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Novak, Anne J., Deanna M. Grote, Steven C. Ziesmer, Michael P. Kline, Michelle K. Manske, Susan Slager, Thomas E. Witzig et al. "Elevated Serum B-Lymphocyte Stimulator Levels in Patients With Familial Lymphoproliferative Disorders". Journal of Clinical Oncology 24, n. 6 (20 febbraio 2006): 983–87. http://dx.doi.org/10.1200/jco.2005.02.7938.
Testo completoAbstract (sommario):
Purpose Serum B-lymphocyte stimulator (BLyS) levels have been found to be elevated in a number of immune disease models. Therefore, we sought to establish whether BLyS levels were elevated in patients with B-cell lymphoproliferative disorders and to determine whether elevated BLyS levels correlated with clinical characteristics of the disease. Patients and Methods Specimens were collected from the peripheral blood of individuals diagnosed with B-cell chronic lymphocytic leukemia (B-CLL; n = 70) or from age- and sex-matched patients seen at the same institution (n = 41). Serum BLyS levels were determined by enzyme-linked immunosorbent assay, and sequencing of the BLyS promoter was performed by conventional methods and confirmed by restriction fragment length polymorphism analysis. Results We found that elevated BLyS levels were more common in patients with familial B-CLL than individuals with sporadic B-CLL or normal controls. Because of this association, we sequenced the BLyS promoter in patients with B-CLL and normal controls and identified a polymorphic site, −871 C/T. We found that the wild-type sequence was significantly underrepresented in patients with familial B-CLL (4%) compared with patients with sporadic B-CLL (30%; P = .01) or controls (24%; P = .04). Furthermore, using a luciferase reporter under control of the BLyS promoter containing either a C or a T at position −871, we found that the reporter construct containing a T at −871 had a 2.6-fold increase in activity (P = .004). Conclusion Our data suggest serum BLyS levels are elevated in patients with familial B-CLL and that elevated BLyS levels correlate with the presence of a T at −871 in the BLyS promoter.
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Berczi, Csaba, János Dócs e Tibor Flaskó. "Nyílt és laparoszkópos műtéttel végzett radikális prostatectomiák után kialakult szövődmények összehasonlítása". Magyar Urológia 34, n. 3 (2022): 97–101. http://dx.doi.org/10.22591/magyurol.2022.3.berczics.97.
Testo completoAbstract (sommario):
Célkitűzés: A vizsgálatban a prosztatatumorok miatt nyílt és laparoszkópos eljárással végzett radikális prostatectomiák utáni szövődmények gyakoriságát tanulmányozták intézetükben. Betegek és módszerek: A tanulmányban a 2015. 01. 01. és 2020. 01. 01. között prosztatadaganat miatt radikális prostatectomián átesett 871 beteg adatai kerültek feldolgozásra. Az 1. csoportba (n: 707) tartozó betegek esetében laparoszkópos, míg a 2. csoportba sorolt betegeknél (n:164) nyílt, retropubikus radikális prostatectomia történt. A betegek átlagos életkora 65,6±6,3 év, míg az átlagos PSA-szint az 13,1±13,0 ng/ml volt. A szövődmények osztályozása során a Clavien–Dindo-féle klasszifikációt használták. Eredmények: A korai posztoperatív szakban az 1. csoportban Clavien–Dindo-szerinti grade 1+2 szövődmény 91 esetben (12,8%) míg grade 3+4 szövődmény 19 betegben (2,6%) alakult ki. A 2. csoportban Clavien–Dindo-szerinti grade 1+2 szövődmény 91 (55,4%), míg Grade 3+4 szövődmény 9 (5,4%) fordult elő. A grade 1+2 szövődmények előfordulása szignifikánsan, (p<0,0001), míg a grade 3+4 komplikációké nem szignifikánsan (p=0,138) bizonyult magasabbnak a nyílt műtétes betegcsoportban. A késői posztoperatív szakban az 1. csoportban Clavien–Dindo-szerinti grade 1+2 szövődmény 11 alkalommal (1,5%), míg grade 3+4 szövődmény 12 betegben (1,7%) alakult ki. A 2. csoportban Clavien–Dindo-szerinti grade 1+2 szövődmény 5 esetben (3,0%), míg grade 3+4 szövődmény 7 alkalommal (4,2%) fordult elő. A késői komplikációk vonatkozásában sem a grade 1+2, sem a grade 3+4 szövődmények tekintetében nem volt szignifikáns különbség az 1. és a 2. csoport között (p=0,346 és p=0,122). Következtetések: Az eredmények alapján megállapítható, hogy a posztoperatív szövődmények lényegesen gyakrabban fordultak elő a nyílt műtéten átesett betegekben. Szignifikáns eltérést azonban csak a korai komplikációk esetében, az enyhébb (grade 1+2) formákban tapasztaltak a két csoport között.
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Martell Muñoz, Juan, Cirilo Humberto García Cadena, Leopoldo Daniel-González, Patricia Sánchez Miranda e Abraham Mendoza Martínez. "Estructura factorial de la escala de satisfacción con la vida y validez convergente con la escala de calidad de vida en preparatorianos mexicanos". Revista de Psicología y Ciencias del Comportamiento de la Unidad Académica de Ciencias Jurídicas y Sociales 9, n. 2 (7 dicembre 2018): 30–45. http://dx.doi.org/10.29059/rpcc.20181207-70.
Testo completoAbstract (sommario):
El propósito de este estudio fue calcular tanto la validez de constructo como la validez convergente de la escala de Satisfacción con la Vida (SWL), de Diener, Emmons, Larsen y Griffin (1985), en 428 estudiantes de bachillerato. Se usaron análisis factorial exploratorio y confirmatorio. Diener et al. (1985) diseñan una escala que estandariza la medida de la satisfacción con la vida, de manera válida y confiable. Se encuentra que las ?´s de los ítems tienen un recorrido desde .58 hasta .88. El coeficiente de consistencia interna alfa de Cronbach es de .85, con un intervalo de confianza del 95% (de .826 a .871). El coeficiente de correlación de Pearson entre la SWLS y la escala de Calidad de Vida es de r= .395; p< .01; IC95%: .293, .486. Hay coincidencia entre los hallazgos arrojados por ambos tipos de análisis factorial. El modelo de medición se corresponde con el creado por Diener et al. (1985): los cinco ítems muestran validez y confiabilidad, al igual que lo reportado por otros estudios en diferentes contextos culturales.
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Inaba, Hidefumi, Yosuke Kaido, Saya Ito, Tomonao Hirobata, Gen Inoue, Takakazu Sugita, Yuki Yamamoto et al. "Human Leukocyte Antigens and Biomarkers in Type 1 Diabetes Mellitus Induced by Immune-Checkpoint Inhibitors". Endocrinology and Metabolism 37, n. 1 (28 febbraio 2022): 84–95. http://dx.doi.org/10.3803/enm.2021.1282.
Testo completoAbstract (sommario):
Background: Type 1 diabetes mellitus induced by immune-checkpoint inhibitors (ICI-T1DM) is a rare critical entity. However, the etiology of ICI-T1DM remains unclear.Methods: In order to elucidate risk factors for ICI-T1DM, we evaluated the clinical course and immunological status of patients with ICI-T1DM who had been diagnosed during 2016 to 2021.Results: Seven of 871 (0.8%, six men and one woman) patients developed ICI-T1DM. We revealed that the allele frequencies of human leukocyte antigen (HLA)-DPA1*02:02 and DPB1*05:01 were significantly higher in the patients with ICI-T1DM In comparison to the controls who received ICI (11/14 vs. 10/26, P=0.022; 11/14 vs. 7/26, P=0.0027, respectively). HLA-DRB1*04:05, which has been found to be a T1DM susceptibility allele in Asians, was also observed as a high-risk allele for ICI-T1DM. The significance of the HLA-DPB1*05:01 and DRB1*04:05 alleles was confirmed by an analysis of four additional patients. The absolute/relative neutrophil count, neutrophils-lymphocyte ratio, and neutrophil-eosinophil ratio increased, and the absolute lymphocyte count and absolute/relative eosinophil count decreased at the onset as compared with 6 weeks before. In two patients, alterations in cytokines and chemokines were found at the onset.Conclusion: Novel high-risk HLA alleles and haplotypes were identified in ICI-T1DM, and peripheral blood factors may be utilized as biomarkers.
