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Skull-base temporal encephalocele: Hidden cause of temporal lobe epilepsy. J Postgrad Med 2024; 70:97-100. [PMID: 37555423 DOI: 10.4103/jpgm.jpgm_354_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 12/22/2022] [Indexed: 08/10/2023] Open
Abstract
ABSTRACT In the present study patients with previously diagnosed MRI-negative temporal lobe epilepsy (TLE) on long-term video electroencephalography (VEEG) monitoring were re-evaluated with high resolution 3T MRI brain to look out for a skull base temporal lobe encephalocoele (TE). A total of 234 VEEGs were analyzed. TLE had been diagnosed in 104 patients based on semiology, ictal, interictal EEG data, and brain positron emission tomography (PET) studies. Of these, 99 patients had temporal lobe abnormality (78 had mesial temporal sclerosis, 8 had tumor, 3 had focal cortical dysplasia, and 10 had mixed pathology). Out of the five 1.5T MRI-negative TLE patients, two patients were diagnosed with TE on subsequent 3T MRI brain scans and one patient underwent electrocorticography-guided tailored resection for complete removal of epileptogenic tissue; with Engels class I seizure freedom at one year follow-up. We propose that TE should be carefully searched for, as a cause of refractory TLE, using high-resolution MRI sequences.
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Abstract No. 587 Morbidity and mortality conferencing as a quality assessment tool in interventional radiology: a survey of Society of Interventional Radiology members. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract No. 257 Financial analysis of outpatient evaluation and management billing by interventional radiologists in comparison to other specialties. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract No. 313 Trends in percutaneous musculoskeletal procedure volume among Medicare patients from 2010-2018 by specialty. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abstract No. 92 Effect on intra-procedural metrics of repeat imaging with CT arteriography prior to conventional angiography: analysis of trauma patients with active extravasation on initial portal venous phase imaging. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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The Impact of Injection Distance to Bifurcations on Yttrium-90 Distribution in Liver Cancer Radioembolization. J Vasc Interv Radiol 2022; 33:668-677.e1. [PMID: 35301128 PMCID: PMC9156550 DOI: 10.1016/j.jvir.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/22/2022] [Accepted: 03/06/2022] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To model the effect of the injection location on the distribution of yttrium-90 (90Y) microspheres in the liver during radioembolization using computational simulation and to determine the potential effects of radial movements of the catheter tip. MATERIALS AND METHODS Numerical studies were conducted using images from a representative patient with hepatocellular carcinoma. The right hepatic artery (RHA) was segmented from contrast-enhanced cone-beam computed tomography scans. The blood flow was investigated in the trunk of the RHA using numerical simulations for 6 injection position scenarios at 2 sites located at a distance of approximately 5 and 20 mm upstream of the first bifurcation (RHA diameters of approximately 4.6 mm). The 90Y delivery to downstream vessels was calculated from the simulated hepatic artery hemodynamics. RESULTS Varying the injection location along the RHA and across the vessel cross-section resulted in different simulated microsphere distributions in the downstream vascular bed. When the catheter tip was 5 mm upstream of the bifurcation, 90Y distribution in the downstream branches varied by as much as 53% with a 1.5-mm radial movement of the tip. However, the catheter radial movement had a weaker effect on the microsphere distribution when the injection plane was farther from the first bifurcation (20 mm), with a maximum delivery variation of 9% to a downstream branch. CONCLUSIONS An injection location far from bifurcations is recommended to minimize the effect of radial movements of the catheter tip on the microsphere distribution.
