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Reyes JM, Gutierrez MV, Madariaga H, Otero W, Guzman R, Izquierdo J, Abello M, Velez P, Castillo D, Ponce de Leon D, Lukic T, Amador L. Patient-reported outcomes in RA patients treated with tofacitinib or bDMARDs in real-life conditions in two Latin American countries. Reumatol Clin (Engl Ed) 2023; 19:319-327. [PMID: 37286268 DOI: 10.1016/j.reumae.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/03/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To describe efficacy, safety, and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) treated with tofacitinib or biological DMARDs (bDMARDs) in real-life conditions. METHODS A noninterventional study was performed between March 2017 and September 2019 at 13 sites in Colombia and Peru. Outcomes measured at baseline and at the 6-month follow-up were disease activity (RAPID3 [Routine Assessment of Patients Index Data] score), functional status (HAQ-DI [Health Assessment Questionnaire] score), and quality of life (EQ-5D-3L [EuroQol Questionnaire]). The Disease Activity Score-28 (DAS28-ESR) and frequency of adverse events (AEs) were also reported. Unadjusted and adjusted differences from baseline were estimated and expressed as the least squares mean difference (LSMD). RESULTS Data from 100 patients treated with tofacitinib and 70 patients with bDMARDs were collected. At baseline, the patients' mean age was 53.53 years (SD 13.77), the mean disease duration was 6.31 years (SD 7.01). The change from baseline at month 6 was not statistically significant different in the adjusted LSMD [SD] for tofacitinib vs. bDMARDs for RAPID3 score (-2.55[.30] vs. -2.52[.26]), HAQ-DI score (-.56[.07] vs. -.50[.08]), EQ-5D-3L score (.39[.04] vs. .37[.04]) and DAS28-ESR (-2.37[.22] vs. -2.77[.20]). Patients from both groups presented similar proportions of nonserious and serious AEs. No deaths were reported. CONCLUSION Changes from baseline were not statistically significantly different between tofacitinib and bDMARDs in terms of RAPID3 scores and secondary outcomes. Patients from both groups presented similar proportions of nonserious and serious AEs. CLINICAL TRIAL NUMBER NCT03073109.
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Affiliation(s)
| | | | - H Madariaga
- Centro Especializado de enfermedades neoplásicas (CEEN), Arequipa, Peru
| | - W Otero
- Centro Servimed, Bucaramanga, Colombia
| | - R Guzman
- Instituto de Enfermedades Autoinmunes Renato Guzmán (IDEARG), Bogota, Colombia
| | | | - M Abello
- Centro Integral de Reumatología Circaribe, Barranquilla, Colombia
| | - P Velez
- Centro de Investigación en Reumatología y Especialidades Médicas (CIREEM), Bogota, Colombia
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Gutierrez-Ardila MV, Reyes J, Madariaga H, Otero W, Guzman R, Izquierdo J, Abello M, Velez P, Castillo D, Ponce de Leon D, Lukic T, Amador L. Work productivity in rheumatoid arthritis patients from two Latin American countries treated with tofacitinib or biological DMARDs. Expert Rev Pharmacoecon Outcomes Res 2022; 22:787-794. [PMID: 35249439 DOI: 10.1080/14737167.2022.2047935] [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
OBJECTIVE To evaluate work productivity of adult Latin American patients with rheumatoid arthritis (RA) treated with tofacitinib and biological disease-modifying anti-rheumatic drugs (bDMARDs) measured by the Work Productivity and Activity Impairment (WPAI) in RA questionnaire at 0- and 6-month follow-up. METHODS This non-interventional study was performed in Colombia and Peru. Evaluated the effects of tofacitinib and bDMARDs in patients with RA after failure of conventional DMARDs. The WPAI-RA questionnaire was administered at baseline and at the 6-month (±1 month) follow-up. The results are expressed as least squares means (LSMs), and standard errors (SEs). RESULTS One hundred patients treated with tofacitinib and 70 patients treated with bDMARDs were recruited. Twenty-eight percent of patients from the tofacitinib group and 40.0% from the bDMARDs group were working for pay at baseline. At month 6, the changes in absenteeism, presenteeism, and work impairment due to health were -18.3% (SE 7.7), -34.8% (SE 5.9), and -11.0% (SE 16.5), respectively, in the tofacitinib group and -19.4% (SE 8.0), -34.8% (SE 6.2), and -15.9% (SE 15.0), for the bDMARD group. CONCLUSION For patients who reported working, there were improvements in presenteeism, absenteeism, and work impairment due to health in both groups. TRIAL REGISTRATION NCT03073109.
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Affiliation(s)
| | | | - H Madariaga
- Rheumatology, Centro Médico CEEN, Arequipa, Peru
| | - W Otero
- Rheumatology, Centro Servimed, Bucaramanga, Colombia
| | - R Guzman
- Rheumatology, Centro IDEARG, Bogotá, Colombia
| | - J Izquierdo
- Rheumatology, Clínica del Occidente, Cali, Colombia
| | - M Abello
- Rheumatology, Centro Integral de Reumatología Circaribe, Barranquilla, Colombia
| | - P Velez
- Rheumatology, Centro Médico CIREEM, Bogotá, Colombia
| | - D Castillo
- Rheumatology, Clínica del Occidente, Cali, Colombia
| | | | - T Lukic
- Medical department, Pfizer Inc, New York, USA
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Thomale UW, Auer C, Spennato P, Schaumann A, Behrens P, Gorelyshev S, Bogoslovskaia E, Shulaev A, Kabanian A, Seliverstov A, Alexeev A, Ozgural O, Kahilogullari G, Schuhmann M, Jimenez-Guerra R, Wittayanakorn N, Sukharev A, Marquez-Rivas J, Linsler S, Damaty AE, Vacek P, Lovha M, Guzman R, Stricker S, Beez T, Wiegand C, Azab M, Buis D, Sáez M, Fleck S, Dziugan C, Ferreira A, Radovnicky T, Bührer C, Lam S, Sgouros S, Roth J, Constantini S, Cavalheiro S, Cinalli G, Kulkarni AV, Bock HC. TROPHY registry - status report. Childs Nerv Syst 2021; 37:3549-3554. [PMID: 34184098 PMCID: PMC8578079 DOI: 10.1007/s00381-021-05258-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration. METHODS On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported. RESULTS According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers. CONCLUSIONS Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.
