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  1. Article ; Online: Autoinflammation.

    Rosenberg, Daniel L / Hoffman, Harold M

    The journal of allergy and clinical immunology. In practice

    2024  Volume 12, Issue 5, Page(s) 1391–1392.e13

    MeSH term(s) Humans ; Inflammation ; Autoimmune Diseases/immunology ; Autoimmune Diseases/diagnosis ; Animals
    Language English
    Publishing date 2024-02-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2024.02.033
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  2. Article ; Online: Dupilumab for chronic spontaneous urticaria-marvelous or meek?

    Mathur, Sameer K / Rosenberg, Daniel L / Viswanathan, Ravi K / Wis, Madison

    The Journal of allergy and clinical immunology

    2024  

    Language English
    Publishing date 2024-05-14
    Publishing country United States
    Document type Editorial
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2024.05.004
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  3. Article ; Online: A 2-week medical student curriculum in an outpatient allergy clinic.

    Rosenberg, Daniel L / Moss, Mark H / Johnson, Sarah K / Osman, Fauzia

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2022  Volume 129, Issue 4, Page(s) 525–527

    MeSH term(s) Curriculum ; Education, Medical, Undergraduate ; Humans ; Hypersensitivity/therapy ; Outpatients ; Students, Medical
    Language English
    Publishing date 2022-04-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2022.03.036
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  4. Article ; Online: Characterization of idiopathic angioedema in a university-based allergy/immunology practice.

    Rosenberg, Daniel L / Mathur, Sameer K / Viswanathan, Ravi K

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2019  Volume 123, Issue 4, Page(s) 403–404

    MeSH term(s) Angioedema/diagnosis ; Angioedema/epidemiology ; Angioedema/pathology ; Angioedema/therapy ; Histamine Antagonists/therapeutic use ; Humans ; Urticaria
    Chemical Substances Histamine Antagonists
    Language English
    Publishing date 2019-07-31
    Publishing country United States
    Document type Letter
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2019.07.023
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  5. Article ; Online: Biopsy features associated with prostate cancer progression in active surveillance patients: comparison of three statistical models.

    Iremashvili, Viacheslav / Manoharan, Murugesan / Rosenberg, Daniel L / Soloway, Mark S

    BJU international

    2013  Volume 111, Issue 4, Page(s) 574–579

    Abstract: Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Active surveillance is an established management option for patients with favourable-risk prostate cancer. However, about 25-30% of active surveillance patients demonstrate biopsy ... ...

    Abstract Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Active surveillance is an established management option for patients with favourable-risk prostate cancer. However, about 25-30% of active surveillance patients demonstrate biopsy progression within the first 3-5 years of follow-up. Although several factors, such as the results of the diagnostic and surveillance biopsies, are known to be associated with the risk of progression, our ability to accurately predict this risk remains limited. Our analysis demonstrated that the overall number of positive cores in the diagnostic and first surveillance biopsies is strongly associated with the risk of progression in active surveillance patients. Furthermore, combined results of diagnostic and first surveillance biopsies provide more information about the probability of progression than they do separately. The most important variable affecting the progression-free survival was the overall number of cores positive for cancer. By 3 years of active surveillance, most of the patients who had four positive cores in the diagnostic and surveillance biopsies progressed, while those who had only one positive core had an excellent prognosis. These findings could be used to improve the accuracy of assessments of the prognosis of patients with low-risk prostate cancer and to help them make informed decisions about their treatment.
    Objective: To analyse the prognostic importance of information provided by the diagnostic biopsy, the first surveillance biopsy and a combination thereof to identify active surveillance patients with a particularly high risk of progression.
    Materials and methods: The present study included 161 active surveillance patients who had at least two surveillance biopsies. The first surveillance biopsy was performed within 1 year of the diagnosis. Further surveillance biopsies usually took place every 1-2 years. Progression on the surveillance biopsy was defined as the presence of Gleason 4/5 cancer, > two positive cores or >20% involvement of any core. Cox proportional hazards regression analysis was used to examine the relationship between biopsy characteristics and progression. Three distinct statistical models were built using characteristics of diagnostic biopsies, surveillance biopsies, and a combination thereof. Harrell's c-index was used to quantify the predictive accuracy of each multivariate Cox model.
    Results: The median follow-up was 3.6 years; 46 (28.6%) patients progressed. In multivariate analysis the major factor associated with progression was the number of positive cores. The model based on the combined results of diagnostic and first surveillance biopsies was significantly more predictive than the models based on the individual results of each biopsy. Patients with four positive cores in the diagnostic and first surveillance biopsies had estimated 5-year progression rate of 100%.
    Conclusion: The total number of positive cores in the diagnostic and first surveillance biopsies provides important information about the risk of prostate cancer progression in active surveillance patients.
    MeSH term(s) Adult ; Aged ; Analysis of Variance ; Biopsy, Needle ; Cohort Studies ; Databases, Factual ; Disease Progression ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Models, Statistical ; Multivariate Analysis ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Proportional Hazards Models ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/therapy ; Survival Analysis ; Time Factors ; United States ; Watchful Waiting/methods
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2013-04
    Publishing country England
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1462191-5
    ISSN 1464-410X ; 1464-4096 ; 1358-8672
    ISSN (online) 1464-410X
    ISSN 1464-4096 ; 1358-8672
    DOI 10.1111/j.1464-410X.2012.11127.x
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  6. Article ; Online: Clinical and demographic characteristics associated with prostate cancer progression in patients on active surveillance.

