid (SPMA), nicotine, and cotinine. Levels of these compounds were compared to those found in cigarette smokers from three previous studies. RESULTS Levels of 1-HOP, total NNAL, 3-HPMA, 2-HPMA, HMPMA, and SPMA were significantly lower in the urine of e-cigarette users compared to cigarette smokers. Levels of nicotine and cotinine were significantly lower in e-cigarette users compared to cigarette smokers in one study but not in another. CONCLUSIONS With respect to the compounds analyzed here, e-cigarettes have a more favorable toxicity profile than tobacco cigarettes.
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Affiliation(s)
- Stephen S Hecht
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Steven G Carmella
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Delshanee Kotandeniya
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Makenzie E Pillsbury
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Menglan Chen
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Benjamin W S Ransom
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Rachel Isaksson Vogel
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Elizabeth Thompson
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Sharon E Murphy
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Dorothy K Hatsukami
- Tobacco Research Programs and Masonic Cancer Center, University of Minnesota, Minneapolis, MN
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Ji Y, Vogel RI, Lou E. Meta-analysis of temozolomide treatment of pituitary carcinomas and aggressive adenomas. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e13014] [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: 11/20/2022] Open
Affiliation(s)
- Yan Ji
- University of Minnesota Med Ctr, Minneapolis, MN
| | | | - Emil Lou
- University of Minnesota, Hopkins, MN
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44
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Baxstrom K, Lee CKK, Peterson BA, Vogel RI, Blaes AH. Impact of consultation in a long term follow-up clinic on breast cancer and cardiovascular screening in Hodgkin lymphoma survivors. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e20607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
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45
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Dickson EL, Hubbs JL, Vogel RI, Rivard CL, Teoh DGK, Geller MA. What women want: Sexual quality of life after the treatment of gynecologic cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e20617] [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: 11/20/2022] Open
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46
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Harris AC, Tally L, Schmidt CE, Muelken P, Stepanov I, Saha S, Vogel RI, LeSage MG. Animal models to assess the abuse liability of tobacco products: effects of smokeless tobacco extracts on intracranial self-stimulation. Drug Alcohol Depend 2015; 147:60-7. [PMID: 25561387 PMCID: PMC4337227 DOI: 10.1016/j.drugalcdep.2014.12.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/12/2014] [Accepted: 12/11/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Preclinical models are needed to inform regulation of tobacco products by the Food and Drug Administration (FDA). Typically, animal models of tobacco addiction involve exposure to nicotine alone or nicotine combined with isolated tobacco constituents (e.g. minor alkaloids). The goal of this study was to develop a model using extracts derived from tobacco products that contain a range of tobacco constituents to more closely model product exposure in humans. METHODS This study compared the addiction-related effects of nicotine alone and nicotine dose-equivalent concentrations of aqueous smokeless tobacco extracts on intracranial self-stimulation (ICSS) in rats. Extracts were prepared from Kodiak Wintergreen, a conventional product, or Camel Snus, a potential "modified risk tobacco product". Binding affinities of nicotine alone and extracts at various nicotinic acetylcholine receptor (nAChR) subtypes were also compared. RESULTS Kodiak and Camel Snus extracts contained levels of minor alkaloids within the range of those shown to enhance nicotine's behavioral effects when studied in isolation. Nonetheless, acute injection of both extracts produced reinforcement-enhancing (ICSS threshold-decreasing) effects similar to those of nicotine alone at low to moderate nicotine doses, as well as similar reinforcement-attenuating/aversive (ICSS threshold-increasing) effects at high nicotine doses. Extracts and nicotine alone also had similar binding affinity at all nAChRs studied. CONCLUSIONS Relative nicotine content is the primary pharmacological determinant of the abuse liability of Kodiak and Camel Snus as measured using ICSS. These models may be useful to compare the relative abuse liability of other tobacco products and to model FDA-mandated changes in product performance standards.