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Affiliation(s)
- U. W. Thomale
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - C. Auer
- Division of Pediatric Neurosurgery, Kepler Universitätsklinikum, Linz, Austria
| | - P. Spennato
- Pediatric Neurosurgery, AORN Santobono Pausilipon, Naples, Italy
| | - A. Schaumann
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - P. Behrens
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Gorelyshev
- Pediatric Neurosurgery, Moscow Bashlyaeva Pediatric Hospital, Moscow, Russia
| | - E. Bogoslovskaia
- Pediatric Neurosurgery, Surgut Clinical Perinatal Center, Surgut, Russia
| | - A. Shulaev
- Pediatric Neurosurgery, Children’s Republic Clinical Hospital, Kazan, Russia
| | - A. Kabanian
- Pediatric Neurosurgery, Children’s Regional Hospital, Krasnodar, Russia
| | - A. Seliverstov
- Pediatric Neurosurgery, Kemerovo Regional Pediatric Hospital, Kemerovo, Russia
| | - A. Alexeev
- Pediatric Neurosurgery, Chelyabinsk Regional Children’s Clinical Hospital, Chelyabinsk, Russia
| | - O. Ozgural
- Neurosurgery, Ankara University, Ankara, Turkey
| | | | - M. Schuhmann
- Pediatric Neurosurgery, University Hospital of Tübingen, Tubingen, Germany
| | - R. Jimenez-Guerra
- Neonatal Neurosurgery, National Institute of Perinatology, Mexico City, Mexico
| | - N. Wittayanakorn
- Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - A. Sukharev
- Pediatric Neurosurgery, Regional Children Hospital, Yekaterinburg, Russia
| | | | - S. Linsler
- Neurosurgery, Saarland University Hospital, Homburg, Saarland Germany
| | - A. El Damaty
- Pediatric Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - P. Vacek
- Neurosurgery, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - M. Lovha
- Neurosurgery, Volyn Regional Pediatric Hospital, Lutsk, Ukraine
| | - R. Guzman
- Neurosurgery, Universitätskinderspital Beider Basel, Basel, Switzerland
| | - S. Stricker
- Neurosurgery, Universitätskinderspital Beider Basel, Basel, Switzerland
| | - T. Beez
- Neurosurgery, Heinrich-Heine-University, Duesseldorf, Germany
| | - C. Wiegand
- Neurosurgery, Marienhospital, Osnabrück, Germany
| | - M. Azab
- Neurosurgery, Damietta Specialized Hospital, Damietta, Egypt
| | - D. Buis
- Neurosurgery, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | - M. Sáez
- Neurosurgery, Hospital La Paz, Madrid, Spain
| | - S. Fleck
- Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - C. Dziugan
- Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - A. Ferreira
- Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - T. Radovnicky
- Neurosurgery, Masaryk Hospital, Usti Nad Labem, Czech Republic
| | - C. Bührer
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Lam
- Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - S. Sgouros
- Pediatric Neurosurgery, Iaso Childrens Hospital, Athens, Greece
| | - J. Roth
- Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S. Constantini
- Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S. Cavalheiro
- Pediatric Neurosurgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - G. Cinalli
- Pediatric Neurosurgery, AORN Santobono Pausilipon, Naples, Italy
| | - A. V. Kulkarni
- Pediatric Neurosurgery, Sick Children Hospital, University of Toronto, Toronto, Canada
| | - H. C. Bock
- Pediatric Neurosurgery, University Medical Center Göttingen, Gottingen, Germany
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Citera G, Jain R, Irazoque-Palazuelos F, Guzman R, Madariaga H, Gruben DC, Wang L, Stockert L, Hsu MA, Santana K, Ebrahim A, Ponce de Leon D. THU0196 TOFACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS AND INDICATIVE OF DEPRESSION AND/OR ANXIETY: A POST HOC ANALYSIS OF PHASE 3 AND PHASE 3B/4 CLINICAL TRIALS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.417] [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: 03/15/2023]
Abstract
Background:Depression/anxiety are common in RA pts. SF-36 MCS ≤38 can identify probable major depressive disorder and/or probable generalised anxiety disorder (pMDD/pGAD) in RA pts. Tofacitinib is an oral JAK inhibitor for the treatment of RA.Objectives:To assess pMDD/pGAD prevalence in the tofacitinib RA program and efficacy by baseline (BL) pMDD/pGAD status.Methods:Data from pts receiving tofacitinib, ADA, or PBO were pooled from 5 Phase (P)3 and 1 P3b/4 trials. Demographics/BL characteristics were reported by BL pMDD/pGAD (SF-36 MCS ≤38, presence; >38, absence). Month (M)3/6/9/12 SF-36 MCS change from BL (Δ) was estimated, and % with pMDD/pGAD reported. M3/6/12 efficacy outcomes compared tofacitinib-treated pts by BL pMDD/pGAD.Results:BL pMDD/pGAD was seen in 44.5% (tofacitinib 5 mg BID), 39.8% (tofacitinib 10 mg BID), 45.4% (ADA 40 mg Q2W) and 39.1% (PBO) of pts. pMDD/pGAD pts had higher BL CRP and worse disability, fatigue, pain and sleep vs pts without. SF-36 MCS increases were greater for tofacitinib vs PBO/ADA (Fig 1a). The % of pts with BL pMDD/pGAD who continued to have pMDD/pGAD reduced over time, and was generally lower for tofacitinib vs PBO/ADA (Fig 1b). Regardless of BL pMDD/pGAD, efficacy was generally similar for tofacitinib 5 mg BID (Table) and 10 mg BID.Conclusion:~40% of RA pts had BL pMDD/pGAD. SF-36 MCS improvements were greater for tofacitinib vs PBO/ADA. With tofacitinib, % of pts with SF-36 MCS ≤38 reduced by ~60% at M12. Tofacitinib efficacy was similar in pts with/without BL pMDD/pGAD. Limitations include using SF-36 MCS to identify probable rather than confirmed MDD or GAD. Future research using gold standard psychiatric interviews to validate use of SF-36 MCS ≤38 is needed.Table.M3/6/12 efficacy with tofacitinib 5 mg BID, by BL pMDD/pGADaSF-36 MCS ≤38SF-36 MCS >38OR (95% CI)P valueACR20 (%)b,cM355.157.90.89 (0.74, 1.08)0.2330M661.762.80.96 (0.79, 1.16)0.6511M1258.458.60.99 (0.80, 1.22)0.9279ACR50 (%)b,cM325.929.20.85 (0.70, 1.03)0.1022M636.038.00.92 (0.76, 1.11)0.3724M1233.834.30.98 (0.80, 1.20)0.8366ACR70 (%)b,cM310.111.00.91 (0.69, 1.18)0.4704M616.516.51.00 (0.79, 1.26)0.9901M1218.317.51.06 (0.83, 1.34)0.6560DAS28-4(ESR)<2.6 (%)b,cM35.47.40.72 (0.49, 1.05)0.0872M65.98.50.68 (0.49, 0.94)0.0199*M128.011.90.64 (0.47, 0.89)0.0073**ΔHAQ-DI, LS meanc,dSF-36 MCS ≤38SF-36 MCS >38Difference (95% CI)P valueM3-0.41-0.430.01 (-0.04, 0.06)0.6008M6-0.49-0.48-0.01 (-0.06, 0.04)0.6617M12-0.52-0.52-0.01 (-0.06, 0.05)0.8475*p<0.05; **p<0.01 Data pooled from 5 P3 and 1 P3b/4 tofacitinib trialsaBL pMDD/pGAD = SF-36 MCS ≤38;bLogistic regression fit;cFor PBO pts advancing to tofacitinib post-M3, only PBO data were included;dMixed-effects linear model fitΔ, change from baseline; ACR, American College of Rheumatology; BID, twice daily; BL, baseline; CI, confidence interval; DAS28-4(ESR), Disease Activity Score in 28 joints, erythrocyte sedimentation rate; HAQ-DI, Health Assessment Questionnaire-Disability Index; LS, least squares; M, month; MCS, Mental Component Summary score; OR, odds ratio; P, Phase; pGAD, probable generalised anxiety disorder; PBO, placebo; pMDD, probable major depressive disorder; pt, patient; RA, rheumatoid arthritis; SF-36, Short Form-36 health surveyAcknowledgments:Study sponsored by Pfizer Inc. Medical writing support was provided by Sarah Piggott of CMC Connect and funded by Pfizer Inc.Disclosure of Interests:Gustavo Citera Grant/research support from: AbbVie, Amgen, Eli Lilly, Gema, Genzyme, Novartis and Pfizer Inc, Consultant of: AbbVie, Amgen, Eli Lilly, Gema, Genzyme, Novartis and Pfizer Inc, Rakesh Jain Grant/research support from: Allergan, Eli Lilly, Lundbeck, Otsuka, Pfizer Inc, Shire and Takeda, Consultant of: Acadia, Alfasigma, Allergan, Eisai, Eli Lilly, Evidera, Impel, Janssen, Lundbeck, Merck, Neos Therapeutics, Neurocrine Biosciences, Osmotica, Otsuka, Pamlab, Pfizer Inc, Shire, Sunovion, Supernus, Takeda and Teva, Speakers bureau: Alkermes, Allergan, Eli Lilly, Janssen, Lundbeck, Merck, Neos Therapeutics, Neurocrine, Otsuka, Pamlab, Pfizer Inc, Shire, Sunovion, Takeda, Teva and Tris Pharmaceuticals, Fedra Irazoque-Palazuelos Consultant of: Bristol-Myers Squibb, Janssen, Pfizer Inc, Roche and UCB, Renato Guzman: None declared, Hugo Madariaga: None declared, David C Gruben Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Lisy Wang Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Lori Stockert Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Ming-Ann Hsu Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Karina Santana Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Abbas Ebrahim Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Dario Ponce de Leon Shareholder of: Pfizer Inc, Employee of: Pfizer Inc
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Soler L, Jareño J, Banchewski J, Rasi S, Chamorro N, Guzman R, Yáñez R, Mocuta C, Ricart S, Farjas J, Roura-Grabulosa P, Obradors X, Puig T. Ultrafast transient liquid assisted growth of high current density superconducting films. Nat Commun 2020; 11:344. [PMID: 31953396 PMCID: PMC6969047 DOI: 10.1038/s41467-019-13791-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/29/2019] [Indexed: 11/10/2022] Open
Abstract
The achievement of high growth rates in YBa2Cu3O7 epitaxial high-temperature superconducting films has become strategic to enable high-throughput manufacturing of long length coated conductors for energy and large magnet applications. We report on a transient liquid assisted growth process capable of achieving ultrafast growth rates (100 nm s−1) and high critical current densities (5 MA cm−2 at 77 K). This is based on the kinetic preference of Ba-Cu-O to form transient liquids prior to crystalline thermodynamic equilibrium phases, and as such is a non-equilibrium approach. The transient liquid-assisted growth process is combined with chemical solution deposition, proposing a scalable method for superconducting tapes manufacturing. Additionally, using colloidal solutions, the growth process is extended towards fabrication of nanocomposite films for enhanced superconducting properties at high magnetic fields. Fast acquisition in situ synchrotron X-ray diffraction and high resolution scanning transmission electron microscopy (STEM) become crucial measurements in disentangling key aspects of the growth process. High throughput manufacturing of long length coated conductors requires fast epitaxial growth of high-temperature superconducting films. Here, Soler et al. report an ultrafast growth rates and high critical current densities of YBa2Cu3O7 films using a transient liquid-assisted growth method.
