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Pollini T, Tran T, Wong P, Adam MA, Alseidi A, Corvera C, Hirose K, Nakakura E, Warren R, Maker VK, Maker AV. Improved survival of patients receiving immunotherapy and chemotherapy following curative-intent resection of colorectal liver metastases. J Gastrointest Surg 2024; 28:246-251. [PMID: 38445916 DOI: 10.1016/j.gassur.2023.12.026] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/25/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Despite significant advancements in the treatment of patients with colorectal liver metastases (CRLMs), only a minority will experience long-term survival. This study aimed to determine the effect of chemotherapy (CT) and immunotherapy (IT) compared with that of CT alone on patient survival after surgical resection. METHODS Patients undergoing curative-intent liver resection followed by adjuvant systemic therapy for stage IV colon cancer were identified using the National Cancer Database. Patients were stratified into type of therapy (CT alone vs CT + IT) and microsatellite status. Propensity score-weighted analysis was performed through 1:1 matching based on the nearest neighbor method. RESULTS Of 9943 patients who underwent resection of CRLMs, 7971 (80%) received systemic adjuvant therapy. Of 7971 patients, 1432 (18%) received a combination of CT and IT. Microsatellite status was not associated with overall survival (OS). Adjuvant CT + IT was associated with increased 3-year OS compared with that of CT alone in both the unmatched cohort (55% vs 48%, respectively; P < .001) and matched cohort (52% vs 48%, respectively; P = .050). On multivariate analysis, older age, positive resection margins, and KRAS mutation were independent predictors of poor survival, whereas the administration of adjuvant CT + IT was an independent predictor of improved survival. CONCLUSION IT combined with CT was associated with improved survival compared with that of CT alone after curative-intent resection of CRLMs, regardless of microsatellite instability status. Clinical trials to determine optimal patient selection, IT regimen, and long-term efficacy to improve outcomes of patients with CRLMs are warranted.
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Affiliation(s)
- Tommaso Pollini
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Thuy Tran
- Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, California, United States; Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Paul Wong
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Mohamed A Adam
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Adnan Alseidi
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Carlos Corvera
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Kenzo Hirose
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Eric Nakakura
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Robert Warren
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States
| | - Vijay K Maker
- Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Ajay V Maker
- Division of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, United States.
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Cook KD, Tran T, Thomas VA, Devanaboyina SC, Rock DA, Pearson JT. Correlation of In Vitro Kinetic Stability to Preclinical In Vivo Pharmacokinetics for a Panel of Anti-PD-1 Monoclonal Antibody Interleukin 21 Mutein Immunocytokines. Drug Metab Dispos 2024; 52:228-235. [PMID: 38135505 DOI: 10.1124/dmd.123.001555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023] Open
Abstract
The development of therapeutic fusion protein drugs is often impeded by the unintended consequences that occur from fusing together domains from independent naturally occurring proteins, consequences such as altered biodistribution, tissue uptake, or rapid clearance and potential immunogenicity. For therapeutic fusion proteins containing globular domains, we hypothesized that aberrant in vivo behavior could be related to low kinetic stability of these domains leading to local unfolding and susceptibility to partial proteolysis and/or salvage and uptake. Herein we describe an assay to measure kinetic stability of therapeutic fusion proteins by way of their sensitivity to the protease thermolysin. The results indicate that in vivo pharmacokinetics of a panel of anti-programmed cell death protein 1 monocolonal antibody:interleukin 21 immunocytokines in both mice and nonhuman primates are highly correlated with their in vitro susceptibility to thermolysin-mediated proteolysis. This assay can be used as a tool to quickly identify in vivo liabilities of globular domains of therapeutic proteins, thus aiding in the optimization and development of new multispecific drug candidates. SIGNIFICANCE STATEMENT: This work describes a novel assay utilizing protein kinetic stability to identify preclinical in vivo pharmacokinetic liabilities of multispecific therapeutic fusion proteins. This provides an efficient, inexpensive method to ascertain inherent protein stability in vitro before conducting in vivo studies, which can rapidly increase the speed of preclinical drug development.
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Affiliation(s)
- Kevin D Cook
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | - Thuy Tran
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | - Veena A Thomas
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | | | - Dan A Rock
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | - Josh T Pearson
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
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Hagopian G, Jiang X, Grant C, Brazel D, Kumar P, Yamamoto M, Jakowatz J, Chow W, Tran T, Shen W, Moyers J. Survival impact of post-operative immunotherapy in resected stage III cutaneous melanomas in the checkpoint era. ESMO Open 2024; 9:102193. [PMID: 38271786 PMCID: PMC10937207 DOI: 10.1016/j.esmoop.2023.102193] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/03/2023] [Accepted: 11/01/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Checkpoint inhibitors have shown improvement in recurrence-free survival in the post-operative setting for node-positive melanoma and were first approved in late 2015. However, single-agent checkpoint therapies have yet to show benefit to overall survival (OS) for lower-risk stage III cancers. We evaluated the OS benefit of post-operative immunotherapy in the National Cancer Database (NCDB). PATIENTS AND METHODS Patient cases were selected from the NCDB 2020 Participant Use File. Patients diagnosed with stage III cutaneous melanoma between 2016 and 2019 who underwent definitive resection for their melanoma were included. OS between those who received post-operative immunotherapy within 84 days of surgery and those who did not was analyzed by the Kaplan-Meier method. Demographic and clinical characteristics between the two groups were compared via Cox proportional hazard models. RESULTS 14 978 patients with stage III melanoma were included. Of those, 34.9% (n = 5234) received post-operative immunotherapy and 65.1% (n = 9744) did not. Using the American Joint Committee on Cancer version 8 (AJCCv8) staging, 36-month survival was significantly higher in patients who received post-operative immunotherapy compared to no post-operative systemic therapy in those diagnosed with stage IIIB (88.0% versus 84.7%, P = 0.011), IIIC (75.6% versus 68.1%, P < 0.001), or IIID (59.2% versus 48.4%, P = 0.002). No significant improvement in 36-month survival was seen in patients who received post-operative immunotherapy in patients with stage IIIA disease (93.0% versus 92.2%, P = 0.218). CONCLUSIONS Post-operative immunotherapy had an OS benefit in patients with AJCCv8 stage IIIB, IIIC, and IIID disease, but had no significant survival benefit for patients with stage IIIA melanomas.
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Affiliation(s)
- G Hagopian
- Department of Medicine, University of California Irvine Medical Center, Orange
| | - X Jiang
- Department of Statistics, University of California Irvine, Irvine
| | - C Grant
- Department of Medicine, University of California Irvine Medical Center, Orange
| | - D Brazel
- Department of Medicine, University of California Irvine Medical Center, Orange
| | - P Kumar
- Department of Medicine, University of California Irvine Medical Center, Orange
| | - M Yamamoto
- Division of Surgical Oncology, Department of Surgery, University of California Irvine Medical Center, Orange
| | - J Jakowatz
- Division of Surgical Oncology, Department of Surgery, University of California Irvine Medical Center, Orange
| | - W Chow
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine Medical Center, Orange
| | - T Tran
- Division of Surgical Oncology, Department of Surgery, University of California Irvine Medical Center, Orange
| | - W Shen
- Department of Statistics, University of California Irvine, Irvine
| | - J Moyers
- The Angeles Clinic & Research Institute, A Cedars-Sinai Affiliate, Los Angeles, USA.
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Kayal A, Nahar N, Barker L, Tran T, Williams M, Blackall PJ, Turni C, Omaleki L. Molecular identification and characterisation of Mannheimia haemolytica. Vet Microbiol 2024; 288:109930. [PMID: 38086163 DOI: 10.1016/j.vetmic.2023.109930] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/08/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023]
Abstract
Mannheimia haemolytica is known as one of the major bacterial contributors to Bovine Respiratory Disease (BRD) syndrome. This study sought to establish a novel species-specific PCR to aid in identification of this key pathogen. As well, an existing multiplex PCR was used to determine the prevalence of serovars 1, 2 or 6 in Australia. Most of the 65 studied isolates originated from cattle with a total of 11 isolates from small ruminants. All problematic field isolates in the identification or serotyping PCRs were subjected to whole genome sequencing and bioinformatic analysis. The field isolates were also subjected to rep-PCR fingerprinting. A total of 59 out of the 65 tested isolates were conformed as M. haemolytica by the new species-specific PCR which is based on the rpoB gene. The confirmed M. haemolytica field isolates were assigned to serovars 1 (24 isolates), 2 (seven isolates) and 6 (26 isolates) while two of the isolates were negative in the serotyping PCR. The two non-typeable isolates were assigned to serovar 7 and 14 following whole genome sequencing and bioinformatic analysis. The rep-PCR typing resulted in five major clusters with serovars 1 and 6 often within the same cluster. The M. haemolytica-specific PCR developed in this work was species specific and should be a valuable support for frontline diagnostic laboratories. The serotyping results support the relative importance of serovars 1 and 6 in bovine respiratory disease.
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Affiliation(s)
- Advait Kayal
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St Lucia, Queensland 4067, Australia
| | - Nusrat Nahar
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St Lucia, Queensland 4067, Australia
| | - Leslie Barker
- Biosecurity Sciences Laboratory, Department of Agriculture and Fisheries, Coopers Plains, Queensland 4108, Australia
| | - Thuy Tran
- Biosecurity Sciences Laboratory, Department of Agriculture and Fisheries, Coopers Plains, Queensland 4108, Australia
| | - Mariana Williams
- Biosecurity Sciences Laboratory, Department of Agriculture and Fisheries, Coopers Plains, Queensland 4108, Australia
| | - Patrick J Blackall
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St Lucia, Queensland 4067, Australia
| | - Conny Turni
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St Lucia, Queensland 4067, Australia
| | - Lida Omaleki
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, St Lucia, Queensland 4067, Australia.