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Affiliation(s)
- Andrew C Harris
- Minneapolis Medical Research Foundation, Minneapolis, MN, USA; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
| | - Laura Tally
- Minneapolis Medical Research Foundation, Minneapolis, MN, USA
| | - Clare E Schmidt
- Minneapolis Medical Research Foundation, Minneapolis, MN, USA; Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
| | - Peter Muelken
- Minneapolis Medical Research Foundation, Minneapolis, MN, USA; Department of Ecology, Evolution, and Behavior, University of Minnesota, Minneapolis, MN, USA
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Subhrakanti Saha
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Isaksson Vogel
- Masonic Cancer Center, Biostatistics and Bioinformatics Core, University of Minnesota Minneapolis, MN, USA
| | - Mark G LeSage
- Minneapolis Medical Research Foundation, Minneapolis, MN, USA; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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47
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Teoh DG, Marriott AE, Isaksson Vogel R, Marriott RT, Lais CW, Downs LS, Kulasingam SL. Adherence to the 2012 national cervical cancer screening guidelines: a pilot study. Am J Obstet Gynecol 2015; 212:62.e1-9. [PMID: 24992692 DOI: 10.1016/j.ajog.2014.06.057] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 06/05/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The goal of this pilot study was to evaluate adherence to the 2012 cervical cancer screening guidelines among health care providers in a large health maintenance organization. STUDY DESIGN A cross-sectional survey evaluating knowledge, reported practices, and views of the 2012 cervical cancer screening guidelines was distributed to 325 health care providers within HealthPartners. The survey was divided into 3 sections: (1) provider demographics; (2) knowledge of the 2012 age-specific cancer screening guidelines; and (3) provider practice. Comparisons based on appropriate knowledge and practice of the guidelines were made using Fisher exact tests. RESULTS The response rate was 42%. Of 124 respondents, 15 (12.1%) reported they were not aware of the 2012 guideline changes. Only 7 (5.7%) respondents answered all the knowledge questions correctly. A majority of respondents reported correct screening practices in the 21-29 year patient age group (65.8%) and in the >65 year patient age group (74.3%). Correct screening intervals in the 30-65 year patient age group varied by modality, with 89.3% correctly screening every 3 years with Pap smear alone, but only 57.4% correctly screening every 5 years with Pap smear + human papillomavirus cotesting. The most frequently cited reasons for not adhering were lack of knowledge of the guidelines and patient demand for a different screening interval. CONCLUSION Adherence to the 2012 cervical cancer screening guidelines is poor due, in part, to a lack of knowledge of the guidelines. Efforts should focus on improved provider and patient education, and methods that facilitate adherence to the guidelines such as electronic health record order sets.
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Grufferman S, Lupo PJ, Vogel RI, Danysh HE, Erhardt EB, Ognjanovic S. Parental military service, agent orange exposure, and the risk of rhabdomyosarcoma in offspring. J Pediatr 2014; 165:1216-21. [PMID: 25241182 PMCID: PMC4254119 DOI: 10.1016/j.jpeds.2014.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 07/15/2014] [Accepted: 08/07/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the role of parental military service-related exposures and rhabdomyosarcoma (RMS) risk in offspring using data from a large case-control study of childhood RMS. STUDY DESIGN Cases (n = 319) were enrolled from the third trial run by the Intergroup Rhabdomyosarcoma Study Group. Population-based controls (n = 319) were pair-matched to cases on race, sex, and age. Conditional logistic regression was used to evaluate parental military service-related exposures and their associations with childhood RMS by generating aORs and 95% CIs. Statistical significance was defined as P < .05. RESULTS There were no significant associations between parental military service and childhood RMS. The strongest association was with maternal military service; however, this association was attenuated and did not remain significant after adjusting for covariates (aOR = 2.75, 95% CI 0.71, 10.62). An elevated effect estimate was found when assessing paternal exposure to Agent Orange (AO) and childhood RMS but was not statistically significant (aOR = 1.72, 95% CI 0.55, 5.41). CONCLUSIONS We found little evidence that parental military service of AO exposure influences the risk of RMS in offspring. These findings are notable in light of the continuing controversies surrounding the intergenerational effects of AO exposure.
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Affiliation(s)
- Seymour Grufferman
- Division of Epidemiology and Biostatistics, Department of Internal Medicine, University of New Mexico, Albuquerque, NM
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer Center, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX.