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Abstract No. 132 Trends in percutaneous ablation procedures among Medicare patients from 2010-2018: an analysis of procedure volume, specialty involvement, and reimbursement rates. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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A SURVEY OF INTERVENTIONAL RADIOLOGISTS REGARDING THE USE OF MORBIDITY AND MORTALITY CONFERENCING IN DEPARTMENTAL QUALITY IMPROVEMENT PROGAMS. J Vasc Interv Radiol 2021; 33:150-158.e1. [PMID: 34774929 DOI: 10.1016/j.jvir.2021.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/24/2021] [Accepted: 10/26/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Investigate the degree to which Morbidity and Mortality (M&M) conferencing is utilized in Interventional Radiology (IR), identify impediments to its adoption, and assess the experience of those using this tool. MATERIALS AND METHODS Members of the Society of Interventional Radiology (SIR) were offered a 10-question survey of practices and experiences regarding M&M conferencing within their Quality Assessment (QA) programs. RESULTS Among 604 respondents, 37.8% were university-based practitioners and 60% from outside of university practices. 43% of respondents reported practicing 100% IR, with 28.5% practicing 75-99% and 11% practicing IR less than 50% of the time. The use of M&M conferencing was significantly greater in university practices (90.7%) than in non-university practices (37.1%) and among practitioners performing at least 75% IR (71.2%) than among those practicing less than 75% (28.8%). Conferences were held monthly (66.6%) or more often and the majority (56%) of the events identified were scored using the SIR severity score. Roughly 20% of M&M conferences were multidisciplinary, shared most commonly with vascular surgery. The reasons cited for not using M&M included lack of time and the logistical challenges of the process. However, among those who participate in M&M conferences, the QA goals of the conference were met at very high rates. CONCLUSIONS M&M conferencing is well established in university IR programs and among full-time practitioners, but much less so elsewhere. For those sites that do not utilize M&M conferencing, there may be considerable benefit to addressing the obstacles that are limiting their implementation of this tool.
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Untangling the physics of water transport in boron nitride nanotubes. NANOSCALE 2021; 13:18096-18102. [PMID: 34730591 DOI: 10.1039/d1nr04794a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Carbon nanotubes (CNTs) have long been heralded as the material of choice for next-generation membranes. Some studies have suggested that boron nitride nanotubes (BNNTs) may offer higher transport of pure water than CNTs, while others conclude otherwise. In this work, we use a combination of simulations and experimental data to uncover the causes of this discrepancy and investigate the flow resistance through BNNT membranes in detail. By dividing the resistance of the nanotube membranes into their contributing components, we study the effects of pore end configuration, membrane length, and BNNT atom partial charges. Most molecular simulation studies of BNNT membranes use short membranes connected to high and low pressure reservoirs. Here we find that flow resistances in these short membranes are dominated by the resistance at the pore ends, which can obscure the understanding of water transport performance through the nanotubes and comparison between different nanotube materials. In contrast, it is the flow resistance inside the nanotubes that dominates microscale-thick laboratory membranes, and end resistances tend to be negligible. Judged by the nanotube flow resistance alone, we therefore find that CNTs are likely to consistently outperform BNNTs. Furthermore, we find a large role played by the choice of partial charges on the BN atoms in the flow resistance measurements in our molecular simulations. This paper highlights a way forward for comparing molecular simulations and experimental results.
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Mature tertiary lymphoid structures in lung adenocarcinoma are associated with better progression free survival. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Objective
The presence of inducible lymphoid structures known as tertiary lymphoid structures in the tumor microenvironment has been shown to correlate with positive clinical outcome. However, the maturation states of lymphoid aggregates in lung adenocarcinoma are not completely understood.
Methods/Case Report
Seventy tumor samples from 69 patients diagnosed with lung adenocarcinoma (Stages I to III) between 2013 and 2015 were included in the study. The presence and maturation states of the lymphoid structures within the tumors were evaluated by conventional and 26 samples were further analyzed by multiplexed immunohistochemistry of formalin fixed paraffin embedded tissues and then quantified. Mature lymphoid follicles containing germinal centers were identified by the presence of CD21+ and BCL-6+ cells in an organized configuration within tight clusters of T and B cells.
