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  1. Article: A Case for the Conservative Management of Stage IA Cervical Cancer.

    Blackman, Alexandra / Creasman, William

    Cancers

    2023  Volume 15, Issue 20

    Abstract: Cervical cancer remains a significant public health concern within the United States and across the world. Cervical cancer is most frequently diagnosed in women between the ages of 35 and 44 and therefore affects a younger patient population than many ... ...

    Abstract Cervical cancer remains a significant public health concern within the United States and across the world. Cervical cancer is most frequently diagnosed in women between the ages of 35 and 44 and therefore affects a younger patient population than many other cancers. The management of early-stage disease has frequently utilized radical hysterectomy with the associated increased surgical morbidity, without clear evidence of any benefits. In stage IA disease, there are retrospective pathologic data supporting the safety of conservative surgery and lymphadenectomy over radical hysterectomy. There are also emerging prospective studies supporting conservative management. This editorial presents the evidence for conservative management of stage IA cervical cancer by reviewing the existing retrospective studies as well as the ongoing prospective studies.
    Language English
    Publishing date 2023-10-19
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15205051
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The Mental Capacity Act: applications and interface with the Mental Health Act.

    Blackman, Alexandra / Dodge, Liam

    British journal of hospital medicine (London, England : 2005)

    2019  Volume 80, Issue 6, Page(s) C93–C95

    MeSH term(s) Decision Making ; Humans ; Mental Competency/legislation & jurisprudence ; Mental Disorders/epidemiology ; United Kingdom
    Language English
    Publishing date 2019-07-01
    Publishing country England
    Document type Journal Article
    ISSN 1750-8460
    ISSN 1750-8460
    DOI 10.12968/hmed.2019.80.6.C93
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: MYC is sufficient to generate mid-life high-grade serous ovarian and uterine serous carcinomas in a p53-R270H mouse model.

    Blackman, Alexandra / Rees, Amy C / Bowers, Robert R / Jones, Christian M / Vaena, Silvia G / Clark, Madison A / Carter, Shelby / Villamor, Evan D / Evans, Della / Emanuel, Anthony J / Fullbright, George / Long, David T / Spruill, Laura / Romeo, Martin J / Helke, Kristi L / Delaney, Joe R

    bioRxiv : the preprint server for biology

    2024  

    Abstract: Genetically engineered mouse models (GEMM) have fundamentally changed how ovarian cancer etiology, early detection, and treatment is understood. However, previous GEMMs of high-grade serous ovarian cancer (HGSOC) have had to utilize genetics rarely or ... ...

    Abstract Genetically engineered mouse models (GEMM) have fundamentally changed how ovarian cancer etiology, early detection, and treatment is understood. However, previous GEMMs of high-grade serous ovarian cancer (HGSOC) have had to utilize genetics rarely or never found in human HGSOC to yield ovarian cancer within the lifespan of a mouse.
    Language English
    Publishing date 2024-01-29
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2024.01.24.576924
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: HE4 and CA125 serum biomarker monitoring in women with epithelial ovarian cancer.

    Samborski, Alexandra / Miller, M Craig / Blackman, Alexandra / MacLaughlan-David, Shannon / Jackson, Amanda / Lambert-Messerlian, Geralyn / Rowswell-Turner, Rachel / Moore, Richard G

    Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine

    2022  Volume 44, Issue 1, Page(s) 205–213

    Abstract: Background: CA125 is the gold standard serum biomarker for monitoring patients with epithelial ovarian cancer (EOC). Human epididymal protein 4 (HE4) is a novel serum biomarker for EOC patients.: Objective: The objective of this trial was to examine ... ...