| | | | - Heather E Danysh
- Department of Pediatrics, Section of Hematology-Oncology, Texas Children's Cancer Center, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX
| | - Erik B Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM
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Rivard C, Casserly K, Anderson M, Isaksson Vogel R, Teoh D. Factors influencing same-day hospital discharge and risk factors for readmission after robotic surgery in the gynecologic oncology patient population. J Minim Invasive Gynecol 2014; 22:219-26. [PMID: 25304856 DOI: 10.1016/j.jmig.2014.10.001] [Citation(s) in RCA: 43] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 09/30/2014] [Accepted: 10/01/2014] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE To determine the factors that allow for a safe outpatient robotic-assisted minimally invasive gynecologic oncology surgery procedure. DESIGN Retrospective chart review (Canadian Task Force classification II-1). SETTING University hospital. PATIENTS All patients (140) undergoing robotic-assisted minimally invasive surgery with the gynecologic oncology service from January 1, 2013, to December 31, 2013. INTERVENTIONS Risk factors for unsuccessful discharge within 23 hours of surgery and same-day discharge were assessed using logistic regression models. MEASUREMENTS AND MAIN RESULTS All patients were initially scheduled for same-day discharge. The outpatient surgery group was defined by discharge within 23 hours of the surgery end time, and a same-day surgery subgroup was defined by discharge before midnight on the day of surgery. One hundred fifteen (82.1%) were successfully discharged within 23 hours of surgery, and 90 (64.3%) were discharged the same day. The median hospital stay was 5.3 hours (range, 1-48 hours). Unsuccessful discharge within 23 hours was associated with a preoperative diagnosis of lung disease and intraoperative complications; unsuccessful same-day discharge was associated with older age and later surgery end time. Only 2 patients (1.4%) were readmitted to the hospital within 30 days of surgery. CONCLUSIONS Outpatient robotic-assisted minimally invasive surgery is safe and feasible for most gynecologic oncology patients and appears to have a low readmission rate. Older age, preoperative lung disease, and later surgical end time were risk factors for prolonged hospital stay. These patients may benefit from preoperative measures to facilitate earlier discharge.
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Affiliation(s)
- Colleen Rivard
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota.
| | - Kelly Casserly
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota
| | - Mary Anderson
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Isaksson Vogel
- Biostatistics and Bioinformatics, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Deanna Teoh
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota
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Hijazi K, Bomalysz B, Steiling K, Xiao J, Liu G, Alekseyev Y, Yves MD, Hertsgaard LA, Jensen J, Vogel RI, Hatsukami D, O'Connor G, Brooks DR, Beane J, Spira A. Abstract 2354: Nasal gene expression reflects the physiologic response to potentially reduced exposure products. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-2354] [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]
Abstract
Abstract
Rationale
Potentially reduced exposure products (PREPs) are tobacco-based products that may yield lower toxicant levels as compared to traditional cigarettes thereby possibly mitigating tobacco-exposure related harm. Due to their increasing popularity, there is an urgent need to develop approaches for evaluating the biological impact of these products to determine their potential health risks. We have shown that gene expression profiling of intra- and extra-thoracic airway epithelium can serve as an indicator of physiological responses to cigarette smoke exposure. Our goal here is to establish whether this same approach might identify similarities and differences in the response to reduced exposure tobacco products. We therefore examined longitudinal gene-expression alterations upon switching from traditional cigarettes to a lower nicotine product (Xodus) in readily collected nasal epithelium and compared these transcriptomic alterations to those associated with smoking-cessation.
Methods
Nasal epithelial brushings were obtained from 13 active smokers who switched to Xodus cigarettes for 6 weeks and then were tobacco abstinent for the next 18 weeks. Nasal brushings were obtained at baseline and at 4, 6, 16, and 24-weeks. Alveolar carbon monoxide levels were used to confirm cigarette use at baseline, 4 and 6 weeks and tobacco abstinence at 16 and 24 weeks. RNA from the nasal brushings was processed and hybridized to Affymetrix Human Gene 1.0 ST Arrays. Gene expression alterations at each time point were identified using a mixed model ANOVA.
Results
Alterations in the expression levels of 161 genes were associated with either switching to PREPs or with complete smoking cessation (FDR<0.2). For a minority of genes, Xodus usage resulted in decreased expression levels that further decreased upon smoking cessation. These genes were primarily involved in xenobiotic metabolism (P<0.05). The majority of genes altered by smoking cessation time points do not change upon switching to this PREP product.
Conclusion
Our data indicate that some of the gene expression differences induced by switching to the PREP product are intermediate between traditional cigarette smoking and tobacco abstinence whereas majority of gene expression remain unaltered with Xodus use. These data suggest that the PREP product may only constitute partially reduced exposure. Our study further suggests that the nasal epithelium can serve as a minimally invasive tool to measure responses to alternative tobacco products and may ultimately serve as a biomarker to evaluate the potential disease risks associated with these products.
Citation Format: Kahkeshan Hijazi, Bozena Bomalysz, Katrina Steiling, Ji Xiao, Gang Liu, Yuriy Alekseyev, Martine Dumas Yves, Louise A. Hertsgaard, Joni Jensen, Rachel Isaksson Vogel, Dorothy Hatsukami, George O'Connor, Daniel R. Brooks, Jennifer Beane, Avrum Spira. Nasal gene expression reflects the physiologic response to potentially reduced exposure products. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2354. doi:10.1158/1538-7445.AM2014-2354
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Affiliation(s)
| | | | | | - Ji Xiao
- 1Boston University, BOSTON, MA
| | | | | | | | | | - Joni Jensen
- 2Tobacco Use Research Center, University of Minnesota, Delaware, MN
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