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Osborne R, Silva M, Taylor GD. Qualitative study exploring general dental practitioners' views of MIH and its management in the UK and Australia. Int J Paediatr Dent 2023. [PMID: 37969051 DOI: 10.1111/ipd.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 09/08/2023] [Accepted: 10/12/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is a prevalent condition, and how it is managed varies greatly between professional groups. AIM To explore, and compare, the UK and Australian general dental practitioners' management of MIH in children. DESIGN Face-to-face (remote) semistructured interviews were undertaken, using country-specific topic guides. Participants were purposively sampled and recruited through national conferences and research networks (eviDent Foundation and Northern Dental Practice Based Research Network). Interviews (from each country) were audio-recorded, transcribed verbatim and independently analysed using thematic analysis. RESULTS Two major themes arose from the UK interviews: (i) decision-making complexities and understanding of treatment options and (ii) need for specialist input. The main Australian themes were (i) multidisciplinary approach to management supporting decision-making complexities and (ii) economic implications for care. Several difficulties, such as financial implications, multidisciplinary care and clinical decision-making, were identified as barriers to effectively managing MIH by GDPs in primary care. CONCLUSION There are similarities and differences in the knowledge and management of MIH amongst UK and Australian nonspecialists. The different healthcare systems played a significant role in shaping how GDPs manage MIH with barriers relating to affordability, multidisciplinary care and clinical decision-making.
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Affiliation(s)
- R Osborne
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - M Silva
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Evident Foundation, South Yarra, Victoria, Australia
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
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2
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Loffreda G, Osborne R, Arteaga-Cruz E, Baum F. The dangers of "health washing" the fossil fuel industry. BMJ 2023; 381:843. [PMID: 37076173 DOI: 10.1136/bmj.p843] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Affiliation(s)
- Giulia Loffreda
- People's Health Movement Scotland
- Institute for Global Health and Development, Queen Margaret University
| | - Rhiannon Osborne
- People's Health Movement UK and Ecosystems and Health Circle
- Health for a Green New Deal
| | - Erika Arteaga-Cruz
- People's Health Movement Ecosystems and Health Circle, Universidad San Francisco de Quito
| | - Fran Baum
- Stretton Health Equity, Stretton Institute, University of Adelaide
- Advisory Committee, People's Health Movement
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3
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Marques MJ, Gama A, Cheng C, Osborne R, Dias S. Addressing health literacy to reduce inequalities among migrants: which profiles need our attention? Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.368] [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: 11/13/2022] Open
Abstract
Abstract
Health literacy, the ability to access, understand, appraise, remember and use health information and services, has great potential to reduce inequalities in access to and outcomes of care. People may have different patterns of health literacy needs and strengths. Yet, the design of interventions is frequently not responsive to the specificities of different segments of the population, including migrant groups. We aimed to identify profiles of migrants to inform the co-design of interventions targeting people at risk of poor outcomes. A cross-sectional survey was conducted with 1126 adult migrants living in Portugal. Data were collected using the 9-dimension HLQ (Health Literacy Questionnaire), and a sociodemographic questionnaire. A cluster analysis of data was performed. Semi-structured interviews were conducted with 15 migrants, stratified by the clusters. The optimal cluster solution yielded 16 profiles revealing diversity in combinations of strengths and needs across the HLQ domains. While 29.8% of migrants scored moderate to high on all 9 domains (profiles 2, 6, 8, 16), 63.4% of participants struggled with 1 or several aspects of health literacy, namely ‘Feeling understood and supported by healthcare providers'. Notably, 36.8% (6 profiles) exhibited difficulty across most of health literacy domains. The interviews provided a tangible description of the health literacy needs and resources with five main themes (access, understand, appraise, retrieve and use). Regarding ‘access', migrants expressed different preferred learning styles and needed to access different sorts of information at distinct times. The ‘use’ of information was rarely a one-time decision but a decision that people needed to make repeatedly. Health literacy is a highly diverse concept where subgroups exhibited diverse patterns. The cluster analysis can be used to inform the co-design, prioritisation and implementation of locally designed, fit-for-purpose solutions to improve health literacy.
Key messages
• Health literacy profiles can inform interventions to mitigate health inequalities among vulnerable migrant groups.
• The identification of distinct profiles can contribute to minimise the disconnect between what people/communities need and what is developed to improve health and equity.
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Affiliation(s)
- MJ Marques
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - C Cheng
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology , Melbourne, Australia
| | - R Osborne
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology , Melbourne, Australia
| | - S Dias
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
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4
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Hughes RC, Antonio M, Osborne R, Mayhew SH, Haines A. A healthy future for children and adolescents. Lancet 2022; 400:1101. [PMID: 36183724 DOI: 10.1016/s0140-6736(22)01605-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Robert C Hughes
- Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
| | | | - Rhiannon Osborne
- University of Cambridge School of Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Susannah H Mayhew
- Centre of Maternal Child and Adolescent Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Andy Haines
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
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Bandara S, Baral P, Joshi A, Muhia J, Rahman-Shepherd A, Adhikari P, Bayingana A, Bookholane H, Changyit-Levin Y, Dada S, Dutta R, Essar MY, Evaborhene NA, Krugman D, Kumar R, Manoj M, Mathewos K, Olson N, Osborne R, Romero-Alvarez D, Tun ZM, Wong BLH. Open Letter to G7 and G20 leaders: resolve global crises to secure our future. Nat Med 2022; 28:1974-1975. [PMID: 35970922 DOI: 10.1038/s41591-022-01944-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shashika Bandara
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
| | - Prativa Baral
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anshumi Joshi
- Trent/Fleming School of Nursing, Trent University, Ontario, Canada
| | - Joy Muhia
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Afifah Rahman-Shepherd
- Faculty of Health Systems and Behavioural Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Praju Adhikari
- Public and Global Health Program, Tampere University, Tampere, Finland
| | | | - Hloni Bookholane
- Division of Global Surgery, University of Cape Town, Cape Town, South Africa
| | - Yara Changyit-Levin
- Global Health Direct Matriculation Program, Johns Hopkins University, Baltimore, MD, USA
| | - Sara Dada
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rohini Dutta
- Programme for Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | | | | | - Daniel Krugman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ramya Kumar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Malvikha Manoj
- International Working Group for Health Systems Strengthening, New York, NY, USA
| | | | - Nehemiah Olson
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Daniel Romero-Alvarez
- One Health Research Group, Facultad de Medicina, Universidad de las Américas, Quito, Ecuador
| | - Zaw Myo Tun
- Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Brian Li Han Wong
- The International Digital Health & AI Research Collaborative (I-DAIR), Global Health Centre, Geneva Graduate Institute, Geneva, Switzerland
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6
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Instenes I, Brors G, Hjertvikrem N, Allore H, Borregaard B, Deaton C, Larsen AI, Osborne R, Palm P, Thompson DR, Norekval TM. Health literacy and physical and mental health status in octogenarian patients with coronary artery disease - a prospective cohort multicentre study. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): MTG Holding AS
Introduction
The number of octogenarians (≥80 years of age) receiving percutaneous coronary intervention (PCI) is rising. Evidence supports that PCI improves quality of life and functional status in this group. Optimal health-promoting behaviour is strongly influenced by health literacy. However, there is limited knowledge about the association between health literacy, physical and mental health status in octogenarians.
Purpose
To determine if octogenarians health literacy is associated with generic and disease-specific physical and mental health status after PCI.
Methods
A prospective cohort study recruited 3417 participants from seven Danish and Norwegian PCI centres, and was conducted from June 2017 until May 2019. Multiple linear regression analysis was used. Health literacy was assessed by four of the nine scales from the Health Literacy Questionnaire (HLQ) (were higher score are better); "Social support for health" (scale range 1-4) "Appraisal of health information", (scale range 1-4) "Ability to find good health information" (scale range 1-5) and "Understand health information well enough to know what to do" (scale range 1-5). Generic physical and mental health status was assessed with RAND-12 at baseline (scale range 0-100, were higher score are better). After two months, disease-specific physical and mental health status was assessed with Myocardial Infarction Dimensional Assessment Scale (scale range 0-100, were lower score are better). Socio-demographic (age, gender, cohabitation status, education) and clinical variables (number of comorbidities) were included as covariates.
Results
In all, 318 octogenarians with mean age 83.4 years (range 80-96) participated, of which 69% were males. Three aspects of health literacy, "Social support for health", "Ability to find good health information" and "Understand health information well enough to know what to do", were significantly associated with health status. Specifically, for a unit increase of "Social support for health", the generic mental health status increased by 3 units (B: 3.0 [0.2 to 5.8] P=0.034). Further, a unit increase of "Ability to find good health information" was associated with a significant 4.2 higher disease-specific physical health and significant 5.3 higher disease-specific mental health (B:-4.2 [-8.0 to -0.4] P=0.029, B:-5.3 [-9.0 to -1.6] P=0.005, respectively). Finally, for a unit increase of "Understand health information well enough to know what to do" the disease-specific physical health improved by 5.1 units (B:-5.1 [-9.7 to -0.5] P=0.029) and disease-specific mental health improved by 5.2 units (B:-5.2 [-9.7 to -0.7] P=0.025).
Conclusion
In this study, we found that elements of health literacy were associated with both physical and mental health status in octogenerians. These findings highlight the importance of adequate health literacy and the need to support those with lower health literacy following PCI.