Results (if a Case Study enter NA)
Samples with fully mature lymphoid structures (germinal centers) had larger tumors and higher disease stage. The number of mature lymphoid structures correlated with the total number of lymphoid aggregates present in the tumor microenvironment. Additionally, tumor samples with ≥10 mature lymphoid structures had more primary follicles. While there was no difference in overall survival, progression free survival was significantly longer in patients who had ≥10 mature lymphoid structures in comparison with patients who had <10 mature structures.
Conclusion
In conclusion, a spectrum of lymphoid aggregates in different stages of maturation are present in lung adenocarcinoma. An increase in the number of mature lymphoid structures may be associated with progression free survival in patients with lung adenocarcinoma.
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P–397 Threatened Miscarriage and increase in Perinatal Morbidity. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Are women presenting with bleeding in the first trimester of pregnancy at a higher risk for perinatal complications later in pregnancy?
Summary answer
Women presenting with bleeding in the first trimester of pregnancy are more likely to experience perinatal and neonatal morbidity in pregnancy.
What is known already
Observational studies and a previously reported systematic review showed that women who experienced threatened miscarriage are more likely to have still birth, intra uterine growth restriction (IUGR), low birth weight, pre-eclampsia, placental abruption, placenta previa, preterm labour, preterm prelabour rupture of membrane, neonatal asphyxia and congenital anomalies in pregnancy. However, the evidence has been inconclusive and currently the women who experience threatened miscarriage receive low risk care.
Study design, size, duration
This was a prospective cohort study conducted on 298 women with threatened miscarriage (Cohort A) and 107 asymptomatic women (Cohort B). The women were recruited over a period of 18 months and were followed up for 9 months until delivery.
Participants/materials, setting, methods
Cohort A were women who presented with bleeding in the early pregnancy assessment unit and had a confirmed heartbeat on ultrasound scan between 6 weeks and 11 + 6 weeks of pregnancy and cohort B were women who were asymptomatic and booked with the community midwives as low risk. Both groups of women were followed up prospectively until delivery and data were collected on any perinatal outcomes and complications for both mother and the neonate.
Main results and the role of chance
The analysis showed that women who had bleeding in early pregnancy were more likely to have preterm delivery (RR 95% CI; 2.98 (1.07 – 8.27)); IUGR (unable to calculate the RR, as none of the women who continued their pregnancies beyond 24 weeks of gestation, developed IUGR in the asymptomatic control cohort. Nonetheless, IUGR occurred more frequently in the threatened miscarriage cohort than the asymptomatic cohort (P-value 0.02)); LBW (RR 95% CI; 6.14 (1.49 – 25.19), neonatal asphyxia (unable to calculate the RR, as none of the babies who were born to women in the asymptomatic control cohort develop neonatal asphyxia. Nonetheless, neonatal asphyxia occurred more frequently in the threatened miscarriage cohort than the asymptomatic cohort (P-value 0.02)). Preterm prelabour rupture of membrane was not significant with a P-value of 0.07.
Limitations, reasons for caution
The major limitation of this study was lower sample size and hence due to the rarity of many of the perinatal and neonatal outcomes, we were unable to calculate the relative risk.
Wider implications of the findings: Current study agrees with the existing literature and reaffirms the association of perinatal and neonatal morbidities with threatened miscarriage and this group of women need to be managed as high-risk group antenatally.
Trial registration number
Not applicable
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311 Can We Predict Extraprostatic Extension (EPE) Prior To Radical Prostatectomy? – A Single Institution Comparison of Pre-Operative Biopsy Histology and Multiparametric MRI (mpMRI) With Radical Prostatectomy Specimen Histology. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Prostate biopsies and mpMRI play an integral role in diagnosis of prostate cancer. The aim of our study was to assess the ability to predict EPE based on pre-operative histology and mpMRI.
Method
We retrospectively analysed 235 patients who underwent radical prostatectomy between January 2015 and April 2017. All patients underwent pre-biopsy mpMRI scans and prostate biopsies. All mpMRIs were reported by dedicated uro-radiologists and all histology was reported by dedicated uro-pathologists.
