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David W Denning - One of the best experts on this subject based on the ideXlab platform.
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an eortc multicentre prospective survey of invasive aspergillosis in haematological patients diagnosis and Therapeutic Outcome
Journal of Infection, 1998Co-Authors: David W Denning, A Marinus, Jonathan Cohen, D Spence, Raoul Herbrecht, Livio Pagano, C KibblerAbstract:Objectives: the EORTC Invasive Fungal Infections Cooperative Group (IFICG) conducted a prospective survey by questionnaire of all cases of invasive aspergillosis (IA) in cancer patients to ascertain current diagnostic and Therapeutic approaches. Methods: all members of the IFICG were asked prospectively to complete a detailed questionnaire for each IA case identified in their institution over a 12-month period. Results: one hundred and thirty questionnaires were returned, All cases were independently evaluated (DWD & JC) and 123 were eligible. Cases came from 20 hospitals in eight countries and the number of cases per institution varied from 1-21, Acute myeloid leukaemia (AML) (60, 49%), acute lymphoblastic leukaemia (ALL) (21, 17%) and lymphoma (11, 9%) were the most frequent underlying diseases, and 16 (12%) patients had received an allogeneic bone marrow transplant. Pulmonary involvement was present in 87%, infection of sinuses/nose in 16% and brain in 8%. The chest radiograph was initially normal in 9% of those with primary pulmonary disease. The diagnosis was confirmed in 50%, probable in 31% and possible in 19%, The evidence for IA was on the basis of clinical and radiological features alone in 28%, with culture or histology in another 31% and 9%, respectively, and with both culture and histology in 29%, In three (2%) patients the diagnosis was based on culture or histology alone. Treatment was given to 120 patients (98%) - amphotericin B 75%, lipid-associated amphotericin B 36%, itraconazole 40%, flucytosine 12%, growth factors 33%, lobectomy 5%. At 3 months after diagnosis or first suspicion of IA, 44 (36%) patients were alive and 79 (64%) dead. Outcome was best in those with AML (30% death and 46% with a complete antifungal response or cure). Growth factors (mostly granulocyte colony stimulating factor) appeared not to influence Outcome (P=0.99). Conclusion: IA remains a considerable diagnostic and Therapeutic challenge. No single diagnostic procedure was universally successful and a multifaceted approach including surgery is necessary. There was no discernable difference in Outcome between initial therapy with amphotericin B, itraconazole or lipid-associated amphotericin B, although numbers are limited and the study was retrospective.
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Therapeutic Outcome in invasive aspergillosis
Clinical Infectious Diseases, 1996Co-Authors: David W DenningAbstract:A review of series of > or = 4 cases of invasive aspergillosis (total, 1,223 cases) was undertaken to establish the crude mortality and rate of response to therapy with amphotericin B in the major at-risk host groups. In association with pulmonary, sinus, and cerebral aspergillosis in immunocompromised patients, the crude mortality rates were 86%, 66%, and 99%, respectively. No untreated patient survived. Among 84 patients treated for 1-13 days, only one survived. Among those with invasive pulmonary aspergillosis treated for > or = 14 days, the response rates to amphotericin B deoxycholate were 83% (in cases of heart and renal transplantation), 54% (leukemia), 33% (bone marrow transplantation) and 20% (liver transplantation). Patients with AIDS mostly received both amphotericin B and itraconazole, and 37% of those treated for > or = 14 days responded to therapy. Substantial variation in Outcome from series to series was related to underlying disease status, site of disease, and management. Invasive aspergillosis remains a devastating opportunistic infection despite current treatment.
Apostolos H. Karantanas - One of the best experts on this subject based on the ideXlab platform.
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piriformis muscle syndrome a cross sectional imaging study in 116 patients and evaluation of Therapeutic Outcome
European Radiology, 2018Co-Authors: Evangelia E. Vassalou, Pavlos Katonis, Apostolos H. KarantanasAbstract:Objectives To increase the clinical awareness of piriformis muscle syndrome (PMs) by reporting cross-sectional imaging findings, the clinical impact of imaging studies and treatment Outcome.
