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Inhibition of adenovirus serotype 14 infection by octadecyloxyethyl esters of (S)-[(3-hydroxy-2-phosphonomethoxy)propyl]- nucleosides in vitro.
On September 22, 2008, a physician on Prince of Wales Island, Alaska, notified the Alaska Department of Health and Social Services (ADHSS) of an unusually high number of adult patients with recently diagnosed pneumonia (n = 10), including three persons who required hospitalization and one who died. ADHSS and CDC conducted an investigation to determine the cause and distribution of the outbreak, identify risk factors for hospitalization, and implement control measures. This report summarizes the results of that investigation, which found that the outbreak was caused by adenovirus 14 (Ad14), an emerging adenovirus serotype in the United States that is associated with a higher rate of severe illness compared with other adenoviruses. Among the 46 cases identified in the outbreak from September 1 through October 27, 2008, the most frequently observed characteristics included the following: male (70%), Alaska Native (61%), underlying pulmonary disease (44%), aged > or = 65 years (26%), and current smoker (48%). Patients aged > or = 65 years had a fivefold increased risk for hospitalization. The most commonly reported symptoms were cough (100%), shortness of breath (87%), and fever (74%). Of the 11 hospitalized patients, three required intensive care, and one required mechanical ventilation. One death was reported. Ad14 isolates obtained during the outbreak were identical genetically to those in recent community-acquired outbreaks in the United States which suggests the emergence of a new, and possibly more virulent Ad14 variant. Clinicians should consider Ad14 infection in the differential diagnosis for patients with community-acquired pneumonia, particularly when unexplained clusters of severe respiratory infections are detected
Persistence of treatment in patients with ulcerative colitis who responded to tofacitinib therapy: data from the open-label, long-term extension study, OCTAVE open
Tofacitinib is an oral Janus kinase inhibitor for the treatment of ulcerative colitis (UC).
Aim:This post hoc analysis evaluated tofacitinib persistence in patients with UC in OCTAVE Open, an open-label, long-term extension study of patients receiving tofacitinib 5 or 10 mg twice daily.
Methods: Kaplan-Meier estimates for tofacitinib drug survival and reasons for discontinuations were evaluated. Baseline factors were analysed as predictors of persistence.
Results:This analysis included 603 patients: 280 entered OCTAVE Open with a clinical response (164 in remission and 116 not in remission), 220 were delayed responders, 75 were retreatment responders and 35 were dose escalation responders, treated for up to 7 years in OCTAVE Open. Of these, 118 (42.1%) responders, 121 (55.0%) delayed responders, 40 (53.3%) retreatment responders and 17 (48.6%) dose escalation responders discontinued tofacitinib with a median time to discontinuation of 5.6, 4.5, 4.0 and 4.4 years, respectively. The estimated 2- and 5-year drug survival rates in the responders (including patients in remission and not in remission) were 73.9% and 54.5%, respectively. Corresponding persistence values for delayed responders were 69.5% and 45.2%, for retreatment responders, 70.7% and 40.0%, and for dose escalation responders, 74.3% and 32.8%.
ConclusionIn: OCTAVE Open, a high proportion of patients maintained tofacitinib treatment, with the median survival by group ranging from 4.0 to 5.6 years although these analyses are post hoc and limited by sample size. Further research should focus on factors to enhance persistence with tofacitinib treatment in patients with UCThis study was sponsored by Pfizer. Medical writing support, under the guidance of the authors, was provided by Helen Findlow, PhD, CMC Connect, McCann Health Medical Communications and was funded by Pfizer Inc, New York, NY, USA in accordance with Good Publication Practice (GPP3) guidelines (Ann Intern Med. 2015;163:461–464
Characteristics and Outcomes of IBD Patients with COVID-19 on Tofacitinib Therapy in the SECURE-IBD Registry
The coronavirus disease 2019 (COVID-19) pandemic due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to unprecedented loss of life and health on a global scale. COVID-19 outcomes are more severe among those with comorbid conditions, which raises concerns for patients with inflammatory bowel disease (IBD), especially given the increased infection risk with immunosuppression used for IBD therapy
Quantitative Assessment of Mammary Gland Density in Rodents Using Digital Image Analysis
<p>Abstract</p> <p>Background</p> <p>Rodent models have been used extensively to study mammary gland development and for studies of toxicology and carcinogenesis. Mammary gland gross morphology can visualized via the excision of intact mammary gland chains following fixation and staining with carmine using a tissue preparation referred to as a whole mount. Methods are described for the automated collection of digital images from an entire mammary gland whole mount and for the interrogation of digital data using a "masking" technique available with Image-Pro<sup>® </sup>plus image analysis software (Mediacybernetics. Silver Spring, MD).</p> <p>Results</p> <p>Parallel to mammographic analysis in humans, measurements of rodent mammary gland density were derived from area-based or volume-based algorithms and included: total circumscribed mammary fat pad mass, mammary epithelial mass, and epithelium-free fat pad mass. These values permitted estimation of absolute mass of mammary epithelium as well as breast density. The biological plausibility of these measurements was evaluated in mammary whole mounts from rats and mice. During mammary gland development, absolute epithelial mass increased linearly without significant changes in mammographic density. Treatment of rodents with tamoxifen, 9-cis-retinoic acid, or ovariectomy, and occurrence of diet induced obesity decreased both absolute epithelial mass and mammographic density. The area and volumetric methods gave similar results.</p> <p>Conclusions</p> <p>Digital image analysis can be used for screening agents for potential impact on reproductive toxicity or carcinogenesis as well as for mechanistic studies, particularly for cumulative effects on mammary epithelial mass as well as translational studies of mechanisms that explain the relationship between epithelial mass and cancer risk.</p
Antihypertensive treatment in people with dementia
Introduction
The range and magnitude of potential benefits and harms of antihypertensive treatment in people with dementia has not been previously established.