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Affiliation(s)
- L Soler
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain
| | - J Jareño
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain
| | - J Banchewski
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain
| | - S Rasi
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain.,GRMT, Department of Physics, Universitat de Girona, Campus Montilivi, Edif. PII, E17003, Girona, Catalonia, Spain
| | - N Chamorro
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain.,Departament de Química, Universitat Autònoma de Barcelona, 08193, Bellaterra, Catalonia, Spain
| | - R Guzman
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain
| | - R Yáñez
- Departament de Química, Universitat Autònoma de Barcelona, 08193, Bellaterra, Catalonia, Spain
| | - C Mocuta
- Synchrotron SOLEIL, L'Orme des Merisiers Saint-Aubin BP 48, 91192, Gif-sur-Yvette, France
| | - S Ricart
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain
| | - J Farjas
- GRMT, Department of Physics, Universitat de Girona, Campus Montilivi, Edif. PII, E17003, Girona, Catalonia, Spain
| | - P Roura-Grabulosa
- GRMT, Department of Physics, Universitat de Girona, Campus Montilivi, Edif. PII, E17003, Girona, Catalonia, Spain
| | - X Obradors
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain
| | - T Puig
- Institut de Ciència de Materials de Barcelona, ICMAB-CSIC, Campus UAB, 08193, Bellaterra, Catalonia, Spain.
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Chen HW, Von Euw E, Millan P, Fresco R, Carrez S, Afenjar K, Fung H, Burton M, Santiago A, Guzman R, Villalobos I, Press M, Eiermann W, Slamon D. Results from TRIO030, a pre-surgical tissue-acquisition study to evaluate molecular alterations in human breast cancer tissue following short-term exposure to the androgen receptor antagonist darolutamide. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Press MF, Seoane JA, Curtis C, Quinaux E, Guzman R, Sauter G, Eiermann W, Mackey JR, Robert N, Pienkowski T, Crown J, Martin M, Valero V, Bee V, Ma Y, Villalobos I, Slamon DJ. Abstract PD3-11: HER2/ ERBB2 status in “ HER2 equivocal” breast cancers by FISH and ASCO-CAP guidelines: False-positives due to heterozygous deletions of alternative control loci. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd3-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. The ASCO-CAP guidelines for HER2 testing by fluorescence in situ hybridization (FISH) have a category, referred to as “equivocal” (average HER2 copies per tumor cell >4-6 with HER2/CEP17 ratio <2·0), which is neither “HER2-positive” nor “HER2-negative”. Approximately 4% - 12% of invasive breast cancers are “HER2-equivocal” based on FISH. Cancers in this category may be resolved as “negative” or “positive” by FISH alternative control probes (2013/2014 guidelines) or HER2 immunohistochemistry (IHC) (2018 update). Our objectives were to evaluate the following hypotheses: 1.) Genetic loci used as alternative controls show heterozygous deletion in a substantial proportion of breast cancers; 2.) Use of these loci for assessment of HER2 by FISH leads to false-positives; 3.) HER2 FISH false-positive breast cancer patients have outcomes that do not differ from clinical outcomes for HER2-negative breast cancer patients; and 4.) HER2-equivocal breast cancers seldom show HER2 protein overexpression (IHC 3+).
Methods. We retrospectively assessed the use of chromosome 17 p-arm and q-arm alternative control genomic sites (TP53, D17S122, SMS, RARA, TOP2A), as recommended by the 2013/2014 ASCO-CAP guidelines, in patients whose data were available through the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC)(N=1980) or whose tissues were available from the BCIRG-005 clinical trial (N=3298). We used either FDA-approved HER2 IHC (HercepTest) or laboratory-developed HER2 (10H8) IHC assays to assess HER2 protein expression.
Results. Using METABRIC we found heterozygous deletions, particularly in specific p-arm sites, were common in both HER2-amplified and HER2-not-amplified breast cancers. Use of alternative control probes from these regions to assess HER2 by FISH in “HER2 equivocal” as well as HER2-not-amplified breast cancers resulted in high rates of false-positive ratios (HER2-to-alternative control ratio >2·0) due to heterozygous deletions of control p-arm genomic sites used as ratio denominators. Misclassifications of HER2 status was observed not only in breast cancers with ASCO-CAP “equivocal” status but also in breast cancers with an average of <4·0 HER2 copies per tumor cell. These deletions were also identified by FISH. IHC demonstrated <1% of FISH “HER2-equivocal” breast cancers in BCIRG-005 had IHC3+ immunostaining, consistent with HER2-not-amplified status. Clinical outcomes of “HER2-equivocal” breast cancer patients with HER2-to-alternative control ratio >2·0 did not differ significantly from clinical outcomes of those with HER2-to-alternative control ratio<2·0.
Conclusion. Using chromosome 17 p-arm alternative controls, as recommended by 2013/2014 ASCO-CAP guidelines, instead of CEP17 for resolution of “HER2 equivocal” cases, is problematic due to frequent heterozygous deletions of these loci in breast cancers. The indiscriminate use of alternative control probes to calculate a HER2 FISH ratio in “HER2-equivocal” breast cancers leads to false-positive interpretations of HER2 status resulting from unrecognized heterozygous deletions in one or more of these alternative control genomic sites and incorrect HER2 ratio determinations.
Citation Format: Press MF, Seoane JA, Curtis C, Quinaux E, Guzman R, Sauter G, Eiermann W, Mackey JR, Robert N, Pienkowski T, Crown J, Martin M, Valero V, Bee V, Ma Y, Villalobos I, Slamon DJ. HER2/ERBB2 status in “HER2 equivocal” breast cancers by FISH and ASCO-CAP guidelines: False-positives due to heterozygous deletions of alternative control loci [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD3-11.