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Altena R, Af Burén S, Tran T, Axelsson R. HER2-Low Breast Cancer Can Be Visualized by HER2 PET. J Nucl Med 2023; 64:1841. [PMID: 37709535 DOI: 10.2967/jnumed.123.266101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 09/16/2023] Open
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Signorelli J, Tran T, Sirek ME, Díaz-Rohena Y, Taraba JL, Muluneh B, Basu N, Lilly J, Darling J. Development of oral oncolytic nonadherence estimator (ORACLE): A pretreatment nonadherence risk assessment for oral oncolytics. J Oncol Pharm Pract 2023:10781552231208442. [PMID: 37899586 DOI: 10.1177/10781552231208442] [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: 10/31/2023]
Abstract
INTRODUCTION To date, there is no adherence estimator to identify risk of nonadherence prior to initiating oral oncolytics. METHODS A workgroup was assembled through the National Community Oncology Dispensing Association and tasked with creating a tool to meet this need. Tool constructs were defined after a review of the literature identifying top barriers to adherence. A second literature search was conducted to identify questions targeting specific barriers from validated adherence questionnaires. Once a finalized draft was complete, the risk assessment tool was built into an electronic survey where a risk category can be automatically calculated for the patient. RESULTS The six most impactful factors affecting compliance to oral oncolytics were identified as patient's confidence, health literacy, perception of treatment, quality of life, social support, and complexity of chemotherapy regimen. A six-item questionnaire was created with five patient-directed questions and one clinician-directed question. Examples and descriptions were provided for clinicians to consider when categorizing complexity of a regimen. The tool was designed for responses to each question to be indexed into categories through a 10-point system. Results will be stratified into low, moderate, or high risk for nonadherence. CONCLUSION The creation of a tool to predict nonadherence prior to starting therapy is an unmet need for patients initiating oral oncolytics. The aim of this tool is to meet those needs and better guide clinicians to provide patients with strategies to better manage nonadherence. Next steps include tool validation and piloting in clinical practice.
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Affiliation(s)
| | - Thuy Tran
- Specialty Pharmacy Services, Atrium Health, Charlotte, NC, USA
| | | | - Yarelis Díaz-Rohena
- NCODA University, National Community Oncology Dispensing Association, Cazenovia, NY, USA
| | - Jodi L Taraba
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - Benyam Muluneh
- Division of Pharmacotherapy and Experimental Therapeutics, University of Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
- Cancer Prevention and Control Program, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Nayanika Basu
- Department of Pharmacy, University of Virginia Breast Care Center, Charlottesville VA, USA
| | - Jennifer Lilly
- Department of Pharmacy, Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN, USA
| | - Julianne Darling
- NCODA University, National Community Oncology Dispensing Association, Birmingham, AL, USA
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Kim JK, Tam M, Karp JM, Oh C, Kim G, Solomon E, Concert CM, Vaezi AE, Li Z, Tran T, Zan E, Corby P, Feron-Rigodon M, Del Vecchio Fitz C, Goldberg JD, Hochman T, Givi B, Jacobson A, Persky M, Hu KS. A Phase II Trial Evaluating Rapid Mid-Treatment Nodal Shrinkage to Select for Adaptive Deescalation in p16+ Oropharyngeal Cancer Patients Undergoing Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2023; 117:S68-S69. [PMID: 37784553 DOI: 10.1016/j.ijrobp.2023.06.374] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this study is to determine if rapid mid-treatment nodal shrinkage (RMNS) can identify patients with p16+ oropharyngeal cancer (OPC) who can be safely deescalated with reduced dose chemoradiation therapy (CRT). The primary endpoint was 2-year progression free survival (PFS). MATERIALS/METHODS Inclusion criteria were as follows: T1-3, N1, M0 (AJCC 8th edition) p16+ OPC with <10 pack-year smoking history. All patients were initially planned for standard dose CRT (70 Gy) and weekly cisplatin. Patients were evaluated with a CT scan at week 4 for RMNS, defined as >40% nodal volumetric reduction from baseline. If RMNS was achieved, they proceeded to deescalated CRT (60 Gy). If not, they received standard CRT. Biomarker correlates were collected at baseline and week 4 of CRT including plasma TTMV (tumor tissue modified viral) HPV DNA and MRI diffusion weighted imaging (DWI). Univariate logistic regression analyses (UVA) were performed to evaluate predictors of RMNS. Odds ratios with 95% CI are reported, using a p<0.05 for statistical significance with a two-sided test. Wilcoxon rank sum tests were used to evaluate differences between the two groups using p < 0.05, 2-sided) for statistical significance. All statistical procedures were performed using R () with no adjustments for multiple testing. RESULTS Thirty-six patients were enrolled: median age: 60 years; 81% male; primary site: 36% base of tongue, 53% tonsil, 11% both; T-stage: 39% T1, 50% T2, 11% T3; N-stage: 100% N1; any smoking history: 58% yes, 42% no; 67% (n = 24) had RMNS and received deescalated CRT while the remaining proceeded to standard CRT. At a median follow-up of 32.4 months, 2-year PFS between the standard and deescalated groups were 91.7% vs 90.9%, respectively (p = 0.97). All patients with recurrence underwent successful salvage treatment with 2-year OS 100% for all patients. On UVA, rapid TTMV HPV DNA clearance (baseline to week 4) (OR 12.0 [1.65-250], p = 0.034), lower MRI diffusivity (ADC) at baseline (OR 0.79 [0.61-0.97], p = 0.042) and week 4 (OR 0.76 [0.60-0.91], p = 0.009), and higher MRI diffusional kurtosis at baseline (OR 1.09 [1.01-1.21], p = 0.051) and week 4 (OR 1.24 [1.09-1.52], p = 0.009) were significantly associated with RMNS. When comparing the deescalated and standard cohorts, the mean baseline and week 4 MRI ADC were significantly lower and week 4 MRI diffusional kurtosis was significantly higher in the deescalated group. CONCLUSION In this phase II study, rapid mid-treatment nodal shrinkage appeared to select favorable risk p16+ oropharynx cancer patients for treatment de-escalation. Rapid clearance of TTMV HPV DNA at week 4 as well as MRI DWI biomarkers of low ADC and high diffusional kurtosis values were correlated with RMNS. A larger study is planned to incorporate RMNS and biomarkers for further treatment de-escalation. Additional trial information is available at ClinicalTrials.gov (Identifier: NCT03215719).
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Affiliation(s)
- J K Kim
- Department of Radiation Oncology, NYU Langone Health, New York, NY
| | - M Tam
- Department of Radiation Oncology, NYU Langone Health, New York, NY
| | - J M Karp
- NYU Grossman School of Medicine, Department of Radiation Oncology, New York City, NY
| | - C Oh
- Biostatistics, Department of Population Health, NYU Langone Health, New York, NY
| | - G Kim
- NYU Langone Health, New York, NY
| | - E Solomon
- Weill Cornell Medicine, Cornell University, New York, NY
| | - C M Concert
- Department of Radiation Oncology, NYU Langone Health, New York, NY
| | - A E Vaezi
- Perlmutter Cancer Center NYU Langone Long Island, Mineola, NY
| | - Z Li
- Department of Medical Oncology, NYU Langone Health, New York, NY
| | - T Tran
- Department of Otolaryngology, NYU Langone Health, New York, NY
| | - E Zan
- NYU School of Medicine and Langone Medical Center, New York, NY, United States
| | - P Corby
- University of Pennsylvania, School of Dental Medicine, Philadelphia, PA
| | | | | | - J D Goldberg
- New York University School of Medicine, New York, NY
| | - T Hochman
- NYU Langone Medical Center, New York, NY
| | - B Givi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Jacobson
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, NY
| | - M Persky
- Department of Otolaryngology, NYU Langone Health, New York, NY
| | - K S Hu
- NYU Langone Medical Center, New York, NY
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Vo T, Tran T, Ho T, Le C, Pham H, Tran H, Ho N, Cao T, Vo B. Clinical evaluation of hysterectomy for the treatment of invasive mole in Southern Vietnam. Eur Rev Med Pharmacol Sci 2023; 27:7720-7727. [PMID: 37667950 DOI: 10.26355/eurrev_202308_33426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE This study aimed to determine the rate of salvage chemotherapy and review associated factors in invasive mole patients treated by primary or delayed hysterectomy. PATIENTS AND METHODS This study was carried out at the Tu Du Hospital, where a total of 189 patients were diagnosed with invasive mole based on histologic examination by hysterectomy between 01/2016 to 12/2020. We used the life table method to estimate the cumulative rate. We applied the Cox proportional hazard model to determine the factors associated with the need for salvage chemotherapy. RESULTS At 12-month follow-up, 47 patients had required salvage chemotherapy. The incidence was 24.87% (95% CI: 18.88-31.66). Applying the multivariate model, prophylactic chemotherapy (HR = 2.75, 95% Cl: 1.20-6.30) and two weeks postoperative hCG value greater than 1,900 mIU/mL (HR = 4.30, 95% Cl: 2.08-8.87) increased the risk of requiring salvage chemotherapy. Postoperative chemotherapy decreased the risk of requiring salvage chemotherapy (HR = 0.43, 95% Cl: 0.22-0.83). CONCLUSIONS Hysterectomy can be considered safe and effective in treating invasive mole patients. Although patients were treated by hysterectomy, 24.87% of patients needed salvage chemotherapy to achieve remission. This study affirms the malignant nature of invasive mole, a subtype of gestational trophoblastic neoplasia (GTN). It is not purely a local invasion of molar villi. Postoperative chemotherapy plays an essential role in reducing the risk of requiring salvage chemotherapy.