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Affiliation(s)
- I Instenes
- Haukeland University Hospital, Department of Heart Disease , Bergen , Norway
| | - G Brors
- St Olavs Hospital, Clinic of Cardiology , Trondheim , Norway
| | - N Hjertvikrem
- Haukeland University Hospital, Department of Heart Disease , Bergen , Norway
| | - H Allore
- Yale School of Medicine, Department of Internal Medicine , New Haven , United States of America
| | - B Borregaard
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - C Deaton
- University of Cambridge School of Clinical Medicine, Department of Public Health and Primary Care , Cambridge , United Kingdom of Great Britain & Northern Ireland
| | - A I Larsen
- Stavanger University Hospital, Department of cardiology , Stavanger , Norway
| | - R Osborne
- Swinburne University of Technology, Centre for Global Health and Equity , Melbourne , Australia
| | - P Palm
- Copenhagen University Hospital, Department of Cardiology , Copenhagen , Denmark
| | - D R Thompson
- Queen's University of Belfast, School of Nursing and Midwifery , Belfast , United Kingdom of Great Britain & Northern Ireland
| | - T M Norekval
- Haukeland University Hospital, Department of Heart Disease , Bergen , Norway
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8
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Keestra S, Rodgers F, Osborne R, Wimmer S. University patenting and licensing practices in the United Kingdom during the first year of the COVID-19 pandemic. Glob Public Health 2022; 17:641-651. [PMID: 35298347 DOI: 10.1080/17441692.2022.2049842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Universities' decisions during technology transfer may affect affordability, accessibility, and availability of COVID-19 health technologies downstream. We investigated measures taken by the top 35 publicly funded UK universities to ensure global equitable access to COVID-19 health technologies between January and end of October 2020. We sent Freedom Of Information (FOI) requests and analysed universities' websites, to (i) assess institutional strategies on the patenting and licensing of COVID-19-related health technologies, (ii) identify all COVID-19-related health technologies licensed or patented and (iii) record whether universities engaged with the Open COVID pledge, COVID-19 Technology Access Pool (C-TAP), or Association of University Technology Managers (AUTM) COVID-19 licensing guidelines during the time period assessed. Except for the Universities of Oxford and Edinburgh, UK universities did not update their institutional strategies during the first year of the pandemic. Nine universities licensed 22 COVID-19 health technologies. Imperial College London disclosed ten patents relevant to COVID-19. No UK universities participated in the Open COVID Pledge or C-TAP, but discussions were ongoing in autumn 2020. The University of Bristol endorsed the AUTM guidelines. Despite important COVID-19 health technologies being developed by UK universities, our findings suggest minimal engagement with measures that may promote equitable access downstream. We suggest universities review their technology transfer policies and implement global equitable access strategies for COVID-19 health technologies. We furthermore propose that public and charitable funders can play a larger role in encouraging universities to adopt such practices by making access and transparency clauses a mandatory condition for receiving public funds for research.
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Affiliation(s)
- Sarai Keestra
- Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Florence Rodgers
- Royal Cornwall Hospital, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sabrina Wimmer
- Manchester University NHS Foundation Trust, Manchester, UK
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9
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Alexander M, Eissa M, McDermott-Levy R, Osborne R, Pleuss E, Prabhakaran P, Sorensen C. COP26: Looking forward from Glasgow by placing health at the center of climate action. J Clim Chang Health 2022; 5:None. [PMID: 35265938 PMCID: PMC8895507 DOI: 10.1016/j.joclim.2022.100117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Marcalee Alexander
- Sustain Our Abilities, United States
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham School of Medicine, United States
- Department of Physical Medicine and Rehabilitation, Harvard School of Medicine, United States
| | - Mohamed Eissa
- Liaison Officer for Public Health Issues, International Federation of Medical Students’ Associations, Denmark
| | - Ruth McDermott-Levy
- M. Louise Fitzpatrick College of Nursing, Villanova University, United States
| | - Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, United Kingdom
- Students for Global Health, United Kingdom
| | | | - Poornima Prabhakaran
- Head-Environmental Health and Additional Professor; Deputy Director, Centre for Environmental Health, Public Health Foundation of India, India
- Senior Research Scientist, Centre for Chronic Disease Control, India
| | - Cecilia Sorensen
- Global Consortium on Climate and Health Education, Columbia University, United States
- Department of Environmental Health Sciences, Mailman School of Public Health, United States
- Department of Emergency Medicine, Columbia University Irving Medical Center, United States
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10
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Guinto RR, Deivanayagam TA, Chuji PT, Hossan A, Jensen A, Jung L, Njuguna E, Osborne R, Otieno MA, Siddiqa A, Singh A, Taomia BKE. Achieving climate justice, safeguarding planetary health: Diagnosis and demands from next generation leaders for COP27 and beyond. PLOS Glob Public Health 2022; 2:e0001304. [PMID: 36962659 PMCID: PMC10021356 DOI: 10.1371/journal.pgph.0001304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Renzo R Guinto
- Planetary and Global Health Program, St. Luke's Medical Center College of Medicine-William H. Quasha Memorial, Quezon City, Philippines
- Sunway Centre for Planetary Health, Sunway University, Selangor, Malaysia
| | - Thilagawathi Abi Deivanayagam
- Institute for Global Health, University College London, London, United Kingdom
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Paccha Turner Chuji
- Faculty of Human, Social and Political Sciences, University of Cambridge, Cambridge, United Kingdom
| | - Azmal Hossan
- Department of Sociology, Colorado State University, Fort Collins, Colorado, United States of America
- Interdisciplinary Training, Education and Research in Food-Energy-Water Systems, Colorado State University, Fort Collins, Colorado, United States of America
| | - Anpotowin Jensen
- Department of Civil and Environmental Engineering, Stanford University, California, United States of America
| | - Laura Jung
- German Alliance on Climate Change and Health, Germany
- Leipzig University Hospital, Division of Infectious Diseases and Tropical Medicine, Leipzig, Germany
| | | | - Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- The People's Health Movement, Global and United Kingdom
| | - Melvine Anyango Otieno
- Planetary Health Eastern Africa Hub, Eldoret, Kenya
- Department of Environmental Biology and Health, University of Eldoret, Eldoret, Kenya
| | - Ayisha Siddiqa
- Fridays for Future MAPA
- Polluters Out and Fossil Free University
- Centre for Human Rights and Global Justice, New York University, New York, NY, United States of America
| | - Amiteshwar Singh
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Health for a Green New Deal, London, United Kingdom
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11
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MacLachlan H, Dhutia H, Bhatia R, Boden K, Forenc K, Basu J, Miles C, Osborne R, Chandra N, Malhotra A, Stuart G, Peirce N, Sharma S, Papadakis M. Results of a nationally implemented cardiac screening programme in elite cricket players in England and Wales. J Sci Med Sport 2021; 25:287-292. [PMID: 35016820 DOI: 10.1016/j.jsams.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES We assessed the diagnostic yield and costs of an electrocardiogram-based national screening programme in elite cricket players and the incremental value of transthoracic echocardiography and periodic evaluation. DESIGN Cross-sectional study. METHODS Between 2008 and 2019, 1208 cricketers underwent screening with a health questionnaire, 12-lead electrocardiogram and cardiology consultation. Athletes with concerning findings underwent on-site transthoracic echocardiography and further investigations as necessary. In addition, despite a normal health questionnaire and electrocardiogram, 342 (28.3%) athletes had a transthoracic echocardiogram and 493 (40.8%) underwent repeat evaluations. RESULTS After initial evaluation, 47 (3.9%) athletes underwent on-site transthoracic echocardiography of whom 35 (2.8%) were referred for further evaluation. Four athletes (0.3%) were diagnosed with major cardiac conditions; hypertrophic cardiomyopathy (n = 1), arrhythmogenic cardiomyopathy (n = 1) and Wolff-Parkinson-White pattern (n = 2). Two athletes were identified with minor valvular abnormalities. Repeat evaluation of 493 athletes identified hypertrophic cardiomyopathy in a 22-year-old athlete, two years after his initial normal screening. During a follow-up of 5.8 ± 2.9 years no additional diagnoses or adverse cardiac events were reported. The cost of the electrocardiogram-based programme was £127,844, translating to £106 per athlete and £25,569 per major cardiac condition identified.Routine transthoracic echocardiography in 342 athletes identified two athletes with major cardiac conditions (bicuspid aortic valve with severe aortopathy and aortic regurgitation and an atrial septal defect associated with right ventricular volume overload) and 10 athletes with minor abnormalities. CONCLUSIONS An electrocardiogram-based national screening programme identified a major cardiac condition in 0.3% of athletes. Routine transthoracic echocardiography and periodic evaluation increased the diagnostic yield to 0.6%, at an incremental cost.
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Affiliation(s)
- H MacLachlan
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - H Dhutia
- Department of Cardiology, Glenfield Hospital, United Kingdom
| | - R Bhatia
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - K Boden
- England and Wales Cricket Board and National Centre for Sports and Exercise Medicine and National Cricket Performance Centre, Loughborough University, United Kingdom
| | - K Forenc
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - J Basu
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - C Miles
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - R Osborne
- Cardiac Risk in the Young, United Kingdom
| | - N Chandra
- Department of Cardiology, Frimley Park Hospital, United Kingdom
| | - A Malhotra
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom
| | - G Stuart
- National Institute of Health Research Cardiovascular Biomedical Research Centre, Bristol Heart Institute, United Kingdom
| | - N Peirce
- England and Wales Cricket Board and National Centre for Sports and Exercise Medicine and National Cricket Performance Centre, Loughborough University, United Kingdom
| | - S Sharma
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom
| | - M Papadakis
- Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom.