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Affiliation(s)
- MF Press
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - JA Seoane
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - C Curtis
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - E Quinaux
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - R Guzman
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - G Sauter
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - W Eiermann
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - JR Mackey
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - N Robert
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - T Pienkowski
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - J Crown
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - M Martin
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - V Valero
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - V Bee
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Y Ma
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - I Villalobos
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
| | - DJ Slamon
- USC/Norris Comprehensive Cancer Center, Los Angeles, CA; Stanford University, Stanford, CA; International Drug Development Institute, Louvain-la-Neuve, Belgium; University of Hamburg, Hamburg, Germany; Frauenklinik vom Roten Kreuz, Munich, Germany; University of Alberta, Edmonton, Canada; Virginia Cancer Specialists/US Oncology Research Network, Fairfax, VA; Postgraduate Medical Education Center, Warsaw, Poland; St Vincent's University Hospital, Dublin, Ireland; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; M.D. Anderson Cancer Center, Houston, TX; Cancer International Research Group/Translational Research in Oncology, Paris, France; Geffen School of Medicine at UCLA, Los Angeles, CA
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Guirao A, Molins L, Guzman R, Cleries M, Vela E, Magen D, Sanchez D, Boada M, Espinas J, Borras J, Argimon J, Agusti A. P3.11-16 Comparative Analysis of Health-Care Resources and Economic Costs of Lung Cancer Patients Treated Medically or Surgically in Catalunya. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1812] [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: 10/28/2022]
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Montesinos Encalada M, Boada M, Sanchez D, Libreros A, Guirao A, Guzman R, Gimferrer J, Molins L. P2.01-72 Bronchial Sleeve vs Pneumonectomy: Complications, Recurrences and Survival. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1126] [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: 10/28/2022]
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Guirao A, Molins L, Ramon I, Sunyer G, Vinolas N, Marrades R, Sanchez D, Fibla J, Hernandez J, Boada M, Guzman R, Libreros A, Agusti A. MA03.11 Trained Dogs Can Identify Malignant Pulmonary Nodules in Exhaled Gas. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carriel N, González D, Guzman R, Sanchez-Lorente D, Montes AG, Boada M, Gimferrer JM, Gómez-Caro A, Molins L. P-165HAEMOTHORAX SECONDARY TO CHEST WALL ARTERIAL LESION: OUR EXPERIENCE WITH TRANSCATHETER ARTERIAL EMBOLIZATION. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.165] [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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Hanf DC, Fasching PA, Villalobos IE, Gasparyan A, Wachter D, Santiago A, Guzman R, Weihbrecht S, Hanf V, Hartmann A, Beckmann MW, Press MF. Abstract P4-12-07: CCND1 amplification in early breast cancer patients: Correlation with subtypes and prognosis. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-12-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Mechanisms of progress and recurrence of early breast cancer (BC) have gained importance since several targeted therapeutic options in metastatic breast cancer have been introduced over the last years, especially in hormone receptor positive BC. This study investigates the amplification of cell cycle regulator cyclin D1 gene (CCND1) amplification as one possible progression mechanism.
Patients & Methods: Patients from an unselected cohort of early BC patients were included into this study. A tissue microarray (TMA) was available for n=832 patients with early breast cancer. CCND1 amplification was assessed after FISH (Abbott Vysis LSI CCND1 SpectumOrange/CEP11 SpectrumGreen Probes Kit). A CCND1/CEP11-ratio ≥ 2.0 was considered as amplification. Staining was successful in 545 tumor cores. Amplification results were correlated with clinical patient and tumor characteristics and survival analyses were performed with regard to distant disease free survival and overall survival.
Results: CCND1 amplification was found in 13.6% of patients. Triple negative, luminal A like, luminal B like and HER2 positive tumors were amplified in 7.5%, 7.8%, 18.6% and 15.7% respectively (p = 0.010). CCDN1 amplification was significantly associated with a higher grading and a higher body mass index. Furthermore an amplification was seen more frequently in lobular BC and ductal BC than other histological subtypes.
Survival analysis showed a reduced DDFS for patients with CCDN1-amplification. 5 year DDFS rates were 90.6% for non-amplified tumors and 86.0% for amplified tumors (p, log-rank =0.066 ). 5 year OS rates were 93.0% for non-amplified tumors and 90.1% for amplified tumors (p, log-rank =0.119).
Adjusted for age, tumor size, nodal status and molecular subtype, cox regression showed HR of 1.3 (95% CI: 0.76-2.5, p=0.46) for DDFS and a HR of 1.33 (95% CI: 0.7-2.53, p=0.38) for OS.
Conclusion: With a 13.6% prevalence in all breast cancer patients, mainly present in luminal B like cancers, CCND1-amplification is a genetic aberration associated with an unfavorable prognosis. Within hormone receptor positive women CCDN1 amplification might play a role in treatment resistance mechanisms in early breast cancer patients.
Citation Format: Hanf DC, Fasching PA, Villalobos IE, Gasparyan A, Wachter D, Santiago A, Guzman R, Weihbrecht S, Hanf V, Hartmann A, Beckmann MW, Press MF. CCND1 amplification in early breast cancer patients: Correlation with subtypes and prognosis [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-12-07.
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Affiliation(s)
- DC Hanf
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - PA Fasching
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - IE Villalobos
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - A Gasparyan
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - D Wachter
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - A Santiago
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - R Guzman
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - S Weihbrecht
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - V Hanf
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - A Hartmann
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - MW Beckmann
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - MF Press
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Breast Center Klinikum Fuerth, Fuerth, Germany; Institute of Pathology, University Hospital Erlangen, Erlangen, Germany
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Feathers JT, Kieffer EC, Palmisano G, Anderson M, Janz N, Spencer MS, Guzman R, James SA. The Development, Implementation, and Process Evaluation of the REACH Detroit Partnership's Diabetes Lifestyle Intervention. Diabetes Educ 2016; 33:509-20. [PMID: 17570882 DOI: 10.1177/0145721707301371] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this article was to describe the development, implementation, and process evaluation findings of a culturally tailored diabetes lifestyle intervention for African Americans and Latinos. METHODS African American and Latino adults with type 2 diabetes from 3 health care systems in Detroit, Michigan, participated in diabetes lifestyle intervention of the Racial and Ethnic Approaches to Community Health Detroit Partnership. The intervention curricula were culturally and linguistically tailored for each population. Trained community residents delivered the curricula in 5 group meetings aimed at improving dietary, physical activity, and diabetes self-care behaviors of study participants. The aims of the process evaluation were to assess participant satisfaction with the intervention, utility, and applicability of information and cultural relevance of intervention materials. Content analysis was used to analyze qualitative data. Matrices were developed along thematic lines, and common themes were determined by grouping responses by question. RESULTS Ninety-eight percent of participants attended 1 or more intervention classes; 41% attended all 5 meetings. Attendance rates ranged from 59% to 88% for individual meetings. Participants reported that program information and activities were useful, culturally relevant, and applicable to diabetes self-management. Participants also appreciated the convenient community location for meetings and the social support received from other participants. CONCLUSIONS A community-based, culturally tailored diabetes lifestyle intervention delivered by trained community residents was associated with high participant satisfaction and retention.