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Affiliation(s)
- T Vo
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Fisher J, Tran T, Tran H, Luchters S, Hipgrave DB, Nguyen H, Tran T, Hanieh S, Simpson JA, Biggs BA, Tran T. Structured, multicomponent, community-based programme for women's health and infant health and development in rural Vietnam: a parallel-group cluster randomised controlled trial. Lancet Child Adolesc Health 2023; 7:311-325. [PMID: 37011652 DOI: 10.1016/s2352-4642(23)00032-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Interventions to improve early childhood development have previously addressed only one or a few risk factors. Learning Clubs is a structured, facilitated, multicomponent programme designed to address eight potentially modifiable risk factors, and offered from mid-pregnancy to 12 months post partum; we aimed to establish whether this programme could improve the cognitive development of children at 2 years of age. METHODS For this parallel-group cluster-randomised controlled trial, 84 of 116 communes (the clustering unit) in HaNam Province in rural Vietnam were randomly selected and randomly assigned to receive the Learning Clubs intervention (n=42) or usual care (n=42). Women aged at least 18 years who were pregnant (gestational age <20 weeks) were eligible for inclusion. Data sources were standardised, and study-specific questionnaires assessing risks and outcomes were completed in interviews in mid-pregnancy (baseline), late pregnancy (after 32 weeks of gestation), at 6-12 months post partum, and at the end of the study period when children were 2 years of age. Mixed-effects models were used to estimate trial effects, adjusting for clustering. The primary outcome was the cognitive development of children at 2 years of age, assessed by the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III) cognitive score. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000442303). FINDINGS Between April 28, 2018, and May 30, 2018, 1380 women were screened and 1245 were randomly assigned (669 to the intervention group and 576 to the control group). Data collection was completed on Jan 17, 2021. Data at the end of the study period were contributed by 616 (92%) of 669 women and their children in the intervention group, and by 544 (94%) of 576 women and their children in the control group. Children aged 2 years in the intervention group had significantly higher mean Bayley-III cognitive scores than those in the control group (99·6 [SD 9·7] vs 95·6 [9·4]; mean difference 4·00 [95% CI 2·56-5·43]; p<0·0001). At 2 years of age, 19 (3%) children in the intervention group had Bayley-III scores less than 1 SD, compared with 32 (6%) children in the control group, but this difference was not significant (odds ratio 0·55 [95% CI 0·26-1·17]; p=0·12). There were no significant differences between groups in maternal, fetal, newborn, or child deaths. INTERPRETATION A facilitated, structured, community-based, multicomponent group programme improved early childhood development to the standardised mean in rural Vietnam and could be implemented in other similarly resource-constrained settings. FUNDING Australian National Health and Medical Research Council and Grand Challenges Canada Saving Brains Initiative. TRANSLATION For the Vietnamese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jane Fisher
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Thach Tran
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ha Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Stanley Luchters
- Centre for Sexual Health and HIV AIDS Research (CeSHHAR), Harare, Zimbabwe; Liverpool School of Tropical Medicine, Liverpool, UK; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - David B Hipgrave
- UNICEF, New York, NY, USA; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Hau Nguyen
- Women and Global Health Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Thuy Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Sarah Hanieh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Julie Anne Simpson
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Beverley-Ann Biggs
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Department of Medicine and Victorian Infectious Diseases Service at the Doherty Institute, University of Melbourne, Melbourne, VIC, Australia
| | - Tuan Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
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Tran T, Peterson S, Gubbels A. Impact of pelvic pain diagnosis and age of hysterectomy. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.12.169] [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: 03/11/2023]
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King ALO, Lee V, Yu B, Mirza FN, Zogg CK, Yang DX, Tran T, Leventhal J, An Y. Factors associated with the use of adjuvant radiation therapy in stage III melanoma. Front Oncol 2023; 13:1005930. [PMID: 36816935 PMCID: PMC9929351 DOI: 10.3389/fonc.2023.1005930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023] Open
Abstract
Objective The role of radiation therapy (RT) in melanoma has historically been limited to palliative care, with surgery as the primary treatment modality. However, adjuvant RT can be a powerful tool in certain cases and its application in melanoma has been increasingly explored in recent years. The aim of this study is to explore national patterns of care and associations surrounding the use of adjuvant RT for stage III melanoma. Methods The National Cancer Data Base (NCDB) was used to identify patients who were diagnosed with stage III melanoma between 2004 and 2014. Exclusion criteria included those with distant metastatic disease, in-situ histology, no confirmed positive nodes, palliative intent therapy, and dosing regimens inconsistent with National Comprehensive Cancer Network (NCCN) guidelines for adjuvant RT in melanoma. Patients treated with and without adjuvant RT were compared and factors associated with use of adjuvant RT were identified using multivariable logistic regression analyses. Results A total of 7,758 cases of stage III melanoma were analyzed, of which 11.7% received adjuvant RT. The mean age of the overall cohort was 58.5 years, and the majority of patients were male (64.7%), white (96.6%), on private insurance (51.3%), and presented to a non-high-volume facility (90.3%). Multivariable regression analyses revealed that patients who present to the hospital in 2009-2014 as compared to 2004-2008 (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.36-1.92), had 4 or more positive nodes (OR 4.30, 95% CI 3.67-5.04), and had microscopic residual tumor (OR 2.11, 95% CI 1.46-3.04) were more likely to receive adjuvant RT. Factors that were negatively associated with receiving adjuvant RT included female gender (OR 0.72, 95% CI 0.61-0.85) and median income of at least $63,000 (OR 0.66, 95% CI 0.52-0.83). Conclusions This study demonstrates the rising use of RT for stage III melanoma in recent years and identifies demographic, social, clinical, and hospital-specific factors associated with patients receiving adjuvant RT. Further investigation is needed to explore disease benefits to improve guidance on the utilization of RT in melanoma.
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Affiliation(s)
- Amber L. O. King
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Victor Lee
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Beverly Yu
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Fatima N. Mirza
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Cheryl K. Zogg
- Department of Surgery, Yale School of Medicine, New Haven, CT, United States
| | - Daniel X. Yang
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Thuy Tran
- Department of Medicine (Medical Oncology), Yale School of Medicine, New Haven, CT, United States
| | - Jonathan Leventhal
- Department of Dermatology, Yale School of Medicine, New Haven, CT, United States
| | - Yi An
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
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Tran T, Niu X, Wu J, Lu D, Leon RL, Minassian B, Mirpuri J. Maternal high fat diet exposure results in differential inflammatory gene expression, diminished hippocampal neurons and reduced sensitivity to stimuli in offspring, dependent on the maternal microbiome. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00517-7] [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: 01/28/2023]
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13
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Meek B, Desai N, Moore DC, Tran T, Knovich MA, Arnall J. Real-world experience and considerations on concomitant caplacizumab and anticoagulation in thrombotic thrombocytopenic purpura. Ann Hematol 2023; 102:457-459. [PMID: 36441262 DOI: 10.1007/s00277-022-05049-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Benson Meek
- Specialty Pharmacy Service, Atrium Health, 4400 Golf Acres Drive, Building J Suite B1, Charlotte, NC, USA
| | - Nuti Desai
- WakeMed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC, 27610, USA
| | - Donald C Moore
- Levine Cancer Institute, 1021 Morehead Medical Dr., Charlotte, NC, 28204, USA
| | - Thuy Tran
- Specialty Pharmacy Service, Atrium Health, 4400 Golf Acres Drive, Building J Suite B1, Charlotte, NC, USA
| | - Mary Ann Knovich
- Levine Cancer Institute, 1021 Morehead Medical Dr., Charlotte, NC, 28204, USA
| | - Justin Arnall
- Specialty Pharmacy Service, Atrium Health, 4400 Golf Acres Drive, Building J Suite B1, Charlotte, NC, USA.
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Tran T, Martinsson E, Gustavsson R, Tronarp O, Nilsson M, Hansson KR, Lundström I, Mandenius CF, Aili D. Process integrated biosensors for real-time monitoring of antibodies for automated affinity purification. Anal Methods 2022; 14:4555-4562. [PMID: 36314900 DOI: 10.1039/d2ay01567f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Therapeutic monoclonal antibodies (mAbs) provide new means for treatments of a wide range of diseases and comprise a large fraction of all new approved drugs. Production of mAbs is expensive compared to conventional drug production, primarily due to the complex processes involved. The affinity purification step is dominating the cost of goods in mAb manufacturing. Process intensification and automation could reduce costs, but the lack of real-time process analytical technologies (PAT) complicates this development. We show a specific and robust fiber optical localized surface plasmon resonance (LSPR) sensor technology that is optimized for in-line product detection in the effluent in affinity capture steps. The sensor system comprises a flow cell and a replaceable sensor chip functionalized with biorecognition elements for specific analyte detection. The high selectivity of the sensor enable detection of mAbs in complex sample matrices at concentrations below 2.5 μg mL-1. In place regeneration of the sensor chips allowed for continuous monitoring of multiple consecutive chromatographic separation cycles. Excellent performance was obtained at different purification scales with flow rates up to 200 mL min-1. This sensor technology facilitates efficient column loading, optimization, and control of chromatography systems, which can pave the way for continuous operation and automation of protein purification steps.