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piriformis muscle syndrome a cross sectional imaging study in 116 patients and evaluation of Therapeutic Outcome
European Radiology, 2018Co-Authors: Evangelia E. Vassalou, Pavlos Katonis, Apostolos H. KarantanasAbstract:To increase the clinical awareness of piriformis muscle syndrome (PMs) by reporting cross-sectional imaging findings, the clinical impact of imaging studies and treatment Outcome. Within a 10-year-period, 116 patients referred for radiological evaluation of clinically suspected PMs, with excluded lumbar pathology related to symptomatology, were prospectively studied with MRI and/or computed tomography (CT). Piriformis muscle (PM), sciatic nerve (SN), piriformis region and sacroiliac joints were evaluated. PMs was categorised into primary/secondary, according to a reported classification system. Treatment decisions were recorded. Outcome was categorised using a 3-point-scale. Seventy-four patients (63.8%) exhibited pathologies related to PMs. Primary causes were detected in 12 and secondary in 62 patients. PM enlargement was found in 45.9% of patients, abnormal PM signal intensity/density in 40.5% and sciatic neuritis in 25.7%. Space-occupying lesions represented the most common related pathology. Treatment proved effective in 5/8 patients with primary and 34/51 patients with secondary PMs. In 34 patients, imaging revealed an unknown underlying medical condition and altered treatment planning. Secondary PMs aetiologies appear to prevail. In suspected PMs, PM enlargement represented the most common imaging finding and space-occupying lesions the leading cause. Imaging had the potential to alter treatment decisions. • In clinically suspected PMs cross-sectional imaging may reveal variable pathology. • Secondary PMs aetiologies appeared to be more common than primary. • PM enlargement represented the most common imaging finding in clinically suspected PMs. • Space-occupying lesions in the piriformis region represented the leading cause of PMs. • In clinically suspected PMs cross-sectional imaging may alter treatment planning.
Evangelia E. Vassalou - One of the best experts on this subject based on the ideXlab platform.
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piriformis muscle syndrome a cross sectional imaging study in 116 patients and evaluation of Therapeutic Outcome
European Radiology, 2018Co-Authors: Evangelia E. Vassalou, Pavlos Katonis, Apostolos H. KarantanasAbstract:Objectives To increase the clinical awareness of piriformis muscle syndrome (PMs) by reporting cross-sectional imaging findings, the clinical impact of imaging studies and treatment Outcome.
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piriformis muscle syndrome a cross sectional imaging study in 116 patients and evaluation of Therapeutic Outcome
European Radiology, 2018Co-Authors: Evangelia E. Vassalou, Pavlos Katonis, Apostolos H. KarantanasAbstract:To increase the clinical awareness of piriformis muscle syndrome (PMs) by reporting cross-sectional imaging findings, the clinical impact of imaging studies and treatment Outcome. Within a 10-year-period, 116 patients referred for radiological evaluation of clinically suspected PMs, with excluded lumbar pathology related to symptomatology, were prospectively studied with MRI and/or computed tomography (CT). Piriformis muscle (PM), sciatic nerve (SN), piriformis region and sacroiliac joints were evaluated. PMs was categorised into primary/secondary, according to a reported classification system. Treatment decisions were recorded. Outcome was categorised using a 3-point-scale. Seventy-four patients (63.8%) exhibited pathologies related to PMs. Primary causes were detected in 12 and secondary in 62 patients. PM enlargement was found in 45.9% of patients, abnormal PM signal intensity/density in 40.5% and sciatic neuritis in 25.7%. Space-occupying lesions represented the most common related pathology. Treatment proved effective in 5/8 patients with primary and 34/51 patients with secondary PMs. In 34 patients, imaging revealed an unknown underlying medical condition and altered treatment planning. Secondary PMs aetiologies appear to prevail. In suspected PMs, PM enlargement represented the most common imaging finding and space-occupying lesions the leading cause. Imaging had the potential to alter treatment decisions. • In clinically suspected PMs cross-sectional imaging may reveal variable pathology. • Secondary PMs aetiologies appeared to be more common than primary. • PM enlargement represented the most common imaging finding in clinically suspected PMs. • Space-occupying lesions in the piriformis region represented the leading cause of PMs. • In clinically suspected PMs cross-sectional imaging may alter treatment planning.
Maximilian Niyazi - One of the best experts on this subject based on the ideXlab platform.