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Affiliation(s)
- Jacqueline Two Feathers
- The School of Public Health, Department of Health Behavior and Health Education (Dr. Two Feathers, Dr. Kieffer, Dr. Janz)
- Dr Two Feathers is now at the Alaska Native Tribal Health Consortium in Anchorage, Alaska
| | - Edith C Kieffer
- The School of Public Health, Department of Health Behavior and Health Education (Dr. Two Feathers, Dr. Kieffer, Dr. Janz)
- Dr Kieffer is now in the School of Social Work, University of Michigan, Ann Arbor
| | - Gloria Palmisano
- Community Health and Social Services, Inc, Detroit, Michigan (Dr. Palmisano, Dr. Anderson and Mr. Guzman)
| | - Mike Anderson
- Community Health and Social Services, Inc, Detroit, Michigan (Dr. Palmisano, Dr. Anderson and Mr. Guzman)
| | - Nancy Janz
- The School of Public Health, Department of Health Behavior and Health Education (Dr. Two Feathers, Dr. Kieffer, Dr. Janz)
| | - Michael S Spencer
- The School of Social Work University of Michigan, Ann Arbor (Dr. Spencer)
| | - Ricardo Guzman
- Community Health and Social Services, Inc, Detroit, Michigan (Dr. Palmisano, Dr. Anderson and Mr. Guzman)
| | - Sherman A James
- The School of Public Health, Departments of Epidemiology and Health Behavior and Health Education (Dr. James)
- Dr James is now the Susan B. King professor of public policy studies and professor of sociology and family and community medicine at Duke University, Durham, North Carolina
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Ortega AP, Gonzalez-Diaz S, Arias-Cruz A, Macias-Weinmann A, Monge-Ortega O, Ibarra-Chávez J, Macouzet-Sánchez C, Ramos Valencia L, De Lira Quezada C, Guzman R. P138 Evaluation of functional capacity by six-minute walk test in pediatric asthma patients. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.148] [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: 11/25/2022]
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Shafiq ul Hassan M, Zhang G, Latifi K, Oliver J, Hunt D, Guzman R, Balagurunathan Y, Mackin D, Court L, Gillies R, Moros E. MO-DE-207B-04: Impact of Reconstruction Field of View On Radiomics Features in Computed Tomography (CT) Using a Texture Phantom. Med Phys 2016. [DOI: 10.1118/1.4957253] [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: 11/07/2022] Open
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Reganne M, Röthlisberger M, Guzman R, Schaefer D, Kalbermatten D, Madduri S. Dual Functional Collagen Nerve Conduits for Bridging Critical Nerve Gaps. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564551] [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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Fisch U, Brégère C, Chicha L, Guzman R. Phenotypical Characterization of Microglia in the Subventricular Zone after Neonatal Hypoxia-ischemia in Rat. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564550] [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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Röthlisberger M, Zumofen D, Schatlo B, Stienen M, Zumofen D, Sailer M, Fung C, Burkhardt J, Tok S, D'Alonzo D, Marbacher S, Hiroki D, Dell-Kuster S, Achermann R, Corniola M, Bervini D, Fathi A, Daniel R, Hildebrandt G, Regli L, Reinert M, Raabe A, Fandino J, Bijlenga P, Schaller K, Keller E, Mariani L, Guzman R. Clinical and Radiological Characteristics of Aneurysmal Subarachnoid Hemorrhage in Older Adults. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564548] [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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Schatlo B, Fung C, Stienen M, Fathi A, Fandino J, Smoll N, Tok S, Daniel R, Zumofen D, Burkhard J, Dan-Ura H, Röthlisberger M, Reinert M, Winkler K, Ahlborn P, Mendes-Pereira V, D́Alonzo D, Seule M, Kerkeni H, Bervini D, Sailer M, Kuhlen D, Remonda L, Rohde V, Mostaguir K, Marbacher S, Valsecchi D, Corniola M, Schöni D, Woernle C, Regli L, Levivier M, Hildebrandt G, Mariani L, Beck J, Guzman R, Raabe A, Bijlenga P, Keller E, Schaller K. Incidence, Therapy, and Outcome of Aneurysmal Subarachnoid Hemorrhage. The Swiss Study on Aneurysmal Subarachnoid Hemorrhage (Swiss SOS). J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564496] [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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Röthlisberger M, Madduri S, Marbacher S, Schaefer D, Kalbermatten D, Mariani L, Guzman R. Modular Bioactive Scaffold for Facial Nerve Reconstruction. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564516] [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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Soleman J, Thieringer F, Beinemann J, Oesch V, Kunz C, Guzman R. Computer-Assisted Virtual Planning and Surgical Template Fabrication for Fronto-orbital Advancement. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564539] [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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Bregere C, Fisch U, Lieb S, Sailer M, Chicha L, Goepfert F, Kremer T, Guzman R. Doublecortin in the Cerebrospinal Fluid Is a Candidate Biomarker of Neurogenesis after Neonatal Hypoxia Ischemia Brain Injury in Rats. J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564547] [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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Stienen M, Corniola MV, Smoll N, Burkhardt JK, Fung C, Schöni D, Röthlisberger M, Bervini D, Valsecchi D, Arrighi M, Maduri R, Danura H, Fathi AR, Keller E, Regli L, Fandino J, Hildebrandt G, Guzman R, Schatlo B, Schaller K, Bijlenga P. Decompressive Hemicraniectomy in Aneurysmal Subarachnoid Hemorrhage—Insights from a Swiss National Database (Swiss SOS). J Neurol Surg A Cent Eur Neurosurg 2015. [DOI: 10.1055/s-0035-1564340] [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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Dulemba J, Guzman R, Mirzakhani P. Evaluation of a Robotic Uterine Manipulation. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Soleman J, Soleman J, Datta A, Strozzi S, Ramelli G, Mariani L, Mariani Luigi L, Guzman R, Guzman R. Implantation of Vagal Nerve Stimulation in Children. J Neurol Surg A Cent Eur Neurosurg 2014. [DOI: 10.1055/s-0034-1383772] [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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Abstract
Neonatal hypoxic-ischemic insults are a significant cause of pediatric encephalopathy, developmental delays, and spastic cerebral palsy. Although the developing brain's plasticity allows for remarkable self-repair, severe disruption of normal myelination and cortical development upon neonatal brain injury are likely to generate life-persisting sensory-motor and cognitive deficits in the growing child. Currently, no treatments are available that can address the long-term consequences. Thus, regenerative medicine appears as a promising avenue to help restore normal developmental processes in affected infants. Stem cell therapy has proven effective in promoting functional recovery in animal models of neonatal hypoxic-ischemic injury and therefore represents a hopeful therapy for this unmet medical condition. Neural stem cells derived from pluripotent stem cells or fetal tissues as well as umbilical cord blood and mesenchymal stem cells have all shown initial success in improving functional outcomes. However, much still remains to be understood about how those stem cells can safely be administered to infants and what their repair mechanisms in the brain are. In this review, we discuss updated research into pathophysiological mechanisms of neonatal brain injury, the types of stem cell therapies currently being tested in this context, and the potential mechanisms through which exogenous stem cells might interact with and influence the developing brain.
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Affiliation(s)
- L Chicha
- Department of Biomedicine, University of Basel, Basel, Switzerland
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Mohedano M, Guzman R, Arrabal R, López Lacomba JL, Matykina E. Bioactive plasma electrolytic oxidation coatings-The role of the composition, microstructure, and electrochemical stability. J Biomed Mater Res B Appl Biomater 2013; 101:1524-37. [DOI: 10.1002/jbm.b.32974] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/11/2013] [Accepted: 04/23/2013] [Indexed: 12/15/2022]
Affiliation(s)
- M. Mohedano
- Departamento de Ciencia de Materiales, Facultad de Ciencias Químicas; Universidad Complutense; 28040 Madrid Spain
| | - R. Guzman
- Grupo de Ingeniería de Tejidos, Instituto de Estudios Biofuncionales; Universidad Complutense; 28040 Madrid Spain
| | - R. Arrabal
- Departamento de Ciencia de Materiales, Facultad de Ciencias Químicas; Universidad Complutense; 28040 Madrid Spain
| | - J.-L. López Lacomba
- Grupo de Ingeniería de Tejidos, Instituto de Estudios Biofuncionales; Universidad Complutense; 28040 Madrid Spain
| | - E. Matykina
- Departamento de Ciencia de Materiales, Facultad de Ciencias Químicas; Universidad Complutense; 28040 Madrid Spain
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Guzman R, Roa G, Rodriguez W, Cordoba J, Villalba A. AB0285 First real life experience with certolizumab pegol in rheumathoid arthritis (ra) in latinamerica. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2607] [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: 11/03/2022]