    Iremashvili, Viacheslav / Soloway, Mark S / Rosenberg, Daniel L / Manoharan, Murugesan

    The Journal of urology

    2012  Volume 187, Issue 5, Page(s) 1594–1599

    Abstract: Purpose: Active surveillance is an established management option for patients with low risk prostate cancer. However, little is known about the characteristics associated with the increased probability of progression in patients on active surveillance. ... ...

    Abstract Purpose: Active surveillance is an established management option for patients with low risk prostate cancer. However, little is known about the characteristics associated with the increased probability of progression in patients on active surveillance. We analyzed our active surveillance cohort in search of such features.
    Materials and methods: A total of 272 men with prostate cancer have enrolled in our active surveillance program since 1994, of whom 249 underwent at least 1 surveillance biopsy and were included in analysis. Our active surveillance inclusion criteria are biopsy Gleason grade less than 7, 2 or fewer positive biopsy cores, 20% or less tumor in any core and clinical stage T1-T2a. Changes in any of these parameters during followup that went beyond these limits were considered progression. Univariate and multivariate Cox regression analysis was done to determine patient characteristics associated with an increased risk of progression.
    Results: A total of 64 patients (26%) showed progression at a median 2.9-year followup on a mean of 2.3 surveillance biopsies. The progression risk was significantly increased in black patients (adjusted HR 3.87-4.12), and in men with a smaller prostate and higher prostate specific antigen density. The latter 2 variables had no specific cutoff for an association with progression.
    Conclusions: Black men with low risk prostate cancer should be advised that the risk of progression on active surveillance may be higher than that in the available literature. Integral prognostic tools incorporating race and prostate specific antigen density may be useful to accurately assess the individual risk of progression in patients on active surveillance.
    MeSH term(s) Adult ; African Americans/statistics & numerical data ; Aged ; Comorbidity ; Disease Progression ; European Continental Ancestry Group/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Population Surveillance ; Prognosis ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/pathology
    Language English
    Publishing date 2012-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1016/j.juro.2011.12.082
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  7. Article ; Online: Comprehensive analysis of post-diagnostic prostate-specific antigen kinetics as predictor of a prostate cancer progression in active surveillance patients.

    Iremashvili, Viacheslav / Manoharan, Murugesan / Lokeshwar, Soum D / Rosenberg, Daniel L / Pan, David / Soloway, Mark S

    BJU international

    2013  Volume 111, Issue 3, Page(s) 396–403

    Abstract: Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: A significant proportion of patients diagnosed with prostate cancer do not require immediate treatment and could be managed by active surveillance, which usually includes serial ... ...