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Burns, Con, John J. Murphy e Ciaran MacDonncha. "Year in School and Physical Activity Stage of Change as Discriminators of Variation in the Physical Activity Correlate Profile of Adolescent Females". Journal of Physical Activity and Health 11, n. 4 (maggio 2014): 721–28. http://dx.doi.org/10.1123/jpah.2011-0353.
Testo completoAbstract (sommario):
Background:Knowledge of the physical activity correlate profile of adolescent females will provide insight into decreasing physical activity patterns among adolescent females.Methods:Correlates of physical activity and physical activity stage of change were assessed during 2007–2008 among 871 Irish adolescent females in years 1–6 in secondary schools (15.28 ± 1.8 years). Multivariate Analysis of Variance was used to identify whether differences in correlates of physical activity could be detected across year in school and physical activity stages of change.Results:Significant differences (P < .01) were found in 11 of the 16 measured correlates across year in school and in 14 of the 16 correlates across stage of change. Effect size estimates and regression analysis revealed perceived competence, peer social support and intention to be physically active (partial eta range (ηp2) .21–.25) to be the most important predictors of physical activity stage of change.Conclusions:Females in more senior years in school and in earlier physical activity stages of change reported a significantly less positive physical activity correlate profile than females in junior years and in later physical activity stages of change. This finding supports the construct validity of the physical activity stages of change.
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Aguirre, Miguel Castresana, Annelie Johansson, Linda S. Lindström e Nick Tobin. "Abstract P6-01-08: Gene signatures provide independent prognostic information in elderly breast cancer patients". Cancer Research 83, n. 5_Supplement (1 marzo 2023): P6–01–08—P6–01–08. http://dx.doi.org/10.1158/1538-7445.sabcs22-p6-01-08.
Testo completoAbstract (sommario):
Abstract Background: Elderly breast cancer patients (≥70 years old) are under-represented in clinical trials and remain an undertreated population. Gene expression signatures have been shown to add additional prognostic information beyond that of routine clinicopathological factors, however their utility in elderly breast cancer patients remains unclear. As such, the main aim of this study is to determine if gene signatures can provide prognostic information that may help to aid treatment decisions for elderly breast cancer patients. Material and methods: Research versions of the genomic grade index (GGI), 70-gene, 21-gene recurrence score (RS), cell cycle score (CCS), PAM50 and PAM50 Risk of Relapse score - Proliferation (ROR-P) signatures were applied to 39 open access breast cancer datasets totalling 9583 patients. After filtering based on age ≥ 70 years old, the presence of Estrogen Receptor (ER) and survival information availability 871 patients remained. The prognostic capacity of signatures was tested in all (N=871), Estrogen Receptor positive/Lymph node positive (ER+/LN+, N=335) and Estrogen Receptor positive/Lymph node negative (ER+/LN-, N=374) patients using Kaplan-Meier and multi-variable Cox proportional hazard modeling. Models were adjusted for tumor size, grade, ER and lymph node status in all patients, and tumor size and grade in the ER+/LN+ and ER+/LN- subgroup analyses. Recurrence Free Survival (RFS) censored at 10 years was used as clinical endpoint and defined as the time from date of curative surgery to the time of recurrence or death. Both loco-regional recurrences and distant metastatic events were included in this endpoint. Results: Tumours from patients ≥ 70 years of age showed high levels of ER (87%), were large (69% ≥ 20 mm) and were of intermediate or high grade (82%). All gene signatures were statistically significant in Kaplan-Meier analysis of all and ER+/LN+ patients (Logrank P < 0.001). This significance remained in multi-variable analysis (Cox proportional hazards, P ≤ 0.05) with the exception of PAM50 which showed a trend (P ≤ 0.1) in ER+/LN+ patients. In ER+/LN- patients the GGI, 70-gene, PAM50, ROR-P, and CCS signatures were significant in Kaplan-Meier analysis (Logrank P ≤ 0.05) but only the 70-gene, PAM50, ROR-P, and CCS signatures remained so in multi-variable analysis (Cox proportional hazards, P ≤ 0.05). Conclusions: In general, we found that gene signatures provide statistically significant prognostic information in Kaplan-Meier and multi-variable analyses of all, ER+/LN+ and ER+/LN- breast patients over the age of 70. Table 1: Multivariable proportional hazard (Cox) analyses for all gene signatures for patients above age of 70. NOTE: Bold values indicate P < 0.05. aAdjusted for tumor size, tumor grade, estrogen receptor status, and lymph node status. bAdjusted for tumor size and tumor grade. Citation Format: Miguel Castresana Aguirre, Annelie Johansson, Linda S. Lindström, Nick Tobin. Gene signatures provide independent prognostic information in elderly breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-01-08.
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Stankovska, Gordana, Fadbi Osmani, Svetlana Pandilovska Grncarovska e Slagana Angelkoska. "Relationship Between Stressful Life Events And Anxiety During The Period Of Adolescence". European Scientific Journal, ESJ 12, n. 11 (27 aprile 2016): 332. http://dx.doi.org/10.19044/esj.2016.v12n11p332.
Testo completoAbstract (sommario):
The purpose of this study is to investigate the relationships between stressful life events and anxiety during the period of adolescence. It is known that stressful life events are commonly studied risk and environmental factors in the development of psychopathology in childhood and adolescence. In addition, physical and psychological symptoms of anxiety are often associated with stressful life events. These events are related to the different experiences of conflict and disrupted communication in the family. Subsequently, these events directly or indirectly affect the self-esteem and the self-image of adolescents during the period of adolescence. This research starts with the assumption that stressful life events predicted anxiety during the period of adolescence. Another assumption, in this research, is that females have higher level of anxiety compared with males. This study was conducted on a sample of 160 participants (80 girls and 80 boys) students in the fourth year of secondary school. The instruments used in the research include: scale of stressful life events for children and adolescents – Stress-D, and the Scale for anxiety for children and adolescents – SCAD-62. The results showed that stressful life events were significantly associated with anxiety symptoms (r= .962, p<.01). Also, the symptoms of anxiety are closely associated with medical (F,24,135= .871, p<.05) and family stressful events (F,24,135= 2.017, p<.05). There were significant relationship between medical stressful life events and gender (p= .045), and social stressful life events and gender (p= .001). On the other hand, there was a negative correlation between academic stressful life events and gender (p= .944), and family stressful life events and gender (p= .564). In conclusion, the results of the study show that females have higher level of anxiety compared with males (r= .985, p<.01). The results show that there is a significant relationship between specific types of stressful life events, including those related to physical health and family which discord the anxiety during the period of adolescence.
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Hogan, Christopher, Darci Bowles, Moshe Feldman, Shannon Lubin e Markos Kashiouris. "871". Critical Care Medicine 43 (dicembre 2015): 219. http://dx.doi.org/10.1097/01.ccm.0000474699.75650.64.
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Meert, Kathleen, e Susan Eggly. "871". Critical Care Medicine 40 (dicembre 2012): 1–328. http://dx.doi.org/10.1097/01.ccm.0000425086.74471.65.
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Goldstein, Jennifer, Kirk Gosik, Angela Heisey, Camille Filoromo e Scott Armen. "871". Critical Care Medicine 42 (dicembre 2014): A1570. http://dx.doi.org/10.1097/01.ccm.0000458368.20726.0d.
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Mulherin, Diana, Kelli Rumbaugh, David Mulherin, Austin Ing e Douglas Seidner. "871". Critical Care Medicine 47 (gennaio 2019): 414. http://dx.doi.org/10.1097/01.ccm.0000551620.47518.97.
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Willmon, Julie, Eric Pyles, Caitlin Thomas, Bibidh Subedi, Kacie Clark, Alex Bokun, Abbi Rowe e Patricia Louzon Lynch. "871". Critical Care Medicine 48 (gennaio 2020): 415. http://dx.doi.org/10.1097/01.ccm.0000631620.95033.f4.
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DePietro, Michael, Erkan Hassan, Omar Badawi, Megan Farraj, Maureen Seckel, Robin French, Anita Witzke e Marc Zubrow. "871". Critical Care Medicine 41 (dicembre 2013): A218. http://dx.doi.org/10.1097/01.ccm.0000440109.49749.b2.
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Woo, S. H. "ABSTRACT 871". Pediatric Critical Care Medicine 15 (maggio 2014): 194. http://dx.doi.org/10.1097/01.pcc.0000449597.26350.2d.
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Alexander, S. L., C. H. G. Irvine, J. H. Livesey e R. A. Donald. "Effect of isolation stress on concentrations of arginine vasopressin, α-melanocyte-stimulating hormone and ACTH in the pituitary venous effluent of the normal horse". Journal of Endocrinology 116, n. 3 (marzo 1988): 325–34. http://dx.doi.org/10.1677/joe.0.1160325.