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Cross S, Rho Y, Reddy H, Pepperrell T, Rodgers F, Osborne R, Eni-Olotu A, Banerjee R, Wimmer S, Keestra S. Who funded the research behind the Oxford-AstraZeneca COVID-19 vaccine? BMJ Glob Health 2021; 6:e007321. [PMID: 34937701 PMCID: PMC8704023 DOI: 10.1136/bmjgh-2021-007321] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/17/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19, Vaxzevira or Covishield) builds on two decades of research and development (R&D) into chimpanzee adenovirus-vectored vaccine (ChAdOx) technology at the University of Oxford. This study aimed to approximate the funding for the R&D of ChAdOx and the Oxford-AstraZeneca vaccine and to assess the transparency of funding reporting mechanisms. METHODS We conducted a scoping review and publication history analysis of the principal investigators to reconstruct R&D funding the ChAdOx technology. We matched award numbers with publicly accessible grant databases. We filed freedom of information (FOI) requests to the University of Oxford for the disclosure of all grants for ChAdOx R&D. RESULTS We identified 100 peer-reviewed articles relevant to ChAdOx technology published between January 2002 and October 2020, extracting 577 mentions of funding bodies from acknowledgements. Government funders from overseas (including the European Union) were mentioned 158 times (27.4%), the UK government 147 (25.5%) and charitable funders 138 (23.9%). Grant award numbers were identified for 215 (37.3%) mentions; amounts were publicly available for 121 (21.0%). Based on the FOIs, until December 2019, the biggest funders of ChAdOx R&D were the European Commission (34.0%), Wellcome Trust (20.4%) and Coalition for Epidemic Preparedness Innovations (17.5%). Since January 2020, the UK government contributed 95.5% of funding identified. The total identified R&D funding was £104 226 076 reported in the FOIs and £228 466 771 reconstructed from the literature search. CONCLUSION Our study approximates that public and charitable financing accounted for 97%-99% of identifiable funding for the ChAdOx vaccine technology research at the University of Oxford underlying the Oxford-AstraZeneca vaccine until autumn 2020. We encountered a lack of transparency in research funding reporting.
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Affiliation(s)
- Samuel Cross
- Faculty of Medicine, Imperial College London, London, UK
| | | | - Henna Reddy
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Toby Pepperrell
- School of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Florence Rodgers
- Royal Cornwall Hospital, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Rhiannon Osborne
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Rishi Banerjee
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Sabrina Wimmer
- Manchester University NHS Foundation Trust, Manchester, UK
- Department of Management, London School of Economics and Political Science, London, UK
| | - Sarai Keestra
- Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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13
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Osborne R. In September 2020, the World Health Organization called for 'equitable access to COVID-19 tools' which included 'the development, production and equitable access to COVID-19 tests, treatments and vaccines globally, while strengthening health systems'. What evidence is there of inequity of access so far in this pandemic? What is the role of national governments and of the WHO in this? Med Confl Surviv 2021; 37:187-196. [PMID: 34547947 DOI: 10.1080/13623699.2021.1969879] [Citation(s) in RCA: 1] [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: 10/20/2022]
Affiliation(s)
- Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Hicks-Roof K, Osborne R, McInnes D, Bush S, Osborne J, Harrison T, Braun M, Quartano J. Post-graduate Interprofessional Education Series (IPES): Insights from Dietetic Interns. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keestra SM, Rodgers F, Lenz D, Osborne R, Bruckner T, Lee S. Clinical trial reporting performance of thirty UK universities on ClinicalTrials.gov-evaluation of a new tracking tool for the US clinical trial registry. Trials 2021; 22:375. [PMID: 34074329 PMCID: PMC8169390 DOI: 10.1186/s13063-021-05330-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
Clinical trial transparency forms the foundation of evidence-based medicine, and trial sponsors, especially publicly funded institutions such as universities, have an ethical and scientific responsibility to make the results of clinical trials publicly available in a timely fashion. We assessed whether the thirty UK universities receiving the most Medical Research Council funding in 2017-2018 complied with World Health Organization best practices for clinical trial reporting on the US Clinical Trial Registry ( ClinicalTrials.gov ). Firstly, we developed and evaluated a novel automated tracking tool ( clinical-trials-tracker.com ) for clinical trials registered on ClinicalTrials.gov . This tracker identifies the number of due trials (whose completion lies more than 395 days in the past) that have not reported results on the registry and can now be used for all sponsors. Secondly, we used the tracker to determine the number of due clinical trials sponsored by the selected UK universities in October 2020. Thirdly, using the FDAAA Trials Tracker, we identified trials sponsored by these universities that are not complying with reporting requirements under the Food and Drug Administration Amendments Act 2007. Finally, we quantified the average and median number of days between primary completion date and results posting. In October 2020, the universities included in our study were sponsoring 1634 due trials, only 1.6% (n = 26) of which had reported results within a year of completion. 89.8% (n = 1468) of trials remained unreported, and 8.6% (n = 140) of trials reported results late. We also identified 687 trials that contained inconsistent data, suggesting that UK universities often fail to update their data adequately on ClinicalTrials.gov . The mean reporting delay after primary completion for trials that posted results was 981 days, the median 728 days. Only four trials by UK universities violated the FDAAA 2007. We suggest a number of reasons for the poor reporting performance of UK universities on ClinicalTrials.gov : (i) efforts to improve clinical trial reporting in the UK have to date focused on the European clinical trial registry (EU CTR), (ii) the absence of a tracking tool for timely reporting on ClinicalTrials.gov has limited the visibility of institutions' reporting performance on the US registry and (iii) there is currently a lack of repercussions for UK sponsors who fail to report results on ClinicalTrials.gov which should be addressed in the future.
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Affiliation(s)
- Sarai Mirjam Keestra
- Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK
- Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Daphne Lenz
- Department of Science, Technology and Society, University of Vienna, Vienna, Austria
| | - Rhiannon Osborne
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Till Bruckner
- BIH QUEST Center, Berlin, Germany
- TranspariMED, Bristol, UK
| | - Sean Lee
- Market Securities LLP, London, UK
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Bakker MM, Dikovec C, Putrik P, Rademakers J, Van de Laar M, Vonkeman H, Kok MR, Voorneveld H, Ramiro S, De Wit M, Buchbinder R, Batterham R, Osborne R, Boonen A. POS0299 SOCIOECONOMIC BACKGROUND IS ASSOCIATED WITH DISCORDANCE BETWEEN HEALTH LITERACY OF PEOPLE WITH RMDs AND ASSESSMENT OF HEALTH LITERACY BY THEIR TREATING HEALTH PROFESSIONAL. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Health literacy is increasingly recognised as a critical determinant of health. While care should be tailored to the health literacy needs of each patient [1], research in primary care shows that physicians often under- or overestimate their patients’ health literacy, with socioeconomic factors playing a role [2]. Evidence in a rheumatology setting is scarce.Objectives:-To investigate discordance between health literacy of patients with rheumatic and musculoskeletal diseases (RMDs) and assessment by their treating health professional, across the nine domains of the Health Literacy Questionnaire (HLQ).-To explore whether discordance is associated with the patient’s socioeconomic background.Methods:Patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), or gout from three Dutch outpatient rheumatology clinics completed the HLQ [3]. The treating health professional (rheumatologist, physician assistant, nurse (practitioner) or resident) assessed their patient’s level for each HLQ domain, or answered “I don’t know”. Discordance per domain was calculated as the patient’s score subtracted from the professional’s score (both on a 0-10 scale). Discordance was defined as a ≥2-point difference in either direction. Adjusted multilevel multinomial regression models (ref. = no discordance) with patients clustered by health professionals were computed to test the role of socioeconomic factors (age, gender, education level, immigration background, living alone and employment status) in negative (i.e. professional scored lower) and positive (i.e. professional scored higher) discordance.Results:Of 778 patients included, 41% had RA, 34% had SpA, and 25% had gout. We observed considerable discordance across all HLQ domains (Table 1). Professionals answered “I don’t know” most often for “Having social support for health” (19.4%, domain 4). Most discordance occurred for “Critically appraising information” (42.1%, domain 5). For all HLQ domains except “Having social support for health” (domain 4), discordance was associated with socioeconomic factors. In patients with a non-Western immigration background, professionals were likely to assign lower scores than patients’ HLQ scores in six domains. Education level was an important driver of discordance in seven domains, with the direction of the association being domain-dependent. Other factors associated with discordance in multiple domains were type of rheumatic disease, comorbidities, mastery, how well the professional knew the patient, type of professional, and disease impact.Table 1.Discordance per HLQ domain (n=778)HLQ domainProfessional scored lowerNo discordanceProfessional scored higherProfessional did not known (%)1. Healthcare provider support128 (16)514 (66)126 (16)10 (1)2. Having sufficient information100 (13)528 (68)143 (18)7 (1)3. Actively managing health95 (12)461 (59)208 (27)14 (2)4. Having social support for health55 (7)397 (51)175 (22)151 (19)5. Critically appraising information78 (10)448 (58)250 (32)2 (0)6. Actively engaging with providers205 (26)500 (64)70 (9)3 (0)7. Navigating the health system115 (15)544 (70)107 (14)12 (2)8. Finding health information163 (21)492 (63)98 (13)25 (3)9. Understanding health information145 (19)511 (66)110 (14)12 (2)Conclusion:Considerable discordance between patients’ health literacy and their treating health professionals’ assessment exists across health literacy domains. In eight out of nine domains, discordance was associated with the patient’s socioeconomic background, particularly education and immigration background. Understanding and addressing the reasons for discordance between patient-reported and professional-perceived health literacy has potential to improve responsiveness to patients’ needs, promote better communication and ultimately improve care outcomes.References:[1]Bakker et al., Arthrit Care Res (2021)[2]Storms et al., BMJ Open (2019)[3]Osborne et al., BMC Public Health (2013)Disclosure of Interests:None declared
