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  1. Article ; Online: Glofitamab stimulates immune cell infiltration of CNS tumors and induces clinical responses in secondary CNS lymphoma.

    Godfrey, James K / Gao, Lei / Shouse, Geoffrey / Song, Joo Y / Pak, Stacy / Lee, Brian / Chen, Bihong T / Kallam, Avyakta / Baird, John H / Marcucci, Guido / Ghoda, Lucy Y / Vauleon, Stephanie / Danilov, Alexey V / Herrera, Alex F / Kwak, Larry W / Budde, Lihua E

    Blood

    2024  

    Abstract: Although CD20xCD3 bispecific antibodies are effective against systemic B-cell lymphomas, their efficacy in CNS lymphoma is unknown. Here, we report the CD20xCD3 bispecific, glofitamab, penetrates the blood-brain barrier, stimulates immune-cell ... ...

    Abstract Although CD20xCD3 bispecific antibodies are effective against systemic B-cell lymphomas, their efficacy in CNS lymphoma is unknown. Here, we report the CD20xCD3 bispecific, glofitamab, penetrates the blood-brain barrier, stimulates immune-cell infiltration of CNS tumors, and induces responses in CNS lymphoma.
    Language English
    Publishing date 2024-03-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2024024168
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The prevalence of gastroesophageal reflux disease and laryngopharyngeal reflux in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma.

    Ku, Peter K M / Vlantis, Alexander C / Hui, Thomas S C / Yeung, Zenon W C / Cho, Ryan H W / Wong, Marc H K / Lee, Alex K F / Yeung, David C M / Chan, Simon Y P / Chan, Becky Y T / Chang, Wai-Tsz / Mok, Florence / Wong, Kam-Hung / Wong, Jeffrey K T / Abdullah, Victor / van Hasselt, Andrew / Wu, Justin C Y / Tong, Michael C F

    Head & neck

    2024  

    Abstract: Background: The prevalence of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in post-irradiated patients with nasopharyngeal carcinoma (NPC) is unknown.: Materials and methods: In a cross-sectional study, 31 NPC and 12 ... ...

    Abstract Background: The prevalence of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in post-irradiated patients with nasopharyngeal carcinoma (NPC) is unknown.
    Materials and methods: In a cross-sectional study, 31 NPC and 12 control patients completed questionnaires for GERD/LPR before esophageal manometry and 24-h pH monitoring. The DeMeester score and reflux finding score (RFS) were used to define GERD and LPR, respectively. Risk factors were identified.
    Results: 51.6% of NPC and 8.3% of control patients, and 77.4% of NPC and 33% of control patients, were GERD-positive and LPR-positive, respectively. The GERD/LPR questionnaire failed to identify either condition in patients with NPC. No parameter differences in esophageal manometry or pneumonia incidence were noted between GERD/LPR-positive and GERD/LPR-negative patients. Post radiotherapy duration, high BMI, lack of chemotherapy, and dysphagia were positive risk factors for GERD/LPR.
    Conclusions: A high prevalence of GERD/LPR in patients with post-irradiated NPC exists, but reflux symptoms are inadequate for diagnosis.
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645165-2
    ISSN 1097-0347 ; 0148-6403 ; 1043-3074
    ISSN (online) 1097-0347
    ISSN 0148-6403 ; 1043-3074
    DOI 10.1002/hed.27645
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A Safety and Feasibility Trial of Ultrasound-Guided Radiofrequency Ablation of Parotid Warthin's Tumor.

    Yeung, David C M / Leung, Hanson H S / Lai, Ronald / Lee, Alex K F / Wong, Jefferey K T / Wong, Eddy W Y / Chan, Jason Y K / Lau, Eric H L

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2023  Volume 170, Issue 1, Page(s) 103–111

    Abstract: Objective: To determine if ultrasound-guided (USG) radiofrequency ablation (RFA) of Parotid Warthin's tumor under local anesthesia is a safe and effective procedure.: Study design: Safety and feasibility study.: Setting: Tertiary academic medical ... ...