Method
A scoping review to identify potential domains of benefits and harms of antihypertensive therapy in people with dementia was undertaken. Systematic reviews of these domains were undertaken to examine the magnitude of the benefits or harms.
Results
Potential outcome domains identified in the 155 papers in the scoping review were cardio-vascular events, falls, fractures and syncope, depression, orthostatic hypotension, behavioural disturbances, polypharmacy risks, kidney problems, sleep problems, interactions with cholinesterase inhibitors and pain. The systematic reviews across these domains identified relatively few studies done in people with dementia, and no convincing evidence of safety, benefit or harm across any of them.
Discussion
There is no justification for materially different guidance for the treatment of hypertension in people with dementia, but sufficient evidence to warrant particular caution and further research into treatment in this group of patients
International Consortium on Mammographic Density:methodology and population diversity captured across 22 countries
Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses
Novel Associations between Common Breast Cancer Susceptibility Variants and Risk-Predicting Mammographic Density Measures.
Mammographic density measures adjusted for age and body mass index (BMI) are heritable predictors of breast cancer risk, but few mammographic density-associated genetic variants have been identified. Using data for 10,727 women from two international consortia, we estimated associations between 77 common breast cancer susceptibility variants and absolute dense area, percent dense area and absolute nondense area adjusted for study, age, and BMI using mixed linear modeling. We found strong support for established associations between rs10995190 (in the region of ZNF365), rs2046210 (ESR1), and rs3817198 (LSP1) and adjusted absolute and percent dense areas (all P < 10(-5)). Of 41 recently discovered breast cancer susceptibility variants, associations were found between rs1432679 (EBF1), rs17817449 (MIR1972-2: FTO), rs12710696 (2p24.1), and rs3757318 (ESR1) and adjusted absolute and percent dense areas, respectively. There were associations between rs6001930 (MKL1) and both adjusted absolute dense and nondense areas, and between rs17356907 (NTN4) and adjusted absolute nondense area. Trends in all but two associations were consistent with those for breast cancer risk. Results suggested that 18% of breast cancer susceptibility variants were associated with at least one mammographic density measure. Genetic variants at multiple loci were associated with both breast cancer risk and the mammographic density measures. Further understanding of the underlying mechanisms at these loci could help identify etiologic pathways implicated in how mammographic density predicts breast cancer risk.ABCFS: The Australian Breast Cancer Family Registry (ABCFR; 1992-1995) was supported by
the Australian NHMRC, the New South Wales Cancer Council, and the Victorian Health
Promotion Foundation (Australia), and by grant UM1CA164920 from the USA National
Cancer Institute. The Genetic Epidemiology Laboratory at the University of Melbourne has
also received generous support from Mr B. Hovey and Dr and Mrs R.W. Brown to whom we
are most grateful. The content of this manuscript does not necessarily reflect the views or
policies of the National Cancer Institute or any of the collaborating centers in the Breast
Breast Cancer Susceptibility Variants and Mammographic Density
5
Cancer Family Registry (BCFR), nor does mention of trade names, commercial products, or
organizations imply endorsement by the USA Government or the BCFR.
BBCC: This study was funded in part by the ELAN-Program of the University Hospital
Erlangen; Katharina Heusinger was funded by the ELAN program of the University Hospital
Erlangen. BBCC was supported in part by the ELAN program of the Medical Faculty,
University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg.
EPIC-Norfolk: This study was funded by research programme grant funding from Cancer
Research UK and the Medical Research Council with additional support from the Stroke
Association, British Heart Foundation, Department of Health, Research into Ageing and
Academy of Medical Sciences.
MCBCS: This study was supported by Public Health Service Grants P50 CA 116201, R01 CA
128931, R01 CA 128931-S01, R01 CA 122340, CCSG P30 CA15083, from the National Cancer
Institute, National Institutes of Health, and Department of Health and Human Services.
MCCS: Melissa C. Southey is a National Health and Medical Research Council Senior
Research Fellow and a Victorian Breast Cancer Research Consortium Group Leader. The
study was supported by the Cancer Council of Victoria and by the Victorian Breast Cancer
Research Consortium.
MEC: National Cancer Institute: R37CA054281, R01CA063464, R01CA085265, R25CA090956,
R01CA132839.