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Andres R, Andereggen L, Ducray A, Mordasini P, Guzman R, Barth A, Raabe A, Widmer H. Intracerebral Hemorrhage Affects the Extrapyramidal System and Promotes Endogenous Neurogenesis in the Subventricular Zone and Hippocampus. J Neurol Surg A Cent Eur Neurosurg 2012. [DOI: 10.1055/s-0032-1316234] [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: 10/28/2022]
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Adoue D, Navarra S, Petri M, Gallacher A, Guzman R, Furie R, Thomas M, Zamani O, Levy R, Van Vollenhoven R, Cerva R, Wallace D. Profil de tolérance du bélimumab, inhibiteur de BLyS, chez des patients atteints de lupus systémique (LS) actif dans les essais cliniques de phase 2 et 3. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.214] [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: 11/25/2022]
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Woo K, Qu X, Babaev V, Linton M, Guzman R, Fazio S, Baldwin H. L1 Tie1 ATTENUATION RESULTS IN A LOCATION-SPECIFIC AND SHEAR STRESS-DEFINED REDUCTION IN ATHEROSCLEROSIS. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70061-1] [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: 11/12/2022]
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Backhouse MR, Keenan AM, Young A, James D, Cox N, Williams P, Musa R, Helliwell PS, Kingsley GH, Packham JC, McHugh NJ, Mulherin DM, Kitas GD, Chakravarty K, Ibrahim F, Taylor H, Kowalczyk A, Maddison PJ, Scott DL, D'Cruz D, Tanasescu C, Navarra S, Guzman R, Gallacher A, Levy RA, Li EK, Thomas M, Jimenez RE, Leon MG, Hall S, Lan JL, Kim HY, Pineda L, Zhong J, Freimuth WW. BSR and BHPR Plenary Oral [OP1-OP3]: OP1. Use of Conservative and Surgical Foot Care in Rheumatoid Arthritis: The Eras Cohort. Rheumatology (Oxford) 2010; 49 Suppl 1:i1-167. [DOI: 10.1093/rheumatology/keq700] [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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Wang GX, Luo LL, Yin TY, Li Y, Jiang T, Ruan CG, Guidoin R, Chen YP, Guzman R. Ultrasonic atomization and subsequent desolvation for monoclonal antibody (mAb) to the glycoprotein (GP) IIIa receptor into drug eluting stent. J Microencapsul 2010. [DOI: 10.3109/02652040903046798] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rizvi S, Komalavilas P, Guzman R, Dattilo J, Brophy C. Expression of the Heat Shock Protein, HSPB1, Is Associated with Impaired Smooth Muscle Relaxation. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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35
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Wang GX, Luo LL, Yin TY, Li Y, Jiang T, Ruan CG, Guidoin R, Chen YP, Guzman R. Ultrasonic atomization and subsequent desolvation for monoclonal antibody (mAb) to the glycoprotein (GP) IIIa receptor into drug eluting stent. J Microencapsul 2009; 27:105-14. [PMID: 19566394 DOI: 10.1080/02652040903046798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An eluting-stent system with mAb dispersed in the PLLA (poly (L-lactic acid)) was validated in vitro. Specifically designed spray equipment based on the principle of ultrasonic atomization was used to produce a thin continuous PLLA (poly (L-lactic acid)) polymer coating incorporating monoclonal antibody (mAb). This PLLA coating was observed in light microscopy (LM) and scanning electron microscopy (SEM). The concentration of the monoclonal antibody (mAb) to the platelet glycoprotein (GP) IIIa receptor and the eluting rate were then measured by a radioisotope technique with (125)I-labelled GP IIIa mAb. An in vitro perfusion circuit was designed to evaluate the release rates at different velocities (10 or 20 ml min(-1)). The PLLA coating was thin and transparent, uniformly distributed on the surface of the stent. Three factors influenced its thickness: PLLA concentration, duration and gas pressure. The concentration of mAb was influenced by the duration of absorption and the concentration of the mAb solution; the maximum was 1662.23 + or - 38.83 ng. The eluting rate was fast for the first 2 h, then decreased slowly and attained 80% after 2 weeks. This ultrasonic atomization spray equipment and technological process to prepare protein eluting-stents were proved to be effective and reliable.
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Affiliation(s)
- G X Wang
- Bioengineering College of Chongqing University, Chongqing, PR China.
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Guzman R, Lovblad KO, Altrichter S, Remonda L, de Koning P, Andres RH, El-Koussy M, Kelly ME, Reiber JHC, Schroth G, Oswald H, Barth A. Clinical validation of an automated vessel-segmentation software of the extracranial-carotid arteries based on 3D-MRA: a prospective study. J Neuroradiol 2008; 35:278-85. [PMID: 18707758 DOI: 10.1016/j.neurad.2008.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To determine the accuracy of automated vessel-segmentation software for vessel-diameter measurements based on three-dimensional contrast-enhanced magnetic resonance angiography (3D-MRA). METHOD In 10 patients with high-grade carotid stenosis, automated measurements of both carotid arteries were obtained with 3D-MRA by two independent investigators and compared with manual measurements obtained by digital subtraction angiography (DSA) and 2D maximum-intensity projection (2D-MIP) based on MRA and duplex ultrasonography (US). In 42 patients undergoing carotid endarterectomy (CEA), intraoperative measurements (IOP) were compared with postoperative 3D-MRA and US. RESULTS Mean interoperator variability was 8% for measurements by DSA and 11% by 2D-MIP, but there was no interoperator variability with the automated 3D-MRA analysis. Good correlations were found between DSA (standard of reference), manual 2D-MIP (rP=0.6) and automated 3D-MRA (rP=0.8). Excellent correlations were found between IOP, 3D-MRA (rP=0.93) and US (rP=0.83). CONCLUSION Automated 3D-MRA-based vessel segmentation and quantification result in accurate measurements of extracerebral-vessel dimensions.
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Affiliation(s)
- R Guzman
- Department of Neurosurgery, Inselspital, Bern, Switzerland
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Guzman R, Altrichter S, El-Koussy M, Gralla J, Weis J, Barth A, Seiler RW, Schroth G, Lövblad KO. Contribution of the apparent diffusion coefficient in perilesional edema for the assessment of brain tumors. J Neuroradiol 2008; 35:224-9. [PMID: 18420272 DOI: 10.1016/j.neurad.2008.02.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [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: 11/17/2022]
Abstract
OBJECTIVES Diffusion-weighted MRI is sensitive to molecular motion and has been applied to the diagnosis of stroke. Our intention was to investigate its usefulness in patients with brain tumor and, in particular, in the perilesional edema. METHODS We performed MRI of the brain, including diffusion-weighted imaging and mapping of the apparent diffusion coefficient (ADC), in 16 patients with brain tumors (glioblastomas, low-grade gliomas and metastases). ADC values were determined by the use of regions of interest positioned in areas of high signal intensities as seen on T2-weighted images and ADC maps. Measurements were taken in the tumor itself, in the area of perilesional edema and in the healthy contralateral brain. RESULTS ADC mapping showed higher values of peritumoral edema in patients with glioblastoma (1.75 x 10(-3)mm(2)/s) and metastatic lesions (1.61 x 10(-3)mm(2)/s) compared with those who had low-grade glioma (1.40 x10(-3)mm(2)/s). The higher ADC values in the peritumoral zone were associated with lower ADC values in the tumor itself. CONCLUSIONS The higher ADC values in the more malignant tumors probably reflect vasogenic edema, thereby allowing their differentiation from other lesions.
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Affiliation(s)
- R Guzman
- Department of Neurosurgery, Inselspital, University of Berne, Berne, Switzerland
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Andres RH, Guzman R, Weis J, Schroth G, Barth A. Granuloma formation and occlusion of an unruptured aneurysm after wrapping. Acta Neurochir (Wien) 2007; 149:953-8; discussion 958. [PMID: 17676408 DOI: 10.1007/s00701-007-1260-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Accepted: 05/22/2007] [Indexed: 11/29/2022]
Abstract
Excessive granulomatous foreign-body reaction is a very rare complication after wrapping of intracranial aneurysms. The pathogenetic mechanisms underlying this process are unknown. We report on a patient who developed a space-occupying granulomatous abscess after wrapping of an unruptured aneurysm of the M2/M3 bifurcation. The patient underwent revision craniotomy for abscess removal. The aneurysm was explored and found to be completely thrombosed and excluded from the circulation. Exuberant granulomatous foreign-body reaction was pathologically confirmed and Candida parapsilosis was isolated from the pus. The patient underwent an antifungal treatment regimen and recovered with no residual neurological deficits. Our findings support the assumption that a low-grade infectious process might trigger excessive inflammatory reaction after wrapping. We suggest that this process may also result in complete thrombosis of cerebral aneurysms, which is otherwise a rarely observed phenomenon.
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Affiliation(s)
- R H Andres
- Department of Neurosurgery, University of Berne, Inselspital, Berne, Switzerland.