    Abstract Objective: To determine if ultrasound-guided (USG) radiofrequency ablation (RFA) of Parotid Warthin's tumor under local anesthesia is a safe and effective procedure.
    Study design: Safety and feasibility study.
    Setting: Tertiary academic medical center.
    Methods: This is an IDEAL phase 2a trial in a tertiary referral center. Twenty patients with Parotid Warthin's tumor were recruited. RFA was done between September and December 2021 for all 20 patients using a CoATherm AK-F200 machine with a disposable, 18G × 7 mm radiofrequency electrode. Results and follow-up statistics were compared with a historic sample of patients with parotid Warthin's tumor who underwent parotidectomy between 2019 and 2021 in the same center.
    Results: Nineteen patients were included in the analysis as 1 patient dropped out after 4 weeks of follow-up. The mean age for the RFA group was 67 years old with most of them being male smokers. At a median of 45 weeks (44-47 weeks) postprocedure there was a 7.48 mL (68.4%) volume reduction compared to baseline. Three patients had transient facial nerve (FN) paresis, 1 recovered within hours, and the other 2 by 12 weeks follow-up. Three patients had great auricular nerve numbness; 1 patient had infected hematoma treated in an out-patient manner. Compared to a historic cohort of parotidectomy patients for Warthin's tumor, there was no significant difference in FN paresis and other minor complications between the 2 treatment modalities.
    Conclusion: The current analysis suggests that USG RFA of Warthin's Tumor is a safe alternative to parotidectomy with shorter operative time and length of stay.
    MeSH term(s) Humans ; Male ; Aged ; Female ; Feasibility Studies ; Parotid Neoplasms/diagnostic imaging ; Parotid Neoplasms/surgery ; Parotid Neoplasms/pathology ; Adenolymphoma/diagnostic imaging ; Adenolymphoma/surgery ; Adenolymphoma/pathology ; Ultrasonography, Interventional ; Radiofrequency Ablation ; Paresis
    Language English
    Publishing date 2023-07-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.417
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Adrenal-Permissive Germline HSD3B1 Allele and Prostate Cancer Outcomes.

    McKay, Rana R / Nelson, Tyler J / Pagadala, Meghana S / Teerlink, Craig C / Gao, Anthony / Bryant, Alex K / Agiri, Fatai Y / Guram, Kripa / Thompson, Reid F / Pridgen, Kathryn M / Seibert, Tyler M / Lee, Kyung Min / Carter, Hannah / Lynch, Julie A / Hauger, Richard L / Rose, Brent S

    JAMA network open

    2024  Volume 7, Issue 3, Page(s) e242976

    Abstract: Importance: The adrenal androgen-metabolizing 3β-hydroxysteroid dehydrogenase-1 enzyme, encoded by the HSD3B1 gene, catalyzes the rate-limiting step necessary for synthesizing nontesticular testosterone and dihydrotestosterone production. The common ... ...

