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Angela Vincent - One of the best experts on this subject based on the ideXlab platform.
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n methyl d aspartate receptor antibodies in post herpes simplex virus encephalitis neurological Relapse
Movement Disorders, 2014Co-Authors: Yael Hacohen, Kumaran Deiva, Phillipa Pettingill, Patrick Waters, Ata Siddiqui, Pascale Chretien, Esse Menson, Marc Tardieu, Angela VincentAbstract:Herpes simplex virus encephalitis (HSVE) is a devastating condition that Relapses, often with a chorea in children, despite adequate antiviral treatment. At Relapse, evidence of viral replication is frequently absent, suggesting that the Relapse may be immune-mediated. Seven children who had a neurological Relapse following their initial encephalitis, identified from 20 cases of pediatric HSVE, were studied. Serum and/or cerebrospinal fluid (CSF) were tested for N-methyl-D-aspartate receptor (NMDAR) and other antibodies previously reported in central nervous system autoimmunity. Five of the 7 relapsing children had choreoathetosis; 2 of these were NMDAR antibody-positive, 2 were negative (1 with HSV-positive CSF), and 1 was not available for testing. An additional patient, who Relapsed with cognitive regression but with no movement disorder, was also NMDAR antibody-positive. In 2 of the NMDAR antibody-positive patients who were treated at Relapse and in 1 who was treated only after 10 years of having a relaps- ing encephalopathy, a beneficial response was observed. Neurological Relapses after HSVE may frequently be immune-mediated, particularly in children with chorea. NMDAR antibodies are common, and immunotherapy may be beneficial. V C 2013 International Parkinson and Move- ment Disorder Society. Key W ords: herpes simplex virus; encephalitis; N-methyl-D-aspartate (NMDA) receptor; choreoatheto- sis; movement disorder; relapsing
Andrew Protheroe - One of the best experts on this subject based on the ideXlab platform.
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Patterns of Relapse in patients with clinical stage I testicular cancer managed with active surveillance
Journal of Clinical Oncology, 2015Co-Authors: Christian Kollmannsberger, Gabriella Cohn-cedermark, Torgrim Tandstad, Peter W. Chung, Tom Powles, Padraig R. Warde, Siamak Daneshmand, Philippe L. Bedard, Michael A.s. Jewett, Andrew ProtheroeAbstract:PURPOSE: To evaluate the performance of active surveillance as a management strategy in broad populations and to inform the development of surveillance schedules by individual patient data regarding timing and type of Relapse. METHODS: Retrospective study including data from 2,483 clinical stage I (CSI) patients, 1,139 CSI nonseminoma and 1,344 CSI seminoma managed with active surveillance, with the majority treated between 1998 and 2010. Clinical outcomes including Relapse and death, time distribution, extent of Relapse and method of Relapse detection observed on active surveillance were recorded. RESULTS: Relapse occurred in 221 (19%) CSI-nonseminoma and 173 (13%) CSI-seminoma patients. Median time to Relapse was 4 months (range, 2-61 months), 8 months (range, 2-77 months) and 14 months (range, 2-84 months) for lymphovascular invasion-positive CSI nonseminoma, lymphovascular invasion-negative CSI nonseminoma and CSI seminoma. Most Relapses were observed within the first 2 years/3 years after orchiectomy for CSI nonseminoma (90%)/CSI seminoma (92%). Relapses were detected by computed tomography scan/tumor-markers in 87%/3% of seminoma recurrences, in 48%/38% of lymphovascular invasion-negative and 41%/61% of lymphovascular invasion-positive patients, respectively. 90% of CSI-nonseminoma and 99% of CSI-seminoma Relapses exhibited International Germ Cell Collaborative Group good-risk features. Three patients with CSI nonseminoma died of disease (0.3%). One patient with CSI seminoma and two patients with CSI nonseminoma died because of treatment-related events. Overall, advanced disease was seen in both early- and late-Relapse patients. All late recurrences were cured with standard therapy. Five-year disease-specific survival was 99.7% (95% CI, 99.24% to 99.93%). CONCLUSION: Active surveillance for CSI testis cancer leads to excellent outcomes. The vast majority of Relapses occur within 2 years of orchiectomy for CSI nonseminoma and within 3 years for CSI seminoma. Late and advanced stage Relapse are rarely seen. These data may inform further refinement of rationally designed surveillance schedules.
