50 research outputs found
Differences in pupil control ideology : an analysis of the pupil control attitudes of student-teachers at Memorial University of Newfoundland
- Author
- Publication venue
- Memorial University of Newfoundland
- Publication date
- 01/01/1973
- Field of study
One of the most critical components of the competent teacher is his/her attitude toward children. All facets of teacher-training programs then, should be research in terms of their effect on the attitudes of the participants. Because of this importance of these attitudes, this study focuses on a comparison between student-teachers in the first undergraduate year and those in the final undergraduate year of their preparation program, in an attempt to discover what attitudes toward pupil control are crystallized and/or developed by student-teachers during the training period. -- The major problem of this study was to determine whether there were differences between the attitudes toward pupil control of junior and senior students in teacher-training, and to show the relationships between such differences of attitudes and certain situational factors or variables. It was hypothesized that the attitudes of junior (first year) student-teachers toward pupil control would be different from those of senior (fourth and/or fifth year) student-teachers, in that the attitudes of the latter would be more humanistic. -- The 322 student-teachers who were randomly selected to participate in the study were requested to complete two questionnaires dealing with certain aspects of pupil control. Form A of the Pupil Control Ideology Instrument consisted of 20 items and the response categories were scored 5, 4, 3, 2, 1, on a continuum ranging from extreme custodialism to extreme humanism. Form B of the instrument contained 60 items and was used to measure other aspects of pupil control ideology not measured by Form A. On each form of the instrument, the lower the score obtained the more humanistic the respondent was deemed to be. -- As hypothesized, there were significant differences in the attitudes toward pupil control of junior and senior student-teachers, in that the attitudes of the latter were much more humanistic, even when controlling for the variable, years of teaching experience. -- The implications of this study are quite clear. Student-teachers who had spent four or five years at Memorial University of Newfoundland had mellowed somewhat in their attitudes toward instruction and guidance of pupils at school, school discipline and general views on child psychology, when compared with student-teachers who were just starting their training at the institution. Thus, undergraduate training had a considerable impact upon the socialization of student-teachers with respect to their attitudes toward pupil control or their pupil control ideology
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O.
- Ademuyiwa Adesoji O.
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O.
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W.
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A.
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Ali Wadah
- Alihonou Thierry
- Alis Halil
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
- Allam Yomna
- Alnaby Mohamed Hassab
- Alnusairat Aseel
- Alqahtani Saleh
- Alsaggaf Mohammed Ubaid
- Alser Osaid H.
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Altibi Ahmed
- Altinel Yuksel
- Altinel Yuksel
- Altwijri Abdulaziz
- Alvi Abdul Rehman
- Aly Mohammed Yahia Mohamed
- Alyacoubi Said
- Alyahya Reem
- Alzahrani Ahmed
- Aman Nowrin F.
- Amandito Radhian
- Amandito Radhian
- Ambrona-Zafra David
- Amin Hager Abdul Aziz
- Amjad Mohammadasim
- Amoah Michael
- Amoako Joachim
- Amoako Philip Taah
- Amoako-Boateng Mabel
- Amole Isaac
- Amreia Mahmoud
- Anderson Frank
- Andika Ferry Fitriya Ayu
- Andreotti Dario
- Andress Cedar
- Andriola Valeria
- Ang Yun Lin
- Angelieri Daniele
- Anis Echaieb
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- Ansaloni Luca
- Ansaloni Luca
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- Anthoulakis Christos
- Antoniozzi Angelo
- Anwar Nourhan
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- Arslan Ekin
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- Awadallah Salwa
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- Aydin Mehmet Can
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- Azizeldine Mohammed G.
- Azzie Georges
- Azzis Olivier
- Baba Suleiman
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- Badawy Mahmoud
- Badenjki Mohamed Adel
- Badicel Maria
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- Cox Michael
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- D'Souza Michelle S.
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- Darwish Abdelrhman K. Z.
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- Donnelly Philippa
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- Dousset Bertrand
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- Drake Thomas M.
- Drake Thomas M.
- Drungilas Mantas
- du Plooy Flip
- Du Toit Frederick
- Duane Therese
- Duinhouwer Lucia
- Dulskas Audrius
- Ebidy Mai
- Ebidy Mai Mohamed
- Eid Mostafa Mahmoud
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- El Gendy Noran Halim
- El Halawany Mohamed
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- El Kashash Ahmed
- El Sayed Islam Magdy
- El-Dien Khalid Salah
- El-Din Reham Alaa
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- El-Sawy Aya
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- Elhadad Alaa
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- Elrazek Aly Abd
- Elsabbagh Nourhan
- Elsameea Ahmed Abd
- Elsawy Amira
- Elsayed Nada Ahmed Reda
- Elsemelawy Rofida
- Elshaar Mohammed
- Elshaer Mohamed
- Elshami Mohamedraed
- Elsharkawy Aya Adel
- Elsherbiney Saged
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- Elwy Eman
- Elzahed Nada
- Emadeldin Hossam
- Emara Eman
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- Espinoza Fernando
- Essam A. A.
- Essam Ahmed
- Essam Mahitab
- Essoun Samuel
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- Etchill Eric
- Etienne Sara
- Etwire Victor
- Evajelista Cicilia Viany
- Evans David
- Evans Elizabeth
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- Farag Sameh
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- Fares Mohamed
- Farhan-Alanie Muhamed M. H.
- Farhangmehr Neda
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- Farrugia Alexia
- Farrugia Alexia
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- Fathy Aya Mohamed
- Fatuga Adedeji
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- Feidantsis Thomas
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- Fergusson Stuart J.
- Fergusson Stuart J.
- Fermani Claudio Gabriel
- Fernandes Cristina
- Fernandez Carmen
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- Ferousis Christoforos
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- Filatau Aliaksandr
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- Firdouse Mohammed
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- Fitzgerald J. Edward
- Florez Farfan Erick Samuel
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- Gad Ahmed
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- Halhouli Oday
- Halhouli Oday
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- Hall Elisabeth
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- Hamill Daniel
- Hammad Aya
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- Hantour Usama
- Hany Ethar
- Haque Muhtarima
- Har Prisca A. L.
- Haraux Elodie
- Harrison Ewen M.
- Harrison Ewen M.
- Harrison Ewen M.
- Hartford Leila
- Harvey Neil
- Hasan Ahmad
- Hasan Doaa
- Hasanah Afifatun
- Hasanain Doaa
- Hascoet Juliette
- Hashad Eman
- Hashim Abdullah
- Haslegrave Aidan
- Hassaan Amr
- Hassaan Ayat
- Hassan Ahmed Tarek Abdelbaset
- Hassan Ihab
- Hassan Osama Mokhtar Mohamed
- Hassanain Mazen
- Hassanein Adel B.
- Heard Rachel
- Hegazy Eman Magdy
- Helene Francois-Coridon
- Helguero-Santin Luis M.
- Hemmila Mark
- Heng Hian Ee
- Henric Nicolas
- Henry Fitjerald
- Henshall David Ewart
- Herebat Azher
- Herikstad Ragnar
- Herrera Cruz Danilo
- Herrera Matta Juan Jaime
- Herrod Philip
- Hervieux Erik
- Hesham Omar
- Hilal Karim
- Hjertberg Maria
- Hmila Sophian
- Ho Adrienne
- Hodonou Fred
- Holte Silje
- Homeida Anmar
- Hossameldin Amr
- Hrora Abdelmalek
- Hunter Kristina
- Husseiny Reem
- Iacono Calogero
- Iannone Immacolata
- Ibraheem Aya AbdelFatah
- Ibrahem Ahmad Aboelkassem
- Ibrahim Ahmed Mohamed
- Ibrahim Amal
- Ibrahim Arij
- Ibrahim Arwa
- Ibrahim Eman
- Ibrahim Eman Mohamed
- Ibrahim Khaled
- Ibrahim Mohamed
- Idress Tasneem
- Idris Faisal
- Iftekhar Farhana
- Iftikhar Zainab
- Ignatavicius Povilas
- Ihediwa George
- Imoro Osman
- Ingabire J. C. Allen
- Ingabire J. C. Allen
- Ioannidis Orestis
- Iqbal Muhammad Rafaih
- Ireland Philip
- Irtan Sabine
- Irwin Gareth
- Irwin Gareth
- Ishak Norzawani
- Iskandar Ferdy
- Isler Vedatcan
- Ismail Ahmed
- Ismail Lawani
- Ismail Lawani
- Ismail Lawani
- Ismail Lawani
- Ismail Mohamed
- Ismail Mohammed Kamal
- Ismail Samar Adel
- Israelsson Leif
- Ivros Nikolaos
- Iyer Dush
- Iyer Dushyant
- Jabal Mohamed Sobhi
- Jaber Sahar
- Jaffry Zahra
- Jaich Robert
- Jama Guled M.
- Jamal Luai
- Janardha K. C.
- Janik Michal
- Jankus Tomas
- Jaradat Dana
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- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Identification of a BRCA2-Specific modifier locus at 6p24 related to breast cancer risk
- Author
- Aalfs C. M.
- Aalfs Cora M.
- Adenis Claude
- Adlard Julian
- Adlard Julian
- Aittomäki Kristiina
- Alonso M. Rosario
- Altshuler David
- Andrulis Irene L.
- Antoniou Antonis C.
- Arason Adalgeir
- Ardern-Jones Audrey
- Arnold Norbert
- Attard Virginia
- Ausems M. G E M
- Ausems Margreet G E M
- Bacot Francois
- Baisch Christian
- Bancroft Elizabeth
- Bardsley Cathryn
- Barile Monica
- Barjhoux Laure
- Barjhoux Laure
- Barouk-Simonet Emmanuelle
- Barrowdale Daniel
- Barton David
- Barwell Julian
- Belotti Muriel
- Belotti Muriel
- Benitez Javier
- Berlin Cheryl
- Berthet Pascaline
- Bignon Yves Jean
- Blanco Ignacio
- Blok M. J.
- Bojesen Stig E.