Results
17/25 patients showing EPE on mpMRI had it confirmed on final histology.
a53/210 patients showing organ-confirmed disease on mpMRI had EPE on final histology.
40/49 patients who had Gleason 6 adenocarcinoma were organ-confined.
61/186 patients with > Gleason 7 adenocarcinoma had EPE.
Sensitivity of mpMRI was 25% with a specificity of 95%. The positive predictive value (PPV) was 68% and negative predictive value (NPV) was 75%.
The specificity of pre-biopsy Gleason score > 7 to predict EPE was 81% and sensitivity was 33% with a PPV of 87%.
Conclusions
Our data suggests that by using > Gleason 7 and mpMRI as a combination, we can reliably predict EPE on final histology which in turn will help counsel patients appropriately for treatment options. Further data collection is ongoing at our institution.
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Abstract No. 534 Evolving role of radiology in performing basic procedures for Medicare beneficiaries from 1996 to 2018. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract No. 472 Alternate venous access sites for ported catheters: experience at a single quaternary care institution. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract No. 568 Interpretation of diagnostic vascular imaging studies for Medicare patients by interventional radiologists: a comparison to other specialties and implications for interventional radiology. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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MA01.09 Efficacy and Safety of Glembatumumab Vedotin in Patients With Advanced or Metastatic Squamous Cell Carcinoma of the Lung (PrECOG 0504). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Long-term efficacy and safety of brodalumab in psoriasis through 120 weeks and after withdrawal and retreatment: subgroup analysis of a randomized phase III trial (AMAGINE-1). Br J Dermatol 2020; 183:1037-1048. [PMID: 32286683 PMCID: PMC7754427 DOI: 10.1111/bjd.19132] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Brodalumab is efficacious for the treatment of moderate-to-severe plaque psoriasis through 52 weeks. OBJECTIVES To evaluate the efficacy and safety of brodalumab through 120 weeks, including following withdrawal and retreatment. METHODS At baseline, patients were randomized to brodalumab (n = 222) or placebo (n = 220). At week 12, patients achieving a static Physician's Global Assessment (sPGA) score of 0 or 1 (sPGA 0/1) with brodalumab were rerandomized to brodalumab (n = 83) or placebo (n = 84; later re-treated with brodalumab if sPGA ≥ 3 occurred), and patients receiving placebo switched to brodalumab (n = 208). Safety was assessed by exposure-adjusted rates of treatment-emergent adverse events. RESULTS Among those who achieved sPGA 0/1 at week 12 and were rerandomized to brodalumab, 96% and 80% using observed data, respectively, and 74% and 61% using nonresponder imputation, respectively, achieved 75% improvement in Psoriasis Area and Severity Index (PASI 75) and PASI 100 at week 120. Following withdrawal from brodalumab, return of disease occurred after a mean ± SD duration of 74·7 ± 50·5 days. Among those who switched from brodalumab to placebo at week 12, PASI 75 rates using observed data and nonresponder imputation were 55% and 51% at week 20, respectively and 94% and 75% at week 120, respectively; PASI 100 rates at week 120 were 75% and 60%, respectively. Efficacy was maintained through week 120 in those receiving brodalumab after placebo. No new safety signals were observed. CONCLUSIONS These findings indicate that brodalumab is efficacious and safe for continuous long-term treatment of psoriasis, and support the potential for response after discontinuation and retreatment.