Testo completoAbstract (sommario):
ABSTRACT A non-surgical, non-stressful technique was used for collection of pituitary venous blood from five conscious horses every minute for two 10-min periods before and during isolation from the herd, which caused a predictable, yet humane and physiological, emotional stress. Pituitary blood was also sampled every 5 min for two approximately 90-min periods before and after isolation, while jugular blood was sampled every 15 min throughout the experiment. During isolation, all horses became agitated, hyperventilating and sweating. Packed red cell volume increased, as did pituitary venous concentrations of adrenaline (mean ± s.e.m. concentration before isolation, 621·5±112·3 pmol/l; peak during isolation, 2665·4 ± 869·8 pmol/l; P <0·05) and noradrenaline (before, 871·8 ± 111·8 pmol/l; peak, 2726·1 ± 547·4 pmol/l; P<0·02). Concentrations of arginine vasopressin (AVP) were higher in pituitary venous but not in jugular blood during isolation than during the preceding 10-min period (P <0·05). Although AVP secretion increased in all horses, in three of the five it rose dramatically in the first minute of isolation to 25·7 (horse 1), 13·6 (horse 4) and 145·1 (horse 5) times the level in the last sample collected before isolation. Mean pituitary venous concentrations of ACTH and α-MSH increased during isolation in the three horses which had large increases in AVP secretion, but, overall, stress did not significantly affect ACTH or α-MSH secretion. Similarly, mean jugular cortisol levels were not significantly altered by isolation. However, the magnitudes of ACTH, AVP and α-MSH responses to isolation were negatively correlated with the jugular cortisol level before isolation. The changes in pituitary venous concentrations of ACTH and AVP were synchronous under resting conditions, whether samples were collected at intervals of 1 (P <0·01) or 5 (P <0·005) min; however, this synchrony was lost during isolation. The changes in pituitary venous concentrations of ACTH and α-MSH were synchronous both at rest (P <0·025 for 1-min sampling, P <0·01 for 5-min sampling) and during isolation (P<0·01). We conclude that isolation stress increases AVP secretion and may alter the temporal relationship between pituitary venous concentrations of AVP and ACTH. Furthermore, the magnitude of the responses of AVP, ACTH and α-MSH to isolation is significantly affected by the prevailing cortisol level. J. Endocr. (1988) 116, 325–334
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Nash Smyth, Emily, Samuel Whipple, Mark Guinter, Nadine Haddad, Wenxian Piao, Zhanglin Lin Cui e Arjun Vasant Balar. "Real-world treatment (Tx) sequences and time to discontinuation (rwTTD) in the first-line (1L) metastatic castration-resistant prostate cancer (mCRPC) setting." Journal of Clinical Oncology 42, n. 4_suppl (1 febbraio 2024): 55. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.55.
Testo completoAbstract (sommario):
55 Background: There is limited real-world data on tx sequencing in metastatic prostate cancer. Additionally, while guidelines support adding novel hormonal agents (NHA) to androgen deprivation tx (ADT) for metastatic hormone-sensitive prostate cancer, use is limited because of clinical and/or pt-driven factors. We evaluated tx patterns, rwTTD, and time-to-chemotherapy (rwTTC) for 1L mCRPC pts, including Black/African Americans (BAA) treated predominantly in a community oncology setting. Additionally, we analyzed systemic treatments prior to 1L mCRPC as well as progression to 2L mCRPC. Methods: This retrospective study included pts with mCRPC from the nationwide Flatiron Health EHR-derived, deidentified database who initiated 1L tx between 1/2013 and 1/2023. Study end was 4/2023. Tx patterns were described by time period (TP) of 1L initiation: TP1 - 01/2013–12/2017 and TP2 - 01/2018–01/2023; Kaplan-Meier analyses were conducted for rwTTD/TTC and a Cox proportional hazards regression model was used to determine the association between pt characteristics and rwTTD/TTC for 1L mCRPC. Subgroup analyses were performed for BAAs. Results: Of the 8915 1L-tx pts (median age 74 yrs), 871 (10%) were BAA (median age 70 yrs) and 5870 (66%) were NHA-naïve at 1L mCRPC. Overall, the percent of pts who were NHA-naïve decreased from 2018 (72%) to 2023 (39%) and a similar trend was observed for BAA (74% [2018] to 25% [2023]). 1L NHA use in mCRPC increased from TP1 to TP2 (overall: 70% to 80%; BAA: 73% to 83%), primarily driven by enzalutamide (Enz) (overall: 30% to 39%; BAA: 33% to 38%) and decrease in chemotherapy (overall: 16% to 12%; BAA: 17% to 13%). The top 3 1L mCRPC regimens for the overall population and BAA were abiraterone (Abi) (35%; 38%), Enz (32%; 33%), and docetaxel (10%; 11%). Among pts who progressed to 2L mCRPC, the most common sequences for patients tx with Abi or Enz for 1L mCRPC were ADT monotherapy in the prior line of tx and a switch to Abi (19%) or Enz (24%) upon progression from 1L to 2L. 1L rwTTD for the overall cohort is in the Table. Age ≥80 years, ECOG PS ≥1, socioeconomic status = 5 (highest), and median time ≤39.8 months from initial dx to mCRPC were associated with a higher hazard of discontinuation (all p ≤0.05). Conclusions: Overall, most pts received their first NHA in 1L mCRPC; NHA use increased and chemotherapy use decreased from TP1 to TP2. There was heterogeneity in tx sequences in patients treated with an NHA in 1L mCRPC; some pts were rechallenged with a different NHA in 2L despite lack of robust prospective data to support use. Overall, 1L rwTTD was short with a small numerical increase in TP2. Factors contributing to discontinuation, such as treatment resistance, need to be better understood to further improve real-world outcomes. [Table: see text]
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Jones, Mary, e Desiree Kosmisky. "871: Paliperidone-Induced Hypothermia". Critical Care Medicine 49, n. 1 (11 dicembre 2020): 432. http://dx.doi.org/10.1097/01.ccm.0000729372.67177.32.
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Zhou, Y., A. K. Windham, C. Staker, M. Whitted, B. Brimhall, A. Podichetty e K. Clark. "Sepsis Inpatient Diagnostic Testing at Mid-Size Academic and Non-academic Health Systems". American Journal of Clinical Pathology 160, Supplement_1 (1 novembre 2023): S102. http://dx.doi.org/10.1093/ajcp/aqad150.224.
Testo completoAbstract (sommario):
Abstract Introduction/Objective Comparison of clinical laboratory test and radiology imaging utilization for sepsis inpatients across multiple academic and non-academic health systems would be useful for healthcare resource utilization benchmarking. Methods/Case Report We compared laboratory and imaging utilization for adult patients hospitalized for sepsis procedures at mid-size (250-450 hospital beds), academic (N=12; 31,353 hospitalizations) and non-academic (N=18; 54,192 hospitalizations), hospitals using the Vizient Clinical Data Base™ over 3 years (2019-2021). We used Medicare Severity Diagnosis Related Groups (MSDRG), used by the US Centers for Medicare and Medicaid Services (CMS), to identify hospitalizations for sepsis (MSDRG triplet 870/871/872). We stratified patients by severity comorbid conditions and complications into high, moderate, and low severity groups. We compared the mean number of clinical laboratory (CPT codes 80000-89999) and imaging studies (CPT codes 70000-79999) per hospitalization and per hospital day. We also measured aggregate clinical Resource Intensity Weight (RIW) per hospitalization to quantify diagnostic resource consumption for each encounter. The RIW is based on the US Centers for Medicare and Medicaid Services (CMS) Ambulatory Payment Classification (APC) weights. Results (if a Case Study enter NA) Mean laboratory tests were significantly greater (p<.01) at academic hospitals per encounter (152.2 vs. 95.4 tests, 59.5% higher) and per hospital day (14.5 vs. 9.9 tests, 46.5% higher). Laboratory RIW was also higher per hospitalization (21.0 vs. 13.5 RIW, 55.6% higher) and per hospital day (2.0 vs. 1.4 RIW, 42.9% higher) at academic hospitals. Mean imaging studies at academic hospitals were higher per case (7.8 vs. 7.2 studies, 8.3% higher) but not different per day (0.80 for both hospital groups). Imaging RIW was not significantly different between academic and non-academic hospitals either by encounter (11.1 vs. 9.9, 12.1% higher) or per day (1.2 for both hospital groups). Imaging comparisons lacked statistical significance. Analysis of utilization after stratification for severity levels revealed a similar pattern with greater differences in the high severity group. Conclusion Mean laboratory tests and laboratory RIW per hospitalization are greater at academic hospitals. These differences persist after adjustment for hospital length of stay and severity level. Differences in imaging studies and imaging RIW were not significant.