- Bonadona Valérie
- Bonnet Françoise
- Bourdon Violaine
- Bradshaw Nicola
- Brady Angela
- Brauch Hiltrud
- Brenner Hermann
- Bressac-de-Paillerets Brigitte
- Brewer Carole
- Brice Glen
- Bronner Myriam
- Bruening Thomas
- Bubien Virginie
- Buecher Bruno
- Burwinkel Barbara
- Caldes Trinidad
- Caron Olivier
- Castro Elena
- Chang-Claude Jenny
- Chenevix-Trench Georgia
- Claber Oonagh
- Colas Chrystelle
- Cole Trevor
- Collier Rebecca
- Collée J. M.
- Cook Jackie
- Coron Fanny
- Couch Fergus J.
- Coulet Florence
- Coupier Isabelle
- Cox Angela
- Crawford Gillian
- D'Andrea Emma
- Damiola Francesca
- Damiola Francesca
- Davidson Rosemarie
- de Bock G. H.
- de Lange J. L.
- de Pauw Antoine
- Delnatte Capucine
- Demange Liliane
- Dennis Joe
- Devilee P.
- Devillee Peter
- Dicks Ed
- Domchek Susan M.
- Donaldson Alan
- Dorkins Huw
- Douglas Fiona
- Dreyfus Hélène
- Drummond Sarah
- Duncan Alexis
- Dunning Alison M.
- Durell Sarah
- Dörk Thilo
- Eason Jacqueline
- Easton Douglas F.
- Eccles Diana
- Eddy Charlotte
- Eeles Rosalind A.
- Eisinger François
- Eldridge Ronald C.
- Ellis Ian
- Ellis Steve
- Ellis Steve
- Evans D. Gareth
- Evans D. Gareth
- Faivre Laurence
- Fasching Peter A.
- Feillel Viviane
- Ferrer Sandra Fert
- Ferrer Sandra Fert
- Fineberg Elena
- Fineberg Elena
- Fischer Hand Peter
- Fournier Joëlle
- Fricker Jean Pierre
- Friedman Eitan
- Frost Debra
- Frost Debra
- Frénay Marc
- Garber Judith
- García-Closas Montserrat
- Gaudet Mia M.
- Gauthier-Villars Marion
- Genuardi Maurizio
- Gibson Sarah
- Giles Graham G.
- Gille J. J P
- Giraud Sophie
- Gladieff Laurence
- Goff Sheila
- Goldgar David E.
- Golmard Lisa
- González-Neira Anna
- Goodman Selina
- Greene Mark H.
- Gregory Helen
- Guimbaud Rosine
- Guénel Pascal
- Gómez-Garcia E. B.
- Haiman Christopher A.
- Hall Per
- Halliday Dorothy
- Handallou Sandrine
- Hansen Thomas V O
- Haque Eshika
- Hardouin Agnés
- Healey Sue
- Hill Kathryn
- Hodgson Shirley
- Hoffman Jonathan
- Hogervorst F. B L
- Hogervorst Frans B L
- Hooning M. J.
- Hooning Maartje J.
- Houdayer Claude
- Houghton Catherine
- Houlston Richard
- Humphreys Manjeet K.
- Izatt Louise
- Jacobs Chris
- Jacobs Chris
- Jakubowska Anna
- James Margaret
- Jeffers Lisa
- Jensen Uffe Birk
- Jobson Irene
- Kennedy M. John
- Kets C. M.
- Kets Carolien M.
- Kientz Caroline
- Killick Emma
- Kirchhoff Tomas
- Kivuva Emma
- Klein Robert J.
- Ko Yon Dschun
- Kohut Kelly
- Kuchenbaecker Karoline B.
- Kulkarni Anjana
- Lalloo Fiona
- Lambrechts Diether
- Langman Caroline
- Lasset Christine
- Lazaro Conxi
- Lebrun Marine
- Lee Andrew
- Lehmann Anna
- Lidereau Rosette
- Lochmann Magdalena
- Longmuir Mark
- Longy Michel
- Longy Michel
- Lucassen Anneke
- Lynch Henry T.
- Léone Mélanie
- Mai Phuong L.
- Male Alison
- Mannermaa Arto
- Manoukian Siranoush
- Margolin Sara
- Martin Sue
- Mazoyer Sylvie
- Mazoyer Sylvie
- McBride Donna
- McCann Emma
- McGuffog Lesley
- McLeod Diane
- Meijers-Heijboer H. E J
- Meindl Alfons
- Melville Athalie
- Mensenkamp A. R.
- Michailidou Kyriaki
- Miedzybrodzka Zosia
- Milne Roger L.
- Moncoutier Virginie
- Morrison Patrick
- Mortemousque Isabelle
- Mourits M. J.
- Muller Danièle
- Murday Victoria
- Murray Alexandra
- Nathanson Katherine L.
- Neuhausen Susan L.
- Nevanlinna Heli
- Noguchi Tetsuro
- Nogues Catherine
- Offit Kenneth
- Ong Kai ren
- Oosterwijk J. C.
- Orr Nick
- Osorio Ana
- Page Elizabeth
- Pankratz Vernon S.
- Paterson Joan
- Peock Susan
- Peock Susan
- Pesch Beate
- Peterlongo Paolo
- Peto Julian
- Peyrat Jean Philippe
- Peysselon Magalie
- Pfeiler Georg
- Pharoah Paul D P
- Piedmonte Marion
- Pita Guillermo
- Platte Radka
- Platte Radka
- Porteous Mary
- Porteous Mary E.
- Prieur Fabienne
- Pujol Pascal
- Quarrell Oliver
- Rabstein Sylvia
- Radice Paolo
- Rahman Nazneen
- Randhawa Kashmir
- Rea Gillian
- Rebischung Christine
- Remenieras Audrey
- Rennert Gad
- Robson Mark
- Rogers Mark T.
- Rookus M. A.
- Rouleau Etienne
- Révillion Françoise
- Sawyer Elinor J.
- Schmidt M. K.
- Schmidt Marjanka K.
- Schmutzler Rita K.
- Schoof Nils
- Searle Anne
- Serra-Feliu Gemma
- Sevenet Nicolas
- Seynaeve C.
- Shah Sohela
- Shanley Susan
- Side Lucy
- Simard Jacques
- Singer Christian F.
- Sinilnikova Olga
- Sinilnikova Olga M.
- Smalley Sarah
- Snadden Lesley
- Snyder Carrie L.
- Sobol Hagay
- Sokolowska Johanna
- Soubrier Florent
- Soucy Penny
- Southey Melissa C.
- Spickenheuer Anne
- Spurdle Amanda B.
- Stayner Barbara
- Stoppa-Lyonnet Dominique
- Stoppa-Lyonnet Dominique
- Sutter Christian
- Taylor Amy
- Taylor Jane
- Tessier Daniel C.
- Thomassen Mads
- Tirapo Carole
- Tischkowitz Marc
- Tischkowitz Marc
- Tobias Ed
- Tollenaar R. A.
- Toulas Christine
- Tripathi Vishakha
- Uhrhammer Nancy
- van Asperen C. J.
- van Cronenburg T. C T E F
- van den Ouweland A. M W
- van den Ouweland Ans M W
- van der Hout A. H.
- van der Hout Annemarie H.
- van der Luijt R. B.
- van Deurzen C. H M
- van Leeuwen F. E.
- van Os T. A M
- van Rensburg Elizabeth J.
- Vasen H. F.
- Vennin Philippe
- Verhoef S.
- Verny-Pierre Carole
- Vijai Joseph
- Vincent Daniel
- Vénat-Bouvet Laurence
- Waisfisz Q.
- Walker Lisa
- Wang Qin
- Wang Xianshu
- Wappenschmidt Barbara
- Watt Catherine
- Weitzel Jeffrey N.
- Wiggins Jennifer
- Wijnen J. T.
- Wijnen Juul T.
- Winchester Lizzie
- Winqvist Robert
- Publication venue
- Public Library of Science (PLoS)
- Publication date
- 01/01/2013
- Field of study
Common genetic variants contribute to the observed variation in breast cancer risk for BRCA2 mutation carriers; those known to date have all been found through population-based genome-wide association studies (GWAS). To comprehensively identify breast cancer risk modifying loci for BRCA2 mutation carriers, we conducted a deep replication of an ongoing GWAS discovery study. Using the ranked P-values of the breast cancer associations with the imputed genotype of 1.4 M SNPs, 19,029 SNPs were selected and designed for inclusion on a custom Illumina array that included a total of 211,155 SNPs as part of a multi-consortial project. DNA samples from 3,881 breast cancer affected and 4,330 unaffected BRCA2 mutation carriers from 47 studies belonging to the Consortium of Investigators of Modifiers of BRCA1/2 were genotyped and available for analysis. We replicated previously reported breast cancer susceptibility alleles in these BRCA2 mutation carriers and for several regions (including FGFR2, MAP3K1, CDKN2A/B, and PTHLH) identified SNPs that have stronger evidence of association than those previously published. We also identified a novel susceptibility allele at 6p24 that was inversely associated with risk in BRCA2 mutation carriers (rs9348512; per allele HR = 0.85, 95% CI 0.80-0.90, P = 3.9×10−8). This SNP was not associated with breast cancer risk either in the general population or in BRCA1 mutation carriers. The locus lies within a region containing TFAP2A, which encodes a transcriptional activation protein that interacts with several tumor suppressor genes. This report identifies the first breast cancer risk locus specific to a BRCA2 mutation background. This comprehensive update of novel and previously reported breast cancer susceptibility loci contributes to the establishment of a panel of SNPs that modify breast cancer risk in BRCA2 mutation carriers. This panel may have clinical utility for women with BRCA2 mutations weighing options for medical prevention of breast cancer
An original phylogenetic approach identified mitochondrial haplogroup T1a1 as inversely associated with breast cancer risk in BRCA2 mutation carriers
- Author
- Aalfs Cora M.
- Aaltonen Kirsimari
- Adenis Claude
- Adlard Julian
- Agnarsson Bjarni A.