    Abstract Importance: The adrenal androgen-metabolizing 3β-hydroxysteroid dehydrogenase-1 enzyme, encoded by the HSD3B1 gene, catalyzes the rate-limiting step necessary for synthesizing nontesticular testosterone and dihydrotestosterone production. The common adrenal-permissive HSD3B1(1245C) allele is responsible for encoding the 3β-HSD1 protein with decreased susceptibility to degradation resulting in higher extragonadal androgen synthesis. Retrospective studies have suggested an association of the HSD3B1 adrenal-permissive homozygous genotype with androgen deprivation therapy resistance in prostate cancer.
    Objective: To evaluate differences in mortality outcomes by HSD3B1 genetic status among men with prostate cancer.
    Design, setting, and participants: This cohort study of patients with prostate cancer who were enrolled in the Million Veteran Program within the Veterans Health Administration (VHA) system between 2011 and 2023 collected genotyping and phenotyping information.
    Exposure: HSD3B1 genotype status was categorized as AA (homozygous adrenal-restrictive), AC (heterozygous adrenal-restrictive), or CC (homozygous adrenal-permissive).
    Main outcomes and measures: The primary outcome of this study was prostate cancer-specific mortality (PCSM), defined as the time from diagnosis to death from prostate cancer, censored at the date of last VHA follow-up. Secondary outcomes included incidence of metastases and PCSM in predefined subgroups.
    Results: Of the 5287 participants (median [IQR] age, 69 [64-74] years), 402 (7.6%) had the CC genotype, 1970 (37.3%) had the AC genotype, and 2915 (55.1%) had the AA genotype. Overall, the primary cause of death for 91 patients (1.7%) was prostate cancer. Cumulative incidence of PCSM at 5 years after prostate cancer diagnosis was higher among men with the CC genotype (4.0%; 95% CI, 1.7%-6.2%) compared with the AC genotype (2.1%; 95% CI, 1.3%-2.8%) and AA genotype (1.9%; 95% CI, 1.3%-2.4%) (P = .02). In the 619 patients who developed metastatic disease at any time, the cumulative incidence of PCSM at 5 years was higher among patients with the CC genotype (36.0%; 95% CI, 16.7%-50.8%) compared with the AC genotype (17.9%; 95% CI, 10.5%-24.7%) and AA genotype (18.5%; 95% CI, 12.0%-24.6%) (P = .01).
    Conclusions and relevance: In this cohort study of US veterans undergoing treatment for prostate cancer at the VHA, the HSD3B1 CC genotype was associated with inferior outcomes. The HSD3B1 biomarker may help identify patients who may benefit from therapeutic targeting of 3β-hydroxysteroid dehydrogenase-1 and the androgen-signaling axis.
    MeSH term(s) Male ; Humans ; Aged ; Alleles ; Prostatic Neoplasms/genetics ; Androgen Antagonists ; Androgens ; Cohort Studies ; Retrospective Studies ; Multienzyme Complexes/genetics ; Germ Cells
    Chemical Substances Androgen Antagonists ; Androgens ; Multienzyme Complexes
    Language English
    Publishing date 2024-03-04
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2024.2976
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Chromatographic separation of the isobaric compounds cyclopropylfentanyl, crotonylfentanyl, methacrylfentanyl, and para-methylacrylfentanyl for specific confirmation by LC-MS/MS

    Lee, Juseon / Fogarty, Melissa F / Krotulski, Alex J / Logan, Barry K / Papsun, Donna M

    Journal of chromatography. 2019 June 15, v. 1118-1119

    2019  

    Abstract: Cyclopropylfentanyl has been encountered by law enforcement and public health officials beginning in mid-2017 and has been associated with numerous overdoses and fatalities. The detection and identification of cyclopropylfentanyl has become more ... ...

    Abstract Cyclopropylfentanyl has been encountered by law enforcement and public health officials beginning in mid-2017 and has been associated with numerous overdoses and fatalities. The detection and identification of cyclopropylfentanyl has become more challenging with the subsequent emergence of multiple structural isomeric fentanyl species, some of which have been detected in seized drug casework. These include crotonylfentanyl, methacrylfentanyl, para-methylacrylfentanyl, and ortho-methylacrylfentanyl; all of which have the same exact mass and similar fragmentation patterns. Since these compounds may be scheduled differently and pharmacologically act differently, it is important to be able to differentiate them analytically. Our method was developed and validated for the analysis and differentiation of cyclopropylfentanyl from its isomers by liquid chromatography tandem mass spectrometry (LC-MS/MS), in order to confirm the identify of cyclopropylfentanyl in biological specimens from death investigation casework; 36 postmortem blood samples were submitted for analysis. Cyclopropylfentanyl, crotonylfentanyl, methacrylfentanyl, and para-methylacrylfentanyl were successfully resolved using a 13-minute run time and a simple gradient elution. Ortho-methacrylfentanyl was resolved only in a 20-minute chromatographic run. The assay met validation performance characteristics, with an analytical range of 1–100 ng/mL and limits of detection of 0.1 ng/mL for all analytes. Analysis of commonly encountered substances showed no interferences. All samples previously reported positive for cyclopropylfentanyl were confirmed positive for cyclopropylfentanyl in the absence of its isomers. To our knowledge to date, no positive toxicological specimens have been encountered for any cyclopropylfentanyl isomers.
    Keywords blood sampling ; death ; detection limit ; fentanyl ; isomers ; law enforcement ; liquid chromatography ; public health ; tandem mass spectrometry
    Language English
    Dates of publication 2019-0615
    Size p. 164-170.
    Publishing place Elsevier B.V.
    Document type Article
    ISSN 1570-0232
    DOI 10.1016/j.jchromb.2019.04.033
    Database NAL-Catalogue (AGRICOLA)

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  6. Article ; Online: Incorporating Alternative Polygenic Risk Scores into the BOADICEA Breast Cancer Risk Prediction Model.