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Zhou, Y., A. K. Windham, C. Staker, M. Whitted, B. Brimhall e A. Podichetty. "Correlation Between Large-Scale Health System Operational Parameters and Laboratory Test Utilization". American Journal of Clinical Pathology 160, Supplement_1 (1 novembre 2023): S102—S103. http://dx.doi.org/10.1093/ajcp/aqad150.225.
Testo completoAbstract (sommario):
Abstract Introduction/Objective The extent of correlation between clinical laboratory test utilization and large-scale operational parameters would be helpful to adjust for these parameters when benchmarking utilization. Methods/Case Report We compared clinical laboratory and imaging utilization over 3 years (2019-2021) for adult patients hospitalized for specific surgical, medical, and obstetrics diagnoses at multiple academic hospitals (N=58; 625,436 hospitalizations) ranging in size from 250-1300 hospital beds. We queried the Vizient Clinical Data Base with permission from Vizient, Inc.® employing Medicare Severity Diagnosis Related Groups (MSDRG), used by the US Centers for Medicare and Medicaid Services (CMS), to identify hospitalizations for gastrointestinal (GI) surgery (MSDRG triplet 329/330/331), sepsis (MSDRG triplet 870/871/872), and vaginal delivery (MSDGR triplet 805/806/807). We stratified patients within each diagnostic group for comorbid conditions and complications into high, moderate, and low severity groups. We compared mean laboratory tests and Resource Intensity Weight (RIW) per hospitalization and hospital day. The RIW is based on the CMS Ambulatory Payment Classification (APC) weights. We measured correlation of laboratory utilization with hospital bed size as well as annual discharges (sepsis group), surgical procedures (GI surgery group), births (vaginal delivery group), and diagnosis-specific discharges. Results (if a Case Study enter NA) For sepsis hospitalizations, there were small significant (p<.01) negative correlations (r2 0.05-0.16) between laboratory utilization, measured as test numbers or RIW, and diagnosis-specific discharges for low and moderate severity groups; there was no significant correlation with either bed size or overall annual discharges. There were no consistent correlations of laboratory utilization with bed size, annual surgical procedures, or diagnosis-specific discharges for GI surgery patients. Hospitalizations for vaginal delivery demonstrated small negative correlations between laboratory utilization and bed size, annual births, and diagnosis- specific discharges. Conclusion For specific diagnostic groups, laboratory utilization (tests as well as laboratory RIW) exhibited negative correlations with large-scale hospital operational parameters. These correlations were typically weak with varying statistical significance. The findings suggest that laboratory test utilization efficiency may require evaluation of individual health systems on a case-by-case basis.
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Johns, Natalie, Jody Wallace, Darbey Raible, Jordan Brady, Grace Miller e Brooke Phillips. "Abstract PO2-08-01: Universal Multi-Gene Panel Testing of Newly Diagnosed Breast Cancer Patients in a Community Healthcare System". Cancer Research 84, n. 9_Supplement (2 maggio 2024): PO2–08–01—PO2–08–01. http://dx.doi.org/10.1158/1538-7445.sabcs23-po2-08-01.
Testo completoAbstract (sommario):
Abstract Introduction Multi-gene panel, germline genetic testing has emerged over the last decade as a useful tool in the assessment of hereditary cancer syndromes. As barriers to genetic testing are reduced, offering universal genetic testing to all cancer patients is a practice gaining traction. We present outcomes data specific to the offering of universal, multi-gene panel testing to newly diagnosed breast cancer patients in a community hospital setting. Methods A retrospective chart review was performed for all newly diagnosed breast cancer patients (n=1005) at a community hospital between 8/5/2019 and 8/5/2022. Uptake and outcomes of genetic counseling and genetic testing were assessed. All patients were offered genetic counseling, and those who consented to genetic testing were offered a multi-gene panel (37-93 genes). The National Comprehensive Cancer Network (NCCN) Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic (2020) guidelines were utilized to distinguish which patients met traditional genetic testing criteria. Results Of all newly diagnosed breast cancer patients, 915 (91.1%) patients underwent genetic counseling and 871 (86.7%) patients elected for genetic testing. Of those who declined genetic testing (n=134), 39 (29.1%) reported previous genetic testing. Of patients tested, 489 (56.1%) met NCCN criteria. Overall, 114 (13.1%) of tested patients received results with likely pathogenic/pathogenic (LP/P) variants. Of those, 86 (75.4%) had a clinically significant variant, a high-risk, moderate-risk or another dominantly inherited gene variant, while 28 (24.6%) were identified as genetic carriers; Table 1 summarizes genes with LP/P variants in this cohort, with 10 patients receiving results for 2 variants. Of the patients with clinically significant genetic results, 58 (67.4%) met NCCN criteria. Furthermore, 65 patients (75.6%) reported a family history of cancer relevant to the identified LP/P variant. The average age of the total population, and of those with a positive result, was 62 years. While nearly 19% of all patients tested were under age 50, patients under 50 comprised only 14.0% (n=12) of patients with a clinically significant result. Breast cancer management changes, including addition of a PARP inhibitor to chemotherapy regimen and/or elected bilateral mastectomies in the setting of unilateral disease, were noted in 71.4% (n=20) of patients with high-risk genetic findings and 20.6% (n=7) of patients with moderate-risk genetic findings. Conclusion The 86.7% uptake of genetic testing suggests implementation of universal testing in a community setting is feasible and favored by patients. Clinically significant genetic results would have gone undetected in 32.6% of patients if NCCN criteria was strictly utilized to offer testing. In addition to the 62 patients with high and moderate risk genetic results, utilization of expanded panel testing provided benefit for an additional 24 patients found to have an actionable variant in a gene that would not have been detected on traditional breast cancer panels. Our data supports the offering of genetic testing to all newly diagnosed breast cancer patients, regardless of age, family history, or other criterion, to inform precise breast cancer management and overall, lifetime cancer risks. Genetic Findings of Universal Multi-Gene Panels in a Community Setting Citation Format: Natalie Johns, Jody Wallace, Darbey Raible, Jordan Brady, Grace Miller, Brooke Phillips. Universal Multi-Gene Panel Testing of Newly Diagnosed Breast Cancer Patients in a Community Healthcare System [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-08-01.
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Weaver, Cory, Sandra Kane-Gill, Scott Gunn e Pamela Smithburger. "871: EVALUATING THE EFFICACY OF ANTIPSYCHOTICS FOR THE TREATMENT OF ICU DELIRIUM". Critical Care Medicine 44, n. 12 (dicembre 2016): 294. http://dx.doi.org/10.1097/01.ccm.0000509547.02902.1c.
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Damhoff, Heather, Kyle Combs, Christopher Johnsrude e Kelvin Lau. "871: THE EFFECT OF ECMO ON PROCAINAMIDE INFUSION DOSING AND SERUM CONCENTRATIONS". Critical Care Medicine 46, n. 1 (gennaio 2018): 420. http://dx.doi.org/10.1097/01.ccm.0000528880.07771.67.
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O’Doherty, J. V., e U. Keady. "The effect of expander processing and extrusion on the nutritive value of peas for pigs". Animal Science 72, n. 1 (febbraio 2001): 43–53. http://dx.doi.org/10.1017/s1357729800055545.