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patterns of Relapse in patients with clinical stage i testicular cancer managed with active surveillance
Journal of Clinical Oncology, 2015Co-Authors: Christian Kollmannsberger, Torgrim Tandstad, Tom Powles, Padraig R. Warde, Siamak Daneshmand, Philippe L. Bedard, Michael A.s. Jewett, Gabriella Cohncedermark, Peter Chung, Andrew ProtheroeAbstract:Purpose To evaluate the performance of active surveillance as a management strategy in broad populations and to inform the development of surveillance schedules by individual patient data regarding timing and type of Relapse. Methods Retrospective study including data from 2,483 clinical stage I (CSI) patients, 1,139 CSI nonseminoma and 1,344 CSI seminoma managed with active surveillance, with the majority treated between 1998 and 2010. Clinical outcomes including Relapse and death, time distribution, extent of Relapse and method of Relapse detection observed on active surveillance were recorded. Results Relapse occurred in 221 (19%) CSI-nonseminoma and 173 (13%) CSI-seminoma patients. Median time to Relapse was 4 months (range, 2-61 months), 8 months (range, 2-77 months) and 14 months (range, 2-84 months) for lymphovascular invasion–positive CSI nonseminoma, lymphovascular invasion–negative CSI nonseminoma and CSI seminoma. Most Relapses were observed within the first 2 years/3 years after orchiectomy fo...
Torgrim Tandstad - One of the best experts on this subject based on the ideXlab platform.
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patterns of Relapse in patients with clinical stage i testicular cancer managed with active surveillance
Journal of Clinical Oncology, 2015Co-Authors: Christian Kollmannsberger, Torgrim Tandstad, Tom Powles, Padraig R. Warde, Siamak Daneshmand, Philippe L. Bedard, Michael A.s. Jewett, Gabriella Cohncedermark, Peter Chung, Andrew ProtheroeAbstract:Purpose To evaluate the performance of active surveillance as a management strategy in broad populations and to inform the development of surveillance schedules by individual patient data regarding timing and type of Relapse. Methods Retrospective study including data from 2,483 clinical stage I (CSI) patients, 1,139 CSI nonseminoma and 1,344 CSI seminoma managed with active surveillance, with the majority treated between 1998 and 2010. Clinical outcomes including Relapse and death, time distribution, extent of Relapse and method of Relapse detection observed on active surveillance were recorded. Results Relapse occurred in 221 (19%) CSI-nonseminoma and 173 (13%) CSI-seminoma patients. Median time to Relapse was 4 months (range, 2-61 months), 8 months (range, 2-77 months) and 14 months (range, 2-84 months) for lymphovascular invasion–positive CSI nonseminoma, lymphovascular invasion–negative CSI nonseminoma and CSI seminoma. Most Relapses were observed within the first 2 years/3 years after orchiectomy fo...
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Patterns of Relapse in patients with clinical stage I testicular cancer managed with active surveillance
Journal of Clinical Oncology, 2015Co-Authors: Christian Kollmannsberger, Gabriella Cohn-cedermark, Torgrim Tandstad, Peter W. Chung, Tom Powles, Padraig R. Warde, Siamak Daneshmand, Philippe L. Bedard, Michael A.s. Jewett, Andrew ProtheroeAbstract:PURPOSE: To evaluate the performance of active surveillance as a management strategy in broad populations and to inform the development of surveillance schedules by individual patient data regarding timing and type of Relapse. METHODS: Retrospective study including data from 2,483 clinical stage I (CSI) patients, 1,139 CSI nonseminoma and 1,344 CSI seminoma managed with active surveillance, with the majority treated between 1998 and 2010. Clinical outcomes including Relapse and death, time distribution, extent of Relapse and method of Relapse detection observed on active surveillance were recorded. RESULTS: Relapse occurred in 221 (19%) CSI-nonseminoma and 173 (13%) CSI-seminoma patients. Median time to Relapse was 4 months (range, 2-61 months), 8 months (range, 2-77 months) and 14 months (range, 2-84 months) for lymphovascular invasion-positive CSI nonseminoma, lymphovascular invasion-negative CSI nonseminoma and CSI seminoma. Most Relapses were observed within the first 2 years/3 years after orchiectomy for CSI nonseminoma (90%)/CSI seminoma (92%). Relapses were detected by computed tomography scan/tumor-markers in 87%/3% of seminoma recurrences, in 48%/38% of lymphovascular invasion-negative and 41%/61% of lymphovascular invasion-positive patients, respectively. 90% of CSI-nonseminoma and 99% of CSI-seminoma Relapses exhibited International Germ Cell Collaborative Group good-risk features. Three patients with CSI nonseminoma died of disease (0.3%). One patient with CSI seminoma and two patients with CSI nonseminoma died because of treatment-related events. Overall, advanced disease was seen in both early- and late-Relapse patients. All late recurrences were cured with standard therapy. Five-year disease-specific survival was 99.7% (95% CI, 99.24% to 99.93%). CONCLUSION: Active surveillance for CSI testis cancer leads to excellent outcomes. The vast majority of Relapses occur within 2 years of orchiectomy for CSI nonseminoma and within 3 years for CSI seminoma. Late and advanced stage Relapse are rarely seen. These data may inform further refinement of rationally designed surveillance schedules.