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Affiliation(s)
- Thuy Tran
- Laboratory of Molecular Materials, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden.
| | | | - Robert Gustavsson
- Biotechnology, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
| | - Otto Tronarp
- Wolfram MathCore AB, Teknikringen 1E, Linköping 583 30, Sweden
| | - Mats Nilsson
- BioInvent International AB, Ideon Science Park, Lund 223 70, Sweden
| | | | - Ingemar Lundström
- Sensor and Actuator Systems, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
| | - Carl-Fredrik Mandenius
- Biotechnology, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
| | - Daniel Aili
- Laboratory of Molecular Materials, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden.
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Tran T, Martinsson E, Vargas S, Lundström I, Mandenius CF, Aili D. Nanoplasmonic Avidity-Based Detection and Quantification of IgG Aggregates. Anal Chem 2022; 94:15754-15762. [DOI: 10.1021/acs.analchem.2c03446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thuy Tran
- Laboratory of Molecular Materials, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
| | | | - Sergio Vargas
- Wolfram MathCore AB, Teknikringen 1E, Linköping 583 30, Sweden
| | - Ingemar Lundström
- Sensor and Actuator Systems, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
| | - Carl-Fredrik Mandenius
- Biotechnology, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
| | - Daniel Aili
- Laboratory of Molecular Materials, Division of Biophysics and Bioengineering, Department of Physics, Chemistry and Biology, Linköping University, Linköping 581 83, Sweden
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16
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Tran T, Keesing S, Harris C, Ciccarelli M. Managing work‐related lateral elbow tendinopathy: Australian hand therapist's experiences with workplace‐based interventions. Aust Occup Ther J 2022; 70:233-245. [PMID: 36367158 DOI: 10.1111/1440-1630.12851] [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] [Received: 12/17/2021] [Revised: 10/06/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Lateral elbow tendinopathy (LET) is one of the most prevalent work-related musculoskeletal conditions. Current treatments for LET focus mainly on the physiological symptoms of pain, grip strength, and function. Recently, a novel workplace-based hand therapy educational intervention, Working Hands-ED, was developed based on the Person-Environment-Occupation- Performance model, International Classification of Functioning, Disability and Health framework and the Australian Clinical Framework for the Delivery of Health Services. Combining a hand therapist's specialised knowledge and skills in upper limb rehabilitation with an approach that considers injured workers' occupations and work environments may provide a more holistic approach to managing work-related LET. To the best of our knowledge, no previous studies have investigated the experiences of hand therapists who perform workplace-based educational interventions for the management of LET. METHOD An exploratory, descriptive qualitative design using semi-structured interviews was used with hand therapists who delivered the novel hand therapy intervention Working Hands-ED. FINDINGS Ten occupational therapists working in hand therapy were interviewed. Three main themes and eight subthemes were identified from interview data: Person-centred approach, opportunity for therapists to provide enhanced service, and improved stakeholder engagement in the return-to-work process. Logistical challenges such as the costs and time spent away from the clinical setting were identified. CONCLUSION All hand therapists reported delivering Working Hands-ED when managing work-related LET was a positive experience for them. They believed that the novel intervention could provide a more holistic approach to care that added value to their service delivery; however, there were some logistical factors to consider including the additional time and costs associated with the intervention.
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Affiliation(s)
- Thuy Tran
- Curtin School of Allied Health Curtin University Perth Western Australia Australia
- Hand Works Occupational Therapy Perth Western Australia Australia
| | | | - Courtenay Harris
- Curtin School of Allied Health Curtin University Perth Western Australia Australia
| | - Marina Ciccarelli
- Curtin School of Allied Health Curtin University Perth Western Australia Australia
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17
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Kim J, Tam M, Oh C, Feron-Rigodon M, Joseph B, Vaezi A, Li Z, Tran T, Kim G, Zan E, Corby P, Vecchio Fitz CD, Goldberg J, Hochman T, Givi B, Jacobson A, Persky M, Persky M, Hu K. Circulating Tumor HPV-DNA Kinetics in p16+ Oropharyngeal Cancer Patients Undergoing Adaptive Radiation De-Escalation Based on Mid-Treatment Nodal Response. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1385] [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: 10/31/2022]
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18
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Huang RJ, Epplein M, Hamashima C, Choi IJ, Lee E, Deapen D, Woo Y, Tran T, Shah SC, Inadomi JM, Greenwald DA, Hwang JH. An Approach to the Primary and Secondary Prevention of Gastric Cancer in the United States. Clin Gastroenterol Hepatol 2022; 20:2218-2228.e2. [PMID: 34624563 PMCID: PMC8983795 DOI: 10.1016/j.cgh.2021.09.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Gastric cancer (GC) remains a leading cause of mortality among certain racial, ethnic, and immigrant groups in the United States (US). The majority of GCs are diagnosed at advanced stages, and overall survival remains poor. There exist no structured national strategies for GC prevention in the US. METHODS On March 5-6, 2020 a summit of researchers, policy makers, public funders, and advocacy leaders was convened at Stanford University to address this critical healthcare disparity. After this summit, a writing group was formed to critically evaluate the effectiveness, potential benefits, and potential harms of methods of primary and secondary prevention through structured literature review. This article represents a consensus statement prepared by the writing group. RESULTS The burden of GC is highly inequitably distributed in the US and disproportionately falls on Asian, African American, Hispanic, and American Indian/Alaskan Native populations. In randomized controlled trials, strategies of Helicobacter pylori testing and treatment have been demonstrated to reduce GC-specific mortality. In well-conducted observational and ecologic studies, strategies of endoscopic screening have been associated with reduced GC-specific mortality. Notably however, all randomized controlled trial data (for primary prevention) and the majority of observational data (for secondary prevention) are derived from non-US sources. CONCLUSIONS There exist substantial, high-quality data supporting GC prevention derived from international studies. There is an urgent need for cancer prevention trials focused on high-risk immigrant and minority populations in the US. The authors offer recommendations on how strategies of primary and secondary prevention can be applied to the heterogeneous US population.
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Affiliation(s)
- Robert J Huang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California
| | - Meira Epplein
- Department of Population Health Sciences, Duke University, and Cancer Risk, Detection, and Interception Program, Duke Cancer Institute, Durham, North Carolina
| | | | - Il Ju Choi
- Center for Gastric Cancer, National Cancer Center, Goyang, South Korea
| | - Eunjung Lee
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Dennis Deapen
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Yanghee Woo
- Division of Surgical Oncology, Department of Surgery, City of Hope National Comprehensive Cancer Center, Duarte, California
| | - Thuy Tran
- Division of Surgical Oncology, Department of Surgery, City of Hope National Comprehensive Cancer Center, Duarte, California
| | - Shailja C Shah
- Gastroenterology Section, Veterans Affairs San Diego Healthcare System, La Jolla, California; Division of Gastroenterology and Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - John M Inadomi
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - David A Greenwald
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joo Ha Hwang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford, California.
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Tran T, Dym A, Rosania A, Nelson L, Ramdin C, Santos C. 91 The Promising Use of an Emergency Department Observation Unit to Manage Patients With Opioid Use Disorder. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.114] [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: 11/30/2022]
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Kohut A, Santiago NL, Attiyeh M, Malhotra G, Tran T, Cloud T, Lee S, Dellinger T, Tergas A, Hakim A, Kebria M, de Leon M, Lin WC, Wang E, Stewart D, Cristea M, Han E, Song M, Rodriguez-Rodriguez L, Raoof M, Lin J. HIPEC is associated with improved survival in stage III-IV ovarian cancer patients undergoing complete cytoreductive surgery: An NCDB-based analysis (561). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01782-6] [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: 11/16/2022]
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21
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Tran T, Qin M, Agak G, Teles R, Baugh A, To T, Kim J. 569 The role of siglecs in acne pathogenesis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.579] [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: 10/17/2022]
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22
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Tay S, Bowen AC, Blyth CC, Clifford P, Clack R, Ford T, Herbert H, Kuthubutheen J, Mascaro F, O'Mahoney A, Rodrigues S, Tran T, Campbell AJ. A quality improvement study: Optimizing pneumococcal vaccination rates in children with cochlear implants. Vaccine 2022; 40:4531-4537. [PMID: 35718588 DOI: 10.1016/j.vaccine.2022.06.022] [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] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022]
Abstract
Children with cochlear implants are at increased risk of invasive pneumococcal disease, with national and international guidelines recommending additional pneumococcal vaccines for these children. This study aimed to examine the pneumococcal immunization status and rate of invasive pneumococcal disease in children with cochlear implants at a tertiary paediatric hospital over a 12-year period. Additionally, the impacts of vaccination reminders and a dedicated immunization clinic on pneumococcal vaccination rates were assessed. This quality improvement study included 200 children who had received a cochlear implant through the Children's Hearing Implant Program at a tertiary paediatric hospital servicing the state of Western Australia. The majority of children (88%) were not up to date with additionally recommended pneumococcal vaccinations. Over the 12-year study period, 2% of children developed invasive pneumococcal disease associated with cochlear implant infections. Generic and personalized electronic immunization reminders improved pneumococcal vaccine up-take in this paediatric cochlear implant setting from 12% (19/153) at baseline to 49% (75/153, p < 0.0001) post implementation. The value of a nurse-led dedicated immunization clinic was also demonstrated with all children (42/42, 100%) up to date with Prevenar13 and the majority (34/42, 81%) up to date with Pneumovax23 post initiation of this referral pathway. These data support the expansion of this model to other medically-at-risk paediatric groups that have been highlighted consistently to be under-vaccinated.