    Abstract Background: CA125 is the gold standard serum biomarker for monitoring patients with epithelial ovarian cancer (EOC). Human epididymal protein 4 (HE4) is a novel serum biomarker for EOC patients.
    Objective: The objective of this trial was to examine the utility of measuring serum HE4 levels for monitoring EOC patients and to compare HE4 performance parameters to serum CA125.
    Methods: A retrospective trial using residual longitudinal serum samples drawn during treatment and monitoring from EOC patients. Serum CA125 and HE4 levels were analyzed at each time point, and a velocity of change was calculated and correlated with clinical status. The null hypothesis was that HE4 is inferior to CA125, and this was tested using concordance and two-sided Fisher's exact testing. McNemar's test was used to assess the overall agreement of the two assays with the clinical status.
    Results: A total of 129 patients with 272 separate clinical periods and 1739 events (serum samples) were evaluated. Using a 25% change in serum biomarker levels to indicate change in disease status, the accuracy and NPV determined for HE4 versus CA125 were 81.8% versus 82.6% (p = 0.846) and 87.4% versus 89.7% (p = 0.082), respectively. Concordance comparison of HE4 accuracy / CA125 accuracy was 0.990, indicating HE4 was not inferior to CA125 (McNemar's test p-value = 0.522). Performing a velocity of change analysis, the accuracy and NPV determined for HE4 versus CA125 were 78.3% versus 78.6% (p = 0.995) and 74.9% versus 76.3% (p = 0.815), respectively. Concordance comparison of HE4 velocity accuracy / CA125 velocity accuracy was 0.996, again indicating HE4 was not inferior to CA125 (McNemar's test p-value = 0.884). The combination of HE4 and CA125 velocity changes showed a similar accuracy of 81.3% (p = 0.797 compared to HE4 and CA125 alone) and NPV of 81.1% (p≥0.172 compared to HE4 and CA125 alone), and an increased sensitivity of 70.5% (p≤0.070 compared to HE4 and CA125 alone).
    Conclusion: HE4 is equivalent to CA125 for monitoring of EOC patients. The combination of CA125 and HE4 velocities is superior to either marker alone.
    MeSH term(s) Biomarkers, Tumor ; CA-125 Antigen ; Carcinoma, Ovarian Epithelial ; Female ; Humans ; Membrane Proteins ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Retrospective Studies
    Chemical Substances Biomarkers, Tumor ; CA-125 Antigen ; Membrane Proteins
    Language English
    Publishing date 2022-10-03
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605825-5
    ISSN 1423-0380 ; 0289-5447 ; 1010-4283
    ISSN (online) 1423-0380
    ISSN 0289-5447 ; 1010-4283
    DOI 10.3233/TUB-220016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1598: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Analysis of serum HE4 levels in various histologic subtypes of epithelial ovarian cancer and other malignant tumors.

    Blackman, Alexandra / Mitchell, Jessica / Rowswell-Turner, Rachael / Singh, Rakesh / Kim, Kyu Kwang / Eklund, Elizabeth / Skates, Steven / Bast, Robert C / Messerlian, Geralyn / Miller, M Craig / Moore, Richard G

    Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine

    2021  Volume 43, Issue 1, Page(s) 355–365

    Abstract: Background: The measurement of serum HE4 levels has emerged as a sensitive and specific biomarker for epithelial ovarian cancers (EOCs). However, serum levels in women diagnosed with various histologic subtypes of EOC and in women with metastatic non- ... ...