- Aittomäki Kristiina
- Alonso Rosario
- Amadori Alberto
- Andrulis Irene L.
- Angelakos Maggie
- Antoniou Antonis C.
- Ardern Jones Audrey
- Ardnor Christina Edwinsdotter
- Arnold Norbert
- Arun Banu K.
- Arver Brita
- Attard Virginia
- Ausems M. G. E. M.
- Balmaña J.
- Balogh Maria
- Bancroft Elizabeth
- Bardel Claire
- Bardsley Cathryn
- Barile Monica
- Barjhoux Laure
- Barouk Simonet Emmanuelle
- Barroso Alicia
- Barrowdale Daniel
- Barton David
- Barwell Julian
- Belotti Muriel
- Benitez Javier
- Berger Andreas
- Berlin Cheryl
- Berthet Pascaline
- Bignon Yves Jean
- Blanco Amie
- Blanco Ignacio
- Blein Sophie
- Blok M. J.
- Blomqvist Drs Carl
- Bonadona Valérie
- Bonanni Bernardo
- Bonnet Françoise
- Borg Ake
- Bourdon Violaine
- Bove Betsy
- Bozsik Aniko
- Bradshaw Nicola
- Brady Angela
- Breast Cancer Family Registry Null
- Bressac de Paillerets Brigitte
- Brewer Carole
- Brice Glen
- Bronner Myriam
- Bubien Virginie
- Buecher Bruno
- Bustinza Gisela Barbany
- Buys Saundra S.
- Caldes Trinidad
- Calender Alain
- Caligo Maria A.
- Capella Gabriel
- Capone Gabriele L.
- Caron Olivier
- Carter Jonathan
- Castro Elena
- Chan Salina
- Chenevix Trench Georgia
- Chung Wendy K.
- Claber Oonagh
- Claes Kathleen
- Colas Chrystelle
- Cole Trevor
- Collier Rebecca
- Collonge Rame Marie Agnès
- Collée J. M.
- Conejero Raquel Andrés
- Conrad Peggy
- Cook Jackie
- Corines Marina
- Coron Fanny
- Couch Fergus J.
- Coulet Florence
- Coupier Isabelle
- Cox David G.
- Craven Caroline
- Crawford Beth
- Crawford Gillian
- Damette Alexandre
- Damiola Francesca
- Danjean Vincent
- Davidson Rosemarie
- de Bock G. H.
- de la Hoya Miguel
- de Lange J. L.
- De Leeneer Kim
- de Pauw Antoine
- Del Valle Jesús
- Delatycki Martin
- della Puppa Lara
- Delnatte Capucine
- Demange Liliane
- Dennis Joe
- Devilee Peter
- Diez Orland
- Ding Chun
- Ding Yuan Chun
- Dishon Sara
- Disilvestro Paul A.
- Dite Gillian
- Ditsch Nina
- Dolcetti Riccardo
- Domchek Susan M.
- Domokos Gabriella
- Donaldson Alan
- Dorfling Cecilia M.
- Dorkins Huw
- Douglas Fiona
- Dreyfus Hélène
- Driessen Rebecca
- Drummond Sarah
- Dumont Martine
- Duncan Alexis
- Durda Katarzyna
- Durell Sarah
- Eason Jacqueline
- Easton Douglas F.
- Eccles Diana
- Eddy Charlotte
- Eeles Ros
- Eglitis Drs Janis
- Ehrencrona Hans
- Einbeigi Zakaria
- Eisinger François
- Ejlertsen Bent
- Ellis Ian
- Ellis Steve
- Emanuelsson Monica
- Embrace Null
- Engel Christoph
- Erkkilä Irja
- Evans D. Gareth
- Faivre Laurence
- Feillel Viviane
- Ferenczi Judit
- Ferrer Sandra Fert
- Fineberg Elena
- Fink Retter Anneliese
- Foo Claire
- Foretova Lenka
- Foulkes William
- Fournier Joëlle
- Franko Judit
- Fricker Jean Pierre
- Friedman Eitan
- Frost Debra
- Frénay Marc
- Garber Judy
- Gauthier Villars Marion
- Gayther Simon
- Gehrig Andrea
- Gerdes Anne Marie
- Gibson Sarah
- Gille J. J. P.
- Giraud Sophie
- Gladieff Laurence
- Glendon Gord
- Godwin Andrew K.
- Goff Sheila
- Goldgar David E.
- Golmard Lisa
- Goodman Selina
- Greene Mark H.
- Gregory Helen
- Griškevicius Laimonas
- Gronwald Jacek
- Guimbaud Rosine
- Gómez Garcia E. B.
- Halliday Dorothy
- Hamann Ute
- Handallou Sandrine
- Hansen Thomas V. O.
- Haque Eshika
- Harbst Katja
- Hardouin Agnès
- Harrington Patricia
- Harris Marion
- Healey Sue
- Henriksson Karin
- Hill Kathryn
- Hodgson Shirley
- Hoffman Jonathan
- Hogervorst Frans B. L.
- Hooning M. J.
- Houdayer Claude
- Houghton Catherine
- Houlston Richard
- Imyanitov Evgeny N.
- Isaacs Claudine
- Izatt Louise
- Jacobs Chris
- Jacobs Lauren
- Jager Agnes
- Jakubowska Anna
- James Margaret
- Janavicius Ramunas
- Jaworska Bieniek Katarzyna
- Jeffers Lisa
- Jensen Uffe Birk
- Jernström Helena
- Jobson Irene
- Karlan Beth Y.
- Karlsson Per
- Kast Karin
- Kaulich Daphne Geschwantler
- Kennedy M. John
- Kets Carolien M.
- Kientz Caroline
- Killick Emma
- Kivuva Emma
- Kleibl Zdenek
- Kohut Kelly
- Konstantopoulou Irene
- Krilova Anna
- Kristoffersson Ulf
- Kruse Torben A.
- Kuchenbaecker Karoline B.
- Kulkarni Anjana
- Kwan Lorna
- Laitman Yael
- Lalloo Fiona
- Lambo Rossana
- Langman Caroline
- Lasset Christine
- Lazaro Conxi
- Lebrun Marine
- Lee Andrew
- Lee Robin
- Lefol Cédrick
- Lehmann Anna
- Lejbkowicz Flavio
- Leroux Dominique
- Lester Jenny
- Lidereau Rosette
- Liedgren Sigrun
- Liljegren Annelie
- Lincoln Anne
- Lindblom Annika
- Lindeman Geoffrey
- Lindor Noralane M.
- Loman Niklas
- Longmuir Mark
- Longy Michel
- Loranger Kate
- Lubinski Jan
- Lucassen Anneke
- Lynch Henry T.
- Léone Mélanie
- Machackova Eva
- Mai Phuong L.
- Mak Julie
- Male Alison
- Manoukian Siranoush
- Markov Nadja Bogdanova
- Martayan Aline
- Martin Sue
- Maskiell Judi
- Maugard Christine
- Mazoyer Sylvie
- Mcbride Donna
- Mccann Emma
- Mcguffog Lesley
- Mcleod Diane
- Meijers Heijboer Hanne E. J.
- Meindl Alfons
- Melin Beatrice
- Mensenkamp A. R.
- Miedzybrodzka Zosia
- Mitchell Gillian
- Moncoutier Virginie
- Montagna Marco
- Morrison Patrick J.
- Mortemousque Isabelle
- Mourits M. J.
- Muller Danièle
- Mulligan Anna Marie
- Muranen Taru A.
- Murday Victoria
- Murray Alexandra
- Nathanson Katherine L.
- Neuhausen Susan L.
- Nevanlinna Heli
- Niederacher Dieter
- Niedermayr Eveline
- Nielsen Finn C.
- Niu Qun
- Noguchi Tetsuro
- Nogues Catherine
- Nordling Margareta
- Nussbaum Robert L.
- O'Conor Michelle
- Obdeijn I. M.
- Offit Kenneth
- Olah Edith
- Olopade Olufunmilayo I.
- Olsson Håkan
- Olswold Curtis
- Ong Kai Ren
- Oosterwijk Jan C.
- Orsulic Sandra
- Osorio Ana
- OTTINI LAURA
- Overbeek L. I. H.
- Page Elizabeth
- Palola Virpi
- Pankratz Vernon S.
- Papi Laura
- Papp Janos
- Paterson Joan
- Pedersen Inge Sokilde
- Peissel Bernard
- Peixoto Ana
- Pensotti Valeria
- Peterlongo Paolo
- Peyrat Jean Philippe
- Peysselon Magalie
- Pfeiler Georg
- Pharoah Paul D. P.
- Phelan Catherine M.
- Piedmonte Marion
- Pigg Maritta Hellström
- Pilato Brunella
- Pinchev Mila
- Pinto Pedro
- Pita Guillermo
- Platte Radka
- Plendl Hansjoerg
- Pocza Timea
- Pohlreich Petr
- Porteous Mary E.
- Preisler Adams Sabine
- Prieur Fabienne
- Pujol Pascal
- Pye Carole
- Quarrell Oliver
- Radice Paolo
- Rahman Nazneen
- Ramus Susan J.
- Rantala Johanna
- Rappaport Christine
- Rea Gillian
- Rebbeck Timothy R.
- Rebischung Christine
- Remenieras Audrey
- Rennert Gad
- Rhiem Kerstin
- Robson Mark
- Rocha Patrícia
- Rogers Mark T.
- Rookus Matti A.
- Rosenquist Richard
- Rouleau Etienne
- Rudaitis Vilius
- Révillion Françoise
- Santos Catarina
- Sawyer Sarah
- Schmidt M. K.
- Schmutzler Rita K.
- Scuvera Giulietta
- Searle Anne
- Segota Ena
- Seldon Joyce
- Senter Leigha
- Serra Feliu Gemma
- Sevenet Nicolas
- Seynaeve C.
- Shanley Susan
- Side Lucy E.
- Siesling S.
- Simard Jacques
- Singer Christian F.
- Sinilnikova Olga M.
- Smalley Sarah
- Snadden Lesley
- Snyder Carrie L.