Testo completoAbstract (sommario):
AbstractTwo experiments were conducted to investigate the effect of expander processing of food for growing and finishing pigs. Experiment 1 examined the effects of expander processing on the nutritive value of a cereal-based diet and a pea-based diet for pigs while experiment 2 determined the effects of extrusion and expansion of the peas component of the diet on the nutritive value. In experiment 1, growth performance, carcass characteristics (no. = 12) and nutrient digestibility (no. = 4) were determined in pigs offered individually food containing a cereal diet (T1), a complete cereal diet that had been expander processed (T2), a 400 g/kg peas diet (T3) or a complete 400 g/kg peas diet that had been expander processed (T4). The expanded diets were processed at 105°C for 5 s at 35 bar pressure. In experiment 2, productive performance and nutrient digestibility were determined in pigs (no. = 12) offered individually diets including a control cereal diet (no peas) (TT1), a 400 g/kg raw peas diet (TT2), a 400 g/kg expander processed peas diet (TT3) or a 400 g/kg extruded peas diet (TT4). The pea portions of the diets were extruded at 130°C for 30 s and expanded at 130°C for 10 s at 42 bar pressure. In experiment 1, the inclusion of peas in the diet reduced (P < 0·001) the digestibility of the organic matter (OM) (0·871 v. 0·893, s.e. 0·003), protein (0·867 v. 0·907, s.e. 0·004) and energy (0·857 v. 0·880, s.e. 0·003). Expansion had no effect on the nutrient digestibility of the diets, however, it did increase (P < 0·05) the digestible energy content of the cereal diet. The inclusion of peas in the diet reduced (P < 0·05) daily gain (0·929 v. 0·999, s.e. 0·024 kg/day) and increased (P < 0·001) food conversion ratio (FCR) (2·31 v. 2·16, s.e. 0·029) from 34 kg to slaughter. Expansion had no effect on daily gain or FCR. In experiment 2, OM digestibilities of 0·891, 0·872, 0·882 and 0·885 (s.e. 0·0042) (P < 0·01), protein digestibilities of 0·905, 0·879, 0·874 and 0·877 (s.e. 0·0069) (P < 0·001) and gross energy digestibilities of 0·875, 0·861, 0·870 and 0·875 (s.e. 0·005) (P < 0·05) were recorded for TT1 to TT4 respectively. Gains (kg/day) of 0·981, 0·927, 0·940, and 1·016 (s.e. 0·036) (P < 0·05) and FCR of 2·17, 2·32, 2·28 and 2·18 (s.e. 0·037) (P < 0·05) were recorded for TT1 to TT4 respectively. In conclusion, expansion had no effect on the nutritive value of food for pigs.
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Furtado, R., C. Tonial, F. Crestani, G. Andrades, C. Costa, F. Bruno, P. R. Einloft, M. J. Alvarado, F. Soares e P. Garcia. "P0447 / #871: LIFE SUPPORT LIMITATION PRACTICES IN A PEDIATRIC INTENSIVE CARE UNIT". Pediatric Critical Care Medicine 22, Supplement 1 3S (marzo 2021): 229. http://dx.doi.org/10.1097/01.pcc.0000740128.09310.e9.
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Babalola, Omotooke, e Thomson Pancoast. "871: POST-PNEUMONECTOMY BRONCHOPLEURAL FISTULA: IS THIS A VENTILATOR-INDUCED LUNG INJURY?" Critical Care Medicine 51, n. 1 (15 dicembre 2022): 428. http://dx.doi.org/10.1097/01.ccm.0000909212.14947.e4.
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Pavia, Kathryn, Sonya Tang Girdwood, Peter Tang, Calise Curry, Rhonda Jones, Erin Stoneman, Toni Yunger, Min Dong, Alexander Vinks e Jennifer Kaplan. "871: IMPAIRED RENAL FUNCTION IS ASSOCIATED WITH HIGH CEFEPIME CONCENTRATIONS IN CRITICALLY ILL CHILDREN". Critical Care Medicine 50, n. 1 (16 dicembre 2021): 431. http://dx.doi.org/10.1097/01.ccm.0000809808.12625.19.
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Nayar, Ribhu, Sonal Jangalwe, Mollie Jurewicz, Antoine Boudot, Andrew Basinski, Robert Prenovitz, Elizabeth Olesin et al. "156 Discovery of TSC-100: A natural HA-1-specific TCR to treat leukemia following hematopoietic stem cell transplant therapy". Journal for ImmunoTherapy of Cancer 8, Suppl 3 (novembre 2020): A170. http://dx.doi.org/10.1136/jitc-2020-sitc2020.0156.
Testo completoAbstract (sommario):
BackgroundApproximately 30–40% of AML patients relapse following allogeneic hematopoietic stem cell transplant therapy, leaving them with very few treatment options.1 2 Rare patients that naturally develop an HA-1-specific graft-versus-leukemia T cell response, however, show substantially lower relapse rates.3 4 HA-1 (VLHDDLLEA, genotype RS_1801284 A/G or A/A) is an HLA-A*02:01-and hematopoietically restricted minor histocompatibility antigen, making it an ideal candidate for TCR immunotherapy for liquid tumors.5MethodsWe developed a high-throughput TCR discovery platform that enables rapid cloning of antigen-specific TCRs from healthy donors. We then used this platform to screen 178.3 million naïve CD8+ T cells from six unique HA-1- (VLRDDLLEA, genotype RS_1801284 G/G) donors, identifying 329 HA-1-specific TCRs. We tested each TCR for expression and the ability to kill HA-1+ target cells, using a previously published, clinical-stage HA-1-specific TCR as a benchmark for these studies.6 In parallel, we tested TCR constant region modifications to promote expression and proper pairing of exogenous TCR alpha and beta chains and designed a lentiviral vector to co-deliver CD8 coreceptors as well as a CD34 enrichment tag to enable purification of engineered T cells. The top 11 candidates were cloned into our optimized backbone and evaluated for cytotoxicity, cytokine production, and T cell proliferation using a panel of HLA-A*02:01+ HA-1+ cell lines. Finally, the top two TCRs were evaluated for allo-reactivity and off-target cross-reactivity using our proprietary genome-wide T-Scan platform.ResultsThe TCR discovery and evaluation platform described here identified 329 HA-1-specific TCRs from a total of 178.3 million naïve T cells, and TSC-100 as the most active TCR. Defined mutations in the constant region of TSC-100 enhanced its surface expression while decreasing expression of endogenous TCRs, and co-introduction of CD8 enabled efficient engagement and function of engineered CD4 cells. Overall, TSC-100 exhibited comparable activity to a clinical-stage benchmark TCR when challenged with cell lines expressing moderate to high levels of HA-1, and superior activity when incubated with cell lines expressing low levels of both HA-1 and MHC-I.6 In addition, TSC-100 exhibited no detectable allo-reactivity to 108 different HLA types tested, and minimal off-target effects when challenged with a genome-wide library expressing peptides derived from human proteins.ConclusionsTSC-100 exhibits comparable or superior activity to a clinical-stage therapeutic TCR, with minimal allo-reactivity or off-target effects. Based on these results, TSC-100 has been advanced to IND-enabling activities to prepare for first-in-human testing in 2021.Ethics ApprovalAll clinical samples used in the study were collected by STEMCELL Technologies, StemExpress and HemaCare using their IRB approved protocols.ReferencesPavletic SZ, Kumar S, Mohty M, et al. NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse After Allogeneic Hematopoietic Stem Cell Transplantation: Report from The Committee on the Epidemiology and Natural History of Relapse following Allogeneic Cell Transplantation. Biol Blood Marrow Transplant. 2010;16(7):871–890.Miller JS, Warren EH, van den Brink MR, et al. NCI First International Workshop on The Biology, Prevention, and Treatment of Relapse After Allogeneic Hematopoietic Stem Cell Transplantation: Report from the Committee on the Biology Underlying Recurrence of Malignant Disease following Allogeneic HSCT: Graft-versus-Tumor/Leukemia Reaction. Biol Blood Marrow Transplant 2010;16(5):565–586.Marijt WAE, Heemskerk MHM, Kloosterboer FM, et al. Hematopoiesis-restricted minor histocompatibility antigens HA-1- or HA-2-specific T cells can induce complete remissions of relapsed leukemia. PNAS 2003;100:2742–2747.Spierings E, Kim Y, Hendriks M, et al. Multicenter analyses demonstrate significant clinical effects of minor histocompatibility antigens on GvHD and GvL after HLA-Matched related and unrelated hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2013; 19: 1244–1253.Bleakley M, Riddell SR. Exploiting T cells specific for human minor histocompatibility antigens for therapy of leukemia. Immunol Cell Biol 2011;89(3):396–407.Dossa RG, Cunningham T, Sommermeyer D, et al. Development of T-cell immunotherapy for hematopoietic stem cell transplantation recipients at risk of leukemia relapse. Blood 2018;131(1):108–120.
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Wang, Xiao Jing, Mengfei Liu, Bradley Anderson, Subhankar Chakraborty, Sushil Garg, Sunanda Kane e William Sanchez. "871 Impact of Patient Screening Process on Diagnostic and Therapeutic Yield of Double Balloon Enteroscopy". American Journal of Gastroenterology 114, n. 1 (ottobre 2019): S505. http://dx.doi.org/10.14309/01.ajg.0000593020.34408.8f.
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Narvland, Runar. "Utmåling av erstatning når skadelidte har flere skader - Rt. 2006 s. 871". Tidsskrift for Erstatningsrett 4, n. 01-02 (3 giugno 2016): 117–31. http://dx.doi.org/10.18261/issn0809-9545-2007-01-02-08.