    Abstract Background: The measurement of serum HE4 levels has emerged as a sensitive and specific biomarker for epithelial ovarian cancers (EOCs). However, serum levels in women diagnosed with various histologic subtypes of EOC and in women with metastatic non-ovarian primary malignancies have not been widely reported.
    Objective: The goal of this study was to identify how serum HE4 levels vary in women diagnosed with different histologic subtypes of EOC and non-ovarian malignancies.
    Methods: Data from six prospective pelvic mass clinical trials was combined and an evaluation of serum HE4 levels in women diagnosed with a malignancy was performed. For all patients, serum was obtained prior to surgery and final pathology, including primary tumor site, histologic subtype, grade and stage, were recorded. The mean, median, standard deviation, maximum, and minimum HE4 levels were determined for each group.
    Results: A total of 984 patients were included in this study, with the average patient age being 60 years old. There were 230 premenopausal and 754 postmenopausal patients. Serum HE4 levels were elevated (≥70.0 pMol) in 85%of EOCs, 40%of LMP tumors, 21%of non-EOCs (germ cell tumors), 25%of cervical cancers, and 47%of non-gynecologic metastatic cancers. Analysis of histologic subtypes revealed 90%(n = 391) of serous, 85%(n = 73) of endometrioid, 45%(n = 42) of mucinous, 86%(n = 51) of mixed tumors, and 69%(n = 36) of clear cell tumors had elevated serum HE4 levels.
    Conclusions: Serum HE4 levels are most often elevated in women with high grade serous and endometrioid EOCs, and though serum elevations are seen more often with advanced stage disease, HE4 is also often elevated in early stage disease and lower grade tumors.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor/blood ; Carcinoma, Ovarian Epithelial/blood ; Carcinoma, Ovarian Epithelial/pathology ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms/blood ; Ovarian Neoplasms/pathology ; Prospective Studies ; WAP Four-Disulfide Core Domain Protein 2/analysis ; Young Adult
    Chemical Substances Biomarkers, Tumor ; WAP Four-Disulfide Core Domain Protein 2 ; WFDC2 protein, human
    Language English
    Publishing date 2021-12-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605825-5
    ISSN 1423-0380 ; 0289-5447 ; 1010-4283
    ISSN (online) 1423-0380
    ISSN 0289-5447 ; 1010-4283
    DOI 10.3233/TUB-211546
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1598: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  6. Article ; Online: Multiple biomarker algorithms to predict epithelial ovarian cancer in women with a pelvic mass: Can additional makers improve performance?

    Moore, Richard G / Blackman, Alexandra / Miller, M Craig / Robison, Katina / DiSilvestro, Paul A / Eklund, Elizabeth E / Strongin, Robert / Messerlian, Geralyn

    Gynecologic oncology

    2019  Volume 154, Issue 1, Page(s) 150–155

    Abstract: Introduction: Management of a woman with a pelvic mass is complicated by difficulty in discriminating malignant from benign disease. Many serum biomarkers have been examined to determine their sensitivity for detecting malignancy. This study was ... ...