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Affiliation(s)
- S Tay
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia.
| | - A C Bowen
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Western Australia, Australia
| | - C C Blyth
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Western Australia, Australia
| | - P Clifford
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia
| | - R Clack
- Children's Hearing Implant Program, Ear Nose and Throat Department, Perth Children's Hospital, Western Australia, Australia
| | - T Ford
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia; Discipline of Paediatrics, School of Medicine, University of Western Australia, Crawley, Australia
| | - H Herbert
- Children's Hearing Implant Program, Ear Nose and Throat Department, Perth Children's Hospital, Western Australia, Australia
| | - J Kuthubutheen
- Children's Hearing Implant Program, Ear Nose and Throat Department, Perth Children's Hospital, Western Australia, Australia; Division of Surgery, University of Western Australia, Western Australia, Australia
| | - F Mascaro
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia
| | - A O'Mahoney
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia
| | - S Rodrigues
- Children's Hearing Implant Program, Ear Nose and Throat Department, Perth Children's Hospital, Western Australia, Australia
| | - T Tran
- Children's Hearing Implant Program, Ear Nose and Throat Department, Perth Children's Hospital, Western Australia, Australia
| | - A J Campbell
- Immunisation Service, Department of Infectious Diseases, Perth Children's Hospital, Western Australia, Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Western Australia, Australia
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Vu A, Ngo V, Bui T, Tran T. POS-013 THROMBOTIC MICROANGIOPATHY AFTER COVID-19: LACK OF EVIDENCE OF COMPLEMENT ACTIVATION? A CASE REPORT. Kidney Int Rep 2022. [PMCID: PMC9213007 DOI: 10.1016/j.ekir.2022.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Tran T, Huang R, Shen C. P-98 Diabetes promotes the progression of pancreatic ductal adenocarcinoma via the interaction between transforming acinar cells and cancer cells through AKT/CEBPβ/LCN2 pathway. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.188] [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: 11/16/2022] Open
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25
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Kohut A, Santiago NL, Attiyeh M, Malhotra G, Tran T, Cloud T, Lee S, Dellinger T, Tergas A, Hakim A, Kebria M, de Leon M, Lin WC, Wang E, Stewart D, Cristea M, Han E, Song M, Rodriguez-Rodriguez L, Raoof M, Lin J. P12 HIPEC is associated with improved survival in stage III-IV ovarian cancer pat1ients undergoing complete cytoreductive surgery: an NCDB-based analysis. Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)00357-2] [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: 11/04/2022]
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Harms HJ, Bravo PE, Bajaj NS, Zhou W, Gupta A, Tran T, Taqueti VR, Hainer J, Bibbo C, Dorbala S, Blankstein R, Mehra M, Sörensen J, Givertz MM, Di Carli MF. Cardiopulmonary transit time: A novel PET imaging biomarker of in vivo physiology for risk stratification of heart transplant recipients. J Nucl Cardiol 2022; 29:1234-1244. [PMID: 33398793 PMCID: PMC8254830 DOI: 10.1007/s12350-020-02465-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/12/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Myocardial blood flow (MBF) can be quantified using dynamic PET studies. These studies also inherently contain tomographic images of early bolus displacement, which can provide cardiopulmonary transit times (CPTT) as measure of cardiopulmonary physiology. The aim of this study was to assess the incremental prognostic value of CPTT in heart transplant (OHT) recipients. METHODS 94 patients (age 56 ± 16 years, 78% male) undergoing dynamic 13N-ammonia stress/rest studies were included, of which 68 underwent right-heart catherization. A recently validated cardiac allograft vasculopathy (CAV) score based on PET measures of regional perfusion, peak MBF and left-ventricular (LV) ejection fraction (LVEF) was used to identify patients with no, mild or moderate-severe CAV. Time-activity curves of the LV and right ventricular (RV) cavities were obtained and used to calculate the difference between the LV and RV bolus midpoint times, which represents the CPTT and is expressed in heartbeats. Patients were followed for a median of 2.5 years for the occurrence of major adverse cardiac events (MACE), including cardiovascular death, hospitalization for heart failure or acute coronary syndrome, or re-transplantation. RESULTS CPTT was significantly correlated with cardiac filling pressures (r = .434, P = .0002 and r = .439, P = .0002 for right atrial and pulmonary wedge pressure), cardiac output (r = - .315, P = .01) and LVEF (r = - .513, P < .0001). CPTT was prolonged in patients with MACE (19.4 ± 6.0 vs 14.5 ± 3.0 heartbeats, P < .001, N = 15) with CPTT ≥ 17.75 beats showing optimal discriminatory value in ROC analysis. CPTT ≥ 17.75 heartbeats was associated with a 10.1-fold increased risk (P < .001) of MACE and a 7.3-fold increased risk (P < .001) after adjusting for PET-CAV, age, sex and time since transplant. CONCLUSION Measurements of cardiopulmonary transit time provide incremental risk stratification in OHT recipients and enhance the value of multiparametric dynamic PET imaging, particularly in identifying high-risk patients.
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Affiliation(s)
- H J Harms
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
- Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - P E Bravo
- Division of Cardiovascular Medicine, Department of Medicine; and Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - N S Bajaj
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - W Zhou
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - A Gupta
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - T Tran
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - V R Taqueti
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - J Hainer
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - C Bibbo
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - S Dorbala
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - R Blankstein
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - M Mehra
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - J Sörensen
- Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgical Sciences, Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden
| | - M M Givertz
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA
| | - M F Di Carli
- Cardiovascular Imaging Program, Departments of Radiology and Medicine; Division of Nuclear Medicine and Molecular Imaging, Brigham and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA, USA.
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Moein MM, Dahl K, Meijer E, Ferrat M, Tegnebratt T, Saliba P, Norman F, Samen E, Steiger C, Savitcheva I, Tran T. High yield GMP production of [18F]FE-PE2I, a radiotracer for in vivo PET imaging the dopamine transporter. Nucl Med Biol 2022. [DOI: 10.1016/s0969-8051(22)00290-6] [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: 10/18/2022]
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Tran T, Bolin M, Dahl K, Johnstrom P, Mitran B, Siikanen J, Schou M. Comparative in vivo biodistribution and dosimetry in non-human primate of the fibroblast activation protein radiotracers [68Ga]Ga-FAPI-04, [68Ga]Ga-FAPI-46 and [18F]FAPI-74. Nucl Med Biol 2022. [DOI: 10.1016/s0969-8051(22)00443-7] [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: 11/27/2022]
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Reich J, Tran T, Kashem M, Kehara H, Sunagawa G, Leotta E, Yanagida R, Mangukia C, Shigemura N, Toyoda Y. Lung Transplantation in the Elderly: How Old is Too Old? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.657] [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: 11/16/2022] Open
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Tran T, Reich J, Kashem M, Kehara H, Leotta E, Yanagida R, Mangukia C, Shigemura N, Toyoda Y. Prior and Perioperative Revascularization Impact on Survival in Lung Transplant Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.659] [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: 10/18/2022] Open
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Chinivasagam HN, Estella W, Rodrigues H, Mayer DG, Tran T, Onysk A, Weyand C, Diallo I, Billington C. Re-used or New Bedding Are Not Drivers of Salmonella Levels and Serovar Emergence in Commercially Farmed Broilers in Australia. Front Sustain Food Syst 2022. [DOI: 10.3389/fsufs.2022.816181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To inform Salmonella on-farm management during broiler rearing, a 2-year study on two farms compared the Australian practices of new bedding use, partial litter re-use and an alternative, full litter re-use. Six sequential commercial cycles of ~50 days each were tested on each farm, on ~day 7 from placement (litter only), prior to first thin-out, and prior to final removal (litter and ceca). A random number sample collection occurred, defined by shed supports (33, 39), different drinkers, feeders, and shed center. Across the six cycles on both farms, Salmonella levels in ceca just prior to thin-out on full re-use litter were higher (log 3.11 MPN/g, P = 0.008) than for new bedding (log 2.04 MPN/g) and partial re-use (log 2.43 MPN/g) litter (the latter two were not significantly different). Prior to final removal across all practices the Salmonella levels in ceca from new bedding (log 1.72 MPN/g), partial re-use litter (log 1.77 MPN/g), and full re-use litter (log 2.33 MPN/g) were not statistically different, suggesting no effect of litter practice. The Salmonella levels in litter prior to the first (log 1.96–2.31 MPN/g) and second (log 2.24–2.48 MPN/g) removals were also not statistically different. The emergence of Salmonella serovars in the partitioned chicken-free grow-out end (back) of all sheds at ~day 7 did not suggest carry-over. Both the pattern of emergence of Salmonella serovars and Salmonella levels in litter ~day 7 in the brooder-end with chickens (front), suggested the Salmonella present were due to flock contribution and not practice driven. The dominant Salmonella serovar across cycles on both farms was S. Sofia (75 and 77% isolates) followed by S. Typhimurium (11 and 17%). Irrespective of initial serovars, Salmonella Sofia rapidly gained dominance and displaced 14 other serovars including S. Typhimurium on both farms. This study demonstrates that the litter practices are not the major driver of Salmonella prevalence in broiler farming, supporting the commercial re-use of bedding as a sustainable farming practice in Australia. The major contributor of Salmonella load in production is the Salmonella status of the incoming flock, indicating this is the key area to focus future control measures.