MMHS: This work was supported by grants from the National Cancer Institute, National
Institutes of Health, and Department of Health and Human Services. (R01 CA128931, R01 CA
128931-S01, R01 CA97396, P50 CA116201, and Cancer Center Support Grant P30 CA15083).
Breast Cancer Susceptibility Variants and Mammographic Density
6
NBCS: This study has been supported with grants from Norwegian Research Council
(#183621/S10 and #175240/S10), The Norwegian Cancer Society (PK80108002,
PK60287003), and The Radium Hospital Foundation as well as S-02036 from South Eastern
Norway Regional Health Authority.
NHS: This study was supported by Public Health Service Grants CA131332, CA087969,
CA089393, CA049449, CA98233, CA128931, CA 116201, CA 122340 from the National
Cancer Institute, National Institutes of Health, Department of Health and Human Services.
OOA study was supported by CA122822 and X01 HG005954 from the NIH; Breast Cancer
Research Fund; Elizabeth C. Crosby Research Award, Gladys E. Davis Endowed Fund, and the
Office of the Vice President for Research at the University of Michigan. Genotyping services
for the OOA study were provided by the Center for Inherited Disease Research (CIDR), which
is fully funded through a federal contract from the National Institutes of Health to The Johns
Hopkins University, contract number HHSN268200782096.
OFBCR: This work was supported by grant UM1 CA164920 from the USA National Cancer
Institute. The content of this manuscript does not necessarily reflect the views or policies of
the National Cancer Institute or any of the collaborating centers in the Breast Cancer Family
Registry (BCFR), nor does mention of trade names, commercial products, or organizations
imply endorsement by the USA Government or the BCFR.
SASBAC: The SASBAC study was supported by Märit and Hans Rausing’s Initiative against
Breast Cancer, National Institutes of Health, Susan Komen Foundation and Agency for
Science, Technology and Research of Singapore (A*STAR).
Breast Cancer Susceptibility Variants and Mammographic Density
7
SIBS: SIBS was supported by program grant C1287/A10118 and project grants from Cancer
Research UK (grant numbers C1287/8459).
COGS grant: Collaborative Oncological Gene-environment Study (COGS) that enabled the
genotyping for this study. Funding for the BCAC component is provided by grants from the
EU FP7 programme (COGS) and from Cancer Research UK. Funding for the iCOGS
infrastructure came from: the European Community's Seventh Framework Programme
under grant agreement n° 223175 (HEALTH-F2-2009-223175) (COGS), Cancer Research UK
(C1287/A10118, C1287/A 10710, C12292/A11174, C1281/A12014, C5047/A8384,
C5047/A15007, C5047/A10692), the National Institutes of Health (CA128978) and Post-
Cancer GWAS initiative (1U19 CA148537, 1U19 CA148065 and 1U19 CA148112 - the GAMEON
initiative), the Department of Defence (W81XWH-10-1-0341), the Canadian Institutes of
Health Research (CIHR) for the CIHR Team in Familial Risks of Breast Cancer, Komen
Foundation for the Cure, the Breast Cancer Research Foundation, and the Ovarian Cancer
Research Fund.This is the author accepted manuscript. The final version is available via American Association for Cancer Research at http://cancerres.aacrjournals.org/content/early/2015/04/10/0008-5472.CAN-14-2012.abstract
Polymorphisms in a Putative Enhancer at the 10q21.2 Breast Cancer Risk Locus Regulate NRBF2 Expression.
Genome-wide association studies have identified SNPs near ZNF365 at 10q21.2 that are associated with both breast cancer risk and mammographic density. To identify the most likely causal SNPs, we fine mapped the association signal by genotyping 428 SNPs across the region in 89,050 European and 12,893 Asian case and control subjects from the Breast Cancer Association Consortium. We identified four independent sets of correlated, highly trait-associated variants (iCHAVs), three of which were located within ZNF365. The most strongly risk-associated SNP, rs10995201 in iCHAV1, showed clear evidence of association with both estrogen receptor (ER)-positive (OR = 0.85 [0.82-0.88]) and ER-negative (OR = 0.87 [0.82-0.91]) disease, and was also the SNP most strongly associated with percent mammographic density. iCHAV2 (lead SNP, chr10: 64,258,684:D) and iCHAV3 (lead SNP, rs7922449) were also associated with ER-positive (OR = 0.93 [0.91-0.95] and OR = 1.06 [1.03-1.09]) and ER-negative (OR = 0.95 [0.91-0.98] and OR = 1.08 [1.04-1.13]) disease. There was weaker evidence for iCHAV4, located 5' of ADO, associated only with ER-positive breast cancer (OR = 0.93 [0.90-0.96]). We found 12, 17, 18, and 2 candidate causal SNPs for breast cancer in iCHAVs 1-4, respectively. Chromosome conformation capture analysis showed that iCHAV2 interacts with the ZNF365 and NRBF2 (more than 600 kb away) promoters in normal and cancerous breast epithelial cells. Luciferase assays did not identify SNPs that affect transactivation of ZNF365, but identified a protective haplotype in iCHAV2, associated with silencing of the NRBF2 promoter, implicating this gene in the etiology of breast cancer.This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.ajhg.2015.05.002
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