    Abstract Introduction: Management of a woman with a pelvic mass is complicated by difficulty in discriminating malignant from benign disease. Many serum biomarkers have been examined to determine their sensitivity for detecting malignancy. This study was designed to evaluate if the addition of biomarkers to HE4 and CA125, as used in the Risk of Malignancy Algorithm (ROMA), can improve the detection of EOC.
    Methods: This was an IRB approved, prospective clinical trial examining serum obtained from women diagnosed with a pelvic mass who subsequently underwent surgery. Serum biomarker levels for CA125, HE4, YKL-40, transthyretin, ApoA1, Beta-2-microglobulin, transferrin, and LPA were measured. Logistic regression analysis was performed for various marker combinations, ROC curves were generated, and the area under the curves (AUCs) were determined.
    Results: A total of 184 patients met inclusion criteria with a median age of 56 years (Range 20-91). Final pathology revealed there were 103 (56.0%) benign tumors, 4 (2.2%) LMP tumors, 61 EOC (33.1%), 2 (1.1%) non-EOC ovarian cancers, 6 (3.3%) gynecologic cancers with metastasis to the ovary and 8 (4.3%) non-gynecologic cancers with metastasis to the ovary. The combination of HE4 and CA125 (i.e. ROMA) achieved an AUC of 91.2% (95% CI: 86.0-96.4) for the detection of EOC vs benign disease. The combination of CA125, HE4, YKL-40, transthyretin, ApoA1, Beta 2 microglobulin, transferrin, LPA and menopausal status achieved the highest AUC of 94.6% (95% CI: 90.1-99.2) but this combination was not significantly better than the HE4 and CA125 combination alone (p = 0.078).
    Conclusions: The addition of select further serum biomarkers to HE4 and CA125 does not add to the performance of the dual marker combination for the detection of ovarian cancer.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Algorithms ; Biomarkers, Tumor/blood ; CA-125 Antigen/metabolism ; Carcinoma, Ovarian Epithelial/blood ; Carcinoma, Ovarian Epithelial/diagnosis ; Carcinoma, Ovarian Epithelial/pathology ; Chitinase-3-Like Protein 1/blood ; Cohort Studies ; Female ; Humans ; Membrane Proteins/metabolism ; Middle Aged ; Neoplasm Staging ; Prealbumin/metabolism ; Predictive Value of Tests ; Prospective Studies ; Proteins/metabolism ; Transferrin/metabolism ; WAP Four-Disulfide Core Domain Protein 2 ; Young Adult ; beta 2-Microglobulin/metabolism
    Chemical Substances Biomarkers, Tumor ; CA-125 Antigen ; CHI3L1 protein, human ; Chitinase-3-Like Protein 1 ; MUC16 protein, human ; Membrane Proteins ; Prealbumin ; Proteins ; TTR protein, human ; Transferrin ; WAP Four-Disulfide Core Domain Protein 2 ; WFDC2 protein, human ; beta 2-Microglobulin
    Language English
    Publishing date 2019-04-13
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2019.04.006
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    Zs.A 885: Show issues Location:
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  7. Article ; Online: The prevalence of diabetes mellitus and abnormal glucose metabolism in the inpatient psychiatric setting: A systematic review and meta-analysis.

    Roberts, Emmert / Jones, Leah / Blackman, Alexandra / Dewhurst, Thomas / Matcham, Faith / Kan, Carol / Mustafa, Omar / Thomas, Toral / Siddiqi, Najma / Ismail, Khalida / Price, Hermione

    General hospital psychiatry

    2017  Volume 45, Page(s) 76–84

    Abstract: Objective: To systematically determine the prevalence of diabetes mellitus (DM), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) in psychiatric inpatients and explore the impact of patient and study variables on prevalence estimates. ...

    Abstract Objective: To systematically determine the prevalence of diabetes mellitus (DM), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) in psychiatric inpatients and explore the impact of patient and study variables on prevalence estimates.
    Method: We searched EMBASE, PsychINFO, Medline and CENTRAL from database inception until 1st December 2015. We included studies of any design reporting prevalence of abnormal glucose metabolism in any adult psychiatric inpatients. We conducted a random effects meta-analysis to generate pooled prevalence estimates. Chi-square tests compared differences within categorical variables (inpatient setting, continent of study and patient diagnostic category) and Spearman's correlation analyses assessed the impact of linear variables (age, year of data collection and study quality). Study quality was assessed using an adapted Newcastle-Ottawa Scale.
    Results: 36 study reports representing 42 unique cohorts were included. Across all studies prevalence of unspecified type DM was 10% (95%CI: 9-12), of T1DM was 1% (0-1), of T2DM was 9% (6-13), of IFG 18% (8-28), and of IGT was 22% (16-28). These estimates were not affected by study quality.
    Conclusions: All estimates are higher compared to the general population. Mental health professionals should be aware of this elevated prevalence to improve screening and management of abnormal glucose metabolism.
    MeSH term(s) Comorbidity ; Glucose Metabolism Disorders/epidemiology ; Hospitals, Psychiatric/statistics & numerical data ; Humans ; Mental Disorders/epidemiology
    Language English
    Publishing date 2017-01-11
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 392299-6
    ISSN 1873-7714 ; 0163-8343
    ISSN (online) 1873-7714
    ISSN 0163-8343
    DOI 10.1016/j.genhosppsych.2017.01.003
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