- Sobol Hagay
- Sokolowska Johanna
- Soller Maria
- Sornin Valérie
- Soubrier Florent
- Soucy Penny
- Spurdle Amanda B.
- Stayner Barbara
- Steele Linda
- Steinemann Doris
- Stengrevics Aivars
- Stenmark Askmalm Marie
- Stewart Nicola
- Stoppa Lyonnet Dominique
- Sukiennicki Grzegorz
- Sutter Christian
- Sweet Kevin
- Szabo Csilla I.
- Taylor Amy
- Taylor Jane
- Tchatchou Sandrine
- Tea Muy Kheng
- Teixeira Manuel R.
- Terry Mary Beth
- Teulé Alex
- Thelander Margo
- Thomas Gilles
- Thomassen Mads
- Thompson Ella
- Thorne Heather
- Tibiletti Maria Grazia
- Tihomirova Laima
- Tirapo Carole
- Tischkowitz Marc
- Tobias Ed
- Toland Amanda Ewart
- Tollenaar R. A. E. M.
- Tommasi Stefania
- Toulas Christine
- Tranchant Martine
- Tripathi Vishakha
- Tsimiklis Helen
- Tung Nadine
- Uhrhammer Nancy
- van Asperen C. J.
- van Cronenburg T. C. T. E. F.
- van den Ouweland Ans M. W.
- van der Hout A. H.
- van der Luijt Rob B.
- van Deurzen C. H. M.
- Van Le Linda
- van Leeuwen Flora E.
- van Os T. A. M.
- van Rensburg Elizabeth J.
- van Roozendaal Kees E. P.
- Varesco Liliana
- Varon Mateeva Raymonda
- Vasen H. F.
- Vaszko Tibor
- Vennin Philippe
- Verhoef S.
- Verny Pierre Carole
- Viel Alessandra
- Vijai Joseph
- von Wachenfeldt Anna
- Vénat Bouvet Laurence
- Waisfisz Q.
- Walker Lisa
- Wang Gohrke Shan
- Wappenschmidt Barbara
- Watt Catherine
- Weaver Jo Ellen
- Weitzel Jeffrey N.
- Wiggins Jennifer
- Wijnands R.
- Wijnen J. T.
- Winchester Lizzie
- Wozniak Eva
- Yannoukakos Drakoulis
- Zaffaroni Daniela
- Zidan Jamal
- Zikan Michal
- Zvocec Cecilia
- Öfverholm Anna
- Publication venue
- Publication date
- 01/01/2015
- Field of study
Introduction: Individuals carrying pathogenic mutations in the BRCA1 and BRCA2 genes have a high lifetime risk of breast cancer. BRCA1 and BRCA2 are involved in DNA double-strand break repair, DNA alterations that can be caused by exposure to reactive oxygen species, a main source of which are mitochondria. Mitochondrial genome variations affect electron transport chain efficiency and reactive oxygen species production. Individuals with different mitochondrial haplogroups differ in their metabolism and sensitivity to oxidative stress. Variability in mitochondrial genetic background can alter reactive oxygen species production, leading to cancer risk. In the present study, we tested the hypothesis that mitochondrial haplogroups modify breast cancer risk in BRCA1/2 mutation carriers. Methods: We genotyped 22,214 (11,421 affected, 10,793 unaffected) mutation carriers belonging to the Consortium of Investigators of Modifiers of BRCA1/2 for 129 mitochondrial polymorphisms using the iCOGS array. Haplogroup inference and association detection were performed using a phylogenetic approach. ALTree was applied to explore the reference mitochondrial evolutionary tree and detect subclades enriched in affected or unaffected individuals. Results: We discovered that subclade T1a1 was depleted in affected BRCA2 mutation carriers compared with the rest of clade T (hazard ratio (HR) = 0.55; 95% confidence interval (CI), 0.34 to 0.88; P = 0.01). Compared with the most frequent haplogroup in the general population (that is, H and T clades), the T1a1 haplogroup has a HR of 0.62 (95% CI, 0.40 to 0.95; P = 0.03). We also identified three potential susceptibility loci, including G13708A/rs28359178, which has demonstrated an inverse association with familial breast cancer risk. Conclusions: This study illustrates how original approaches such as the phylogeny-based method we used can empower classical molecular epidemiological studies aimed at identifying association or risk modification effects.Peer reviewe
Identification of a BRCA2-Specific Modifier Locus at 6p24 Related to Breast Cancer Risk
- Author
- Aalfs C.M. (Cora)
- Adenis C. (Claude)
- Adlard J.W. (Julian)
- Aittomäki K. (Kristiina)
- Alonso M.R. (Rosario)
- Altshuler D. (David)
- Andrulis I.L. (Irene)
- Antoniou A.C. (Antonis)
- Arason A. (Adalgeir)
- Ardern-Jones A. (Audrey)
- Arnold N. (Norbert)
- Asperen C.J. (Christi) van
- Attard V. (Virginia)
- Ausems M.G.E.M. (Margreet)
- Bacot F. (Francois)
- Baisch C. (Christian)
- Bancroft E.K. (Elizabeth)
- Bardsley C. (Cathryn)
- Barile M. (Monica)
- Barjhoux L. (Laure)
- Barouk-Simonet E. (Emmanuelle)
- Barrowdale D. (Daniel)
- Barton D.E. (David)
- Barwell J. (Julian)
- Belotti M. (Muriel)
- Benítez J. (Javier)
- Berlin C. (Cheryl)
- Berthet P. (Pascaline)
- Bignon Y.-J. (Yves-Jean)
- Blanco I. (Ignacio)
- Blok M.J. (Marinus)
- Bock G.H. (Geertruida) de
- Bojesen S.E. (Stig)
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- Publication venue
- Publication date
- 15/04/2013
- Field of study
Genome-Wide Association Study in BRCA1 Mutation Carriers Identifies Novel Loci Associated with Breast and Ovarian Cancer Risk
- Author
- Aalfs C.M. (Cora)
- Adenis C. (Claude)
- Adlard J.W. (Julian)
- Agata S. (Simona)
- Agnarsson B.A. (Bjarni)
- Aittomäki K. (Kristiina)
- Andersen M.K. (Mette)
- Andrulis I.L. (Irene)
- Angelakos M. (Maggie)
- Antoniou A.C. (Antonis)
- Ardern-Jones A. (Audrey)
- Ardnor C.E. (Christina Edwinsdotter)
- Arnold N. (Norbert)
- Arun B.K. (Banu)
- Arver B. (Brita Wasteson)
- Asperen C.J. (Christi) van
- Attard V. (Virginia)
- Ausems M.G.E.M. (Margreet)
- Bacot F. (Francois)
- Bae-Jump V.L. (Victoria L.)
- Balmana J. (Judith)
- Bancroft E.K. (Elizabeth)
- Bardsley C. (Cathryn)
- Barjhoux L. (Laure)
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- Barouk-Simonet E. (Emmanuelle)
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- Brady A.F. (Angela)
- Bressac-de Paillerets B. (Brigitte)
- Brewer C. (C.)
- Brewer C. (Carole)
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- Moncoutier V. (Virginie)
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- Mulligan A.M. (Anna Marie)
- Muranen T.A. (Taru)
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- Murray A. (Alexandra)
- Murray A. (Anna)
- Narod S. (Steven)
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- Neuhausen S.L. (Susan)
- Nevanlinna H. (Heli)
- Niederacher D. (Dieter)
- Niedermayr E. (Eveline)
- Nielsen F.C. (Finn)
- Noguchi T. (Tetsuro)
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- Nordling M. (Margareta)
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- Ouweland A.M.W. (Ans) van den
- Ozcelik H. (Hilmi)
- Page E. (Elizabeth)
- Pankratz V.S. (Shane)
- Papi L. (Laura)
- Pastinen T. (Tomi)
- Paterson J. (Joan)
- Pauw A. (Antoine) de
- Pedersen I.S. (Inge Sokilde)
- Peissel B. (Bernard)
- Pensotti V. (Valeria)
- Peock S. (Susan)
- Peterlongo P. (Paolo)
- Peyrat J.-P.
- Peysselon M. (Magalie)
- Pfeiler G. (Georg)
- Phelan C. (Catherine)
- Piedmonte M. (Marion)
- Pigg M.H. (Maritta )
- Platte R. (Radka)
- Plendl H. (Hansjoerg)
- Porteous M.E. (Mary)
- Preisler-Adams S. (Sabine)
- Prieur F. (Fabienne)
- Pujana M.A. (Miguel)
- Pujol P. (Pascal)
- Quarrell O. (Oliver)
- Radice P. (Paolo)
- Rahman N. (Nazneen)
- Ramus S.J. (Susan)
- Randhawa K. (Kashmir)
- Rantala J. (Johanna)
- Rappaport C. (Christine)
- Rea D. (Dan)
- Rebbeck R. (Timothy)
- Rebischung C. (Christine)
- Remenieras A. (Audrey)
- Rennert G. (Gad)
- Rensburg E.J. (Elizabeth) van
- Rhiem K. (Kerstin)
- Robson M. (Mark)
- Rodriguez G.C. (Gustavo)
- Rogers M.T. (Mark)
- Romero A. (Alfonso)
- Rookus M.A. (M.)
- Rookus M.A. (Matti)
- Rosenquist R. (R.)
- Rouleau E. (Etienne)
- Révillion F. (Françoise)
- Sand S.R. (Sharon)
- Sarrel K. (Kara)
- Schmidt M.K. (Marjanka)
- Schmutzler R.K. (Rita)
- Searle A. (Anne)
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- Serra-Feliu G. (Gemma)
- Sevenet N. (Nicolas)
- Seynaeve C.M. (Caroline)
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- Shimon Paluch S. (Shani)
- Side L. (Lucy)
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- Sobol H. (Hagay)
- Sobol H. (Hagay)
- Sokolenko A. (Anna)
- Sokolowska J. (Johanna)
- Soller M. (Maria)
- Soubrier F.