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Audette, Rebecca, e Steven Shein. "871: CHARACTERISTICS AND OUTCOMES OF CRITICAL BRONCHIOLITIS DURING THE 2022 SURGE COMPARED TO BASELINE". Critical Care Medicine 52, n. 1 (14 dicembre 2023): S408. http://dx.doi.org/10.1097/01.ccm.0001001656.83526.b7.
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Diederik, D. C., P. Durez, J. Lenaerts, R. Westhovens e P. Verschueren. "AB0421 REAL-WORLD EFFECTIVENESS OF UPADACITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS". Annals of the Rheumatic Diseases 82, Suppl 1 (30 maggio 2023): 1398.2–1399. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1326.
Testo completoAbstract (sommario):
BackgroundThe Janus Kinase (JAK) inhibitor Upadacitinib (UPA) has shown efficacy in rheumatoid arthritis (RA) in trials, yet real-world evidence is lacking.ObjectivesWe aimed to assess short-term effectiveness of UPA for standard of care for RA.MethodsData from participants included in the electronic platform “Tool for Administrative Reimbursement Drug Information Sharing” (TARDIS) were analysed. TARDIS collects data from all Belgian RA patients on advanced therapy during submissions of reimbursement requests for drug initiation or prolongation. Patients initiating UPA between 01/11/2020-31/12/2021, ≥18 years and DAS28>3.7 were included. Effectiveness was based on drug retention, proportion of patients achieving remission (DAS-28 <2.6), low disease activity (LDA, DAS-28 ≤3.2), HAQ-DI≤0.25 (HAQ25), HAQ-DI≤0.50 (HAQ50) as well as a clinical meaningful HAQ-DI-decrease (MCID_HAQ) since baseline of 0.22 at the first follow-up moment at 3 months. Sensitivity analyses by 1st, 2nd or 3rd+-line advanced therapy were performed.ResultsFrom 13 175 patients in TARDIS in the relevant time period, 996 patients on UPA could be included. Table 1 details this population. Of 871 patients with drug information at next follow-up, 783 (90%) continued UPA, and 42 (5%), 22 (3%), and 18 (2%) changed to a TNFi, non-TNFi and other JAKi respectively.In other effectiveness analyses, 705/996 (71%) patients were included. Remission and LDA were reached in 60% (421/705) and 74% (521/705) of patients respectively. HAQ25, HAQ50 and MCID_HAQ were reached in 11% (78/705), 26% (183/705) and 67% (475/705) of patients. Effectiveness slightly decreased with increasing line of therapy (Figure 1).Table 1.Baseline characteristics of TARDIS patients on UPATotal UPA populationNumber996Age (mean ±SD, years)57.5 ±12.7Disease duration (mean ±SD, years)9.3 ±9.5ESR (mean ±SD, mm/hour)24.3 ±19.9CRP (mean ±SD, mg/L)13.1 ±15.5SJC28 (mean ±SD)6.5 ±4.5TJC28 (mean ±SD)9.2 ±5.4DAS28 (mean ±SD, years)5.0 ±0.8HAQ-DI (mean ±SD, 0-3)*1.3 ±0.8PGA (mean ±SD, 0-100)67.5 ±18.3Advanced treatment naïve (yes)434/996 (43.6%)Advanced treatment Experienced (yes)562/996 (56.4%)2nd line247/562 (24.8%)3th line +315/562 (31.6%)Previous advanced treatment type**TNFi,268/562 (48.2%)Non-TNFi,177/562 (31.8%)JAKi111/562 (20.0%)Legend: Numbers given are mean ± SD or number, proportion. TNFi = tumour necrosis factor inhibitor, JAKi = Janus Kinase inhibitor, HAQ= health assessment questionnaire, PGA= Patient Global assessment; CRP= C-reactive protein; ESR= erythrocyte sedimentation rate; TJC= tender joint count; SJC= Swollen joint Count; DAS28 = disease activity score based on the 28joints. *Missing HAQ(0-3) scores were imputed by regression using age and HAQ(0-60) scores. **for 6 patients this was undefined.Figure 1.Effectiveness outcomes at 3 months of UPA per treatment line.remission (DAS-28 <2.6), LDA - low disease activity (DAS-28 ≤3.2), HAQ-DI≤0.25 (HAQ25), HAQ-DI≤0.50 (HAQ50) and minimum HAQ-DI-decrease (MCID_HAQ) since baseline of 0.22ConclusionMost patients continued UPA treatment. UPA improved clinical outcomes after 3 months in patients with moderately to severely active RA in a real-world setting, even in 3rdline of advanced therapy.AcknowledgementsOn behalf of the Royal Belgian Society for Rheumatology.AbbVie sponsored the study and contributed to the design. AbbVie participated in the reviewing and approval of the final version. No honoraria or payments were made for authorship.Disclosure of InterestsNone Declared.
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Meissner, Y., K. Albrecht, J. Kekow, S. Zinke, H. P. Tony, M. Schaefer e A. Strangfeld. "OP0135 RISK OF CARDIOVASCULAR EVENTS UNDER JANUS KINASE INHIBITORS IN PATIENTS WITH RHEUMATOID ARTHRITIS: OBSERVATIONAL DATA FROM THE GERMAN RABBIT REGISTER". Annals of the Rheumatic Diseases 81, Suppl 1 (23 maggio 2022): 86.2–87. http://dx.doi.org/10.1136/annrheumdis-2022-eular.779.
Testo completoAbstract (sommario):
BackgroundIn 2021, the European and US-American regulatory agencies EMA and FDA issued warnings about the cardiovascular (CV) safety of the Janus kinase inhibitor (JAKi) tofacitinib and required changes in labelling. These actions were based on results of the post-authorisation safety trial Oral Surveillance(1).ObjectivesTo analyse major cardiovascular events (MACE) under treatment with JAKi, tumor necrosis factor inhibitors (TNFi) or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs - bionaive) in patients with rheumatoid arthritis (RA) observed in daily rheumatological care.MethodsData from patients enrolled in the biologics register RABBIT with treatment episodes from 01/2017 - 04/2021 were included. Incidence rates (IR) of MACE per 100 patient-years (PY) with 95% confidence intervals (CI) and adjusted risk ratios (RR) were calculated for all and for high-risk patients (age ≥ 50 years and ≥ 1 CV risk factor). Poisson regression analysis was adjusted for age, sex, smoking, disease activity, prior therapies, glucocorticoids and comorbidities.ResultsStarting from 2017, 2030 JAKi, 2338 TNFi and 871 csDMARD initiations were documented. Patients with a JAKi start were slightly older, more often women and had a longer RA disease duration (Table 1). The proportion with positive autoantibodies was higher than in the TNFi and csDMARD group, the physical function was lower, and they had received more previous biologic treatments. Characteristics of high-risk patients are also given in the Table 1.Table 1.Patient characteristics at the start of a JAKi, TNFi or csDMARD.ALL PATIENTSHIGH RISK PATIENTS*JAKiTNFicsDMARDJAKiTNFicsDMARD# treatment starts2030233887112151254508Age59.9 ± 11.657.6 ± 13.059.5 ± 12.764.3 ± 8.963.5 ± 8.964.4 ± 9.2Women1573 (77.5)1707 (73.0)627 (72.0)907 (74.7)864 (68.9)355 (69.9)Disease duration12.6 ± 9.68.9 ± 8.55.7 ± 6.613.3 ± 9.99.7 ± 9.16.0 ± 7.0Rheumatoid factor/ ACPA positive1531 (79.2)1672 (74.2)548 (66.3)917 (79.7)890 (73.7)321 (66.5)# previous bDMARDs2.0 ± 1.80.7 ± 1.202.0 ± 1.80.7 ± 1.20DAS28-ESR4.2 ± 1.44.5 ± 1.44.2 ± 1.34.4 ± 1.54.7 ± 1.34.3 ± 1.3Percentage of full physical function63.3 ± 24.168.6 ± 22.472.3 ± 21.960.3 ± 24.264.4 ± 23.369.6 ± 22.7Glucocorticoids ≥10 mg/d170 (17.5)239 (21.5)49 (12.4)112 (18.6)142 (22.3)23 (10.0)BMI >30 kg/m2565 (28.2)631 (27.4)271 (31.7)383 (31.8)413 (33.3)180 (36.0)Sum of comorbidities2.9 ± 2.52.6 ± 2.42.2 ± 2.23.7 ± 2.63.5 ± 2.53.1 ± 2.3Current smokers461 (26.3)617 (28.5)274 (33.5)355 (33.5)466 (39.5)202 (42.3)Previous smokers551 (31.4)692 (31.9)230 (28.1)300 (28.3)338 (28.6)114 (23.9)Values are given as mean ± standard deviation or number (percentage). *Age ≥50 years and ≥ 1 CV risk factor (hypertension, coronary heart disease, diabetes, hyperlipoproteinaemia, current smoking)In total, 28 incident MACE were reported. Patients under treatment with JAKi, TNFi and csDMARD showed comparable IR for MACE between 0.26 and 0.41 events per 100 PY (Figure 1). High-risk patients showed higher IRs. The median time under treatment was 10 months on JAKi and TNFi, and 12 months on csDMARDs. The majority of events were reported in the first year after treatment start. In the adjusted analyses, JAKi (RR 0.94 [95% CI 0.39; 2.28]) and csDMARDs (RR 0.85 [0.25; 2.88]) did not show a significantly increased risk for MACE compared with TNFi in unselected patients, and also not in high-risk patients (JAKi: RR 0.90 [0.37; 2.17]; csDMARDs: RR 0.61 [0.16; 2.28]).Figure 1.Incidence rates of MACE per 100 patient years by treatment group.ConclusionIR of MACE in patients receiving JAKi in a real-world setting was lower than the IR reported for tofacitinib in the Oral Surveillance study. We found no evidence of an increased risk of MACE with JAKi compared to TNFi, although patients in the JAKi group were older and had longer disease duration.References[1]Pfizer Press Release (27 Jan 2021):https://www.pfizer.com/news/press-release/press-release-detail/pfizer-shares-co-primary-endpoint-results-post-marketingAcknowledgementsRABBIT is supported by a joint, unconditional grant from AbbVie, Amgen, BMS, Fresenius-Kabi, Galapagos, Hexal, Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi-Aventis, VIATRIS and UCB.Disclosure of InterestsYvette Meissner Speakers bureau: Pfizer, Katinka Albrecht: None declared, Jörn Kekow: None declared, Silke Zinke Speakers bureau: Biogen, Galapagos, UCB, Lilly, Consultant of: Abbvie, Biogen, Galapagos, Novartis, Hans-Peter Tony Consultant of: AbbVie, Astra-Zeneca, BMS, Chugai, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, Martin Schaefer: None declared, Anja Strangfeld Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Janssen, Lilly, Pfizer, Roche, Sanofi, UCB.