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Hicks-Roof K, Osborne R. A Baseline Perspective from Different Healthcare Professional Residents of Interprofessional Collaboration. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bakker M, Putrik P, Rademakers J, Van de Laar M, Vonkeman H, Kok MR, Voorneveld H, Ramiro S, De Wit M, Osborne R, Batterham R, Buchbinder R, Boonen A. OP0257-PARE USING PATIENT HEALTH LITERACY PROFILES TO IDENTIFY SOLUTIONS TO CHALLENGES FACED IN RHEUMATOLOGY CARE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The prevalence of limited health literacy (i.e. cognitive and social resources of individuals to access, understand and apply health information to promote and maintain good health) in the Netherlands is estimated to be over 36% [1]. Access to and outcomes of rheumatological care may be compromised by limited patient health literacy, yet little is known about how to address this, thus action is required. As influencing individual patients’ health literacy in the rheumatology context is often unrealistic, it is paramount for the health system to be tailored to the health literacy needs of its patients. The OPtimising HEalth LIteracy and Access (Ophelia) process offers a method to inform system change [2].Objectives:Following the Ophelia approach:a. Identify health literacy profiles reflecting strengths and weaknesses of outpatients with RA, SpA and gout.b. Use the health literacy profiles to facilitate discussions on challenges for patients and professionals in rheumatological care and identify possible solutions the health system could offer to address these challenges.Methods:Patients with RA, SpA and gout attending outpatient clinics in three centres in the Netherlands completed the Health Literacy Questionnaire (HLQ) and questions on socio-demographic and health-related characteristics. Hierarchical cluster analysis using Ward’s method identified clusters based on the nine HLQ domains. Three researchers jointly examined 24 cluster solutions for meaningfulness by interpreting HLQ domain scores and patient characteristics. Meaningful clusters were translated into health literacy profiles using HLQ patterns and demographic data. A patient research partner confirmed the identified profiles. Patient vignettes were designed by combining cluster analyses results with qualitative patient interviews. The vignettes were used in two two-hour co-design workshops with rheumatologists and nurses to discuss their perspective on health literacy-related challenges for patients and professionals, and generate ideas on how to address these challenges.Results:In total, 895 patients participated: 49% female, mean age 61 years (±13.0), 25% lived alone, 18% had a migrant background, 6.6% did not speak Dutch at home and 51% had low levels of education. Figure 1 shows a heat map of identified health literacy profiles, displaying the score distribution per profile across nine health literacy domains. Figure 2 shows an excerpt of a patient vignette, describing challenges for a patient with profile number 9. The workshops were attended by 7 and 14 nurses and rheumatologists. Proposed solutions included health literacy communication training for professionals, developing and improving (visual) patient information materials, peer support for patients through patient associations or group consultations, a clear referral system for patients who need additional guidance by a nurse, social worker, lifestyle coach, pharmacist or family doctor, and more time with rheumatology nurses for target populations. Moreover, several system adaptations to the clinic, such as a central desk for all patient appointments, were proposed.Conclusion:This study identified several distinct health literacy profiles of patients with rheumatic conditions. Engaging with health professionals in co-design workshops led to numerous bottom-up ideas to improve care. Next steps include co-design workshops with patients, followed by prioritising and testing proposed interventions.References:[1]Heijmans M. et al. Health Literacy in the Netherlands. Utrecht: Nivel 2018[2]Batterham R. et al. BMC Public Health 2014, 14:694Disclosure of Interests:Mark Bakker: None declared, Polina Putrik: None declared, Jany Rademakers Speakers bureau: In March 2017, Prof. Dr. Rademakers was invited to speak about health literacy at the “Heuvellanddagen” Conference, hosted by Janssen-Cilag., Mart van de Laar Consultant of: Sanofi Genzyme, Speakers bureau: Sanofi Genzyme, Harald Vonkeman: None declared, Marc R Kok Grant/research support from: BMS and Novartis, Consultant of: Novartis and Galapagos, Hanneke Voorneveld: None declared, Sofia Ramiro Grant/research support from: MSD, Consultant of: Abbvie, Lilly, Novartis, Sanofi Genzyme, Speakers bureau: Lilly, MSD, Novartis, Maarten de Wit Grant/research support from: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Consultant of: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Speakers bureau: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Richard Osborne Consultant of: Prof. Osborne is a paid consultant for pharma in the field of influenza and related infectious diseases., Roy Batterham: None declared, Rachelle Buchbinder: None declared, Annelies Boonen Grant/research support from: AbbVie, Consultant of: Galapagos, Lilly (all paid to the department)
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Larsen M, Strumse Y, Borge C, Osborne R, Andersen M, Wahl A. 银屑病护理中的健康素养. Br J Dermatol 2019. [DOI: 10.1111/bjd.17974] [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: 11/28/2022]
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Larsen M, Strumse Y, Borge C, Osborne R, Andersen M, Wahl A. Health literacy: a new piece of the puzzle in psoriasis care? A cross‐sectional study. Br J Dermatol 2019; 180:1506-1516. [DOI: 10.1111/bjd.17595] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2018] [Indexed: 12/26/2022]
Affiliation(s)
- M.H. Larsen
- Department of Health Sciences Institute of Health and Society Faculty of Medicine University of Oslo OsloNorway
| | - Y.A.S. Strumse
- Section for Climate Therapy Oslo University Hospital Oslo Norway
| | - C.R. Borge
- Department of Health Sciences Institute of Health and Society Faculty of Medicine University of Oslo OsloNorway
- Department of Patient Safety and Research at Lovisenberg Diaconal Hospital OsloNorway
| | - R. Osborne
- Deakin University Faculty of Health School of Health and Social Development Geelong VICAustralia
| | - M.H. Andersen
- Department of Health Sciences Institute of Health and Society Faculty of Medicine University of Oslo OsloNorway
- Department of Transplantation Medicine Oslo University Hospital Oslo Norway
| | - A.K. Wahl
- Department of Health Sciences Institute of Health and Society Faculty of Medicine University of Oslo OsloNorway
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, Cullen K, Johnson P, Parrimon Y, Hampton M, McCarrell C, Curtis E, Paul, Zambrano Y, Paulus K, Pilger J, Ramiro J, Luvon Ritzie AQ, Sharma A, Shor A, Song X, Terry A, Weinberger J, Wootten M, Lachin JM, Foulkes M, Harding P, Krause-Steinrauf H, McDonough S, McGee PF, Owens Hess K, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Leschek E, Spain L, Savage P, Aas S, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Vigersky R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Veatch R, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Leschek E, Marks J, Matheson D, Rafkin L, Rodriguez H, Spain L, Wilson D, Redondo M, Gomez D, McDonald A, Pena S, Pietropaolo M, Shippy K, Batts E, Brown T, Buckner J, Dove A, Hammond M, Hefty D, Klein J, Kuhns K, Letlau M, Lord S, McCulloch-Olson M, Miller L, Nepom G, Odegard J, Ramey M, Sachter E, St. Marie M, Stickney K, VanBuecken D, Vellek B, Webber C, Allen L, Bollyk J, Hilderman N, Ismail H, Lamola S, Sanda S, Vendettuoli H, Tridgell D, Monzavi R, Bock M, Fisher L, Halvorson M, Jeandron D, Kim M, Wood J, Geffner M, Kaufman F, Parkman R, Salazar C, Goland R, Clynes R, Cook S, Freeby M, Pat Gallagher M, Gandica R, Greenberg E, Kurland A, Pollak S, Wolk A, Chan M, Koplimae L, Levine E, Smith K, Trast J, DiMeglio L, Blum J, Evans-Molina C, Hufferd R, Jagielo B, Kruse C, Patrick V, Rigby M, Spall M, Swinney K, Terrell J, Christner L, Ford L, Lynch S, Menendez M, Merrill P, Pescovitz M, Rodriguez H, Alleyn C, Baidal D, Fay S, Gaglia J, Resnick B, Szubowicz S, Weir G, Benjamin R, Conboy D, deManbey A, Jackson R, Jalahej H, Orban T, Ricker A, Wolfsdorf J, Zhang HH, Wilson D, Aye T, Baker B, Barahona K, Buckingham B, Esrey K, Esrey T, Fathman G, Snyder R, Aneja B, Chatav M, Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Prosser RS, de Solla SR, Holman EAM, Osborne R, Robinson SA, Bartlett AJ, Maisonneuve FJ, Gillis PL. Sensitivity of the early-life stages of freshwater mollusks to neonicotinoid and butenolide insecticides. Environ Pollut 2016; 218:428-435. [PMID: 27450416 DOI: 10.1016/j.envpol.2016.07.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/06/2016] [Accepted: 07/09/2016] [Indexed: 05/03/2023]
Abstract
Neonicotinoid insecticides can be transported from agricultural fields, where they are used as foliar sprays or seed treatments, to surface waters by surface or sub-surface runoff. Few studies have investigated the toxicity of neonicotinoid or the related butenolide insecticides to freshwater mollusk species. The current study examined the effect of neonicotinoid and butenolide exposures to the early-life stages of the ramshorn snail, Planorbella pilsbryi, and the wavy-rayed lampmussel, Lampsilis fasciola. Juvenile P. pilsbryi were exposed to imidacloprid, clothianidin, or thiamethoxam for 7 or 28 d and mortality, growth, and biomass production were measured. The viability of larval (glochidia) L. fasciola was monitored during a 48 h exposure to six neonicotinoids (imidacloprid, thiamethoxam, clothianidin, acetamiprid, thiacloprid, or dinotefuran), or a butenolide (flupyradifurone). The 7-d LC50s of P. pilsbryi for imidacloprid, clothianidin, and thiamethoxam were ≥4000 μg/L and the 28-d LC50s were ≥182 μg/L. Growth and biomass production were considerably more sensitive endpoints than mortality with EC50s ranging from 33.2 to 122.0 μg/L. The 48-h LC50s for the viability of glochidia were ≥456 μg/L for all seven insecticides tested. Our data indicate that neonicotinoid and butenolide insecticides pose less of a hazard with respect to mortality of the two species of mollusk compared to the potential hazard to other non-target aquatic insects.