- Soucy P. (Penny)
- Southey M.C. (Melissa)
- Spurdle A.B. (Amanda)
- Stavropoulou A. (Alexandra)
- Stayner B. (Barbara)
- Steele L. (Linda)
- Stenmark-Askmalm M. (M.)
- Stevens K. (Kristen)
- Stoppa-Lyonnet D. (Dominique)
- Stoppa-Lyonnet D. (Dominique)
- Stormorken A. (Astrid)
- Sutter C. (Christian)
- Szabo C. (Csilla)
- Taylor A. (Amy)
- Taylor J. (James)
- Tea M.-K.
- Teo S.-H. (Soo-Hwang)
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- Tessier Y. (Yann)
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- Tibiletti M.G. (Maria Grazia)
- Tihomirova L. (Laima)
- Tirapo C. (Carole)
- Tischkowitz M. (Marc)
- Tobias E. (Ed)
- Tognazzo S. (Silvia)
- Tollenaar R.A.E.M. (Rob)
- Toulas C. (Christine)
- Tripathi V. (Vishakha)
- Tung N. (Nadine)
- Uhrhammer N. (Nancy)
- Varesco L. (Liliana)
- Varon-Mateeva R. (Raymonda)
- Vaszko T. (Tibor)
- Vennin P. (Philippe)
- Verhoef S.
- Verhoef S. (S.)
- Verny-Pierre C. (Carole)
- Viel A. (Alessandra)
- Vijai J. (Joseph)
- Vincent D. (Daniel)
- Volorio S. (Sara)
- Vénat-Bouvet L. (Laurence)
- Wachenfeldt A. (Anna) von
- Waisfisz Q. (Quinten)
- Walker L.J. (Lisa)
- Walsh C.S. (Christine)
- Wang C. (Chen)
- Wang X. (Xianshu)
- Wapenschmidt B. (Barbara)
- Watt C. (Catherine)
- Weaver J. (JoEllen)
- Weber B.H.F. (Bernhard)
- Weitzel J.N. (Jeffrey)
- Wiggins J. (Jennifer)
- Wijnen J.T. (Juul)
- Wijnen J.T. (Juul)
- Winchester L. (Lizzie)
- Yannoukakos D. (Drakoulis)
- Złowocka-Perłowska E. (Elzbieta)
- Öfverholm A. (Anna)
- Publication venue
- 'Public Library of Science (PLoS)'
- Publication date
- 15/04/2013
- Field of study
BRCA1-associated breast and ovarian cancer risks can be modified by common genetic variants. To identify further cancer risk-modifying loci, we performed a multi-stage GWAS of 11,705 BRCA1 carriers (of whom 5,920 were diagnosed with breast and 1,839 were diagnosed with ovarian cancer), with a further replication in an additional sample of 2,646 BRCA1 carriers. We identified a novel breast cancer risk modifier locus at 1q32 for BRCA1 carriers (rs2290854, P = 2.7×10-8, HR = 1.14, 95% CI: 1.09-1.20). In addition, we identified two novel ovarian cancer risk modifier loci: 17q21.31 (rs17631303, P = 1.4×10-8, HR = 1.27, 95% CI: 1.17-1.38) and 4q32.3 (rs4691139, P = 3.4×10-8, HR = 1.20, 95% CI: 1.17-1.38). The 4q32.3 locus was not associated with ovarian cancer risk in the general population or BRCA2 carriers, suggesting a BRCA1-specific associat
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Ademuyiwa Adesoji O
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- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adiyaman Can
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- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
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- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
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- Syibrah Khuzaimah Zahid
- Tabiri Stephen
- Tabiri Stephen
- Tabiri Stephen
- Tabiri Stephen
- Tackie Enoch
- Taddei Antonio
- Tahboub Haya
- Taher Ayman And
- Taher Mustafa Mohammed
- Taieb Chouikh
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- Taiwo Ogechukwu
- Talaat Muhammed
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- Talving Peep
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- Tan Yi Koon
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- Tariq Sherif
- Tata Mahadevan Deva
- Tawfik Badreldin Adel
- Tawfik Gehad
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- Teasdale Ella
- Teasdale Ella
- Tedeschi Umberto
- Tembo Thelma
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- Tew Yong Yong
- Tew Yong Yong
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- Theodosopoulos Theodosios
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- Thorarinsdottir Hildur
- Thorell Anders
- Timothy Oyediran Kehinde
- Ting Jesse Ron Swire
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- Tolonen Matti
- Tolotra Todisoa Emmanuella Christina
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- Townsend Dominic
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- Turkustani Sondos
- Turpo Espinoza Kenny
- Turpo Espinoza Kevin
- Tutino Roberta
- Tverskis Zygimantas
- Tyler Robert
- Tze R Goh Ern
- Tzikos Georgios
- Ubiali Paolo
- Ukwenya Yahaya
- ul Razi Syed Asaat
- Ulusahin Mehmet
- Upadhyaya Vijaid
- Urbonas Tomas
- Urniezius Zigmantas
- Uscinas Laimonas
- Uzabumwana Norbert
- Vaicius Arturas
- Valcarcel-Saldana Maria
- Valioulis Ioannis
- Van Der Naald Niels
- Van Niekerk Michael
- Van Straten Stephanie
- Vargas Marvin
- Vartanoglu Talar
- Vartic Mihaela
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- Vasquez Idelso
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- Velasquez Ricardo
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- Vendramin Elena
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- Venskutonis Donatas
- Verbeek Anna
- Vergara Mejia Angelica Genoveva
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- Vicario Erika
- Vicenta Collado Maria
- Vida Lucian Corneliu
- Vilcinskas Mantas
- Villalobos Santiago
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- Waledziak Maciej
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- Walker Nathan
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- Walsh Michael
- Waqar Muhammad
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- Werder Gabriela
- Whitaker John
- White Rebecca
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T Ariani
- Widmer Lukas Werner
- Wijayarathna LS
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge PMSN
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial
- Author
- Abab Julie
- Abbas Ali
- Abbassi Sara
- Abd Alazeez Mohamed
- Abdulwahid Danya
- Abdulwahid Danya
- Abed Jessy
- Adab Fawzi
- Adams Marion
- Adamson Vanessa
- Addison Anglise
- Adeyoju Adebanji
- Adinkra Victoria
- Adnaan Jamila
- Afzal Naveed
- Agdiran Didem
- Aggarwal Ajay
- Ahamadali Sheefa
- Ahmad Belal
- Ahmed Ilyas
- Ahmed Imtiaz
- Ahmed Shahida
- Aiku Abimbola
- Ainsworth Sarah
- Ainsworth Sarah
- Aitken Katherine
- Ajzensztejn Daniel
- Akhtar Naeem
- Al-Chamali Hiba
- Al-hasso Abdulla
- Al-hasso Abdulla
- Al-Samarraie Amir
- Albrecht Virginia
- Alcock Christopher
- Alder Leanne
- Alderton Kate
- Aldous Mary
- Ali Jennyfa
- Ali Maryam
- Ali Zulfiqer
- Ali Zulfiqer
- Allan Elaine
- Allan Elaine
- Allen Julie
- Allen Kirsten
- Allen Rachael
- Allen Susan
- Allison Joanna
- Allison Michele
- Alonzi Roberto
- AlRashdan Abdulla
- Alzouebi Mymoona
- Amanie John Oliver
- Ammeter Barb
- Amoaten Thomas
- Amos Claire
- Anderson Beverley
- Anderson Chris
- Anderson Jim
- Anderson John
- Anderson John
- Anderson Juliette
- Anderson Juliette
- Anderson Leanne
- Anderson Naomi
- Anderson Susan
- Anderson Susan
- Andrade Gerard
- Andrews (nee Moore) Eleanor
- Andrews Kelly
- Andrews Stephen
- Ang Daniel
- Ann Taehee
- Annan Lynda
- Ansari Jawaher
- Ansari Jawaher
- Anscombe Eleanor
- Anyamene Nicola
- Appleby Bonny
- Appleby Rowan
- Archer Denise
- Archer Denise
- Archer Simon
- Archer Simon
- Arnott Seonaid
- Arsanious Nasr
- Ashcroft Jan
- Ashworth Sue
- Ashworth Sue
- Askew Sarah
- Aslam Natasha
- Atkinson Jane
- Atkinson Lorraine
- Attlee Julie
- Auladin Raidah
- Austin (nee Glover) Gemma
- Austin Mandy
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- Avis Joanne
- Aya Viviana
- Azirar Hanna
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- Bahl Amit
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- Cousins Jane
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- Crook Juanita
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- Crossley Lin
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- Crundwell M
- Cserbane Anita
- Cuffe Donna
- Cumming Kirsty
- Cunningham Amy
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- Curtis Sandra
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- Griffiths Theresa
- Gruschy Lisa
- Guarino Robyn
- Gudelis Susan O
- Guerrero-Urbano Teresa
- Guerrero-Urbano Teresa
- Guerrero-Urbano Teresa
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- Waring Lynsey
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- Watkinson Catrin
- Watson Melanie R
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- Yusof Hilawati
- Zafar Waheed
- Zaidi Sadaf
- Zarkar Anjali
- Zarkar Anjali
- Zarkar Anjali M.
- Zaza Khaled O
- Zelley Sarah
- Zeltser Fred
- Zhang Hanbo
- Zhang Tina Wanting
- Zietz Maria
- Zilkha Helene
- Zinck Connie
- Zinyemba Vivian
- Zurakovsky Hilary
- Zwarych Darlene
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/06/2024
- Field of study
Background
Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear.
Methods
RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047.
Findings
Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths.