    Mavaddat, Nasim / Ficorella, Lorenzo / Carver, Tim / Lee, Andrew / Cunningham, Alex P / Lush, Michael / Dennis, Joe / Tischkowitz, Marc / Downes, Kate / Hu, Donglei / Hahnen, Eric / Schmutzler, Rita K / Stockley, Tracy L / Downs, Gregory S / Zhang, Tong / Chiarelli, Anna M / Bojesen, Stig E / Liu, Cong / Chung, Wendy K /
    Pardo, Monica / Feliubadaló, Lidia / Balmaña, Judith / Simard, Jacques / Antoniou, Antonis C / Easton, Douglas F

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2023  Volume 32, Issue 3, Page(s) 422–427

    Abstract: Background: The multifactorial risk prediction model BOADICEA enables identification of women at higher or lower risk of developing breast cancer. BOADICEA models genetic susceptibility in terms of the effects of rare variants in breast cancer ... ...

    Abstract Background: The multifactorial risk prediction model BOADICEA enables identification of women at higher or lower risk of developing breast cancer. BOADICEA models genetic susceptibility in terms of the effects of rare variants in breast cancer susceptibility genes and a polygenic component, decomposed into an unmeasured and a measured component - the polygenic risk score (PRS). The current version was developed using a 313 SNP PRS. Here, we evaluated approaches to incorporating this PRS and alternative PRS in BOADICEA.
    Methods: The mean, SD, and proportion of the overall polygenic component explained by the PRS (α2) need to be estimated. $\alpha $ was estimated using logistic regression, where the age-specific log-OR is constrained to be a function of the age-dependent polygenic relative risk in BOADICEA; and using a retrospective likelihood (RL) approach that models, in addition, the unmeasured polygenic component.
    Results: Parameters were computed for 11 PRS, including 6 variations of the 313 SNP PRS used in clinical trials and implementation studies. The logistic regression approach underestimates $\alpha $, as compared with the RL estimates. The RL $\alpha $ estimates were very close to those obtained by assuming proportionality to the OR per 1 SD, with the constant of proportionality estimated using the 313 SNP PRS. Small variations in the SNPs included in the PRS can lead to large differences in the mean.
    Conclusions: BOADICEA can be readily adapted to different PRS in a manner that maintains consistency of the model.
    Impact: : The methods described facilitate comprehensive breast cancer risk assessment.
    MeSH term(s) Humans ; Female ; Breast Neoplasms/genetics ; Risk Assessment/methods ; Retrospective Studies ; Risk Factors ; Genetic Predisposition to Disease ; Polymorphism, Single Nucleotide
    Language English
    Publishing date 2023-01-17
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-22-0756
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: A comparison of ultrasound-guided rotator interval and posterior glenohumeral injection techniques for MR shoulder arthrography.

    Tsoi, Carita / Tsai, Chris S C / Law, Eric K C / Lee, Ryan K L / Ng, Alex W H / Griffith, James F

    Clinical imaging

    2020  Volume 69, Page(s) 255–260

    Abstract: Purpose: The aim of this prospective, randomized study was to compare the performance of a rotator interval approach with the posterior glenohumeral approach for ultrasound-guided contrast injection prior to MR shoulder arthrography.: Method: This ... ...

    Abstract Purpose: The aim of this prospective, randomized study was to compare the performance of a rotator interval approach with the posterior glenohumeral approach for ultrasound-guided contrast injection prior to MR shoulder arthrography.
    Method: This study was approved by the institutional review board. One hundred and twenty consecutive patients referred for MR shoulder arthrography were randomized into four groups: rotator interval approach in-plane (n = 30); rotator interval approach out-of-plane (n = 30); posterior approach in-plane (n = 30); and posterior approach out-of plane (n = 30). Outcome measures included procedure time, number of injection attempts, patient-reported pain score (0-10), and radiologist-reported technical difficulty (0-10). MR arthrograms were assessed for adequacy of joint distension, diagnostic utility, and extra-capsular contrast leakage.
    Results: All 120 patients had a successful ultrasound-guided injection with adequate joint distension and diagnostic utility for MR arthrography. In-plane needle guidance was less technically demanding, quicker, required fewer injection attempts, and had a lower frequency of contrast leakage than out-of-plane needle guidance. The posterior glenohumeral approach was less technically demanding though had a higher frequency of contrast leakage and caused more patient discomfort than the rotator interval approach.
    Conclusion: For ultrasound-guided shoulder joint injection, an in-plane approach is preferable. The posterior glenohumeral approach is less technically demanding though causes more patients discomfort than the rotator interval approach possibly due to the longer needle path.
    MeSH term(s) Arthrography ; Contrast Media ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Shoulder ; Shoulder Joint/diagnostic imaging ; Ultrasonography, Interventional
    Chemical Substances Contrast Media
    Language English
    Publishing date 2020-09-04
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2020.08.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Chromatographic separation of the isobaric compounds cyclopropylfentanyl, crotonylfentanyl, methacrylfentanyl, and para-methylacrylfentanyl for specific confirmation by LC-MS/MS.

