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Kelsey Wong, Margaret Lee, Ian D Davis, Phillip Parente, Joseph Mckendrick, Carmel Pezaro
Posterior reversible encephalopathy syndrome (PRES) has been described in the context of uncontrolled hypertension, eclampsia, renal disease and autoimmune conditions, or in patients treated with chemotherapy or immunosuppressive agents. In contrast, we report the occurrence of PRES in a patient with untreated metastatic transitional cell carcinoma. The case emphasizes important diagnostic challenges associated with atypical presentations without "typical" risk factors and the limitations of common diagnostic imaging modalities...
October 11, 2016: Asia-Pacific Journal of Clinical Oncology
Jose Manuel Ruiz-Morales, Marcin Swierkowski, J Connor Wells, Anna Paola Fraccon, Felice Pasini, Frede Donskov, Georg A Bjarnason, Jae-Lyun Lee, Hao-Wen Sim, Andrzej Sliwczynsk, Aneta Ptak-Chmielewska, Zbigniew Teter, Benoit Beuselinck, Lori A Wood, Takeshi Yuasa, Carmel Pezaro, Brian I Rini, Cezary Szczylik, Toni K Choueiri, Daniel Y C Heng
BACKGROUND: Sunitinib (SU) and pazopanib (PZ) are standards of care for first-line treatment of metastatic renal cell carcinoma (mRCC). However, how the efficacy of these drugs translates into effectiveness on a population-based level is unknown. PATIENTS AND METHODS: We used the International mRCC Database Consortium (IMDC) to assess overall survival (OS), progression-free survival (PFS), response rate (RR) and performed proportional hazard regression adjusting for IMDC prognostic groups...
September 2016: European Journal of Cancer
Sally Pezaro, Wendy Clyne
BACKGROUND: Some midwives are known to experience both professional and organizational sources of psychological distress, which can manifest as a result of the emotionally demanding midwifery work, and the traumatic work environments they endure. An online intervention may be one option midwives may engage with in pursuit of effective support. However, the priorities for the development of an online intervention to effectively support midwives in work-related psychological distress have yet to be explored...
2016: JMIR Mental Health
Sally Pezaro, Wendy Clyne, Clare Gerada
BACKGROUND: Midwife health is intrinsically linked to the quality of safe patient care. To ensure safe patient care, there is a need to deliver emotional support to midwives. One option that midwives may turn to may be a confidential online intervention, instead of localised, face-to-face support. RESEARCH DESIGN: Following the Realist And MEta-narrative Evidence Syntheses: Evolving Standards publication standards, this realist synthesis approach explores the ethical considerations in permitting confidentiality, anonymity and amnesty in online interventions to support midwives in work-related psychological distress...
July 4, 2016: Nursing Ethics
Nadav Pezaro, J Sean Doody, Michael B Thompson
Sex-determining mechanisms are broadly categorised as being based on either genetic or environmental factors. Vertebrate sex determination exhibits remarkable diversity but displays distinct phylogenetic patterns. While all eutherian mammals possess XY male heterogamety and female heterogamety (ZW) is ubiquitous in birds, poikilothermic vertebrates (fish, amphibians and reptiles) exhibit multiple genetic sex-determination (GSD) systems as well as environmental sex determination (ESD). Temperature is the factor controlling ESD in reptiles and temperature-dependent sex determination (TSD) in reptiles has become a focal point in the study of this phenomenon...
June 14, 2016: Biological Reviews of the Cambridge Philosophical Society
David Lorente, Aurelius Omlin, Zafeiris Zafeiriou, Daniel Nava-Rodrigues, Raquel Pérez-López, Carmel Pezaro, Niven Mehra, Elizabeth Sheridan, Ines Figueiredo, Ruth Riisnaes, Susana Miranda, Mateus Crespo, Penny Flohr, Joaquín Mateo, Amelia Altavilla, Roberta Ferraldeschi, Diletta Bianchini, Gerhardt Attard, Nina Tunariu, Johann de Bono
BACKGROUND: The urgent need for castration-resistant prostate cancer molecular characterization to guide treatment has been constrained by the disease's predilection to metastasize primarily to bone. We hypothesized that the use of clinical and imaging criteria could maximize tissue acquisition from bone marrow biopsies (BMBs). We aimed to develop a score for the selection of patients undergoing BMB. MATERIALS AND METHODS: A total of 115 BMBs were performed in 101 patients: 57 were included in a derivation set and 58 were used as the validation set...
May 5, 2016: Clinical Genitourinary Cancer
Sally Pezaro, Wendy Clyne, Andrew Turner, Emily A Fulton, Clare Gerada
PROBLEM: Midwifery practice is emotional and, at times, traumatic work. Cumulative exposure to this, in an unsupportive environment can result in the development of psychological and behavioural symptoms of distress. BACKGROUND: As there is a clear link between the wellbeing of staff and the quality of patient care, the issue of midwife wellbeing is gathering significant attention. Despite this, it can be rare to find a midwife who will publically admit to how much they are struggling...
June 2016: Women and Birth: Journal of the Australian College of Midwives
Elizabeth A Punnoose, Roberta Ferraldeschi, Edith Szafer-Glusman, Eric K Tucker, Sankar Mohan, Penelope Flohr, Ruth Riisnaes, Susana Miranda, Ines Figueiredo, Daniel Nava Rodrigues, Aurelius Omlin, Carmel Pezaro, Jin Zhu, Lukas Amler, Premal Patel, Yibing Yan, Natalee Bales, Shannon L Werner, Jessica Louw, Ajay Pandita, Dena Marrinucci, Gerhardt Attard, Johann de Bono
BACKGROUND: PTEN gene loss occurs frequently in castration-resistant prostate cancer (CRPC) and may drive progression through activation of the PI3K/AKT pathway. Here, we developed a novel CTC-based assay to determine PTEN status and examined the correlation between PTEN status in CTCs and matched tumour tissue samples. METHODS: PTEN gene status in CTCs was evaluated on an enrichment-free platform (Epic Sciences) by fluorescence in situ hybridisation (FISH). PTEN status in archival and fresh tumour tissue was evaluated by FISH and immunohistochemistry...