Interpretation
Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population
Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial
- Author
- Abab Julie
- Abbas Ali
- Abbassi Sara
- Abd Alazeez Mohamed
- Abdulwahid Danya
- Abdulwahid Danya
- Abed Jessy
- Adab Fawzi
- Adams Marion
- Adamson Vanessa
- Addison Anglise
- Adeyoju Adebanji
- Adinkra Victoria
- Adnaan Jamila
- Afzal Naveed
- Agdiran Didem
- Aggarwal Ajay
- Ahamadali Sheefa
- Ahmad Belal
- Ahmed Ilyas
- Ahmed Imtiaz
- Ahmed Shahida
- Aiku Abimbola
- Ainsworth Sarah
- Ainsworth Sarah
- Aitken Katherine
- Ajzensztejn Daniel
- Akhtar Naeem
- Al-Chamali Hiba
- Al-hasso Abdulla
- Al-hasso Abdulla
- Al-Samarraie Amir
- Albrecht Virginia
- Alcock Christopher
- Alder Leanne
- Alderton Kate
- Aldous Mary
- Ali Jennyfa
- Ali Maryam
- Ali Zulfiqer
- Ali Zulfiqer
- Allan Elaine
- Allan Elaine
- Allen Julie
- Allen Kirsten
- Allen Rachael
- Allen Susan
- Allison Joanna
- Allison Michele
- Alonzi Roberto
- AlRashdan Abdulla
- Alzouebi Mymoona
- Amanie John Oliver
- Ammeter Barb
- Amoaten Thomas
- Amos Claire
- Anderson Beverley
- Anderson Chris
- Anderson Jim
- Anderson John
- Anderson John
- Anderson Juliette
- Anderson Leanne
- Anderson Naomi
- Anderson Susan
- Anderson Susan
- Andrade Gerard
- Andrews (nee Moore) Eleanor
- Andrews Kelly
- Andrews Stephen
- Ang Daniel
- Ann Taehee
- Annan Lynda
- Ansari Jawaher
- Ansari Jawaher
- Anscombe Eleanor
- Anyamene Nicola
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- Appleby Rowan
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- Archer Denise
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- Archer Simon
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- Ashworth Sue
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- Atkinson Lorraine
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- Blackwood Geoffrey
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- Brasso Klaus
- Braun Michael W
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- Brawley Chris
- Breakspear Sally
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- Byrne Mary Marg
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- Catton Charles N
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- Choudhury Ananya
- Chowdhury Amitava D
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- Christensen Tine
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- Chu William
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- Clarke Noel W
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- Clarke Rachael
- Clarke Samantha
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- Cole David J
- Collard Susan
- Colligan Steve
- Collins Gerald
- Collins Gerald
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- Conroy Ruth
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- Conway Rachel
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- Coppins Helen
- Corbett Thomas B
- Corcoran Sam
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- Cordwell Amanda
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- Cross William R
- Crossley Lin
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- Crundwell M
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- Dawson-Athey Linda
- Dayes Ian S
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- Dean Lynsey
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- Dixit Sanjay
- Dlodlo Jessica
- Dobson Tracey
- Dodds David
- Dodge Sister Jan
- Doherty A
- Donaghey Sally
- Donaldson David
- Donnison Michelle
- Douch Emma
- Doughty Victoria
- Dover Serena
- Downs Nichola
- Doyle Kerrie
- Drachenberg Darrel E
- Drakeley Susan
- Drew Ellen
- Drew Mary (Ellen)
- Driscoll Celine
- DSouza David
- Dubey Arbind
- Dubey Arbind
- Duckett Tracey
- Duclos Marie
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- DuMontier Joelle
- Duncan (nee Keatley) Claire
- Duncan Graeme
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- Dunne Emma
- Durkan Garret
- Durrant Lisa
- Dymond Harvey
- E Choan
- Eady Robin
- Eapen Libni
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- Edwards Abigail
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- Edwards Steve
- Edwards Steve
- Egan Lisa
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- El-Modir Ahmed
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- Elliott Mark
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- ElSokhn Nidale
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- Escueta Vivette
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- Falconer Alison
- Falconer Alison
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- Fallaize Adrian
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- Farnworth Christine
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- Fearnley Mark
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- Fennelly Ruth
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- Ferreira Miguel
- Fiddes Kathleen
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- Firth Alexandra
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- Flaherty Jan
- Flanagan Laura
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- Garrido-Perez Sandra
- Gauntlett Monica
- Gauthier Isabelle C
- Gearing Jennifer
- George Siny
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- Geraghty Kerry
- Ghoul Mokhtar
- Gibbins Andrew
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- Giovannini Julia
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- Glaholm John
- Glaholm John
- Gleave Martin E
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- Goel Roshni
- Goh Chee
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- Golden Sophie
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- Griffen Ailsa
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- Griffiths Dorothy
- Griffiths Leyshon
- Griffiths Theresa
- Griffiths Theresa
- Gruschy Lisa
- Guarino Robyn
- Gudelis Susan O
- Guerrero-Urbano Teresa
- Guerrero-Urbano Teresa
- Guerrero-Urbano Teresa
- Gujral Sandeep
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- Hanna Emma
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- Harding Joshua
- Hardman John
- Hardstaff Lisa
- Hare Jennifer A
- Hargreaves Carolyn
- Hargreaves Jeanette
- Hargreaves Jeanette
- Harinarayanan Sathish
- Harinarayanan Sathish
- Harland Keith
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- Harris (n. Marchant) Emily
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- Harrison Alison
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- Haskell Annelise
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- Haydock Helen
- Haydock Helen
- Hayes Jill A
- Hayward Lesley
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- Healey-Mariano Jennifer
- Healey-Mariano Jennifer
- Heasley Karen
- Heath Catherine
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- Hedges Andy
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- Henson (nee Savidge) Verity
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- Hillman Paul
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- Hocking Christopher
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- Hughes Owen
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- Hugill Angela
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- Humber Caroline
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- Hynds Sharon
- Ibrahim Azman
- Ingham Jo
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- Innes Helen
- Iordanidi Elina
- Iqbal Fawaad
- Irwin P
- Isaew Andrea
- Iskender Amanda
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- Jackman Dee
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- Jain Suneil
- Jakeman Christine
- James Naomi
- James Nicholas
- James Nicholas D
- Jamieson Ceri
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- Janke Susan
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- Jastrzebska Patrycja
- Javle P
- Jayachandran Resmi
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- Jeffcutt Nicole
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- Joshi Manisha
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- Jovic Gordana
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- Karunakaran Subashini
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- Kay Anne Marie
- Kazingizi Memory
- Keane Patrick
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- Keith Sarah
- Kelkar Anand
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- Kelly Alison
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- Kendal Wayne S
- Keng-Koh Pek
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- Keni Manjusha
- Kennedy Julie
- Kenny Shannon
- Kent Christopher
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- Khoury Ghassan
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- Kilmartin John
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- Kilroy Stephen
- Kiltie Anne
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- Kim-Sing Charmaine
- KimSing Charmaine
- King Amy
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- Klapp Kathi
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- Knapp Jeanette
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- Kodavatiganti Ravi
- Koehler Ingrid
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- Lang Monika
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- Laniado M
- Lao Bernadeth
- Larkins Rachel
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- Lloyd-Jones Hugh
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- Lock Michael I
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- Logue John
- Logue John
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- Lokes Rachel
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- Macavoy Tina
- Macdonald Alison
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- MacGregor Barbara
- Macgregor Carol
- MacIsaac Kathy
- MacIsaac Patricia
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- Macleod Nicholas
- MacMillan Antonia
- MacMullin Lisa
- MacRae Robert M
- Macrory Joanne
- MacVicar Jennifer
- MacVicar Karen
- Madeleine Jude
- Madhava Kudingila
- Madine John
- Magwaro Sophia
- Magwaro Sophia
- Magwaro Sophia
- Mahmood Rana
- Mahmood Rana
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- Mahmud Aamer
- Mahoney Catriona
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- Makepeace Barbara
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- Mallett Debbie
- Malone Shawn
- Malone Shawn C
- Manetta Caroline
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- Mangar Stephen
- Maniatis Christos
- Manley Rachel
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- Mashegede Beverley
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- Masson Susan