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Esposito A, Jacobs D, Ariyan S, Galan A, Kluger H, Clune J, Weiss S, Tran T, Olino K. Merkel Cell Carcinoma: Changing Practice Patterns and Impact on Recurrence-Free and Overall Survival at a Single Institution and Nationally. Ann Surg Oncol 2022; 29:415-424. [PMID: 34494169 PMCID: PMC8677689 DOI: 10.1245/s10434-021-10727-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma of the skin. Our report describes the evolution of management and characteristics associated with recurrence, disease-specific survival (DSS) and overall survival (OS) in the treatment of MCC. METHODS A single institution retrospective review of MCC and SEER data to determine factors associated with RFS, DSS, and OS using a multivariable Cox regression on inverse-probability weighted cohorts. RESULTS One hundred fifty-nine patients were identified with a median age of 75. Of these, 96% were Caucasian and 60% male. Fifty-eight out of 159 (36%) of all patients were deceased with 21/58 (36%) dead from MCC with a median follow-up of 3.1 years. Institutionally, trends over time demonstrated an increased use of immunotherapy with a concomitant decrease in chemotherapy and decreased use of radiotherapy alone. Institutionally and nationally, there has been increased surgical nodal staging. Institutionally, factors associated with shorter DSS included advanced age, active cigarette smoker (p = 0.002), cT2 disease (p = 0.007), and MCC with unknown primary (p < 0.001). Institutionally, factors associated with shorter OS included ages ≥ 75 years (p < 0.001), an immunocompromised state (p < 0.001), truncal primary site (p = 0.002), and cT2 disease (HR 9.59, p < 0.001). CONCLUSION Changing practice patterns in MCC management have been driven by the adoption of immunotherapy. Our study highlights that competing risks of mortality in MCC patients likely prevents OS from being an accurate surrogate outcome measure to understand factors associated with DSS.
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Affiliation(s)
- Andrew Esposito
- Division of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | | | - Stephan Ariyan
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Anjela Galan
- Departments of Dermatology and Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Harriet Kluger
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - James Clune
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Sarah Weiss
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thuy Tran
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Kelly Olino
- Division of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
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Soosapilla K, Akrawi D, Tran T, Huang J, Premawardhana U, Kadappu K. The Novel Use of Salbutamol and Hyoscine in Managing Third-Degree Atrioventricular Block. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tran T, Harris C, Ciccarelli M. The impact of a hand therapy workplace-based educational approach on the management of lateral elbow tendinopathy: A randomized controlled study. J Hand Ther 2021; 36:45-59. [PMID: 34756796 DOI: 10.1016/j.jht.2021.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Lateral elbow tendinopathy (LET) is one of the most prevalent work-related musculoskeletal conditions. Management strategies for LET rarely consider patients' work environments and have limited focus on education regarding occupational risk factors. Workplace-based rehabilitation has shown benefits in the return to work processes for injured workers with other health conditions, but no studies have investigated the impact of a workplace-based educational approach in the management of LET. PURPOSES First, to identify the impact of an additional workplace-based educational intervention to standard hand therapy care on the outcomes of pain, grip strength, and function. Second, to identify the effectiveness of standard hand therapy on the same clinical outcomes. STUDY DESIGN A randomized controlled trial. METHODS Forty-nine participants were randomized to the control group (n = 25) or intervention group (n == 24). The control group received standard hand therapy for 12 weeks. The intervention group received standard hand therapy for the first 12 weeks plus an additional workplace-based educational intervention, "Working Hands-ED," delivered by a hand therapist. Pain levels for provocative tests, grip strength, and function were measured using a Numeric Rating Scale, Jamar Dynamometer, and the Patient-Rated Tennis Elbow Evaluation questionnaire at baseline, weeks 6 and 12. The Patient-Specific Functional Scale was also used for the intervention group. RESULTS There were no statistical differences between both groups for all clinical outcomes by 12 weeks (P> .05). Pain levels for all provocative tests and Patient-Rated Tennis Elbow Evaluation scores statistically improved within both groups (P < .05), however with small effect sizes observed. The Patient-Specific Functional Scale scores statistically improved for the intervention group by 12 weeks (P < .05). CONCLUSION The addition of a hand therapy workplace-based intervention did not result in superior clinical outcomes for pain, grip strength, and function. The study identified that a multimodal self-management approach used by hand therapists improved their patients' pain and function regardless of whether the education was given in the clinic or the workplace.
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Affiliation(s)
- Thuy Tran
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.
| | - Courtenay Harris
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Marina Ciccarelli
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Ojukwu K, Miranda-Taylor M, Tran T, Ji P. Knowledge is Power: Pathology Activity Booths in Community Health Fairs. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.228] [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: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Our pilot project “Pathology Activity Booths” is an innovative approach to investigating whether pathology activity exhibits at health fairs could increase access and promote learning and understanding of health topics and pathology of diseases. Health fairs are an effective form of community-based health promotion conducted in many underserved communities.
Methods/Case Report
Booth #1 (Colorectal Cancer Awareness Fair): Microscopes with histology slides of colon biopsies, with enlarged corresponding colonoscopy images, were displayed showing the histology of normal colon, abnormal colon and cancer (colon adenocarcinoma).
Booth #2 (Children’s Back-To-School Fair): Microscopes with histology slides of normal skin, lung, kidney, liver, intestine, and brain tissue were shown.
Post participation surveys assessed whether participants knew anyone with the diseases presented, had previous experience with microscopes, and/or felt they understood and learned from their experience at the booth.
Results (if a Case Study enter NA)
There were 71 total participants. At Booth #1, 100% (42/42) of participants stated they understood what they saw under the microscope and 95% (40/42) felt they learned something new. At Booth #2, 86% (25/29) of participants stated they understood what they saw under the microscope and 76% (22/29) stated they learned something new. One participant exclaimed she would now make her husband get the colonoscopy he had been avoiding.
Conclusion
The overwhelmingly positive responses indicate that pathology booths could be promising in promoting health knowledge in our patient population. Greater understanding of health topics may lead to increased use of screening tests that can ultimately improve health outcomes. Pathologists are well suited to be direct resources of accurate information for patients. As physicians who closely evaluate human disease, we can effectively provide access to a new, different and engaging perspective to community health education. Pathology activity booths may be a valuable resource for patients, an innovative method of teaching the community and a creative tool to enhance trainees’ experience and teaching ability.
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Affiliation(s)
- K Ojukwu
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - M Miranda-Taylor
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - T Tran
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - P Ji
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
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Chiu R, Tran T, Miranda-Taylor M, Bamdad S, Jia Y, Crabtree M, Cornford M, Yap C, Peng S. Biphasic Sarcomatoid Sweat Gland Carcinoma With Ductal Epithelial And Spindled Myoepithelial Cell Components (Malignant Mixed Tumor Of Skin). Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.093] [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: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Sweat gland carcinomas are a group of malignant skin adnexal tumors that are difficult to diagnose due to their rarity, wide morphologic variation, and limited literature on diagnosis and classification. These tumors may appear bland and morphologically resemble benign skin adnexal tumors, or may appear poorly differentiated and mimic metastatic carcinoma especially from a breast primary. Biphasic sweat gland carcinomas are an even rarer entity, with only few cases reported in literature, and have been described to consist of a well- differentiated ductal epithelial component and a poorly differentiated, sarcomatoid, spindle cell component.
Methods/Case Report
Our case report describes a 53 year old female referred to our institution for diagnosis of an excised skin lesion of the right upper arm, which had been slowly growing for 8 years. The histology revealed a biphasic malignant neoplasm involving the dermis and subcutis. The tumor consisted of an epithelial cell component with glandular and squamoid morphology and positive for CK5/6, CK7, and CAM5.2, and a spindled myoepithelial cell component with sarcomatoid morphology and positive for S100, vimentin, and p63. Stains for CK20, ER, PR, PAX8, CEA, and TTF1 were negative. The histological and clinical findings favored a primary skin adnexal tumor, rather than a metastatic lesion.
The patient underwent wide local excision of the lesion given that margins of the original excision were indeterminate. The histology of this re-excision demonstrated the same biphasic tumor with ductal epithelial and sarcomatoid myoepithelial cell components positive for the same stains. Although margins were negative in this re-excision, 3-4 months later, the patient developed dyspnea with multiple new pulmonary and hilar masses discovered on imaging, and new-onset headache with a frontal lobe mass discovered on brain imaging. These masses were biopsied/resected, and revealed to be metastases of the original cutaneous tumor positive for the same markers.
Results (if a Case Study enter NA)
NA
Conclusion
This case report describes a rare, diagnostically challenging case of a biphasic sweat gland carcinoma with ductal epithelial and sarcomatoid myoepithelial cell components, which demonstrated aggressive behavior with distant metastasis. These tumors are a clinicopathological quandary given their rarity and the paucity of literature on their characterization.