    Abstract Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: A significant proportion of patients diagnosed with prostate cancer do not require immediate treatment and could be managed by active surveillance, which usually includes serial measurements of prostate-specific antigen (PSA) levels and regular biopsies. The rate of rise in PSA levels, which could be calculated as PSA velocity or PSA doubling time, was previously suggested to be associated with the biological aggressiveness of prostate cancer. Although these parameters are obvious candidates for predicting tumour progression in active surveillance patients, earlier studies that examined this topic provided conflicting results. Our analysis showed that PSA velocity and PSA doubling time calculated at different time-points, by different methods, over different intervals, and in different sub-groups of active surveillance patients provide little if any prognostic information. Although we found some significant associations between PSA velocity and the risk of progression as determined by biopsy, the actual clinical significance of this association was small. Furthermore, PSA velocity did not add to the predictive accuracy of total PSA.
    Objective: To study whether prostate-specific antigen (PSA) velocity (PSAV) and PSA doubling time (PSADT) are associated with biopsy progression in patients managed by active surveillance.
    Patients and methods: Our inclusion criteria for active surveillance are biopsy Gleason sum <7, two or fewer positive biopsy cores, ≤20% tumour present in any core, and clinical stage T1-T2a. Changes in any of these parameters during the follow-up that went beyond these limits are considered to be progression. This study included 250 patients who had at least one surveillance biopsy, an available PSA measured no earlier than 3 months before diagnosis, and at least one PSA measurement before each surveillance biopsy. We evaluated the association between PSA kinetics and progression at successive surveillance biopsies in different sub-groups of patients by calculating the area under the curve (AUC) as well as sensitivity and specificity of different thresholds.
    Results: Over a median follow-up of 3.0 years, the disease of 64 (26%) patients progressed. PSADT was not associated with biopsy progression, whereas PSAV was only weakly associated with progression in certain sub-groups. However, incorporation of PSAV in models including total PSA resulted in a moderate increase in AUC only when the entire cohort was analysed. In other sub-groups the predictive accuracy of total PSA was not significantly improved by adding PSAV.
    Conclusions: Our findings confirm that PSA kinetics should not be used in decision-making in patients with low-risk prostate cancer managed by active surveillance. Regular surveillance biopsies should remain as the principal method of monitoring cancer progression in these men.
    MeSH term(s) Aged ; Disease Progression ; Humans ; Male ; Middle Aged ; Prostate/pathology ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/pathology ; Retrospective Studies ; Sensitivity and Specificity
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2013-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1462191-5
    ISSN 1464-410X ; 1464-4096 ; 1358-8672
    ISSN (online) 1464-410X
    ISSN 1464-4096 ; 1358-8672
    DOI 10.1111/j.1464-410X.2012.11295.x
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  8. Article ; Online: Comparative validation of nomograms predicting clinically insignificant prostate cancer.

    Iremashvili, Viacheslav / Soloway, Mark S / Pelaez, Lisét / Rosenberg, Daniel L / Manoharan, Murugesan

    Urology

    2013  Volume 81, Issue 6, Page(s) 1202–1208

    Abstract: Objective: To validate and compare the accuracy and performance of nomograms predicting insignificant prostate cancer and to analyze their performance in patients with different cancer locations.: Methods: Our cohort consisted of 370 radical ... ...

    Abstract Objective: To validate and compare the accuracy and performance of nomograms predicting insignificant prostate cancer and to analyze their performance in patients with different cancer locations.
    Methods: Our cohort consisted of 370 radical prostatectomy patients with Gleason ≤6 prostate cancer diagnosed on transrectal biopsy with at least 10 cores. We quantified the performance of each nomogram with respect to discrimination, calibration, predictive accuracy at different cut points, and the clinical net benefit. We also evaluated these parameters in subgroups of patients with predominantly anterior-apical (AA) and posterior-basal (PB) tumor location.
    Results: Insignificant prostate cancer was present in 141 patients (38%). The Kattan and Steyerberg nomograms outperformed other studied models and demonstrated fair discrimination (areas under the receiver operating characteristics curve 0.768 and 0.770, respectively), good calibration, balanced predictive accuracy, and the highest net benefit. All nomograms were less accurate at higher levels of predicted probability. The performance of the nomograms was better in patients with PB tumors than in those with AA tumors. The loss of correlation with the actual prevalence of insignificant prostate cancer at higher levels of predicted probability was not seen in the PB subgroup but was particularly noticeable in the AA subgroup.
    Conclusion: The Kattan and Steyerberg nomograms demonstrated the best performance in predicting the probability of insignificant prostate cancer in a contemporary cohort of patients with Gleason ≤6 cancer diagnosed on specimens from an extended transrectal biopsy. However, all studied nomograms were more accurate in identifying significant rather than insignificant disease, particularly for tumors located in the apical and anterior prostate.
    MeSH term(s) Area Under Curve ; Biopsy, Needle ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Nomograms ; Predictive Value of Tests ; Probability ; Prostate/pathology ; Prostatectomy ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; ROC Curve
    Language English
    Publishing date 2013-06
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Validation Studies
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2013.01.062
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  9. Article ; Online: Pathologic prostate cancer characteristics in patients eligible for active surveillance: a head-to-head comparison of contemporary protocols.

    Iremashvili, Viacheslav / Pelaez, Lisét / Manoharan, Murugesan / Jorda, Mercé / Rosenberg, Daniel L / Soloway, Mark S

    European urology

    2012  Volume 62, Issue 3, Page(s) 462–468

    Abstract: Background: Although the rationale for active surveillance (AS) in patients with low-risk prostate cancer is well established, eligibility criteria vary significantly across different programs.: Objective: To compare the ability of contemporary AS ... ...