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- McKinna Fiona
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- Morgan Scott
- Morris Stephen
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- Morris William James
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- Nabid Abdenour
- Nabid Abdenour
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- Ngumo Alice
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- Nicholson Alastair
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- Ong Aldrich D
- Ong Aldrich Dixon
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- Paisey Sangeeta
- Palmer Debbie
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- Parker Chris
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- Parmar Mahesh K B
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- Parulekar Wendy
- Parulekar Wendy R
- Paschalis Alec
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- Petersen Peter M
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- Philp Timothy
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- Pickering Holly
- Pickles Thomas A
- Pigott Katherine
- Pilkington Pauline
- Pillai Sijy
- Pineda Sandra
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- Piper Lindsay
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- Pugh Cheryl A
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- Pwint Thinn
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- Raman Rakesh
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- Rauchenberger Mary
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- Redshaw Catherine
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- Richardson Karen
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- Rodda Sree
- Rodda Sree
- Rodda Sree
- Rodrigues George B
- Rodwell Sue
- Rogers Brian
- Rogers Eamonn
- Rogers Heather
- Rogers Jason
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- Saad Fred
- Saad Fred
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- Sabharwal Ami
- Sabharwal Ami
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- Sadare (Olaleye) Ibiyemi
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- Sanders Kay
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- Santos Priscilla
- Sargent Sister Tracey
- Sathya Jinka R
- Saunders Daniel
- Savage Sarah
- Sax Lori
- Saxe Charlotte
- Saxton Wendy
- Sayers Ian
- Sayers Ian
- Sayers Rachel
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- Shaffer Richard
- Shahid Negin
- Shaji Preetha
- Shakespeare Devadasan
- Shantz Brenda S
- Sharif Shahid
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- Sidek Norma
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- Simmons Elaine
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- Skwarski Michael
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- Smedley (nee McCabe) Janine
- Smedley (nee McCabe) Janine
- Smedley (nee McCabe) Janine
- Smith Beccy
- Smith Carlie
- Smith Carolyn
- Smith Dan
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- Smith Lucy
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- So Alan I
- Sohanpal Sundip
- Sohanpal Sundip
- Somasiri Ashane
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- Sreenivasan Thiagarajan
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- Sydes Matthew R
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- Thompson Emma
- Thompson Jane
- Thoms John
- Thomson Alastair H
- Thomson Sister Jane
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- Thorogood Lucy
- Tickle Vivienne
- Tickle Vivienne
- Tiessen Kyoko
- Tighe (nee Bussey) Rachel
- Tighe Helen
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- Varley Gail
- Varro Robert
- Varughese Mohini
- Varughese Mohini
- Vasanthan Subramanian
- Vaughn Jamie
- Vavassis Peter
- Velec Erin
- Vengalil Salil
- Venkatesan Varagur M
- Venkitaraman Ramachandran
- Venkitaraman Ramachandran
- Vermette Tracy
- Vesprini Danny
- Vickery Kathryn
- Vigneault Eric
- Vijayakumar Vijitha
- Vilarino-Varela Maria
- Vincent Francois
- Vincent LindaSuzanne
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- Vu Thi
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- Wakelen Paula
- Waldron Eleanor
- Walker Beth
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- Walker Georgina
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- Walsh Donna
- Walton Jenny
- Walton Sharon
- Ward Angela
- Ward Colin
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- Waring Lynsey
- Waring Lynsey
- Wassall Rebecca
- Watkinson Catrin
- Watson Melanie R
- Watson Michaella
- Watson-Jones Phillip
- Watts Angela
- Watts Erica
- Weaver Andrew
- Weaver Emma
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- Webb Claire
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- Webb Paula
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- Webster Christine
- Wei Joyce
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- Wellman Sandie
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- Wells Paula
- Wells Paula
- Wells Tom
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- Welsh Linda
- Westley Rosalyne
- Weston Alison
- Weston Philip
- Westrop Anna
- Westrop Anna
- Westrop Anna
- Wheatley Duncan
- Wheeler Lucie
- Wheelwright Roger
- Whelan Kate
- Whillis David
- Whinn Samantha
- Whitcher Alison
- White Ann
- White Holly
- White Joanna
- Whitehouse James
- Whitehouse James
- Whiteway Chrystal
- Whittle Stacy
- Whotton Nikita
- Wiggins Sarah
- Wightman John
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- Wild Karen
- Wilke Derek
- Wilkie Karen
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- Wilkinson Nicola
- Williams (Née Allen) Sister Tania
- Williams Amanda
- Williams Bethan
- Williams Candra
- Williams Jo
- Williams Joanne
- Williams Rachel
- Williams Rachel
- Williams-Yesson Barbara
- Williamson Elizabeth
- Williamson Nicola
- Willing Stephanie
- Wilson David
- Wilson Jim
- Wilson Jo
- Wilson Mark
- Wilson Paula
- Wilson Paula
- Wilson Russ
- Winn Carol
- Winter Sister Helen
- Wise Marcus
- Wise Marcus
- Wise Marcus
- Wiss Elliott
- Wollaston Julie
- Woloshyn Rose
- Wong Jason W T
- Wood Allison
- Wood Catherine
- Wood Cathryn
- Wood Marian
- Wood Pauline
- Wood Pauline
- Wood Sister Kim
- Wood Sister Kim
- Wood Sister Kim
- Woodhouse Iain
- Woods Catherine
- Woods Jane
- Woods Martin
- Woodward Cathryn
- Woodward Elizabeth
- Woolf David
- Woolf David
- Workman Bridget
- Worlding Jane
- Worlding Jane
- Worsley Lucy
- Worthington Hannah
- Wright Ann
- Wright Natalie
- Wright Seonaid
- Wrigley Martha
- Wronski Sue
- Wu Helen
- Wu Min
- Wyatt Clare
- Wylie James
- Wylie James
- Wylie James
- Wynn Hazel
- Wynn Hazel
- Yanchuk Janet
- Yarrow Sue
- Yassa Michael
- yates Victoria
- Yee Don
- Yeo Tanya
- Yoon Frederick
- Youd Sister Jill
- Young Anita
- Young Bobbie
- Young Douglas
- Young Sally
- Youngs Nora
- Yu Jason
- Yunace Lorrie
- Yusof Hilawati
- Zafar Waheed
- Zaidi Sadaf
- Zarkar Anjali
- Zarkar Anjali
- Zaza Khaled O
- Zelley Sarah
- Zeltser Fred
- Zhang Hanbo
- Zhang Tina Wanting
- Zietz Maria
- Zilkha Helene
- Zinck Connie
- Zinyemba Vivian
- Zurakovsky Hilary
- Zwarych Darlene
- Publication venue
- Elsevier
- Publication date
- 07/06/2024
- Field of study
Background
Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain.
Methods
RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and
ClinicalTrials.gov
,
NCT00541047
.
Findings
Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths.
Interpretation
Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy.
Funding
Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
- Author
- A. Mohammed Kalakwa
- A. Nemer Ayoub
- Abantanga Francis A.
- Abatli Safa' Jamal
- Abbas Wisam
- Abbo Olivier
- Abdelbaqi Reem
- Abdelhady Dina Sobhy
- Abdelhafez Mohammad Omar Mohammad
- Abdelhamid Sultan S.
- Abdelmaksoud Sherif
- Abdelmoumen Roua
- Abdelmutalib Fakereldeen
- Abdul-Mumin Alhassan
- Abduljawad Fatima Mousa
- Abdullah Fizan
- Abdullah Mohd Yusof bin
- Abdulraheem Nurudeen
- Abdulrahman Alaa
- Abdulsalam Moruf Adekunle
- Abdunomonovich Dekhkonboev Avazjon
- Aboelela Ahmed
- Abouheba Mohamed
- Abrahamsson Kate
- Abrunhosa Matias Marcia
- Abu-Nejmah Fawzi
- Abuajaila Abdulsalam
- Abuattaya Adham Ashraf
- Abubakar Auwal M
- Abueideh Ahmad
- Abuhayyeh Husam Aldean
- Abuhlega Ma'aly A.
- Abukhalaf Sadi
- Abumunshar Ali Abdelhay
- Acuna Gaston
- Adams Stephen
- Adamu Sani
- Adanan Mohd Fitri Shukri bin Mohamed
- Adawi Ihda
- Adawi Samer
- Adawy Ahmad
- Ade-Ajayi Niyi
- Adegboyega Rilwan
- Ademuyiwa Adesoji
- Adesanya Opeoluwa
- Adhiwidjaja Cathline Freya
- Adofo-Ansong Nana
- Agboola Titiloye Hannah
- Agelebe Efeturi
- Aguilar Aguilar Faye
- Aguilar Gargurevich Prince Pamela
- Aguirre-Lopez Pastor
- Agulham Miguel Angelo
- Ahmad Hira
- Ahmad Zahidah Adlynee Haji
- Ahmed Hazem
- Ahmed Mahmoud Abdelfattah
- Ajai Olalekan Temitope
- Ajao Emmanuel Akinlabi
- Ajiboye Olalekan S.
- Ajrami Yara
- Ajwa Ahmad Elian Abu
- Akan M. Eren
- Akhbari Melika
- Akhter Nadeem
- Akova Fatih
- Al-Attar Hala M.
- Al-Halbouni Layana
- Al-Mamun Abdullah
- Al-Mayoof Ali Farooq
- Al-Momani Hashem M.
- Al-Mouakeh Ahmad
- Al-Rayyes Maisara
- Al-saleem Hasan Subhi Hasan Abu
- Al-Salhi Ashraf Ayman
- Al-Shwaikh Samar H.
- Al-Slaibi Ibrahim
- Al-Taher Raed Nael
- Al-Taher Raed Nael
- Al-Tammam Hiba
- Alakaloko Felix
- Alamrain Abdulwhhab Ayman Abu
- Alanguia Chipana Cathy Lee
- Alattas Khalid
- Alberto Carlos
- Albozidi Aya
- Alcántara Elvyn
- ALDIRAWI MOHAMMED A. M.
- Alebbini Mohanad Mutasem
- Alfoghi Mabroka
- Algabri Hayder Nadhim Obaid
- Alglaib Mohammed Meftah
- Alhamid Ahmad
- Alhamid Aos
- Alhassan Priscilla
- Ali Hassan
- Ali Karim Osamy
- Ali Liza
- Ali Mansour
- Alijla Sharif
- Alijla Sharif S.
- Aliwisat Ahmad Hasan
- Aljaboo Hajir
- Aljadidi Wesal Omar F. Saied
- Aljarad Ziad
- Alkareem Raghad mohammad abdu
- Almada Suad Ahmed
- Almadhoun Walaa
- Almasri Murad
- Almeida Aguiar Arthur
- Almeida Giovana
- Almengar Inas
- Almohamady Hisham
- Almosaibli Mohammad
- Almusleh Tasneem Fathi Hasan
- Alnaeri Ali
- Alnahhal Khaled
- Alonso Verónica
- Alosta Hasan Mustafa
- Alqarajeh Firas
- Alqor Mohammad Omar Ibrahim
- Alsaadi Nijmeh Nasser
- Alsaggaf Ameen
- Alsaied Amer
- Alser Mohammed
- Alser Osaid H.
- Alshaikhkhalil Haya Abdulnasser Ali
- Alshehri Abdullah
- Altaweel Ahmed
- Altın Merve
- Altokhais Tariq
- Altomi Mohamed
- Alturki Fahad
- Alvarado Zelada Jackelyne
- Alves Dutra da Silva Érika
- Alwadia Soha Marwan Salem
- Alwaggaa Nouriyah Ali
- Alzamari Ainaa Ata Mohammad
- Alzate Gallego Edgar
- Alzeer Asmahan Mohammad Suliman
- Alzerei Sulaiman T.
- Alzraikat Sayel H.
- Alzubair Afnan
- Alzughayyar Tareq Z.
- Amad Mohamed
- Amado Fernando
- Amaechi Chukwubinyelum
- Amah Christopher Chim
- Amarin Justin Z.