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Shifting the Treatment Paradigm for Pancreaticoportal Fistula Causing Hepatic Necrosis. Dig Dis Sci 2020; 65:1955-1959. [PMID: 31919639 DOI: 10.1007/s10620-020-06045-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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605 Long-term management of moderate-to-severe plaque psoriasis: Maintenance of treatment success following cessation of halobetasol propionate 0.01%/tazarotene 0.045% lotion. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Inhibition of BRAF induces PD-L1 expression in BRAF-mutated papillary thyroid carcinoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nivolumab Plus Low-Dose IPILIMUMAB as First-Line Treatment of Advanced NSCLC: Overall Survival Analysis of Checkmate 817. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P1.15 The Presence of Secondary Follicles in Early Stage Lung Adenocarcinoma Reflects Disease Burden. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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MA01.02 Lung Stereotactic Body Radiotherapy and Concurrent Immunotherapy: A Multi-Center Safety and Toxicity Analysis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Drs. Roudsari et al respond. J Vasc Interv Radiol 2019; 30:1717. [PMID: 31451341 DOI: 10.1016/j.jvir.2019.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022] Open
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Brodalumab in patients who had inadequate response to ustekinumab. Br J Dermatol 2019. [DOI: 10.1111/bjd.17471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brodalumab 用于对乌司奴单抗应答不足的患者. Br J Dermatol 2019. [DOI: 10.1111/bjd.17484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase III trials. Br J Dermatol 2018; 180:306-314. [PMID: 30328108 DOI: 10.1111/bjd.17318] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Brodalumab, a fully human anti-interleukin-17 receptor A monoclonal antibody, has demonstrated superior efficacy and safety over ustekinumab as induction therapy for moderate-to-severe psoriasis. OBJECTIVES To evaluate the efficacy and safety of brodalumab through week 52 in patients who had inadequate responses to ustekinumab. METHODS A subgroup analysis of the phase III AMAGINE-2/-3 double-blind randomized controlled trials was performed. Participants were aged 18-75 years and had a Psoriasis Area and Severity Index (PASI) ≥ 12, static Physician's Global Assessment score ≥ 3 and involvement of ≥ 10% body surface area. The studies were registered at ClinicalTrials.gov: AMAGINE-2, NCT01708603; AMAGINE-3, NCT01708629. RESULTS At baseline, patients with or without prior biologic experience who had an adequate response at week 16 on ustekinumab or brodalumab had lower rates of involved body surface area, PASI, prior biologic use, psoriatic arthritis and body mass index than patients who experienced inadequate response at or after week 16. Among patients who experienced inadequate response to ustekinumab, those rescued with brodalumab had PASI ≥ 75%, ≥ 90% and 100% improvement response rates of 72·6%, 58·1% and 36·3%, respectively, at week 52 compared with 61·7%, 25·5% and 5·4%, respectively, in patients who continued ustekinumab. Exposure-adjusted rates of treatment-emergent adverse events were similar among patients rescued with brodalumab (377·3 adverse events per 100 patient-years) and those who remained on ustekinumab (389·9 adverse events per 100 patient-years). CONCLUSIONS Among patients who experienced inadequate responses to ustekinumab, rescue with brodalumab improved skin clearance outcomes compared with continuing ustekinumab.
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Report of Neurotoxicity after Concurrent Whole Brain Radiation Therapy and Checkpoint Blockade Immunotherapy for Patients with Brain Metastases. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Immune gene expression profiling (GEP) of resected gastric adenocarcinomas (GAs) to identify biomarkers associated with immune checkpoint inhibitor (ICPI) response in early stage disease. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P1.01-79 CheckMate 817: Safety of Flat-Dose Nivolumab Plus Weight-Based Ipilimumab for the First-line (1L) Treatment of Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Impact of previous biologic use on the efficacy and safety of brodalumab and ustekinumab in patients with moderate-to-severe plaque psoriasis: integrated analysis of the randomized controlled trials AMAGINE-2 and AMAGINE-3. Br J Dermatol 2018; 179:320-328. [PMID: 29488226 DOI: 10.1111/bjd.16464] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Biologics are being used increasingly to treat moderate-to-severe psoriasis. Efficacy may differ in patients with previous exposure to biologics. OBJECTIVES To investigate the impact of previous biologic exposure on the efficacy and safety of brodalumab and ustekinumab in patients with moderate-to-severe plaque psoriasis. METHODS Two placebo- and ustekinumab-controlled phase III clinical trials. There was an initial 12-week induction phase where patients were treated with brodalumab [210 mg or 140 mg every 2 weeks (Q2W)], ustekinumab or placebo. Efficacy end points included ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment (score of 0 or 1) vs. placebo, PASI 100 vs. ustekinumab, Dermatology Life Quality Index and Psoriasis Symptom Inventory. Adverse events were monitored throughout. RESULTS In total, 493 patients [334 (27%) brodalumab 210 mg Q2W and 159 (26%) ustekinumab] had received prior biologics; 150 (12%) and 62 (10%), respectively, reported previously failed treatment with a biologic. Brodalumab efficacy in patients with or without previous exposure to biologics was statistically equivalent: 40·9% and 39·5% of biologic-naive and -experienced patients achieved PASI 100 at week 12, compared with 21·1% and 17·0% with ustekinumab (both P < 0·001). In patients where prior biologics had been successful or failed, 41·7% and 32·0% achieved PASI 100, compared with 21·1% and 11·3% with ustekinumab. Tolerability was similar, and did not appear to be influenced by previous treatment with biologics. CONCLUSIONS The efficacy of brodalumab 210 mg Q2W was similar regardless of prior biological therapy (P = 0·31, 0·32 and 0·64 for PASI 75, 90 and 100, respectively). Almost twice as many patients achieved PASI 100 or complete clearance with brodalumab at week 12 compared with ustekinumab; the differences were most noticeable where previous biologics had failed. Both treatments were well tolerated.
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Role of Immune Response in the Prognosis of Carcinoma of the Uterine Cervix: Can in Vitro Analysis Provide a better Framework for more Effective Management? TUMORI JOURNAL 2018; 78:87-93. [PMID: 1326142 DOI: 10.1177/030089169207800205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer of the uterine cervix is the single largest female malignancy in India and also remains a major problem facing oncologists in other parts of the world. While advances in radiation therapy and surgical techniques have made the treatment of cervical carcinoma impressive, limitations to successful management still remain. In fact, the 5-year survival rate, stage for stage, has not improved in the United States or world wide in the past 40 years. With an estimated half a million women developing this disease annually, this lack of improved survival poses an international unresolved health problem. Immune response has been shown to be a major factor involved In the course of the disease for this cancer. Immunologic monitoring was also shown to be of effective value in assessing the prognosis for cervical carcinoma. We studied the various immunologic abnormalities in cervical cancer, the effects of radiation therapy on immune function, prospects of an immunologic staging system, the relationship between human papillomavirus infection and the Immune response, and the possibility of using in vitro Immunologic assessment to provide a better framework for more effective management of cancer of the uterine cervix.
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Abstract No. 465 Making a case for more IR residency positions: comparing qualifications of medical students applying to IR/DR residencies to NRMP DR match data. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract No. 600 Lower extremity endovascular revascularization for Medicare beneficiaries. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Improvement in itch and other psoriasis symptoms with brodalumab in phase 3 randomized controlled trials. J Eur Acad Dermatol Venereol 2018; 32:1305-1313. [PMID: 29512200 DOI: 10.1111/jdv.14913] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with psoriasis have lesional symptoms, including itch, which can reduce quality of life. The efficacy and safety of brodalumab, an interleukin-17 receptor A antagonist, in treating moderate-to-severe psoriasis have been reported in three randomized, controlled, phase 3 trials (AMAGINE-1/-2/-3). OBJECTIVE The effect of brodalumab on lesional symptoms was assessed using the psoriasis symptom inventory (PSI), a validated patient-reported instrument. METHODS Patients were randomized to receive brodalumab (140 or 210 mg every 2 weeks [Q2W]), placebo (AMAGINE-1/-2/-3), or ustekinumab (AMAGINE-2/-3) during a 12-week induction phase, followed by a maintenance phase through week 52. Patients electronically rated the severity of PSI items (itch, burning, stinging, pain, redness, scaling, cracking and flaking) during the previous 24 h on a scale of 0 (not at all severe) to 4 (very severe). At each visit, the PSI total score responder status was assessed, with responders defined as having an average weekly total inventory score ≤8 with no item score >1 at week 12. RESULTS Across AMAGINE-1/-2/-3, brodalumab was associated with improvements in PSI total scores and itch scores vs. placebo from week 2 through week 12 (P < 0.001 in both domains). In AMAGINE-2/-3, brodalumab 210 mg Q2W demonstrated faster onset of PSI total score and itch responses (week 2, 22.1% and 36.4%, respectively) vs. ustekinumab (week 2, 6.9% and 17.1%, respectively) and was associated with improved itch responses vs. ustekinumab after 52 weeks of constant treatment. CONCLUSION Brodalumab demonstrated rapid, robust improvements in symptoms assessed by the PSI, including itch, vs. placebo and ustekinumab.