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a 4 mirna signature predicts the Therapeutic Outcome of glioblastoma
Oncotarget, 2016Co-Authors: Maximilian Niyazi, Adriana Pitea, Michel Mittelbronn, Joachim P Steinbach, Carsten Sticht, Franz Zehentmayr, Daniel Piehlmaier, Horst Zitzelsberger, Ute Ganswindt, Claus RodelAbstract:// Maximilian Niyazi 1, 8, 9 , Adriana Pitea 2, 8 , Michel Mittelbronn 3 , Joachim Steinbach 4 , Carsten Sticht 5 , Franz Zehentmayr 1, 6 , Daniel Piehlmaier 2, 8 , Horst Zitzelsberger 2, 8 , Ute Ganswindt 1, 8 , Claus Rodel 7 , Kirsten Lauber 1, 8 , Claus Belka 1, 8, 9 , Kristian Unger 2, 8 1 Ludwig-Maximilians-University of Munich, Department of Radiation Oncology, Munich, Germany 2 Research Unit of Radiation Cytogenetics, Helmholtz Zentrum Munchen, Neuherberg, Germany 3 Institute of Neurology (Edinger Institute), Goethe-University Frankfurt, Frankfurt/Main, Germany 4 Dr. Senckenbergisches Institut fur Neuroonkologie, Klinikum der J.W. Goethe-Universitat, Frankfurt/Main, Germany 5 Zentrum fur Medizinische Forschung, Medizinische Fakultat Mannheim, Mannheim, Germany 6 Department of Radiation Oncology, Paracelsus Medical University, Salzburg, Austria 7 Department of Radiation Oncology, University Hospital, Frankfurt, Germany 8 Clinical Cooperation Group Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Zentrum Munchen, Neuherberg, Germany 9 German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany Correspondence to: Kristian Unger, email: unger@helmholtz-muenchen.de Keywords: glioblastoma, miRNA, signature Received: February 10, 2016 Accepted: May 22, 2016 Published: June 11, 2016 ABSTRACT Multimodal therapy of glioblastoma (GBM) reveals inter-individual variability in terms of treatment Outcome. Here, we examined whether a miRNA signature can be defined for the a priori identification of patients with particularly poor prognosis. FFPE sections from 36 GBM patients along with overall survival follow-up were collected retrospectively and subjected to miRNA signature identification from microarray data. A risk score based on the expression of the signature miRNAs and cox-proportional hazard coefficients was calculated for each patient followed by validation in a matched GBM subset of TCGA. Genes potentially regulated by the signature miRNAs were identified by a correlation approach followed by pathway analysis. A prognostic 4-miRNA signature, independent of MGMT promoter methylation, age, and sex, was identified and a risk score was assigned to each patient that allowed defining two groups significantly differing in prognosis (p-value: 0.0001, median survival: 10.6 months and 15.1 months, hazard ratio = 3.8). The signature was technically validated by qRT-PCR and independently validated in an age- and sex-matched subset of standard-of-care treated patients of the TCGA GBM cohort (n=58). Pathway analysis suggested tumorigenesis-associated processes such as immune response, extracellular matrix organization, axon guidance, signalling by NGF, GPCR and Wnt. Here, we describe the identification and independent validation of a 4-miRNA signature that allows stratification of GBM patients into different prognostic groups in combination with one defined threshold and set of coefficients that could be utilized as diagnostic tool to identify GBM patients for improved and/or alternative treatment approaches.
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a 4 mirna signature predicts the Therapeutic Outcome of glioblastoma
Oncotarget, 2016Co-Authors: Maximilian Niyazi, Adriana Pitea, Michel Mittelbronn, Joachim P Steinbach, Carsten Sticht, Franz Zehentmayr, Daniel Piehlmaier, Horst Zitzelsberger, Ute GanswindtAbstract:Multimodal therapy of glioblastoma (GBM) reveals inter-individual variability in terms of treatment Outcome. Here, we examined whether a miRNA signature can be defined for the a priori identification of patients with particularly poor prognosis.FFPE sections from 36 GBM patients along with overall survival follow-up were collected retrospectively and subjected to miRNA signature identification from microarray data. A risk score based on the expression of the signature miRNAs and cox-proportional hazard coefficients was calculated for each patient followed by validation in a matched GBM subset of TCGA. Genes potentially regulated by the signature miRNAs were identified by a correlation approach followed by pathway analysis.A prognostic 4-miRNA signature, independent of MGMT promoter methylation, age, and sex, was identified and a risk score was assigned to each patient that allowed defining two groups significantly differing in prognosis (p-value: 0.0001, median survival: 10.6 months and 15.1 months, hazard ratio = 3.8). The signature was technically validated by qRT-PCR and independently validated in an age- and sex-matched subset of standard-of-care treated patients of the TCGA GBM cohort (n=58). Pathway analysis suggested tumorigenesis-associated processes such as immune response, extracellular matrix organization, axon guidance, signalling by NGF, GPCR and Wnt. Here, we describe the identification and independent validation of a 4-miRNA signature that allows stratification of GBM patients into different prognostic groups in combination with one defined threshold and set of coefficients that could be utilized as diagnostic tool to identify GBM patients for improved and/or alternative treatment approaches.
Ute Ganswindt - One of the best experts on this subject based on the ideXlab platform.