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Nazha, Aziz, Manja Meggendorfer, Niroshan Nadarajah, Kassy E. Kneen, Tomas Radivoyevitch, Bartlomiej Przychodzen, Hideki Makishima et al. "TET 2 Alterations in Myeloid Malignancies, Impact on Clinical Characteristics, Outcome, and Disease Predisposition". Blood 126, n. 23 (3 dicembre 2015): 1645. http://dx.doi.org/10.1182/blood.v126.23.1645.1645.
Testo completoAbstract (sommario):
Abstract TET2 mutations are the most common somatic genetic lesions in myeloid neoplasms. TET2 mutant clones have been found also in healthy individuals, increase with age, and convey an increased risk for myeloid clonal diseases. The TET2 gene is very polymorphic, with hundreds of single nucleotide polymorphisms (SNPs) of unknown clinical impact, but with some variants that may be pathogenically important. Similarly, somatic mutations affect all portions of the gene, and can be missense or truncating, homo-, hemi- and heterozygous. While the majority of TET2 mutations are ancestral, they can also be subclonal, implicating the clonal architecture in the consequences of TET2 lesions. This diversity may be hampering establishment of the clear prognostic impact of TET2 mutations. Taking advantage of a large cohort of patients (pts, N=4985 including 1616 MDS, 871 MDS/MPN, 1782 pAML, 304 sAML, 333 MPN, and 79 therapy-related MDS/AML/MDS-MPN) analyzed by targeted deep sequencing for TET2 and other common myeloid lesions, we examined the distribution and impact of TET2 mutations. DNA sequencing of all coding exons of TET2 and 61 other genes representing the most common somatic mutations in myeloid neoplasms. Nonsynonymous alterations not present in SNP database (dbSNP) were annotated as somatic mutations or SNPs if present in myeloid and T cells whenever available. Nonsynonymous alterations not in dbSNP or ExAC databases and not confirmed to be somatic were excluded. Overall, TET2 somatic mutations (TET2mut) were present in 920 pts (18%); 38% of MDS/MPN, 19% pAML, 16% MPN, 16% sAML, 12% MDS, and 13% of therapy related MDS/AML/MDS-MPN. Mutations included 16% missense, 33% frameshift deletions, 18% frameshift insertions, and 33% nonsense. TET2mut pts were older than those with TET2 wild type (TET2wt, 72 vs. 67 yrs, p<.001), had a higher presenting WBC (6 vs. 4 x103 /uL, p <.001), and lower blast % (3 vs. 7%, p =.03). Similar findings were observed in each myeloid subtype. Overall, median OS for TET2mut pts was similar to TET2wt (12 vs. 17 mo, p =.20). Median OS was similar in TET2mut pts compared to TET2wt in pts with MDS (23 vs. 23 mo, p =.77), MDS/MPN (15 vs. 21 mo, p=.1), pAML (9 vs. 14 mo, p =.77), sAML (6 vs. 9 mo, p =.07), and MPN (30 vs. 35 mo, p =.66). Neither the type of mutation (mis-, nonsense vs. truncating) nor location (catalytic domain vs. other) impacted the OS. Using variant allelic frequencies (VAF), we established a clonal hierarchy in individual cases; 24% of TET2 mutations were ancestral, 17% subclonal, and 59% codominant. TET2 mutations were ancestral in 23% of MDS samples, 29% of MDS/MPN, 25% of pAML, and 19% of sAML. Whether the mutation was ancestral or subclonal did not impact OS. The presence of TET2mut was associated with different mutations in each myeloid subtype. In MDS, TET2mut were associated with APC (p<.001), ASXL1 (p<.001), BCOR (p<.001), BCORL1 (p<.001), ETV6 (p<.04), SUZ12 (p<.001), RAD21 (p<.02), NF1 (p<.001), KDM6A (p<.001), ZRSR2 (p<.001), and U2AF1 (p=.02), in MDS/MPD correlated with ASXL1 (p<.04), NRAS (p<.02), and SRSF2 (p<.05), in pAML with JAK2 (p<.001), RUNX1 (p =.05), and CBL (p=.05), and in sAML with RUNX1 (p<.001), ASXL1 (p<.001), BCORL1 (p=.01), SUZ12 (p=.02), STAG2 (p=.05), and JAK2 (p<.001). When we next focused on germ line variants, we identified 2518 SNPs of TET2. All recurring SNPs were ranked according to the difference in their frequencies between pts and healthy controls. A large number of these SNPs were more common in our pts compared to controls, among them we identified 2 SNPs (both located in the dioxygenase domain) with a significantly higher frequency: SNP1 (OR 10.6, p<.0001), and SNP2 (OR 6.7, p=.02). We further investigated whether these SNPs were mutually exclusive or increased the risk for acquisition of somatic TET2 mutations; 91% of cases with SNP1 and 67% with SNP2 also acquired somatic mutations in TET2. In silico and crystallographic analyses showed that SNP1 is adjacent to the iron binding site (7th beta stand in the jelly roll motif) and is predicted to change the orientation of a-KG binding and thereby to be hypomorphic. SNP2 is located in a hot spot area known to be targeted by 3 recurrent somatic mutations. In conclusion, both somatic mutations as well as germ line variants affect TET2 in myeloid neoplasia. The interaction between clonal mutations and germ line lesions may lead to gain of function and thus a growth advantage. These mechanisms are currently being explored. Disclosures Meggendorfer: MLL Munich Leukemia Laboratory: Employment. Nadarajah:MLL Munich Leukemia Laboratory: Employment. Sekeres:TetraLogic: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; Celgene Corporation: Membership on an entity's Board of Directors or advisory committees.
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Milojević, K., I. Stanković, A. Vučurović, D. Ristić, D. Milošević, A. Bulajić e B. Krstić. "First Report of Cucumber mosaic virus Infecting Peperomia tuisana in Serbia". Plant Disease 97, n. 7 (luglio 2013): 1004. http://dx.doi.org/10.1094/pdis-01-13-0089-pdn.