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P3.04-008 A Phase 1b/2 Study of Atezolizumab With or Without Daratumumab in Advanced or Metastatic Non-small Cell Lung Cancer (NSCLC). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P1.08-003 Concomitant Chemotherapy and Radiotherapy with SBRT Boost for Unresectable, Stage III Non-Small Cell Lung Cancer: A Phase I Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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P3.13-027 Utilization of PET Scan in Advanced Stage Non-Small Cell Lung Cancer in the United States. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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KRAS Mutant Non–small Cell Lung Cancer is Associated With Increased Risk of Salvage Whole Brain Radiation after Stereotactic Radiosurgery for Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Next Generation Sequencing and Clinical Outcomes of Lung Adenocarcinomas Treated With Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stereotactic Body Radiation Therapy for Early Stage Non–Small Cell Lung Cancer in Patients 80 Years and Older: A Multi-Center Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.01.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Therapy-Related Myelodysplasia: Somatic Mutations and Allogeneic Hematopoietic Cell Transplantation Outcomes. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Novel association of familial testicular germ cell tumor and autosomal dominant polycystic kidney disease with PKD1 mutation. Pediatr Blood Cancer 2017; 64:100-102. [PMID: 27577987 PMCID: PMC5937546 DOI: 10.1002/pbc.26197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/13/2016] [Accepted: 07/01/2016] [Indexed: 11/07/2022]
Abstract
Adolescent brothers were diagnosed with testicular germ cell tumors within the same month. Both were found to have multiple renal cysts on pretreatment imaging done for staging. The proband, his brother, and their mother, were all found to have a novel splice variant in intron 8 of the PKD1 gene by clinical exome sequencing. This is the second family reported with both familial testicular germ cell tumor (FTGCT) and autosomal dominant polycystic kidney disease (ADPKD), and the first described association of FTGCT with a splice variant in PKD1. We suggest that this novel variant in PKD1 may convey increased risk for FTGCT in addition to causing ADPKD.
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145P Outcomes of treatment of glioblastoma multiforme: A single institution experience from South India. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw578.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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145P Outcomes of treatment of glioblastoma multiforme: A single institution experience from South India. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Treatment outcome in medulloblastoma with the POG 9031 protocol: a single institution review. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw367.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nivolumab monotherapy in metastatic urothelial cancer (mUC): Updated efficacy by subgroups and safety results from the CheckMate 032 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Electrohydrodynamic deformation and interaction of microscale drop pairs. INTERNATIONAL JOURNAL OF COMPUTATIONAL METHODS AND EXPERIMENTAL MEASUREMENTS 2016. [DOI: 10.2495/cmem-v4-n1-33-41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Abstract
The creation of arteriovenous fistulae and the use of arteriovenous grafts are a vital component in the treatment of patients undergoing dialysis. For many patients in this population, these accesses represent the permanent solution to their dialysis needs. Understanding the basic anatomy of the most common accesses used, as well as initial treatment of many underlying causes of access failure is vital for any interventionalist performing such procedures. This article outlines the most common approaches to surgically placed accesses used for renal replacement therapy, as well as the basics of interventional approaches used to treat the most common abnormalities causing their dysfunction.
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