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a 4 mirna signature predicts the Therapeutic Outcome of glioblastoma
Oncotarget, 2016Co-Authors: Maximilian Niyazi, Adriana Pitea, Michel Mittelbronn, Joachim P Steinbach, Carsten Sticht, Franz Zehentmayr, Daniel Piehlmaier, Horst Zitzelsberger, Ute Ganswindt, Claus RodelAbstract:// Maximilian Niyazi 1, 8, 9 , Adriana Pitea 2, 8 , Michel Mittelbronn 3 , Joachim Steinbach 4 , Carsten Sticht 5 , Franz Zehentmayr 1, 6 , Daniel Piehlmaier 2, 8 , Horst Zitzelsberger 2, 8 , Ute Ganswindt 1, 8 , Claus Rodel 7 , Kirsten Lauber 1, 8 , Claus Belka 1, 8, 9 , Kristian Unger 2, 8 1 Ludwig-Maximilians-University of Munich, Department of Radiation Oncology, Munich, Germany 2 Research Unit of Radiation Cytogenetics, Helmholtz Zentrum Munchen, Neuherberg, Germany 3 Institute of Neurology (Edinger Institute), Goethe-University Frankfurt, Frankfurt/Main, Germany 4 Dr. Senckenbergisches Institut fur Neuroonkologie, Klinikum der J.W. Goethe-Universitat, Frankfurt/Main, Germany 5 Zentrum fur Medizinische Forschung, Medizinische Fakultat Mannheim, Mannheim, Germany 6 Department of Radiation Oncology, Paracelsus Medical University, Salzburg, Austria 7 Department of Radiation Oncology, University Hospital, Frankfurt, Germany 8 Clinical Cooperation Group Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Zentrum Munchen, Neuherberg, Germany 9 German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany Correspondence to: Kristian Unger, email: unger@helmholtz-muenchen.de Keywords: glioblastoma, miRNA, signature Received: February 10, 2016 Accepted: May 22, 2016 Published: June 11, 2016 ABSTRACT Multimodal therapy of glioblastoma (GBM) reveals inter-individual variability in terms of treatment Outcome. Here, we examined whether a miRNA signature can be defined for the a priori identification of patients with particularly poor prognosis. FFPE sections from 36 GBM patients along with overall survival follow-up were collected retrospectively and subjected to miRNA signature identification from microarray data. A risk score based on the expression of the signature miRNAs and cox-proportional hazard coefficients was calculated for each patient followed by validation in a matched GBM subset of TCGA. Genes potentially regulated by the signature miRNAs were identified by a correlation approach followed by pathway analysis. A prognostic 4-miRNA signature, independent of MGMT promoter methylation, age, and sex, was identified and a risk score was assigned to each patient that allowed defining two groups significantly differing in prognosis (p-value: 0.0001, median survival: 10.6 months and 15.1 months, hazard ratio = 3.8). The signature was technically validated by qRT-PCR and independently validated in an age- and sex-matched subset of standard-of-care treated patients of the TCGA GBM cohort (n=58). Pathway analysis suggested tumorigenesis-associated processes such as immune response, extracellular matrix organization, axon guidance, signalling by NGF, GPCR and Wnt. Here, we describe the identification and independent validation of a 4-miRNA signature that allows stratification of GBM patients into different prognostic groups in combination with one defined threshold and set of coefficients that could be utilized as diagnostic tool to identify GBM patients for improved and/or alternative treatment approaches.
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a 4 mirna signature predicts the Therapeutic Outcome of glioblastoma
Oncotarget, 2016Co-Authors: Maximilian Niyazi, Adriana Pitea, Michel Mittelbronn, Joachim P Steinbach, Carsten Sticht, Franz Zehentmayr, Daniel Piehlmaier, Horst Zitzelsberger, Ute GanswindtAbstract:Multimodal therapy of glioblastoma (GBM) reveals inter-individual variability in terms of treatment Outcome. Here, we examined whether a miRNA signature can be defined for the a priori identification of patients with particularly poor prognosis.FFPE sections from 36 GBM patients along with overall survival follow-up were collected retrospectively and subjected to miRNA signature identification from microarray data. A risk score based on the expression of the signature miRNAs and cox-proportional hazard coefficients was calculated for each patient followed by validation in a matched GBM subset of TCGA. Genes potentially regulated by the signature miRNAs were identified by a correlation approach followed by pathway analysis.A prognostic 4-miRNA signature, independent of MGMT promoter methylation, age, and sex, was identified and a risk score was assigned to each patient that allowed defining two groups significantly differing in prognosis (p-value: 0.0001, median survival: 10.6 months and 15.1 months, hazard ratio = 3.8). The signature was technically validated by qRT-PCR and independently validated in an age- and sex-matched subset of standard-of-care treated patients of the TCGA GBM cohort (n=58). Pathway analysis suggested tumorigenesis-associated processes such as immune response, extracellular matrix organization, axon guidance, signalling by NGF, GPCR and Wnt. Here, we describe the identification and independent validation of a 4-miRNA signature that allows stratification of GBM patients into different prognostic groups in combination with one defined threshold and set of coefficients that could be utilized as diagnostic tool to identify GBM patients for improved and/or alternative treatment approaches.