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Guzman R, Buchbinder S, Mansergh G, Vittinghoff E, Marks G, Wheeler S, Colfax GN. Communication of HIV viral load to guide sexual risk decisions with serodiscordant partners among San Francisco men who have sex with men. AIDS Care 2007; 18:983-9. [PMID: 17012089 DOI: 10.1080/09540120500497908] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 10/24/2022]
Abstract
The objective of this study was to estimate frequency and correlates of discussing HIV viral load (VL) with serodiscordant sex partners to guide decisions about sexual activities among men who have sex with men (MSM). We conducted a cross-sectional survey of 573 San Francisco MSM. Among 507 who knew their HIV status, 397 (78%) were familiar with the term 'viral load', and half (n=199) had a serodiscordant partner in the prior year. These 199 respondents (n=130 [65%] HIV-positive; n=69 [35%] HIV-negative) were the focus of this analysis. A majority (n=111, 56%) discussed VL in the prior year with serodiscordant partners specifically to guide decisions about sexual risk behaviour. Discussion was more common among HIV-positive than HIV-negative participants (adjusted odds ratio [AOR], 3.5; 95% confidence interval [CI], 1.6-7.6), and African Americans compared to whites (AOR, 3.7; 95% CI, 1.5-9.5). HIV-negative men who discussed VL were more concerned about becoming infected, but also more willing to engage in risky behaviour with a partner whose VL is undetectable, than men not discussing VL. Some HIV-negative men may be discussing VL to engage in higher risk behaviour upon learning of an HIV-positive partner's undetectable VL. Interventions targeting MSM should explain that while risk of transmission is likely reduced with a low blood plasma VL, it is not necessarily eliminated.
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Affiliation(s)
- R Guzman
- AIDS Office, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
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Guidoin R, Zhang Z, Douville Y, Baslé MF, Grizon F, Marinov GR, Zarins CK, Legrand AP, Guzman R. Polymethylmethacrylate (PMMA) as an embedding medium preserving tissues and foreign materials encroaching in endovascular devices. Artif Cells Blood Substit Immobil Biotechnol 2006; 34:349-66. [PMID: 16809135 DOI: 10.1080/10731190600684041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Problems of displacement, poor healing, degradation of the polymers and corrosion of the metallic frame in endovascular devices still require in-depth investigations. As the tissues and the foreign materials are in close contact, it is of paramount importance to efficiently investigate the interfaces between them. Inclusion in polymethymethacrylate (PMMA) permits us to obtain thin slides and preserve the capacity to perform the appropriate stainings. An AneuRx prosthesis was harvested in bloc with the surrounding tissues at the autopsy of a patient 25 months post deployment in a 5.7 cm diameter AAA and sectioned in the direction of the blood flow in two halves. A cross-section of the encapsulated distal segment together with the surrounding aneuryshmal sac was embedded in polymethylmethacrylate (PMMA). Further to complete polymerization, slices of the specimen were cut on a precision banding saw under coolant. They were affixed onto methacrylate slides with a UV cured adhesive. Binding and polishing were done on a numeric grinder and slices 25 to 30 microm in thickness were stained with toluidine blue prior to observation in light microscopy. Additional slices were prepared for scanning electron microscopy and X-ray energy dispersive spectrometry for determination of the elemental composition of the Nitinol stent. The aortic wall did not demonstrate complete integrity along with its circumference. Some areas of rupture were noted. The content of the sac was heavily shrunk and was mostly acellular. The walls of the device were very well encapsulated. The PMMA embedding permitted the polyester wall, the Nitinol wire and the collagen to keep in close contact. Scanning electron microscopy involved backscattered electrons and confirmed the corrosion the Nitinol wire at the boundary with living tissues. Based upon the results obtained, we believe that PMMA embedding is the most appropriate method to process endovascular devices for histological and material investigation. Needless to say, that paraffin embedding would have not been feasible for such a big size specimen involving different materials.
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Affiliation(s)
- R Guidoin
- Department of Surgery, Laval University and Quebec Biomaterials Institute, St François d'Assise Hospital, Quebec, Canada.
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Mansergh G, Shouse RL, Marks G, Guzman R, Rader M, Buchbinder S, Colfax GN. Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sex Transm Infect 2006; 82:131-4. [PMID: 16581738 PMCID: PMC2564684 DOI: 10.1136/sti.2005.017129] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.8] [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: 11/04/2022] Open
Abstract
OBJECTIVES There is evidence that methamphetamine and sildenafil (Viagra) use are associated with sexual risk behaviour among men who have sex with men (MSM). We investigated the association of methamphetamine, sildenafil, and other substance use with unprotected receptive and insertive anal sex among MSM by conducting an encounter specific analysis. METHODS Data were from a cross sectional, community based survey of MSM in San Francisco regarding behaviour during their most recent anal sex encounter. Mulitvariate regression analysed independent associations of specific substance use and demographic variables with unprotected anal sex behaviours. RESULTS The sample (n = 388) was diverse in race/ethnicity, age, income, education, HIV status, and homosexual/bisexual identification. More than half (53%) reported unprotected anal sex, including insertive (29%) and receptive (37%) during their most recent anal sex encounter; 12% reported unprotected insertive and 17% reported unprotected receptive anal sex with an HIV discordant or unknown partner. Methamphetamine was used by 15% and sildenafil was used by 6% of the men before or during the encounter; 2% used both drugs. In multivariate analysis controlling for demographic factors and other substance use, methamphetamine use was associated with unprotected receptive (odds ratio (OR), 2.03; 95% confidence interval (CI), 1.09 to 3.76) and sildenafil use was associated with unprotected insertive (OR, 6.51; CI, 2.46 to 17.24) anal sex. Effects were stronger with HIV discordant or unknown sex partners specifically. CONCLUSION Encounter specific associations of methamphetamine and sildenafil use with unprotected receptive and insertive anal sex, respectively, indicate the importance of assessment specificity and tailoring risk reduction efforts to address certain drugs and sexual behavioural roles among MSM.
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Affiliation(s)
- G Mansergh
- CDC Division of HIV/AIDS Prevention, 1600 Clifton Road, Mailstop E-37, Atlanta, GA 30333, USA.
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Guidoin R, Zhang Z, Douville Y, Bonny JM, Renou JP, Baslé MF, Zarins CK, Legrand AP, Guzman R. MRI virtual biopsies: analysis of an explanted endovascular device and perspectives for the future. ACTA ACUST UNITED AC 2006; 34:241-61. [PMID: 16537177 DOI: 10.1080/10731190600581825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 10/24/2022]
Abstract
Information that can be obtained by magnetic resonance imaging (MRI) of explanted endovascular devices must be validated as this method is non-destructive. Histology of such a device together with its encroached tissues can be elegantly performed after polymethymethacrylate (PMMA) embedding, but this approach requires destruction of the specimen. The issue is therefore to determine if the MRI is sufficient to fully validate an explanted device based upon the characterization of an explanted specimen. An AneuRx device deployed percutaneously 25 months earlier in a 75-year-old patient was removed en bloc at autopsy together with the surrounding aneurysmal sac and segments of the upstream and downstream arteries. Macroscopic pictures were taken and a slice of the cross-section was processed for histology after polymethylmethacrylate (PMMA) embedding. For the magnetic resonance imaging investigation, the device was inserted in a Biospec 4.7 T MRI system with a 20 mm diameter birdcage resonator used for both emission and reception. A Spin-Echo (SE) was used to acquire both T1 proton density (PD) and T2 weighted images. A gradient-echo (GE) sampling of a free induction decay (GESFID) was used to generate multiple GE images using a single excitation pulse so that four images at different TE were obtained in the same acquisition. The selected explanted device was outstandingly well-healed compared to most devices harvested from humans. No inflammatory process was observed in contact or at distance of the materials. In MRI T1 images display no specific contrast and were homogeneous in the different tissues. The contrast was improved on proton density weighed images. On the T2 weighed images, the different areas were well identified. The diffusion images displayed in the surrounding B region had the greatest diffusion coefficient and the greatest anisotropy. The MRI analysis of the explanted AneuRx device illustrates the possibilities of this technique to characterize the interaction of the endovascular graft with the surrounding tissues. MRI is a breakthrough to investigate explanted medical devices but it also can be advantageously used in vivo to obtain virtual biopsies, because real biopsies to determine the 3 Bs (biocompatibility, biofunctionality and bioresilience) cannot be carried out as they could obviously initiate infection and degradation of the foreign materials.