    Lee, Juseon / Krotulski, Alex J / Fogarty, Melissa F / Papsun, Donna M / Logan, Barry K

    Journal of chromatography. B, Analytical technologies in the biomedical and life sciences

    2019  Volume 1118-1119, Page(s) 164–170

    Abstract: Cyclopropylfentanyl has been encountered by law enforcement and public health officials beginning in mid-2017 and has been associated with numerous overdoses and fatalities. The detection and identification of cyclopropylfentanyl has become more ... ...

    Abstract Cyclopropylfentanyl has been encountered by law enforcement and public health officials beginning in mid-2017 and has been associated with numerous overdoses and fatalities. The detection and identification of cyclopropylfentanyl has become more challenging with the subsequent emergence of multiple structural isomeric fentanyl species, some of which have been detected in seized drug casework. These include crotonylfentanyl, methacrylfentanyl, para-methylacrylfentanyl, and ortho-methylacrylfentanyl; all of which have the same exact mass and similar fragmentation patterns. Since these compounds may be scheduled differently and pharmacologically act differently, it is important to be able to differentiate them analytically. Our method was developed and validated for the analysis and differentiation of cyclopropylfentanyl from its isomers by liquid chromatography tandem mass spectrometry (LC-MS/MS), in order to confirm the identify of cyclopropylfentanyl in biological specimens from death investigation casework; 36 postmortem blood samples were submitted for analysis. Cyclopropylfentanyl, crotonylfentanyl, methacrylfentanyl, and para-methylacrylfentanyl were successfully resolved using a 13-minute run time and a simple gradient elution. Ortho-methacrylfentanyl was resolved only in a 20-minute chromatographic run. The assay met validation performance characteristics, with an analytical range of 1-100 ng/mL and limits of detection of 0.1 ng/mL for all analytes. Analysis of commonly encountered substances showed no interferences. All samples previously reported positive for cyclopropylfentanyl were confirmed positive for cyclopropylfentanyl in the absence of its isomers. To our knowledge to date, no positive toxicological specimens have been encountered for any cyclopropylfentanyl isomers.
    MeSH term(s) Adult ; Chromatography, Liquid/methods ; Female ; Fentanyl/analogs & derivatives ; Fentanyl/blood ; Forensic Toxicology ; Humans ; Limit of Detection ; Linear Models ; Male ; Reproducibility of Results ; Tandem Mass Spectrometry/methods
    Chemical Substances Fentanyl (UF599785JZ)
    Language English
    Publishing date 2019-04-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1180823-8
    ISSN 1873-376X ; 0378-4347 ; 1570-0232 ; 1387-2273
    ISSN (online) 1873-376X
    ISSN 0378-4347 ; 1570-0232 ; 1387-2273
    DOI 10.1016/j.jchromb.2019.04.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Common carotid artery responses to the cold-pressor test are impaired in individuals with cervical spinal cord injury.

    Sarafis, Zoe K / Squair, Jordan W / Barak, Otto F / Coombs, Geoff B / Soriano, Jan Elaine / Larkin-Kaiser, Kelly A / Lee, Amanda H X / Hansen, Alex / Vodopic, Maro / Romac, Rinaldo / Grant, Christopher / Charbonneau, Rebecca / Mijacika, Tanja / Krassioukov, Andrei V / Ainslie, Philip N / Dujic, Zeljko / Phillips, Aaron A

    American journal of physiology. Heart and circulatory physiology

    2022  Volume 323, Issue 6, Page(s) H1311–H1322

    Abstract: Cervical spinal cord injury (SCI) leads to autonomic cardiovascular dysfunction that underlies the three- to fourfold elevated risk of cardiovascular disease in this population. Reduced common carotid artery (CCA) dilatory responsiveness during the cold- ... ...