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Affiliation(s)
- R S Prosser
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada.
| | - S R de Solla
- Environment and Climate Change Canada, Ecotoxicology and Wildlife Health Division, Burlington, Ontario, Canada
| | - E A M Holman
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - R Osborne
- University of Waterloo, Department of Biology, Waterloo, Ontario, Canada
| | - S A Robinson
- Environment and Climate Change Canada, Ecotoxicology and Wildlife Health Division, Ottawa, Ontario, Canada
| | - A J Bartlett
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
| | - F J Maisonneuve
- Environment and Climate Change Canada, Ecotoxicology and Wildlife Health Division, Ottawa, Ontario, Canada
| | - P L Gillis
- Environment and Climate Change Canada, Aquatic Contaminants Research Division, Burlington, Ontario, Canada
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Heijmans M, Waverijn G, Rijken M, Osborne R, Rademakers J. Using health literacy profiles to tailor interventions to the needs of chronic disease patients. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv168.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Martinez-Garcia E, Taibjee S, Koch D, Osborne R. Vemurafenib-induced hyperkeratosis of the areola treated with topical adapelene. Clin Exp Dermatol 2015; 41:148-51. [DOI: 10.1111/ced.12606] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - D. Koch
- Dorset County Hospital; Dorchester UK
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26
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Lorigan P, Marples M, Harries M, Wagstaff J, Dalgleish A, Osborne R, Maraveyas A, Nicholson S, Davidson N, Wang Q, Pericleous L, Bapat U, Middleton M. Treatment patterns, outcomes, and resource utilization of patients with metastatic melanoma in the U.K.: the MELODY study. Br J Dermatol 2014; 170:87-95. [DOI: 10.1111/bjd.12503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2013] [Indexed: 12/26/2022]
Affiliation(s)
- P. Lorigan
- Christie NHS Foundation Trust; Wilmslow Road Manchester M20 4BX U.K
| | - M. Marples
- St James's Institute of Oncology; Leeds U.K
| | - M. Harries
- Guy's and St Thomas' Hospital; London U.K
| | | | | | | | | | - S. Nicholson
- University Hospitals of Leicester; Leicester U.K
| | | | - Q. Wang
- Bristol-Myers Squibb Pharmaceuticals; Uxbridge U.K
| | | | - U. Bapat
- Bristol-Myers Squibb Pharmaceuticals; Uxbridge U.K
| | - M.R. Middleton
- Oxford NIHR Biomedical Research Centre; Churchill Hospital; Oxford U.K
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27
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Osborne R, Carver RS, Mullins LA, Finlay DR. Practical application of cellular bioenergetics to the care of aged skin. Br J Dermatol 2014; 169 Suppl 2:32-8. [PMID: 23786618 DOI: 10.1111/bjd.12439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2013] [Indexed: 12/01/2022]
Abstract
In human skin fibroblasts in vitro, procollagen-1 and NAD(+)/NADH were reduced in three strains of adult fibroblasts compared with neonatal fibroblasts. The levels of both procollagen-1 and NAD(+)/NADH were increased in the adult fibroblasts by treatment for 24 (NAD energy) or 48 h (procollagen-1) with a complex containing niacinamide, Pal-KTTKS peptide and an olive oil fatty acid derivative (Olivem(®)), especially in combination with a natural extract from dill (Lys'lastine V(®)). In one of the adult fibroblast strains evaluated, these changes in procollagen-1 and NAD(+)/NADH in response to the complex of bioactives were in parallel with increased expression of mRNA biomarkers related primarily to dermal matrix and basement membrane structure, including COL1A1, COL3A1, COL5A1, COL14A1, ELN and LOXL2, in addition to SOD2, NAMPT and TGFBR3; MMP1 was decreased in expression. In general, these mRNA biomarker effects were maintained or boosted by the addition of Lys'lastine V, particularly at 1%, and were similar to the fold changes in mRNA expression in neonatal compared with adult fibroblasts. These results indicate that the complex of niacinamide, Pal-KTTKS and Olivem, especially with addition of Lys'lastine V, increases the NAD(+)/NADH bioenergy level of adult skin fibroblasts in parallel with increased expression of skin structure biomarkers in vitro to levels similar to those in younger fibroblasts. Thus, niacinamide, Pal-KTTKS, Olivem and Lys'lastine V are promising bioactive candidates for inclusion in cosmetic formulations.
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Affiliation(s)
- R Osborne
- The Procter & Gamble Company, Mason Business Center, 8700 Mason-Montgomery Road, Mason, OH 45040-8006, USA.
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28
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Yi JS, Guidon A, Sparks S, Osborne R, Juel VC, Massey JM, Sanders DB, Weinhold KJ, Guptill JT. Characterization of CD4 and CD8 T cell responses in MuSK myasthenia gravis. J Autoimmun 2013; 52:130-8. [PMID: 24378287 DOI: 10.1016/j.jaut.2013.12.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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: 06/29/2013] [Accepted: 12/08/2013] [Indexed: 01/22/2023]
Abstract
Muscle specific tyrosine kinase myasthenia gravis (MuSK MG) is a form of autoimmune MG that predominantly affects women and has unique clinical features, including prominent bulbar weakness, muscle atrophy, and excellent response to therapeutic plasma exchange. Patients with MuSK MG have predominantly IgG4 autoantibodies directed against MuSK on the postsynaptic muscle membrane. Lymphocyte functionality has not been reported in this condition. The goal of this study was to characterize T cell responses in patients with MuSK MG. Intracellular production of IFN-gamma, TNF-alpha, IL-2, IL-17, and IL-21 by CD4+ and CD8+ T cells was measured by polychromatic flow cytometry in peripheral blood samples from 11 Musk MG patients and 10 healthy controls. Only one MuSK MG patient was not receiving immunosuppressive therapy. Regulatory T cells (Treg) were also included in our analysis to determine if changes in T cell function were due to altered Treg frequencies. CD8+ T cells from MuSK MG patients had higher frequencies of polyfunctional responses than controls, and CD4+ T cells had higher IL-2, TNF-alpha, and IL-17. MuSK MG patients had a higher percentage of CD4+ T cells producing combinations of IFN-gamma/IL-2/TNF-gamma, TNF-alpha/IL-2, and IFN-gamma/TNF-alpha. Interestingly, Treg numbers and CD39 expression were not different from control values. MuSK MG patients had increased frequencies of Th1 and Th17 cytokines and were primed for polyfunctional proinflammatory responses that cannot be explained by a defect in CD39 expression or Treg number.
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Affiliation(s)
- J S Yi
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, 204 SORF (Bldg. 41), 915 S. LaSalle Street, Box 2926, Durham, NC 27710, USA
| | - A Guidon
- Neuromuscular Division, Department of Neurology, Duke University Medical Center, DUMC Box 3403, Durham, NC 27710, USA
| | - S Sparks
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, 204 SORF (Bldg. 41), 915 S. LaSalle Street, Box 2926, Durham, NC 27710, USA
| | - R Osborne
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, 204 SORF (Bldg. 41), 915 S. LaSalle Street, Box 2926, Durham, NC 27710, USA
| | - V C Juel
- Neuromuscular Division, Department of Neurology, Duke University Medical Center, DUMC Box 3403, Durham, NC 27710, USA
| | - J M Massey
- Neuromuscular Division, Department of Neurology, Duke University Medical Center, DUMC Box 3403, Durham, NC 27710, USA
| | - D B Sanders
- Neuromuscular Division, Department of Neurology, Duke University Medical Center, DUMC Box 3403, Durham, NC 27710, USA
| | - K J Weinhold
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, 204 SORF (Bldg. 41), 915 S. LaSalle Street, Box 2926, Durham, NC 27710, USA
| | - J T Guptill
- Neuromuscular Division, Department of Neurology, Duke University Medical Center, DUMC Box 3403, Durham, NC 27710, USA.