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Affiliation(s)
- R Guidoin
- Department of Surgery, Laval University and Quebec Biomaterials Institute, St. François d'Assise Hospital, Quebec, Canada.
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Yang Y, Guzman R, Deymier PA, Umnov M, Hoying J, Raghavan S, Palusinski O, Zelinski BJJ. Adsorption of a microtubule on a charged surface affects its disassembly dynamics. J Nanosci Nanotechnol 2005; 5:2050-6. [PMID: 16430139 DOI: 10.1166/jnn.2005.510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The dynamics of disassembly of microtubules deposited on surfaces is shown to be strongly dependent on the electrostatic interaction between the microtubule and the substrate. Fluorescence microscopy of microtubules adsorbed on a Poly-L-Lysine film and immersed in pure water show a drastic decrease in disassembly velocity compared to the microtubules in bulk water solutions. While microtubules suspended in pure water disassemble in seconds, the dissociation velocity of microtubules adsorbed on a Poly-L-Lysine film ranges from 0.8 to 1.0 microm/min in pure water. Kinetic Monte Carlo simulations of the microtubule dynamics indicate that a decrease in the dissociation velocity of unstable microtubules can be achieved by reducing the heterodimer dissociation rate constant of tubulin heterodimers constituting a single protofilament, adsorbed to the Poly-L-Lysine film. This model suggests that the reduction of the dissociation velocity originates from the electrostatic interactions between the positively charged amino groups of the Poly-L-Lysine film and the negatively charged microtubule surface.
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Affiliation(s)
- Yi Yang
- Department of Materials Science and Engineering, Nano-Biomolecular Engineering Science and Technology (n-BEST) Program, The University of Arizona, Tucson AZ 85721, USA
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Barth A, Guzman R, Andres R, Mordasini P, Widmer H. Hémorragie intracérébrale expérimentale. Neurochirurgie 2005. [DOI: 10.1016/s0028-3770(05)83589-1] [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: 10/22/2022]
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Two Feathers J, Kieffer EC, Palmisano G, Anderson M, Sinco B, Janz N, Heisler M, Spencer M, Guzman R, Thompson J, Wisdom K, James SA. Racial and Ethnic Approaches to Community Health (REACH) Detroit partnership: improving diabetes-related outcomes among African American and Latino adults. Am J Public Health 2005; 95:1552-60. [PMID: 16051927 PMCID: PMC1449397 DOI: 10.2105/ajph.2005.066134] [Citation(s) in RCA: 166] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2005] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to determine the effects of a community-based, culturally tailored diabetes lifestyle intervention on risk factors for diabetes complications among African Americans and Latinos with type 2 diabetes. METHODS One hundred fifty-one African American and Latino adults with diabetes were recruited from 3 health care systems in Detroit, Michigan, to participate in the Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership diabetes lifestyle intervention. The curriculum, delivered by trained community residents, was aimed at improving dietary, physical activity, and diabetes self-care behaviors. Baseline and postintervention levels of diabetes-specific quality-of-life, diet, physical activity, self-care knowledge and behaviors, and hemoglobin A1C were assessed. RESULTS There were statistically significant improvements in postintervention dietary knowledge and behaviors and physical activity knowledge. A statistically significant improvement in A1C level was achieved among REACH Detroit program participants (P<.0001) compared with a group of patients with diabetes in the same health care system in which no significant changes were observed (P=.160). CONCLUSIONS A culturally tailored diabetes lifestyle intervention delivered by trained community residents produced significant improvement in dietary and diabetes self-care related knowledge and behaviors as well as important metabolic improvements.
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Affiliation(s)
- Jacqueline Two Feathers
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, USA.
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Christe A, Läubli R, Guzman R, Berlemann U, Moore RJ, Schroth G, Vock P, Lövblad KO. Degeneration of the cervical disc: histology compared with radiography and magnetic resonance imaging. Neuroradiology 2005; 47:721-9. [PMID: 16136264 DOI: 10.1007/s00234-005-1412-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2005] [Accepted: 04/24/2005] [Indexed: 10/25/2022]
Abstract
Decisions about the treatment of neck pain are largely made on the basis of information gained from plain X-rays and magnetic resonance imaging (MRI), which are used routinely as part of preliminary investigation. We performed a descriptive cadaveric study to compare histology with radiography and MRI. We correlated plain radiography, disc height [Farfan index (FI)] and MRI findings with histology to assess the ability of radiology to detect significant pathologic lesions. The study included 52 motion segments from nine subjects over the age of 50, who underwent routine hospital autopsy. Disc degeneration was assessed by histology, radiography, disc height (FI: anterior disc height plus posterior disc height divided by anterioposterior diameter) and MRI using established grading systems. Most of the discs were classified radiologically as grade 1 (19/52), grade 2 (13/52), grade 3 (9/52) or grade 4 (3/52). Eight of the discs were graded as normal. The distribution of MRI grades was grade 0 (9/36), grade 1 (9/36), grade 2 (7/36), grade 3 (8/36) and grade 4 (3/36). Half of the discs (26/52) showed advanced (grade 4) degeneration histologically. FI correlated with histological grade (P = 0.013), MRI grade (P = 0.02) and radiological grade (P < 0.001) of degeneration. Radiological and histological grade of degeneration showed a weak correlation (r = 0.3, P = 0.033). MRI correlated with overall histological grade (r = 0.41, P = 0.015, n = 34). Histological features (e.g., tears, rim lesions, prolapse of nucleus material) were poorly recognised by MRI, which had a sensitivity for disc material prolapse and annulus tears of less than 40%. Our study showed that discs from patients over 50 years are histologically severely degenerated; however, these changes may not be detected by conventional radiography and MRI.
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Affiliation(s)
- A Christe
- Department of Radiology, Inselspital, University of Berne, Berne, Switzerland
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Guzman R, Lövblad KO, Barth A, Remonda L, Schroth G. Persistent hypoglossal artery found incidentally. JBR-BTR 2005; 88:134-5. [PMID: 16038229] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- R Guzman
- Department of Neurosurgery, IDR, Inselspital, Freiburgstrasse, Berne, Switzerland
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Christodoulou C, Guzman R. Radial artery pseudoaneurysm. Acta Anaesthesiol Scand 2004; 48:796-7. [PMID: 15196121 DOI: 10.1111/j.0001-5172.2004.0408g.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mariani L, Siegenthaler P, Guzman R, Friedrich D, Fathi AR, Ozdoba C, Weis J, Ballinari P, Seiler RW. The impact of tumour volume and surgery on the outcome of adults with supratentorial WHO grade II astrocytomas and oligoastrocytomas. Acta Neurochir (Wien) 2004; 146:441-8. [PMID: 15118879 DOI: 10.1007/s00701-004-0222-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [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: 11/27/2022]
Abstract
BACKGROUND The study was performed to elucidate the impact of tumour volume and surgical resection on the long-term outcome of patients with supratentorial, diffuse, World Health Organization (WHO) grade II astrocytomas and oligo-astrocytomas. METHOD After analysing 79 adult patients consecutively diagnosed between 1991 and 2000, we selected a group of 42 patients treated by surgery without adjuvant therapy. The tumour volume was defined as the whole region of T2-hyperintensity and measured interactively on pre- and postoperative and follow-up Magnetic Resonance Imaging (MRI) using a dedicated imaging software. Volumetric, clinical, and histological data were analysed for correlation with tumour progression (TP), malignant transformation (MT), drop in functional status (DKPS) and overall survival (OS). FINDINGS Pre- and postoperative tumour volumes, and the involvement of more than one lobe were strongly associated with worse outcome. Preoperative tumour volume was the strongest predictor of OS (p<0.01) and the only predictor of MT (p<0.05). The absolute and relative volumes of tumour removed by surgery were not significantly associated with outcome. CONCLUSIONS. Initial tumour volume, measured as the volume of T2-hyperintensity on MRI, and tumour extension are the strongest predictors of outcome in patients with supratentorial diffuse astrocytic WHO Grade II tumours. The potential benefit of aggressive tumour resection needs to be investigated in a prospective controlled trial.
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Affiliation(s)
- L Mariani
- Department of Neurosurgery, Inselspital, Bern, Switzerland.
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