Testo completoAbstract (sommario):
Peperomia tuisana C.DC. ex Pittier (family Piperaceae) is an attractive succulent grown as an ornamental. Despite its tropical origins, it can be successfully grown indoors in any climate. In March 2012, three samples of P. tuisana showing virus-like symptoms were collected from a commercial greenhouse in Zemun (District of Belgrade, Serbia) in which estimated disease incidence was 80%. Infected plants showed symptoms including necrotic ringspots and line patterns that enlarged and caused necrosis of leaves. A serious leaf drop led to growth reduction and even death of the plant. Leaves from three symptomatic P. tuisana plants were sampled and analyzed by double-antibody sandwich (DAS)-ELISA using commercial diagnostic kits (Bioreba AG, Reinach, Switzerland) against the most common viral pathogens of ornamentals: Cucumber mosaic virus (CMV), Tomato spotted wilt virus (TSWV), and Impatiens necrotic spot virus (INSV) (1,2). Commercial positive and negative controls were included in each ELISA. Serological analyses showed that all plants were positive for CMV and negative for TSWV and INSV. The ELISA-positive sample (isolate 1-12) was mechanically inoculated onto five plants each of three test species as well as of healthy young P. tuisana using 0.01 M phosphate buffer (pH 7). Chlorotic local lesions on Chenopodium quinoa and severe mosaic and leaf malformations were observed on all inoculated Nicotiana tabacum ‘Samsun’ and N. glutinosa. Also, the virus was successfully mechanically transmitted to P. tuisana that reacted with symptoms identical to those observed on the original host plants. All mechanically inoculated plants were positive for CMV in DAS-ELISA. For further confirmation of CMV infection, reverse transcription (RT)-PCR was performed on extracts made from symptomatic P. tuisana, N. tabacum ‘Samsun,’ and N. glutinosa leaf materials. Total RNAs were extracted with the RNeasy Plant Mini Kit (Qiagen, Hilden, Germany) and RT-PCR was carried out using One-Step RT-PCR Kit (Qiagen). A CMV-specific primer pair, CMVCPfwd and CMVCPrev (3), which amplifies an 871-bp fragment of the entire coat protein (CP) gene and part of 3′- and 5′-UTRs, were used for both amplification and sequencing. Total RNAs obtained from the Serbian CMV isolate (HM065510) and healthy P. tuisana were used as positive and negative controls, respectively. A product of the correct predicted size was obtained in all naturally and mechanically infected plants, as well as positive control. No amplicon was recorded in the healthy control. The amplified product derived from isolate 1-12 was purified (QIAquick PCR Purification Kit, Qiagen), directly sequenced in both directions, deposited in GenBank (KC505441), and analyzed by MEGA5 software (4). Sequence comparison of the complete CP gene (657 nt) revealed that the Serbian isolate 1-12 shared the highest nucleotide identity of 99.1% (99.5% amino acid identity) with the Japanese isolate (AB006813). To our knowledge, this is the first report on the occurrence of CMV in P. tuisana in Serbia. This is also an important discovery since P. tuisana is commonly grown together with other ornamental hosts of CMV, and thus could represent a serious threat for future expansion of CMV in the greenhouse floriculture industry in Serbia. References: (1) M. L. Daughtrey et al. Plant Dis. 81:1220, 1997. (2) S. Flasinski et al. Plant Dis. 79:843, 1995. (3) K. Milojevic et al. Plant Dis. 96:1706, 2012. (4) K. Tamura et al. Mol. Biol. Evol. 28:2731, 2011.
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"Adjustable Switching Voltage Via Sol-Gel Derived and Ag In Situ Doped SiO2 Thin Films for ReRAM". ECS Meeting Abstracts, 2013. http://dx.doi.org/10.1149/ma2013-01/20/871.
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"(Invited) Aggregation-Induced Emission in Lamellar Solids of Colloidal Perovskite Quantum Wells". ECS Meeting Abstracts, 2018. http://dx.doi.org/10.1149/ma2018-01/10/871.
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"Wet-Chemical Silicon Wafer Thinning Process for High Chip Strength". ECS Meeting Abstracts, 2012. http://dx.doi.org/10.1149/ma2012-01/20/871.
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"Novel Functionalized Graphene Oxide-Polymer Nanocomposite Anion Exchange Membranes". ECS Meeting Abstracts, 2015. http://dx.doi.org/10.1149/ma2015-01/9/871.
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"Optimizing the Electro-Oxidation of Ammonia". ECS Meeting Abstracts, 2008. http://dx.doi.org/10.1149/ma2008-01/24/871.
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"III-V Semiconductor-Based Multi-Junction Solar Cells for Space and Terrestrial Solar Power Applications". ECS Meeting Abstracts, 2009. http://dx.doi.org/10.1149/ma2009-01/21/871.
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"(Invited) DNA As Supramolecular Template for the Assembly of Porphyrin Arrays". ECS Meeting Abstracts, 2016. http://dx.doi.org/10.1149/ma2016-01/13/871.
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"Transient Operation Effects of SOFCs Driven with Tar Loaded Synthesis Gas". ECS Meeting Abstracts, 2011. http://dx.doi.org/10.1149/ma2011-01/12/871.
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"Electrocatalysis of Oxygen Reduction with Elctropolymerized Metallo-Corroles". ECS Meeting Abstracts, 2017. http://dx.doi.org/10.1149/ma2017-01/14/871.
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"Boron-doped Single-walled Carbon Nanotubes for Enhanced Hydrogen-tube Interaction". ECS Meeting Abstracts, 2006. http://dx.doi.org/10.1149/ma2006-01/24/871.
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"Electrodeposition of Ni under a Magnetic Field". ECS Meeting Abstracts, 2007. http://dx.doi.org/10.1149/ma2007-01/18/871.
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"Electrocatalytic Activity and Electroanalytical Performance of Nanodiamond-Derived Carbon Nano-Onions". ECS Meeting Abstracts, 2014. http://dx.doi.org/10.1149/ma2014-01/20/871.
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"Photosensitizers Based on C60 Derivatives as Components in Photorefractive Composites". ECS Meeting Abstracts, 2005. http://dx.doi.org/10.1149/ma2005-01/21/871.
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"Characteristics on Hydrogen Embrittlement and Stress Corrosion Cracking with SSRT for STS 304". ECS Meeting Abstracts, 2010. http://dx.doi.org/10.1149/ma2010-01/16/871.
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"(Invited) Temperature-Dependent Photoluminescence and Stability of Methylammonium Lead Iodide (CH3NH3PbI3) and CsPbX3 (X=Cl, Br, I) Perovskite Nanocrystal Superlattices". ECS Meeting Abstracts, 2019. http://dx.doi.org/10.1149/ma2019-01/13/871.
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Paul, Manika, Bhani Kondal, Ayutyanont Napatkamon, Nicholas Sheets, Ahmed Mahmoud e David Plurad. "Management of Blunt Traumatic Abdominal Wall Hernias: An Analysis of the National Trauma Data Bank". American Surgeon, 23 marzo 2022, 000313482210789. http://dx.doi.org/10.1177/00031348221078987.
Testo completoAbstract (sommario):
Background Blunt traumatic abdominal wall hernias (TAWH) are uncommon injuries with variable presentation and unstandardized management. Few national systematic descriptive studies have been conducted about TAWH. We present a retrospective descriptive study utilizing the National Trauma Data Bank (NTDB) to better characterize risk factors associated with TAWH and management practices. Methods The NTDB (years 2016-2019) was examined for adult blunt trauma patients who had TAWH. Data included demographics, trauma-specific variables, management strategies, and outcome measures. Descriptive statistics were performed by univariate analysis. Results 2 871 367 adult blunt trauma patients were identified in the NTDB dataset. 206 had abdominal wall hernias (<.01%). Compared with the overall blunt trauma cohort, patients with TAWH had higher body mass index (BMI) and Injury Severity Scores (ISS), were more likely to be male, and had a higher mortality rate. 44 patients (21%) underwent operative management during their initial admission. Surgically managed patients were younger, had higher ISS and BMI, and were more likely to have concomitant intra-abdominal injuries. The few patients who had laparoscopic surgery had significantly higher BMI. Patients managed operatively had longer hospital and ICU lengths of stay and increased incidence of medical complications. Conclusions TAWH is an uncommon complication of blunt abdominal trauma, associated with higher BMI, ISS, and increased mortality. Initial operative management was pursued in 21% of cases, more often in younger, more severely injured patients with other intra-abdominal injuries. Evidence-based guidelines, based on multicenter prospective studies with longer follow-up, should be developed for management of these unique injuries.