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Reade C, Osborne R, Shah N, Eiriksson L, Dodge J, Moens F, Goeree R. Treatment of low-risk gestational trophoblastic neoplasia: A probabilistic decision analysis model. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Johnston D, Osborne R, Kuhrt K. A report from Biopharm America 2013 - Sixth Annual International Partnering Conference (September 16-19, 2013 - Boston, Massachusetts, USA). Drugs Today (Barc) 2013; 49:739-44. [DOI: 10.1358/dot.2013.49.11.2089531] [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: 10/25/2022]
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31
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Pham A, Kung R, Liu G, Osborne R, Souvran L, Murphy K, Rahmani R. Laparoscopic Ovarian Cystectomy at 25 Weeks Gestation. J Minim Invasive Gynecol 2012. [DOI: 10.1016/j.jmig.2012.08.754] [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: 10/27/2022]
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32
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Southee JA, McPherson JP, Osborne R, Carr GJ, Rasmussen E. The Performance of the Tissue Equivalent Assay using the Skin(2)(TM) ZK1200 Model in the COLIPA International Validation Study on Alternatives to the Draize Eye Irritation Test. Toxicol In Vitro 2012; 13:355-73. [PMID: 20654493 DOI: 10.1016/s0887-2333(98)00083-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The tissue equivalent assay (TEA) (Osborne et al., 1995) was used to evaluate 55 mixed ingredients and formulations in the COLIPA International Validation Study on Alternatives to the Draize Rabbit Eye Irritation Test (Brantom et al., 1997). The TEA can be used to test all types of materials since it uses a topical application approach and is not limited to only testing liquid or soluble materials. A prediction model (PM) for the test was developed using historical eye irritation data from a total of 132 materials on which in vivo and in vitro data were available. A regression model was derived from these data and used to relate the in vitro endpoint (t(50)) obtained in the study to a Draize MMAS (modified maximum average score). This provided a measure of the predicted in vivo eye irritation scores. In the current study, two separate laboratories used the same protocol to test the same set of coded materials and the results of both laboratories were compared to the initial PM. The TEA met the reliability criteria of the validation study in reproducing the predefined PM in both laboratories, and a good relationship between predicted and observed Draize MMAS values was obtained (r=0.906 and r=0.850). Good correlations were maintained when separate analyses were made of the formulations and ingredients included in the test set. Good relationships between the in vitro endpoint and individual Draize tissue scores (r>0.8) were also exhibited. Although insufficient data were available to make an assessment of interlaboratory variation, some difference in the reproducibility of the assay was noted between the two laboratories, particularly for the highly irritating materials. However, the consistency of data was encouraging and the discrepancies seen between the laboratories suggested a sensitivity of the model to subtle differences in application techniques, and in handling and timing. Taken together, these results indicate the utility of the TEA test for these types of substances and the need to more fully address the issue of interlaboratory reproducibility.
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Affiliation(s)
- J A Southee
- Microbiological Associates Ltd, Stirling University Innovation Park, Stirling, Scotland UK
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33
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Kimball A, Grant R, Wang F, Osborne R, Tiesman J. Beyond the blot: cutting edge tools for genomics, proteomics and metabolomics analyses and previous successes. Br J Dermatol 2012; 166 Suppl 2:1-8. [DOI: 10.1111/j.1365-2133.2012.10859.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Osborne R, Hakozaki T, Laughlin T, Finlay D. Application of genomics to breakthroughs in the cosmetic treatment of skin ageing and discoloration. Br J Dermatol 2012; 166 Suppl 2:16-9. [DOI: 10.1111/j.1365-2133.2012.10960.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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35
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Allender S, Osborne R, Bowen S, Shiell A, Hawe P, Swinburn B. Measuring the ‘system’ in whole of system approaches to obesity prevention. Obes Res Clin Pract 2011. [DOI: 10.1016/j.orcp.2011.08.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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36
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Greco FA, Oien K, Erlander M, Osborne R, Varadhachary G, Bridgewater J, Cohen D, Wasan H. Cancer of unknown primary: progress in the search for improved and rapid diagnosis leading toward superior patient outcomes. Ann Oncol 2011; 23:298-304. [PMID: 21709138 DOI: 10.1093/annonc/mdr306] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This paper explores the enigma of cancer of unknown primary (CUP) in relation to rapidly improving molecular diagnostic approaches. It is based on the first global collaboration meeting on improving research and clinical outcomes in CUP organized by the CUP Foundation. We review the difficulties of classifying this widely heterogeneous disease and the available diagnostic and pathological evaluative techniques, focusing on molecular profiling. Retrospective studies in CUP patients are shown to provide indirect validation of the accuracy of several platforms of gene expression profiling assays that may identify CUP subsets that respond favorably to active chemotherapy regimens. This review concludes that the recent major improvements in pathologic and molecular diagnostics, coupled with new improved therapies for several specific advanced solid tumors, need to be harmonized with more evidence from clinical-translational trials. All patients with CUP could thus be appropriately managed without the constant uncertainty that has previously severely hampered patient care and optimal outcomes. The longer-term objective is to understand the biology of highly metastatic disease, leading to the development of future global therapeutic programs. Current clinical studies, such as CUP-ONE, will address some of these issues.
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Affiliation(s)
- F A Greco
- Department of Internal Medicine, Section of Medical Oncology, Sarah Cannon Cancer Center and Research Institute, Nashville 37203, USA.
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37
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Zweifel M, Jayson GC, Reed NS, Osborne R, Hassan B, Ledermann J, Shreeves G, Poupard L, Lu SP, Balkissoon J, Chaplin DJ, Rustin GJS. Phase II trial of combretastatin A4 phosphate, carboplatin, and paclitaxel in patients with platinum-resistant ovarian cancer. Ann Oncol 2011; 22:2036-2041. [PMID: 21273348 DOI: 10.1093/annonc/mdq708] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A previous dose-escalation trial of the vascular disrupting agent combretastatin A4 phosphate (CA4P) given before carboplatin, paclitaxel, or both showed responses in 7 of 18 patients with relapsed ovarian cancer. PATIENTS AND METHODS Patients with ovarian cancer that had relapsed and who could start trial therapy within 6 months of their last platinum chemotherapy were given CA4P 63 mg/m(2) minimum 18 h before paclitaxel 175 mg/m(2) and carboplatin AUC (area under the concentration curve) 5, repeated every 3 weeks. RESULTS Five of the first 18 patients' disease responded, so the study was extended and closed after 44 patients were recruited. Grade ≥2 toxic effects were neutropenia in 75% and thrombocytopenia in 9% of patients (weekly blood counts), tumour pain, fatigue, and neuropathy, with one patient with rapidly reversible ataxia. Hypertension (23% of patients) was controlled by glyceryl trinitrate or prophylactic amlodipine. The response rate by RECIST was 13.5% and by Gynecologic Cancer InterGroup CA 125 criteria 34%. CONCLUSIONS The addition of CA4P to paclitaxel and carboplatin is well tolerated and appears to produce a higher response rate in this patient population than if the chemotherapy was given without CA4P. A planned randomised trial will test this hypothesis.
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Affiliation(s)
- M Zweifel
- Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood
| | - G C Jayson
- School of Cancer and Enabling Sciences, University of Manchester & Christie Hospital, Manchester
| | - N S Reed
- Beatson Oncology Centre, Western Infirmary, Glasgow
| | - R Osborne
- Dorset Cancer Centre, Poole Hospital NHS Foundation Trust, Poole
| | - B Hassan
- Department of Medical Oncology, Churchill Hospital, Oxford
| | - J Ledermann
- UCL Cancer Institute, Cancer Research UK & University College of London Cancer Trials Centre, London, UK
| | - G Shreeves
- Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood
| | - L Poupard
- Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood
| | - S-P Lu
- OXiGENE Inc., San Francisco, USA
| | | | | | - G J S Rustin
- Department of Medical Oncology, Mount Vernon Cancer Centre, Northwood.
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Dubé V, Chun K, Osborne R, Sherman C, Nofech-Mozes S, Ismiil N, Saad R, Khalifa M. Androgenetic complete mole with trisomy 13: Report of a case with microsatellite genotyping and review of the literature. Pathol Res Pract 2010; 206:776-81. [DOI: 10.1016/j.prp.2010.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 02/08/2010] [Accepted: 02/25/2010] [Indexed: 11/28/2022]
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39
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Kallmes D, Buchbinder R, Jarvik J, Heagerty P, Comstock B, Turner J, Osborne R. Response to "randomized vertebroplasty trials: bad news or sham news?". AJNR Am J Neuroradiol 2009; 30:1809-10. [PMID: 19815617 DOI: 10.3174/ajnr.a1887] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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40
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Valle JW, Wasan H, Johnson P, Jones E, Dixon L, Swindell R, Baka S, Maraveyas A, Corrie P, Falk S, Gollins S, Lofts F, Evans L, Meyer T, Anthoney A, Iveson T, Highley M, Osborne R, Bridgewater J. Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study - The UK ABC-01 Study. Br J Cancer 2009; 101:621-7. [PMID: 19672264 PMCID: PMC2736816 DOI: 10.1038/sj.bjc.6605211] [Citation(s) in RCA: 197] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Revised: 06/24/2009] [Accepted: 07/03/2009] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We assessed the activity of gemcitabine (G) and cisplatin/gemcitabine (C/G) in patients with locally advanced (LA) or metastatic (M) (advanced) biliary cancers (ABC) for whom there is no standard chemotherapy. METHODS Patients, aged > or =18 years, with pathologically confirmed ABC, Karnofsky performance (KP) > or =60, and adequate haematological, hepatic and renal function were randomised to G 1000 mg m(-2) on D1, 8, 15 q28d (Arm A) or C 25 mg m(-2) followed by G 1000 mg m(-2) D1, 8 q21d (Arm B) for up to 6 months or disease progression. RESULTS In total, 86 patients (A/B, n=44/42) were randomised between February 2002 and May 2004. Median age (64/62.5 years), KP, primary tumour site, earlier surgery, indwelling biliary stent and disease stage (LA: 25/38%) are comparable between treatment arms. Grade 3-4 toxicity included (A/B, % patients) anaemia (4.5/2.4), leukopenia (6.8/4.8), neutropenia (13.6/14.3), thrombocytopenia (9.1/11.9), lethargy (9.1/28.6), nausea/vomiting (0/7.1) and anorexia (2.3/4.8). Responses (WHO criteria, % of evaluable patients: A n=31 vs B n=36): no CRs; PR 22.6 vs 27.8%; SD 35.5 vs 47.1% for a tumour control rate (CR+PR+SD) of 58.0 vs 75.0%. The median TTP and 6-month progression-free survival (PFS) (the primary end point) were greater in the C/G arm (4.0 vs 8.0 months and 45.5 vs 57.1% in arms A and B, respectively). CONCLUSION Both regimens seem active in ABC. C/G is associated with an improved tumour control rate, TTP and 6-month PFS. The study has been extended (ABC-02 study) and powered to determine the effect on overall survival and the quality of life.