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Affiliation(s)
- R Chiu
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - T Tran
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - M Miranda-Taylor
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - S Bamdad
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - Y Jia
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - M Crabtree
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - M Cornford
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - C Yap
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
| | - S Peng
- Pathology, Harbor-UCLA Medical Center, Torrance, California, UNITED STATES
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Si L, Eisman JA, Winzenberg T, Sanders KM, Center JR, Nguyen TV, Tran T, Palmer AJ. Development and validation of the risk engine for an Australian Health Economics Model of Osteoporosis. Osteoporos Int 2021; 32:2073-2081. [PMID: 33856500 DOI: 10.1007/s00198-021-05955-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
UNLABELLED The Australian Health Economics Model of Osteoporosis (AusHEMO) has shown good face, internal and cross validities, and can be used to assist healthcare decision-making in Australia. PURPOSE This study aimed to document and validate the risk engine of the Australian Health Economics Model of Osteoporosis (AusHEMO). METHODS AusHEMO is a state-transition microsimulation model. The fracture risks were simulated using fracture incidence rates from the Dubbo Osteoporosis Epidemiology Study. The AusHEMO was validated regarding its face, internal and cross validities. Goodness-of-fit analysis was conducted and Lin's coefficient of agreement and mean absolute difference with 95% limits of agreement were reported. RESULTS The development of AusHEMO followed general and osteoporosis-specific health economics guidelines. AusHEMO showed good face validity regarding the model's structure, evidence, problem formulation and results. In addition, the model has been proven good internal and cross validities in goodness-of-fit test. Lin's coefficient was 0.99, 1 and 0.94 for validation against the fracture incidence rates, Australian life expectancies and residual lifetime fracture risks, respectively. CONCLUSIONS In summary, the development of the risk engine of AusHEMO followed the best practice for osteoporosis disease modelling and the model has been shown to have good face, internal and cross validities. The AusHEMO can be confidently used to predict long-term fracture-related outcomes and health economic evaluations when costs data are included. Health policy-makers in Australia can use the AusHEMO to select which osteoporosis interventions such as medications and public health interventions represent good value for money.
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Affiliation(s)
- L Si
- The George Institute for Global Health, UNSW Sydney, Kensington, Australia.
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China.
| | - J A Eisman
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
- St Vincent's Hospital, UNSW Sydney, Sydney, New South Wales, Australia
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - K M Sanders
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - J R Center
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- St Vincent's Hospital, UNSW Sydney, Sydney, New South Wales, Australia
| | - T V Nguyen
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- St Vincent's Hospital, UNSW Sydney, Sydney, New South Wales, Australia
- School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia
| | - T Tran
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
| | - A J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
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Tran H, Nguyen S, Nguyen K, Pham D, Le A, Nguyen G, Tran D, Shu X, Osarogiagbon R, Tran T. OA18.01 Lung Cancer in Vietnam. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Esposito A, Jacobs D, Ariyan S, Galan A, Kluger H, Clune J, Weiss S, Tran T, Olino K. ASO Visual Abstract: Merkel Cell Carcinoma-Changing Practice Patterns and Impact on Recurrence-Free and Overall Survival at a Single Institution and Nationally. Ann Surg Oncol 2021. [PMID: 34564774 DOI: 10.1245/s10434-021-10784-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Andrew Esposito
- Division of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | | | - Stephan Ariyan
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, USA
| | - Anjela Galan
- Departments of Dermatology and Pathology, Yale School of Medicine, New Haven, USA
| | - Harriet Kluger
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, USA
| | - James Clune
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, USA
| | - Sarah Weiss
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, USA
| | - Thuy Tran
- Division of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, USA
| | - Kelly Olino
- Division of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
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Raoof M, Malhotra G, Kohut A, O'Leary M, Frankel P, Tran T, Fakih M, Chao J, Lim D, Woo Y, Paz IB, Lew M, Cristea MC, Rodriguez-Rodriguez L, Fong Y, Blakely A, Whelan R, Reymond MA, Merchea A, Dellinger TH. PIPAC for the Treatment of Gynecologic and Gastrointestinal Peritoneal Metastases: Technical and Logistic Considerations of a Phase 1 Trial. Ann Surg Oncol 2021; 29:175-185. [PMID: 34387765 DOI: 10.1245/s10434-021-10505-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Peritoneal metastases (PM) from ovarian, gastric, appendiceal, or colorectal origin can be treated via cytoreductive surgery with or without the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) for selected patients. Unfortunately, not all patients are candidates for aggressive surgical debulking. For these patients, pressurized intraperitoneal aerosolized chemotherapy (PIPAC) has emerged as an alternative method for intraperitoneal (IP) chemotherapy administration. This report presents the design and implementation of the first phase 1 trial to evaluate the safety and efficacy of PIPAC in the United States. METHODS This is an ongoing prospective phase 1 clinical trial of PIPAC for patients who have histologically confirmed ovarian, uterine, gastric, appendiceal, or colorectal cancer with PM and have progressed to at least one evidence-based chemotherapeutic regimen. The trial has two clinical arms. The patients in arm 1 have gynecologic and gastric malignancies treated with IP cisplatin and doxorubicin, and the arm 2 patients have colorectal and appendiceal malignancies treated with intravenous fluorouracil and leucovorin followed by IP oxaliplatin. All the patients are monitored for dose-limiting toxicities and adverse events. RESULTS Practical and technical considerations for the phase 1 PIPAC trial are presented. These considerations include patient selection, operating room setup, and technical details for successful aerosolized chemotherapy delivery. The phase 1 study results will be reported separately at completion of the trial. CONCLUSIONS The PIPAC treatment is a feasible, minimally invasive approach that permits IP delivery of chemotherapy. Once completed, the ongoing phase 1 trial will help to provide safety and initial efficacy data.
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Affiliation(s)
- Mustafa Raoof
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA.
| | - Gautam Malhotra
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Adrian Kohut
- Division of Gynecologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center (COH), Duarte, CA, USA
| | - Michael O'Leary
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Paul Frankel
- Biostatistics Core, City of Hope Beckman Research Institute, Duarte, CA, USA
| | - Thuy Tran
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Marwan Fakih
- Department of Medical Oncology, COH, Duarte, CA, USA
| | - Joseph Chao
- Department of Medical Oncology, COH, Duarte, CA, USA
| | - Dean Lim
- Department of Medical Oncology, COH, Duarte, CA, USA
| | - Yanghee Woo
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Isaac B Paz
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Michael Lew
- Department of Anesthesiology, COH, Duarte, CA, USA
| | | | - Lorna Rodriguez-Rodriguez
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | - Yuman Fong
- Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center (COH), Duarte, CA, USA
| | | | | | | | | | - Thanh H Dellinger
- Division of Gynecologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center (COH), Duarte, CA, USA.
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Lee RM, Ethun CG, Gamboa AC, Turgeon MK, Tran T, Poultsides G, Grignol V, Bedi M, Mogal H, Clarke CN, Tseng J, Roggin KK, Chouliaras K, Votanopoulos K, Krasnick BA, Fields RC, Oskouei SV, Monson DK, Reimer NB, Maithel SK, Pickens A, Cardona K. A novel preoperative risk score to guide patient selection for resection of soft tissue sarcoma lung metastases: An analysis from the United States Sarcoma Collaborative. J Surg Oncol 2021; 124:1477-1484. [PMID: 34374088 DOI: 10.1002/jso.26635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/02/2021] [Accepted: 07/29/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Surgical resection for sarcoma lung metastases has been associated with improved overall survival (OS). METHODS Patients who underwent curative-intent resection of sarcoma lung metastases (2000-2016) were identified from the US Sarcoma Collaborative. Patients with extrapulmonary metastatic disease or R2 resections of primary tumor or metastases were excluded. Primary endpoint was OS. RESULTS Three hundred and fifty-two patients met inclusion criteria. Location of primary tumor was truncal/extremity in 85% (n = 270) and retroperitoneal in 15% (n = 49). Forty-nine percent (n = 171) of patients had solitary and 51% (n = 180) had multiple lung metastasis. Median OS was 49 months; 5-year OS 42%. Age ≥55 (HR 1.77), retroperitoneal primary (HR 1.67), R1 resection of primary (HR 1.72), and multiple (≥2) lung metastases (HR 1.77) were associated with decreased OS(all p < 0.05). Assigning one point for each factor, we developed a risk score from 0 to 4. Patients were then divided into two risk groups: low (0-1 factor) and high (2-4 factors). The low-risk group (n = 159) had significantly better 5-year OS compared to the high-risk group (n = 108) (51% vs. 16%, p < 0.001). CONCLUSION We identified four characteristics that in aggregate portend a worse OS and created a novel prognostic risk score for patients with sarcoma lung metastases. Given that patients in the high-risk group have a projected OS of <20% at 5 years, this risk score, after external validation, will be an important tool to aid in preoperative counseling and consideration for multimodal therapy.