    Abstract Cervical spinal cord injury (SCI) leads to autonomic cardiovascular dysfunction that underlies the three- to fourfold elevated risk of cardiovascular disease in this population. Reduced common carotid artery (CCA) dilatory responsiveness during the cold-pressor test (CPT) is associated with greater cardiovascular disease risk and progression. The cardiovascular and CCA responses to the CPT may provide insight into cardiovascular autonomic dysfunction and cardiovascular disease risk in individuals with cervical SCI. Here, we used CPT to perturb the autonomic nervous system in 14 individuals with cervical SCI and 12 uninjured controls, while measuring cardiovascular responses and CCA diameter. The CCA diameter responses were 55% impaired in those with SCI compared with uninjured controls (
    Language English
    Publishing date 2022-11-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603838-4
    ISSN 1522-1539 ; 0363-6135
    ISSN (online) 1522-1539
    ISSN 0363-6135
    DOI 10.1152/ajpheart.00261.2022
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  10. Article ; Online: Post-radiation primary hypothyroidism in patients with head and neck cancer: External validation of thyroid gland dose-volume constraints with long-term endocrine outcomes.

    Chow, James C H / Lui, Jeffrey C F / Cheung, Ka-Man / Tam, Anthony H P / Lam, Martin H C / Yuen, Tony Y S / Lee, Francis K H / Leung, Alex K C / Au, Kwok-Hung / Ng, Wai-Tong / Lee, Anne W M / Kwan, Chung-Kong / Yiu, Harry H Y

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2022  Volume 177, Page(s) 105–110

    Abstract: ... F-score of 0.53. The 5-year hypothyroidism risks of patients with thyroid VS60 ≥ 10 cc and < 10 cc ...

    Abstract Background: Post-radiation primary hypothyroidism is a common late complication in head and neck cancer (HNC) survivors. No radiation dose-volume constraint of the thyroid gland has been externally validated for predicting long-term thyroid function outcomes.
    Materials and methods: This external validation study evaluated the diagnostic properties of 22 radiation dose-volume constraints of the thyroid gland proposed in the literature. Radiation dosimetric data from 488 HNC patients who underwent neck irradiation from January 2013 to December 2015 at two tertiary oncology centers were reviewed. The diagnostic metrics of candidate constraints were computed by inverse probability of censoring weighting and compared using time-dependent receiver operating characteristic (ROC) curves with death designated as a competing event. Multivariable regression analyses were performed using the Fine-Gray sub-distribution hazard model.
    Results: Over a median follow-up period of 6.8 years, 205 (42.0 %) patients developed post-radiation primary hypothyroidism. The thyroid volume spared from 60 Gy (VS60) had the largest area under ROC curve of 0.698 at 5 years after radiotherapy. Of all evaluated constraints, VS60 at a cutoff value of 10 cc had the highest F-score of 0.53. The 5-year hypothyroidism risks of patients with thyroid VS60 ≥ 10 cc and < 10 cc were 14.7 % and 38.2 %, respectively (p < 0.001). The adjusted sub-hazard ratio for post-radiation primary hypothyroidism for VS60 < 10 cc was 1.87 (95 % confidence interval, 1.22-2.87; p < 0.001).
    Conclusion: Thyroid VS60 is the best radiation dose-volume parameter to predict the long-term risk of primary hypothyroidism in patients with HNC who underwent neck irradiation. VS60 ≥ 10 cc is a robust constraint that limits the 5-year primary hypothyroidism risk to less than 15 % and should be routinely employed during radiotherapy optimization.
    MeSH term(s) Humans ; Radiotherapy, Intensity-Modulated/adverse effects ; Radiation Injuries/epidemiology ; Radiation Injuries/etiology ; Head and Neck Neoplasms/complications ; Hypothyroidism/etiology ; Radiotherapy Dosage
    Language English
    Publishing date 2022-11-03
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2022.10.034
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