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Management of seminomatous testicular cancer: A binational prospective population-based study from the Swedish Norwegian Testicular Cancer Study Group
Journal of Clinical Oncology, 2011Co-Authors: Torgrim Tandstad, Rune Smaaland, Carl W. Langberg, Anna Laurell, Ulrika K. Stierner, Olof Ståhl, Eva K. Cavallin-ståhl, R. M. Bremnes, A. Solberg, Olbjørn H. KleppAbstract:PURPOSE A binational, population-based treatment protocol was established to prospectively treat and follow patients with seminomatous testicular cancer. The aim was to standardize care for all patients with seminoma to further improve the good results expected for this disease. PATIENTS AND METHODS From 2000 to 2006, a total of 1,384 Norwegian and Swedish patients were included in the study. Treatment in clinical stage 1 (CS1) was surveillance, adjuvant radiotherapy, or adjuvant carboplatin. In metastatic disease, recommended treatment was radiotherapy in CS2A and cisplatin-based chemotherapy in CS2B or higher. RESULTS At a median follow-up of 5.2 years, 5-year cause-specific survival was 99.6%. In CS1, 14.3% (65 of 512) of patients Relapsed following surveillance, 3.9% (seven of 188) after carboplatin, and 0.8% (four of 481) after radiotherapy. We could not identify any factors predicting Relapse in CS1 patients who were subjected to surveillance only. In CS2A, 10.9% (three of 29) patients Relapsed after radiotherapy compared with no Relapses in CS2A/B patients (zero of 73) treated with chemotherapy (P = .011). CONCLUSION An international, population-based treatment protocol for testicular seminoma is feasible with excellent results. Surveillance remains a good option for CS1 patients. No factors predicted Relapse in CS1 patients on surveillance. Despite resulting in a lower rate of Relapse than with adjuvant carboplatin, adjuvant radiotherapy has been abandoned in the Swedish and Norwegian Testicular Cancer Project (SWENOTECA) as a recommended treatment option because of concerns of induction of secondary cancers. The higher number of Relapses in radiotherapy-treated CS2A patients when compared with chemotherapy-treated CS2A/B patients is of concern. Late toxicity of cisplatin-based chemotherapy versus radiotherapy must be considered in CS2A patients.
Sandra Vukusic - One of the best experts on this subject based on the ideXlab platform.
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vaccinations and the risk of Relapse in multiple sclerosis
The New England Journal of Medicine, 2001Co-Authors: C Confavreux, Samy Suissa, Patricia Saddier, Valerie Bourdes, Sandra VukusicAbstract:Background There has been some concern that vaccination may precipitate the onset of multiple sclerosis or lead to Relapses. Since the recent hepatitis B vaccination program in France, there have been new reports of an increased risk of active multiple sclerosis after vaccination. Methods We conducted a case–crossover study to assess whether vaccinations increase the risk of Relapse in multiple sclerosis. The subjects were patients included in the European Database for Multiple Sclerosis who had a Relapse between 1993 and 1997. The index Relapse was the first Relapse confirmed by a visit to a neurologist and preceded by a Relapse-free period of at least 12 months. Information on vaccinations was obtained in a standardized telephone interview and confirmed by means of medical records. Exposure to vaccination in the two-month risk period immediately preceding the Relapse was compared with that in the four previous two-month control periods for the calculation of relative risks, which were estimated with the...
Riccardo Polosa - One of the best experts on this subject based on the ideXlab platform.
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Handling Relapse in smoking cessation: strategies and recommendations
Internal and Emergency Medicine, 2013Co-Authors: Pasquale Caponnetto, Elaine Keller, Cosimo M. Bruno, Riccardo PolosaAbstract:Once established, smoking is a very difficult addiction to break. Many smokers persist in tobacco use for several years and typically cycle through multiple periods of remission and Relapse. Smoking cessation is not a single event but a process, and Relapse is an ordinary component of this process. While international guidelines place great emphasis on Relapse prevention, very little can be found about managing smokers who have Relapsed. This article is intended to address the challenge of managing smokers who Relapse in the course of a smoking cessation program. This knowledge may lead to an improved smoking cessation outcomes.