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Affiliation(s)
- J W Valle
- Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
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41
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Zweifel M, Jayson G, Reed N, Osborne R, Hassan B, Shreeves G, Poupard L, Walicke PA, Balkissoon J, Chaplin D, Rustin G. Combretastatin A-4 phosphate (CA4P) carboplatin and paclitaxel in patients with platinum-resistant ovarian cancer: Final phase II trial results. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5502 Background: CA4P is a vascular disrupting agent that in pre-clinical models can increase the efficacy of a variety of therapies. A dose escalation trial of CA4P given prior to carboplatin, paclitaxel or both showed the combination was well tolerated and responses were seen in several tumor types including 6/17 with relapsed ovarian cancer. The trial was therefore extended into a phase II trial in patients with platinum resistant ovarian cancer. Methods: Patients with ovarian cancer that had relapsed and could start trial therapy within 6 months of their last platinum chemotherapy were given CA4P 63mg/m2 18–20 hours prior to paclitaxel 175mg/m2 and carboplatin AUC 5 repeated 3 weekly. If > 2 responses were seen in first 18 patients 43 patients were to be treated to confirm response rate>19%. Results: Five of the first 18 patients responded so the study was extended and closed after 44 patients were recruited, with full data available to date on 34. Weekly blood counts have demonstrated grade 3/4 neutropenia in 11 and thrombocytopenia in only 1 patient. Other grade > 2 toxicity seen in > 1 patient was fatigue, nausea / vomiting, pain, alopecia, rapidly reversible ataxia, diarrhoea, neuropathy and was little different to what would be expected with paclitaxel and carboplatin. Hypertension is the commonest CA4P related toxicity and was easily controlled by GTN, then prophylactic amlodipine. Responses according to GCIG criteria, have been seen in 11/34 (32%) patients with an additional unconfirmed PR. Conclusions: The addition of CA4P to paclitaxel and carboplatin is well tolerated and appears to produce a higher response rate in this patient population than if the chemotherapy was given without CA4P. A planned randomised trial will hopefully confirm this. [Table: see text]
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Affiliation(s)
- M. Zweifel
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - G. Jayson
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - N. Reed
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - R. Osborne
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - B. Hassan
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - G. Shreeves
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - L. Poupard
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - P. A. Walicke
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - J. Balkissoon
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - D. Chaplin
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
| | - G. Rustin
- Mount Vernon Cancer Centre, Middlesex, United Kingdom; Christie Hospital, Manchester, United Kingdom; Beatson Cancer Centre, Glasgow, United Kingdom; Dorset Cancer Centre, Poole, United Kingdom; Churchill Hospital, Oxford, United Kingdom; Oxigene Inc, Waltham, MA
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Battersby M, Hoffmann S, Cadilhac D, Osborne R, Lalor E, Lindley R. ‘Getting your Life Back on Track after Stroke’: A Phase II Multi-Centered, Single-Blind, Randomized, Controlled Trial of the Stroke Self-Management Program Vs. the Stanford Chronic Condition Self-Management Program or Standard Care in Stroke Survivors. Int J Stroke 2009; 4:137-44. [DOI: 10.1111/j.1747-4949.2009.00261.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Self-management is seen as a primary mechanism to support the optimization of care for people with chronic diseases such as symptomatic vascular disease. There are no established and evidence-based stroke-specific chronic disease self-management programs. Our aim is to evaluate whether a stroke-specific program is safe and feasible as part of a Phase II randomized-controlled clinical trial. Methods Stroke survivors are recruited from a variety of sources including: hospital stroke services, local paper advertisements. Stroke South Australia newsletter (volunteer peer support organization), Divisions of General Practice, and community service providers across Adelaide, South Australia. Subjects are invited to participate in a multi-center, single-blind, randomized, controlled trial. Eligible participants are randomized to either; standard care, standard care plus a six week generic chronic condition self-management group education program, or, standard care plus an eight week stroke specific self-management education group program. Interventions are conducted after discharge from hospital. Participants are assessed at baseline, immediate post intervention and six months. Study Outcomes The primary outcome measures determine study feasibility and safety, measuring, recruitment, participation, compliance and adverse events. Secondary outcomes include: positive and active engagement in life measured by the Health Education Impact Questionnaire, improvements in quality of life measured by the Assessment of Quality of Life instrument, improvements in mood measured by the Irritability, Depression and Anxiety Scale, health resource utilization measured by a participant held diary and safety. Conclusion The results of this study will determine whether a definitive Phase III efficacy trial is justified.
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Affiliation(s)
- M. Battersby
- Flinders Human Health and Behaviour
Research Unit, Flinders University, Margaret Tobin Centre, Bedford Park, SA, Australia
| | - S. Hoffmann
- National Stroke Foundation,
Melbourne, Vic., Australia
| | - D. Cadilhac
- Public Health Division, Repatriation
Hospital, Austin Health, Melbourne, Vic., Australia
| | - R. Osborne
- Centre for Rheumatic Diseases,
Department of Medicine (RMH/WH), The University of Melbourne, Melbourne, Vic.,
Australia
| | - E. Lalor
- National Stroke Foundation,
Melbourne, Vic., Australia
| | - R. Lindley
- Department of Geriatric Medicine,
Westmead Hospital, Westmead, NSW, Australia
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Neale R, Keane F, Saulsbury N, Haddon L, Osborne R. Who attends primary care services prior to attendance at genitourinary services and what level of care have they received? Sex Transm Infect 2008; 84:233-4. [PMID: 18283092 DOI: 10.1136/sti.2007.028498] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the proportion of patients initially attending primary care services and describe the care received prior to attending genitourinary medicine (GUM) clinics. METHOD A cross-sectional survey of 1000 new patients attending GUM services in Cornwall between June and December 2006. Patients were asked during consultation whether they had attended primary care before coming and what examination, investigation and management had been carried out there. RESULTS 35% (348/1000) of patients had attended primary care initially. Genital examination had been carried out in primary care on 60% (111/185) female and 58% (93/159) male patients (p = 0.78). Chlamydia testing had been carried out in 27% (46/171) female and 6% (8/139) male patients (p<0.005). 33% (100/301) patients seen in primary care had been offered treatment. 74% (68/92) patients with genital warts had been correctly diagnosed in primary care and 9% (8/92) of these offered treatment. CONCLUSIONS The majority of these patients, including those given a diagnosis and/or offered treatment in primary care, had not had a chlamydia test or any other investigations. With the potential "fall out" of patients between primary care and GUM services, this may represent a missed opportunity to detect and appropriately manage sexually transmitted infections.
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Affiliation(s)
- R Neale
- Department of GU medicine, Royal Cornwall Hospital, Truro, TR1 3LJ, UK.
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Chau I, Cunningham D, Hickish T, Massey A, Higgins L, Osborne R, Botwood N, Swaisland A. Gefitinib and irinotecan in patients with fluoropyrimidine-refractory, irinotecan-naive advanced colorectal cancer: a phase I-II study. Ann Oncol 2007; 18:730-7. [PMID: 17237473 DOI: 10.1093/annonc/mdl481] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To establish the recommended dose level (RDL) and to evaluate the efficacy and safety of gefitinib plus irinotecan in patients with advanced fluoropyrimidine-refractory colorectal cancer (CRC). PATIENTS AND METHODS Patients with advanced CRC progressing on or within 12 weeks of fluoropyrimidine-based chemotherapy, irinotecan naive and performance status of two or less were recruited. During dose-finding phase, dose-limiting toxicity (DLT) was encountered at dose level 1, therefore subsequent dose de-escalation and pharmacokinetic (PK) studies were carried out. The RDL was then expanded in a multicentre setting to further evaluate safety and efficacy. RESULTS From June 2002 to February 2005, 39 patients were treated in total with 27 at the RDL. The RDL was established at irinotecan 225 mg/m(2) every 3 weeks and gefitinib 250 mg daily. The DLTs were neutropenia and diarrhoea. For the patients treated at RDL, the objective tumour response rate was 11.1% (95% confidence interval 2.4% to 29.2%) and median survival was 9.3 months. PK studies indicated that the addition of irinotecan to gefitinib resulted in an average of 50% increase in exposure to gefitinib (P < 0.05), but gefitinib did not alter the PK profiles of irinotecan or SN-38. Grade 3-4 toxic effects in all patients included diarrhoea (35.9%), lethargy (15.4%), neutropenia (15.4%), febrile neutropenia (10.3%) and skin rash (7.7%). CONCLUSIONS Irinotecan and gefitinib at this dose schedule was tolerable, but gefitinib did not appear to add substantial efficacy to irinotecan.