- Amarin Marzouq
- Ambriz-González Gabriela
- Ameh Emmanuel
- Amjad Muhammad Bin
- Amoabin Afua Amoabin
- Anatole Nzanzu
- Anatole Nzanzu Kipata
- Anaya Dominguez Marlene
- Anaya Firas
- Andrade Jerhy
- Andreussi Lorna
- Anicama Elias Rocio
- Annajjar Mohammad hasan
- Anntinea Jessmine
- Antunes Amanda
- Antunez-Mora Alexandra
- Anyomih Theophilus Teddy Kojo
- Anzelewicz Stefan
- Apaza Leon Jose Luis
- Appeadu-Mensah William
- Arabiat Esraa
- Arafa Mohamed Ahmed
- Arafat Hasan
- Aragão Liliana
- Arancibia Gutiérrez Elsa
- Aranda Sánchez Cristian Irela
- Arar Ahmad Samih
- Arauco Jenny
- Arbab Hana
- Arboleda Jenny
- Aremo Anuoluwapo
- Arnadóttir Helena
- Arnaud Alexis P
- Arnold Marion
- Arnoletto Lucia Beatriz
- Arrmali Saddam
- Arrmalli Lina Ali
- Arshad Muhammad
- Arthur Felicity
- Arul Suren
- Ashour Dina Ayman
- Ashour Yara shareef
- Aslan Yakup
- Aspirot Ann
- Assi Ahmadfateh
- Assi Muath Abdelrahem Fuad
- Astudillo Miguel
- Atatri Yazid yousef mahmoud
- Atta Ahmed
- Attia Alaa Mobarak
- Avile Romina
- Avolio Luigi
- Awad Hadeel
- Aydin Emrah
- Aykut Merve
- Ayque Rosas Fernando
- Aziz Dayang Anita Abdul
- Ba'baa' Basheer
- Badr Helmy
- Baertschiger Reto
- Bagbio Dominic
- Bah Abdoulie
- Bai Qiang
- Bai Yu Zuo
- Baistrocchi Valentina
- Bakar Ainal Huda Abu
- Baker Wisam
- Ballouhey Quentin
- Balousha Abrar ghassan
- Bamanga Ahmed
- Baniowda Muath A. M.
- Bao Xiaozhou
- Barauskas Vidmantas
- Barbosa Patricia Reis
- Baseggio Natalia
- Bashir Fatma
- Bashir Muhammad Kashif
- Bassan Gonçalves Paulo César
- Bataineh Ziad A.
- Batal Mohammad Mohannad
- Bazozi Hana Milad
- Beasley Spencer
- Becker Karin
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- Seyi-Olajide Justina
- Sferco Carlos Ariel
- Shabana Osaid Shaher
- Shahbal Swaleh
- Shaheen Ahmad Ashraf
- Shaheen Nureddin
- Shaklawoon Aisha
- Shalaby Amr
- Shalaby Hanin
- Shalluf Hawa Ahmed
- Shan Cheah Hui
- Sharabati Fadwa
- Sharabati Mutassem
- Sharif Muhammad
- Sharif Randa Alamen M
- Shaw Kenneth
- Shehada Mohammed
- Shehu Ibrahim
- Sheir Hesham
- Sherer Karen
- Sherzad Ajmal
- Shiha Eman Abu
- Shikha Anas
- Shinondo Patricia
- Shnishah Aya Essam
- Shokri Hajer Ali
- Shonubi Amo
- Shoubaki Ali
- Shu Qiang
- Shyaka Gashugi Ian
- Siddiqui Sabina M
- Sidler Daniel
- Sigalet David
- Sihem Brahimi
- Sikwete Guigui
- Siles Hinojosa Alexander
- Silva Beltrán Nathalia
- Silva dos Santos Carla
- Silva Ferreira dos Santos Marília
- Silva Elisângela
- Silva Julian
- Silva Karina Ilheu da
- Silva Yanina
- Sim Marcus
- Simeon Turatsinze
- Simon Soledad
- Sindi Omar
- Singer Georg
- Singh Michael
- Sivaraj Jayaram
- Sivasubramaniam Mithila
- Siyotula Thozama
- Slavkovi Andjelka
- Slavkovic Milan
- Smith Emily Rose
- Soares de Fraga José Carlos
- Sobrero Helena
- Soccorso Giampiero
- Sokolovic Emir
- Sola Juan
- Solanki Meghna
- Soliman Nourhan Akram
- Son Joonhyuk
- Song Eung song
- Soomro Aqil
- Sotelo Sanchez Jennifer
- Souhem Touabti
- Soula Enas
- Souza Barros Beatriz
- Souza Machado Ana Beatriz
- Sowe Babucarr
- Sriniworn Anan
- St-Louis Etienne
- St-Vil Dickens
- Stark Domitille
- Stojanovic Miona
- Stringer Mark
- Strumila Arunas
- Sueiras Ines
- Sulca Cruzado Gladys Johana
- Suleiman Faruk
- Sultana Sadia
- Suradi Haya H.
- Sutcliffe Jonathan
- Suzana Trein Cristine
- Suzen Alev
- Svensson Emma
- Svirsky Alexander
- Swessi Hisham
- Syed Shahnoor
- Syovata Francisa
- Szklarz Maria Tatiana
- Sánchez Paredes Vicente
- Sönmez Kaan
- T Shajin
- T. Sambo Yusuf
- Tababa Osama
- Tabari Ahmad Khaleghnejad
- Tabiri Stephen
- Tadesse Amezene
- Tahyneh Abdulraheem Adnan Abdulraheem
- Takrouney Mohammed Hamada
- Talat Nabila
- Tallaa Mohamed Anwer El
- Tamada Horácio
- Tamaddun Hafatin Fairos bt
- Tang Weibing
- Tanimola Adebayo Gbenga
- Tanming Patchareeporn
- Tanny Sharman Tan
- Tantush Sara Abobaker
- Tarabishi Ahmad Sankari
- Tarek Ahmed
- Tarmohamed Murad
- Tarniba Sara Ali
- Tarrado Xavier
- Tasker David
- Teague Warwick
- Telles Leila
- Temilade Bolarinwa Bolanle
- Teo Rufinah
- Teran Araceli
- Terzic Sabina
- Testoni Daniela
- Thaiwatcharamas Kanokrat
- Thiessen Jesh
- Thomas Amy Hughes
- Thomas Gordon
- Thomas Mark C
- Thompson Hannah
- Till Holger
- Tillig Bernd
- Tinoco Guzmán Nestor Julien
- Tobor Szymon
- Toczewski Krystian
- Tom Alan
- Toplicic Djordje
- Toral Eliana
- Torres Miranda Cesar
- Torres Picón Cintya Maria de Jesus
- Torres-Canchala Laura
- Toselli Luzia
- Touabti Souhem
- Toufik Iaiche Achour
- Tovar Gutierrez Natalia
- Trainba Sara
- Trigoso Mori Fernando
- Trindade Deyl Rafael
- Trojanová Barbora
- Trypens Agata
- Tumi Mohamed
- Tuyishime Eugene
- Türkyılmaz Canan
- Türkyılmaz Zafer
- Ubhi Harmony
- Ugwu Jideofor O
- Ugwunne Chuka A
- Ulasi Ikechukwu
- Ullrich Sarah
- Vacek Jonathan
- Vaitkiene Agota
- Valencia Santiago
- Valeria Pelussi
- Valerio-Vazquez Rafael
- Vanis Nedim
- Vaquila Justo
- Varela Maria Florencia
- Vasquez Matos Juan Pedro
- Vatta Fabrizio
- Vega Centen Stephany
- Velaña Junior
- Vellusamy V Muthualhagi M
- Venant Ntakarutimana
- Venkatraman Soundappan Sannappa
- Verdeata Roxana
- Verduga Ivan
- Verduga Leonardo
- Vergara Carolina
- Verkauskas Gilvydas
- Veronica Sofficci
- Vervoort Dominique
- Vianney Butoyi Jean Marie
- Vida Lucian
- Vidal Cristian R. Zalles
- Vierboom Liam
- Villalba Villalba Araceli
- Villegas Silva Raúl
- Vinskaite Asta
- Vos Corné de
- Vosoughi Armin
- Wafa Tamer
- Walker Gregor
- Wang Jinhu
- Wang Peng
- Waseem Basma
- Weeratunga Naveen
- Weiszewsk Alicja
- Wen Gang
- Werneck Raposo Juliana
- Wester Tomas
- Wijekoon Naveen
- Wilke Alexandra
- Williams Isabelle
- Williams Omolara
- Williams Regan
- Win Win Sabai Phyu
- Wishah Bisan D. M.
- Wishah Nidal
- Wissanji Hussein
- Wolak Przemyslaw
- Wolny Agnieszka
- Wong Janice
- Wong Marilyn
- Wright Naomi Jane
- Wu Guowei
- Wyrzykowski Dariusz
- Xiaodong Guo
- Xie Hua
- Yacoub Mina A.
- Yaghi Bashar
- Yaghi Dua Hasan
- Yalcinkaya Ali
- Yang Hee-Beom
- Yanis Ahmad H.
- Yanowsky Reyes Guillermo
- Yao Yang
- Yapo Benjamin
- Yarza Fernández Jessica
- Yeniay Aslı Öztürk
- Yola Mariya Mukhtar
- Yong Feng
- Youn Joong Kee
- Yousuf Hina
- Yu Mengnan
- Yu Raisa
- Yuen Quah Soong
- Yuldashev Rustam Z.
- Yunus Aayenah
- Za'nouneh Faris J. Abu
- Zaghlol Louay Y.
- Zahari Dato' Dr Zakaria bin
- Zain Mostafa
- Zaman Azrina SK
- Zanellato Josiane Bernartt
- Zarwawi Ahmad Zulhisyam bin
- Zea-Salazar Luis Enrique
- Zeinelabdeen Ali
- Zhao Xiaoxia
- Zhu Jianming
- Zhu Libin
- Zidan Mazen
- Zivanovic Dragoljub
- Zottis Barcelos Fabricio
- Zreeg Dafer abdulhakim . S.
- Zurikat Rajai O.
- Zvizdic Nada
- Zvizdic Zlatan
- Çekiç Bahanur
- Çelik Müge
- Özçelik Zerrin
- Şeref Kıvanç
- Šafus Antonín
- Škvařil Jan
- Štichhauer Radek
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030