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Affiliation(s)
- Rachel M Lee
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Cecilia G Ethun
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Adriana C Gamboa
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Michael K Turgeon
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Thuy Tran
- Department of Surgery, Stanford University Medical Center, Palo Alto, California, USA
| | - George Poultsides
- Department of Surgery, Stanford University Medical Center, Palo Alto, California, USA
| | - Valerie Grignol
- Department of Surgery, Division of Surgical Oncology, The Ohio State University, Columbus, Ohio, USA
| | - Meena Bedi
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Harveshp Mogal
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Callisia N Clarke
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jennifer Tseng
- Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | - Kevin K Roggin
- Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | | | | | - Bradley A Krasnick
- Department of Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Ryan C Fields
- Department of Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Shervin V Oskouei
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - David K Monson
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Nickolas B Reimer
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Shishir K Maithel
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Allan Pickens
- Department of Surgery, Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA
| | - Kenneth Cardona
- Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
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Wette M, Steinmeier T, Lin Y, Journy N, Tran T, Jackson A, Bolle S, Fresneau B, Lassen-Ramshad Y, Tram Henriksen L, Haustermans K, Brualla L, Bäumer C, Demoor-Goldschmidt C, Thariat J, Thierry-Chef I, Timmermann B. PO-1437 Endocrine Late- Effects after Childhood and Adolescent Cancer - The Pan-European Registry HARMONIC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07888-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nosrati Z, Esquinas PL, Rodríguez-Rodríguez C, Tran T, Maharaj A, Saatchi K, Häfeli UO. Simultaneous SPECT imaging with 123I and 125I - a practical approach to assessing a drug and its carrier at the same time with dual imaging. Int J Pharm 2021; 606:120884. [PMID: 34271154 DOI: 10.1016/j.ijpharm.2021.120884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/07/2021] [Accepted: 07/11/2021] [Indexed: 11/24/2022]
Abstract
Radiolabeling of a drug with radioactive iodine is a good method to determine its pharmacokinetics and biodistribution in vivo that only minimally alters its physicochemical properties. With dual labeling, using the two radioactive iodine isotopes 123I and 125I, two different drugs can be evaluated at the same time, or one can follow both a drug and its drug delivery system using a single photon emission computed tomography (SPECT) imager. One difficulty is that the two radioisotopes have overlapping gamma spectra. Our aim was therefore to develop a technique that overcomes this problem and allows for quantitative analysis of the two radioisotopes present at varied isotope ratios. For this purpose, we developed a simple method that included scatter and attenuation corrections and fully compensated for 123I/125I crosstalk, and then tested it in phantom measurements. The method was applied to the study of an orally administered lipid formulation for the delivery of fenofibrate in rats. To directly compare a traditional study, where fenofibrate was determined in plasma samples to SPECT imaging with 123I-labeled fenofibrate and 125I-labeled triolein over 24 h, the drug concentrations were converted to standardized uptake values (SUVs), an unusual unit for pharmaceutical scientists, but the standard unit for radiologists. A generally good agreement between the traditional and the radioactive imaging method was found in the pharmacokinetics and biodistribution results. Small differences are discussed in detail. Overall, SPECT imaging is an excellent method to pilot a new formulation with just a few animals, replaces blood sampling, and can very quickly highlight potential administration problems, the excretion pathways and the kinetics. Furthermore, dual labeling with the two radioisotopes 123I and 125I clearly shows if a drug and its drug delivery system stay together when traveling through the body, if slow drug release takes place, and where degradation/excretion of the components occurs.
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Affiliation(s)
- Zeynab Nosrati
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Pedro L Esquinas
- IBM Watson Health Imaging, 6303 Airport Road, Mississauga, Ontario, L4V 1R8 Canada
| | - Cristina Rodríguez-Rodríguez
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, British Columbia V6T 1Z1, Canada
| | - Thuy Tran
- Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2100, Denmark
| | - Anil Maharaj
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Katayoon Saatchi
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada.
| | - Urs O Häfeli
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2100, Denmark.
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Tran T, Falkmer T, Ciccarelli M. Do hand therapists have a role in workplace-based education to manage tennis elbow? Beliefs about effective treatments among Australian hand therapists and medical practitioners. Work 2021; 66:539-549. [PMID: 32623416 DOI: 10.3233/wor-203196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/15/2022] Open
Abstract
BACKGROUND Lateral elbow tendinopathy (LET), commonly known as tennis elbow, is a prevalent work-related upper extremity musculoskeletal disorder. Medical practitioners and hand therapists manage LET with commonly available clinic-based treatments, despite no sound evidence to suggest long-term relief and functional restoration for workers with LET. Workplace-based rehabilitation is effective for injured workers with other health conditions, but no studies have investigated this rehabilitation approach in the management of LET. OBJECTIVES (i) Identify, compare, and contrast Australian hand therapists' and medical practitioners' perceptions about the effectiveness of common treatments for LET, and (ii) obtain their views towards a hand therapist delivered workplace-based education approach. METHODS In this cross-sectional study, 38 medical practitioners from Western Australia and 104 hand therapists around Australia completed online surveys. Independent t-tests were used to identify between-group differences in responses. RESULTS Despite some between-group differences regarding the perceived effectiveness of common LET treatments, both groups believed education about LET pathology, activity modification, postures, and workplace recommendations were most effective. Most medical practitioners (81%) and hand therapists (71%) believed workplace-based education delivered by a hand therapist would be beneficial for patients with acute and chronic LET. CONCLUSION Australian hand therapists and medical practitioners believed educational approaches were the most important component in the management of LET, and supported workplace-based educational interventions provided by hand therapists in the management of LET.
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Affiliation(s)
- Thuy Tran
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Perth, WA, Australia.,Hand Works Occupational Therapy, Bullcreek, Western Australia, Australia
| | - Torbjörn Falkmer
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Perth, WA, Australia.,Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - Marina Ciccarelli
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Perth, WA, Australia
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Dahl K, Jussing E, Bylund L, Moein MM, Samén E, Tran T. Fully automated production of the fibroblast activation protein radiotracer [ 18 F]FAPI-74. J Labelled Comp Radiopharm 2021; 64:346-352. [PMID: 34050679 DOI: 10.1002/jlcr.3926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 11/11/2022]
Abstract
We report herein an efficient and fully automated protocol for the radiosynthesis of [18 F]FAPI-74, a new positron emission tomography (PET) radiopharmaceutical for in vivo detection of the fibroblast activation protein. [18 F]FAPI-74 was synthesized via a rapid [18 F]aluminum fluoride coordination reaction, which was first developed on the flexible GE TRACERLab FX2N (FXN) platform and later translated to the cassette-based module Trasis AllInOne (AIO). The results obtained with both modules were comparable in terms of yield and reproducibility. Automation of [18 F]FAPI-74 radiosynthesis on the FXN was carried out in 35 min with a radiochemical yield (RCY) of 18.5 ± 2.5% (n = 5, relative to starting [18 F]fluoride). Method transfer to the AIO platform following minor optimizations allowed for the production of [18 F]FAPI-74 in an isolated RCY of 20 ± 2.5% [n = 3] with an overall synthesis time of 40 min. The radiochemical purity was greater than 95% for [18 F]FAPI-74, obtained from both modules. Overall, the protocol reliably provides a sterile and pyrogen-free good manufacturing practice (GMP) compliant product of [18 F]FAPI-74 suitable for clinical PET imaging.
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Affiliation(s)
- Kenneth Dahl
- Department of Radiopharmacy, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, Stockholm, Sweden
| | - Emma Jussing
- Department of Radiopharmacy, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, Stockholm, Sweden
| | - Lovisa Bylund
- Department of Radiopharmacy, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, Stockholm, Sweden
| | - Mohammad Mahdi Moein
- Department of Radiopharmacy, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, Stockholm, Sweden
| | - Erik Samén
- Department of Radiopharmacy, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, Stockholm, Sweden
| | - Thuy Tran
- Department of Radiopharmacy, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology and Pathology, Kaolinska Institutet, Stockholm, Sweden
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Abstract
BACKGROUND Pharmacists are increasingly fulfilling roles on primary care teams, yet business models for pharmacist services in these settings have not been optimized. This study describes how an ambulatory care pharmacy department implemented various billing methods to generate revenue for pharmacist services. OBJECTIVES (1) Describe pharmacist-delivered billable and non-billable services; and (2) Assess the impact of various billing methods on the return-on-investment (ROI) for billable services. METHODS This study was conducted from September 2016 to August 2017 in Virginia. Pharmacist time spent performing billable encounters using current procedural technology (CPT) codes (e.g., incident-to a physician, annual wellness visits) was calculated. Encounters eligible for the hospital-based facility (G0463) and chronic care management (CCM) codes were considered to be potentially billable services. The ROI was calculated for billable and potentially billable services. RESULTS A total of 948.3 hours (0.46 full-time equivalents (FTE)), 17% of all clinical services, were billed using CPT codes. This resulted in a total revenue of $173,638.66. Missed revenue from not billing for the G0463 and CCM codes was $68,268.37. The cost of pharmacist services for 0.46 FTE was $78,613.08, resulting in a ROI for billed pharmacist services of 1.2:1. The ROI increased to 1.6:1 when considering potentially billable services. CONCLUSION It is feasible to have a positive ROI for billable pharmacist services. To achieve a sustainable business model, there must be a high volume of billable services. G0463 and CCM codes are often underutilized, yet represent significant opportunities in revenue for pharmacist services and should be pursued.
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Affiliation(s)
- Thuy Tran
- Bon Secours Medical Group/Bon Secours Virginia Health System, Mechanicsville, VA, USA
| | - Leticia R Moczygemba
- Health Outcomes Division, 12330University of Texas College of Pharmacy, Austin, TX, USA
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Mutyala S, Tran T, Kashem M, Zhao H, Shigemura N, Toyoda Y. Single Lung Transplantation in Patients under 50: Single Center and UNOS Analysis. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Montgomery K, Ander E, Tran T, Rakita V, Brann S, Toyoda Y, Hamad E. Survival Outcomes with Regards to Implant Strategies in Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1211] [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: 10/21/2022] Open
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Kashem M, Tran T, Suryapalam M, Rakita V, Hamad E, Minakata K, Toyoda Y. Impact of Ventricular Assist Devices on Cardiac Transplant Recipient Survival Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1196] [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: 11/17/2022] Open
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Tran T, Kashem M, Kanaparthi J, Zhao H, Brann S, Leotta E, Minakata K, Yanagida R, Sunagawa G, Shigemura N, Toyoda Y. Lung Transplant Survival Regarding Past and Concomitant Cardiac Revascularization. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1040] [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: 11/27/2022] Open
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