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Affiliation(s)
- I Chau
- Department of Medicine, Royal Marsden Hospital, Downs Road, London and Surrey, Sutton, Surrey, UK
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Ling J, Herbst RS, Mendelson DS, Eckhardt SG, O’Dwyer P, Ebbinghaus S, Osborne R, Cheu M, Lieberman G, Lum BL. Apo2L/TRAIL pharmacokinetics in a phase 1a trial in advanced cancer and lymphoma. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3047] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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
3047 Background: Apo2L/TRAIL (Apo2L ligand/tumor necrosis factor-related apoptosis-inducing ligand) is the first recombinant human protein that selectively induces apoptosis or programmed cell death in cancer cells while sparing normal cells. The molecule used in this joint clinical development between Genentech, Inc. and Amgen, Inc., is an optimized recombinant human Apo2L/TRAIL protein produced in E. coli. It displays broad activity in preclinical models of a variety of solid and hematologic cancers. This is the first report of the pharmacokinetics of Apo2L/TRAIL in humans. Methods: Thirty-nine patients enrolled in a phase 1a study had PK assessments at dose levels ranging from 0.5–15 mg/kg in two cohorts, those with and those without liver metastases. Recombinant human Apo2L/TRAIL was administered as a 1-hr IV infusion for 5 consecutive days over a 21-day cycle. Serum concentrations were determined using a sensitive ELISA assay. PK calculations were performed using Non-compartmental analyses. Results: Currently Apo2L/TRAIL PK data are available for 27 patients, 15 in cohort 1 (no liver metastases) and 12 in cohort 2 (liver metastases). Mean (± SD) PK data for patients in cohort 1 and cohort 2 did not differ. PK data for cohort 1 are outlined in the table below. Apo2L/TRAIL clearance appeared proportional to dose and consistent with that predicted from nonclinical models. Cmax achieved at doses ≥ 4 mg/kg are equivalent to or greater than those displaying activity in preclinical models. There was no evidence of drug accumulation between day 1 and day 5 of treatment. Conclusions: Apo2L/TRAIL at doses which can be safely administered in humans produces serum concentrations consistent with those demonstrating efficacy in tumor xenograft models. Hepatic metastases with or without mild liver dysfunction do not appear to influence the PK of Apo2L/TRAIL. [Table: see text] [Table: see text]
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Affiliation(s)
- J. Ling
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - R. S. Herbst
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - D. S. Mendelson
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - S. G. Eckhardt
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - P. O’Dwyer
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - S. Ebbinghaus
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - R. Osborne
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - M. Cheu
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - G. Lieberman
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
| | - B. L. Lum
- Genentech, Inc., South San Francisco, CA; M. D. Anderson Cancer Center, Houston, TX; Virginia Piper Cancer Center, Scottsdale, AZ; University of Colorado Health Sciences Center, Aurora, CO; University of Pennsylvania, Philadelphia, PA; Arizona Cancer Center, Tucson, AZ
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Hickish T, Chau I, Massey A, Higgins L, Osborne R, Botwood N, Swaisland A, Cunningham DC. Gefitinib and irinotecan in patients with fluoropyrimidine-refractory irinotecan-naïve advanced colorectal cancer (CRC): dose-finding, pharmacokinetics, safety and efficacy. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13520] [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
13520 Background: Gefitinib (IRESSA) is an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that has shown supra-additive activity in human CRC xenografts when combined with irinotecan. We have previously established that the recommended dose level (RDL) to be irinotecan 225mg/m2 q3 weeks and gefitinib 250mg daily (Chau et al ASCO 2004). The dose limiting toxicities were neutropenia and diarrhoea. The continuation phase of this study aimed to evaluate the efficacy and safety of this combination. Patients and Methods: Between Jun 2002 and Feb 2005, patients (pts) with advanced CRC progressing on or within 12 weeks of fluoropyrimidines-based chemotherapy, irinotecan-naïve and performance status ≤2 were recruited. Thirty-nine pts were treated with irinotecan and gefitinib in total with 27 treated at the RDL. Results: Median age was 61 years (range: 31–79) and 13 (33.3%) pts were females. All pts were Caucasians (94.9%) and non-oriental Asians (5.1%). Thirteen (33.3%) pts had received (neo)adjuvant chemotherapy and 16 (41.0%) pts had prior oxaliplatin-based chemotherapy for metastatic disease. Grades 3–4 toxicities were anaemia 2.6%, neutropenia 15.4%, febrile neutropenia 10.3%, diarrhoea 35.9%, nausea 2.6%, vomiting 5.1%, lethargy 15.4% and skin rash 7.7%. For the pts treated at RDL, the objective tumour response rate was 11.1% (3 partial responses [PRs]; 95% confidence interval [CI]: 2.4–29.2%) and the disease control rate was 40.7% (3PRs, 8 stable diseases lasting for ≥12 weeks). The median time to progression was 4.2 months and median survival was 9.3 months. Six-month progression free survival was 22.2% (95% CI: 6.5–37.9%) and 6-month overall survival was 73.4% (95% CI: 56.5–90.3%). Preliminary pharmacokinetic data suggested that the addition of irinotecan to gefitinib resulted in an average of 14–33% increase in exposure to gefitinib (p<0.05). Conclusions: Irinotecan and gefitinib at this dose schedule was tolerable. Gefitinib did not appear to add substantial efficacy to irinotecan. The relative low dose of irinotecan at the RDL and the rarity of EGFR somatic mutation in CRC may be contributory to the modest activity of irinotecan and gefitinib combination. [Table: see text]
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Affiliation(s)
- T. Hickish
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - I. Chau
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - A. Massey
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - L. Higgins
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - R. Osborne
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - N. Botwood
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - A. Swaisland
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
| | - D. C. Cunningham
- Royal Bournemouth Hospital, Bournemouth Dorset, United Kingdom; Royal Marsden Hospital, London and Surrey, United Kingdom; Poole Hospital, Poole, United Kingdom; AstraZeneca, Macclesfield, United Kingdom; Royal Marsden Hospital, London, United Kingdom
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Vasey PA, Atkinson R, Osborne R, Parkin D, Symonds R, Paul J, Lewsley L, Coleman R, Reed NS, Kaye S, Rustin GJS. SCOTROC 2A: carboplatin followed by docetaxel or docetaxel-gemcitabine as first-line chemotherapy for ovarian cancer. Br J Cancer 2006; 94:62-8. [PMID: 16404361 PMCID: PMC2361073 DOI: 10.1038/sj.bjc.6602909] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The feasibility of sequential carboplatin followed by docetaxel-based therapy for untreated ovarian cancer was determined. Patients received four q3w cycles of carboplatin AUC 7, then four q3w cycles of either docetaxel 100 mg m(-2) (day 1) (arm A); docetaxel 75 mg m(-2) (day 8) and gemcitabine 1250 mg m(-2) (days 1,8) (arm B) or docetaxel 25 mg m(-2) and gemcitabine 800 mg m(-2) (both given weekly (days 1,8,15)) (arm C). A total of 44 patients were randomised to each treatment arm. None of the arms demonstrated an eight cycle completion rate (70.5/72.7/45.5% in arms A/B/C, respectively), which was statistically greater than 60% (P=0.102, P=0.056, P=0.982) which was our formal feasibility criteria, although only the completion rate in arm C was clearly worse than this level. The overall response rate (ORR) after carboplatin was 65.7% in 70 evaluable patients. In evaluable patients, ORRs after docetaxel-based cycles were: arm A 84.0% (21 out of 25); arm B 77.3% (17 out of 22); arm C 69.6% (16 out of 23). At follow-up (median 30 months), median progression-free survival times were: arm A 15.5 months (95% CI: 10.5-20.6); arm B 18.1 months (95% CI: 15.9-20.3); arm C, 13.7 months (95% CI: 12.8-14.6). Neutropenia was the predominant grade 3-4 haematological toxicity: 77.8/85.7/54.4% in arms A/B/C, respectively. Dyspnoea was markedly increased in both gemcitabine-containing arms (P=0.001) but was worse in arm C. Although just failing to rule out eight cycle completion rates less than 60%, within the statistical limitations of these small cohorts, the overall results for arms A and B are encouraging. Larger phase III studies are required to test these combinations.
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Affiliation(s)
- P A Vasey
- CR-UK Clinical Trials Unit, Beatson Oncology Centre, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, Scotland, UK.
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Moradi P, Roberton B, Osborne R, Muhtaseb M, Graham EM, Klein J, Stanford MR. HACEK endocarditis causing endogenous endophthalmitis and a metastatic abscess. Eye (Lond) 2005; 20:254-5. [PMID: 15688044 DOI: 10.1038/sj.eye.6701832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Doillon CJ, Watsky MA, Hakim M, Wang J, Munger R, Laycock N, Osborne R, Griffith M. A collagen-based scaffold for a tissue engineered human cornea: physical and physiological properties. Int J Artif Organs 2004; 26:764-73. [PMID: 14521175 DOI: 10.1177/039139880302600810] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.4] [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] [Indexed: 11/16/2022]
Abstract
Stabilized collagen-glycosaminoglycan scaffolds for tissue engineered human corneas were characterized. Hydrated matrices were constructed by blending type I collagen with chondroitin sulphates (CS), with glutaraldehyde crosslinking. A corneal keratocyte cell line was added to the scaffolds with or without corneal epithelial and endothelial cells. Constructs were grown with or without ascorbic acid. Wound-healing was evaluated in chemical-treated constructs. Native, noncrosslinked gels were soft with limited longevity. Crosslinking strengthened the matrix yet permitted cell growth. CS addition increased transparency. Keratocytes grown within the matrix had higher frequencies of K+ channel expression than keratocytes grown on plastic. Ascorbic acid increased uncrosslinked matrix degradation in the presence of keratocytes, while it enhanced keratocyte growth and endogenous collagen synthesis in crosslinked matrices. Wounded constructs showed recovery from exposure to chemical irritants. In conclusion, this study demonstrates that our engineered, stabilized matrix is well-suited to function as an in vitro corneal stroma.
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Affiliation(s)
- C J Doillon
- CHUL Research Centre, Laval University, Quebec City, Quebec, Canada
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