    Abstract Background: Although the rationale for active surveillance (AS) in patients with low-risk prostate cancer is well established, eligibility criteria vary significantly across different programs.
    Objective: To compare the ability of contemporary AS criteria to identify patients with certain pathologic tumor features based on the results of an extended transrectal prostate biopsy.
    Design, settings, and participants: The study cohort included 391 radical prostatectomy patients who had prostate cancer with Gleason scores ≤ 6 on transrectal biopsy with ≥ 10 cores.
    Intervention: Radical prostatectomy without neoadjuvant treatment.
    Outcome measurements and statistical analysis: We identified patients who fulfilled the inclusion criteria of five AS protocols including those of Epstein, Memorial Sloan-Kettering Cancer Center, Prostate Cancer Research International: Active Surveillance (PRIAS), University of California, San Francisco, and University of Miami (UM). We evaluated the ability of these criteria to predict three pathologic end points: insignificant disease defined using a classical and updated formulation, and organ-confined Gleason ≤ 6 prostate cancer. Measures of diagnostic accuracy and areas under the receiver operating curve were calculated for each protocol and compared.
    Results and limitations: A total of 75% of the patients met the inclusion criteria of at least one protocol; 23% were eligible for AS by all studied criteria. The PRIAS and UM criteria had the best balance between sensitivity and specificity for both definitions of insignificant prostate cancer and a higher discriminative ability for the end points than any criteria including patients with two or more positive cores. The Epstein criteria demonstrated high specificity but low sensitivity for all pathologic end points, and therefore the discriminative ability was not superior to those of other protocols.
    Conclusions: Significant variations exist in the ability of contemporary AS criteria to predict pathologically insignificant prostate cancer at radical prostatectomy. These differences should be taken into account when making treatment choices in patients with low-risk prostate cancer.
    MeSH term(s) Biopsy ; Chi-Square Distribution ; Decision Support Techniques ; Disease-Free Survival ; Eligibility Determination ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Patient Selection ; Predictive Value of Tests ; Prostate-Specific Antigen/blood ; Prostatectomy/adverse effects ; Prostatectomy/mortality ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; United States ; Watchful Waiting
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2012-09
    Publishing country Switzerland
    Document type Comparative Study ; Journal Article ; Multicenter Study
    ZDB-ID 193790-x
    ISSN 1873-7560 ; 1421-993X ; 0302-2838
    ISSN (online) 1873-7560 ; 1421-993X
    ISSN 0302-2838
    DOI 10.1016/j.eururo.2012.03.011
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  10. Article ; Online: Clinically significant Gleason sum upgrade: external validation and head-to-head comparison of the existing nomograms.

    Iremashvili, Viacheslav / Manoharan, Murugesan / Pelaez, Liset / Rosenberg, Daniel L / Soloway, Mark S

    Cancer

    2012  Volume 118, Issue 2, Page(s) 378–385

    Abstract: Background: Several nomograms have been developed for the purpose of predicting the likelihood of an increase in Gleason sum (GS) from biopsy information compared with the GS determined after examination of the "entire prostate" in patients with ... ...

    Abstract Background: Several nomograms have been developed for the purpose of predicting the likelihood of an increase in Gleason sum (GS) from biopsy information compared with the GS determined after examination of the "entire prostate" in patients with prostate cancer. In this study, the authors evaluated and compared the ability of 4 nomograms (published by Capitanio et al, Chun et al, Kulkarni et al, and Moussa et al) to predict GS upgrades for patients with biopsy GS ≤6 prostate cancer who underwent radical prostatectomy (RP) at their center.
    Methods: The entire study cohort included 942 patients with a biopsy GS ≤6. Predictive performances of the nomograms were compared using area under the receiver operating characteristic curve (AUC-ROC) analysis, calibration plots, and decision curve analysis (DCA) in the entire cohort, in patients with low-risk prostate cancer (LRPC), and a subgroup of those patients who underwent extended biopsy with ≥10 cores.
    Results: Patients with a GS ≥7 at prostatectomy included 319 of 942 patients (33.9%) in the entire study cohort, 263 of 814 patients (32.2%) with LRPC, and 84 of 301 patients (27.9%) with LRPC who underwent extended biopsy. With an AUC-ROC of 0.637 to 0.647 in the different subgroups of patients with low-risk cancer, the Kulkarni et al nomogram demonstrated significantly higher discriminative ability compared with the other nomograms. The same nomogram provided a small clinical benefit at DCA. All nomograms were poorly calibrated.
    Conclusions: The available prognostic tools had limited ability to predict clinically significant upgrading in patients with biopsy GS ≤6 and, thus, the authors concluded that these tools are not ready for clinical application.
    MeSH term(s) Aged ; Biopsy ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Nomograms ; Predictive Value of Tests ; Prognosis ; Prostatectomy ; Prostatic Neoplasms/pathology
    Language English
    Publishing date 2012-01-15
    Publishing country United States
    Document type Comparative Study ; Evaluation Studies ; Journal Article
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.26306
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