October 20, 2015: British Journal of Cancer
Sally Pezaro, Wendy Clyne
BACKGROUND: The development of an online intervention designed to effectively support midwives in work-related psychological distress will be challenging due to the ethical, practical, and therapeutic issues surrounding its design. Related literature suggests that midwives may require an anonymous, confidential, and therapeutic platform that facilitates amnesty and nonpunitive approaches to remedy ill health. However, it is unclear which requirements may be most salient to midwifery populations...
2015: JMIR Research Protocols
Sally Pezaro, Linda Lilley
BACKGROUND: The first responder, faced with any obstetric incident, frequently finds themselves within a dichotomy of multi-tasking activities. One challenge for the midwife, is to keep accurate and contemporaneous medical records, whilst simultaneously providing immediate clinical care. AIM: This paper aims to propose an innovative conceptualisation and a practical solution for maternity services, which strive to uphold best practice in creating contemporaneous and accurate medical records...
December 2015: Women and Birth: Journal of the Australian College of Midwives
Crescens Tiu, Carmel Pezaro, Ian D Davis, Mathis Grossmann, Phillip Parente
Ipilimumab is a human anti-CTLA-4 monoclonal antibody recently approved for the treatment of advanced melanoma. Stimulation of T-cell activity unmasks antitumor activity, but can cause immune-related adverse events. Autoimmune hypophysitis is of particular importance because its presentation can be subtle but life threatening. We present two cases where early recognition of ipilimumab-related autoimmune hypophysitis led to timely intervention and low subsequent morbidity, without compromise of antitumor effects...
June 2015: Asia-Pacific Journal of Clinical Oncology
A J Lomax, P Parente, C Gilfillan, P M Livingston, I D Davis, C Pezaro
Androgen deprivation therapy (ADT) is a standard systemic treatment for men with prostate cancer. Men on ADT may be elderly and have comorbidities that are exacerbated by ADT, such as cardiovascular disease, diabetes, obesity, sedentary lifestyle and osteoporosis. Studies on managing the impacts of ADT have focused on men with non-metastatic disease, where ADT is given for a limited duration. However, some men with advanced or metastatic prostate cancer will achieve long-term survival with palliative ADT and therefore also risk morbidity from prolonged ADT...
February 2016: Internal Medicine Journal
C Pezaro, A Omlin, R Perez-Lopez, D Mukherji, G Attard, D Bianchini, D Lorente, C Parker, D Dearnaley, J S de Bono, A Sohaib, N Tunariu
AIM: To test the hypothesis that computed tomography (CT)-based signs might precede symptomatic malignant spinal cord compression (MSCC) in men with metastatic castration-resistant prostate cancer (mCRPC). MATERIALS AND METHODS: A database was used to identify suitable mCRPC patients. Staging CT images were retrospectively reviewed for signs preceding MSCC. Signs of malignant paravertebral fat infiltration and epidural soft-tissue disease were defined and assessed on serial CT in 34 patients with MSCC and 58 control patients...
April 2015: Clinical Radiology
Roberta Ferraldeschi, Daniel Nava Rodrigues, Ruth Riisnaes, Susana Miranda, Ines Figueiredo, Pasquale Rescigno, Praful Ravi, Carmel Pezaro, Aurelius Omlin, David Lorente, Zafeiris Zafeiriou, Joaquin Mateo, Amelia Altavilla, Spyridon Sideris, Diletta Bianchini, Emily Grist, Khin Thway, Raquel Perez Lopez, Nina Tunariu, Chris Parker, David Dearnaley, Alison Reid, Gerhardt Attard, Johann de Bono
BACKGROUND: Loss of the tumor suppressor phosphatase and tensin homolog (PTEN) occurs frequently in prostate cancers. Preclinical evidence suggests that activation of PI3K/AKT signaling through loss of PTEN can result in resistance to hormonal treatment in prostate cancer. OBJECTIVE: To explore the antitumor activity of abiraterone acetate (abiraterone) in castration-resistant prostate cancer (CRPC) patients with and without loss of PTEN protein expression. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively identified patients who had received abiraterone and had hormone-sensitive prostate cancer (HSPC) and/or CRPC tissue available for PTEN immunohistochemical analysis...
April 2015: European Urology
Suzanne Carreira, Alessandro Romanel, Jane Goodall, Emily Grist, Roberta Ferraldeschi, Susana Miranda, Davide Prandi, David Lorente, Jean-Sebastien Frenel, Carmel Pezaro, Aurelius Omlin, Daniel Nava Rodrigues, Penelope Flohr, Nina Tunariu, Johann S de Bono, Francesca Demichelis, Gerhardt Attard
It is unclear whether a single clone metastasizes and remains dominant over the course of lethal prostate cancer. We describe the clonal architectural heterogeneity at different stages of disease progression by sequencing serial plasma and tumor samples from 16 ERG-positive patients. By characterizing the clonality of commonly occurring deletions at 21q22, 8p21, and 10q23, we identified multiple independent clones in metastatic disease that are differentially represented in tissue and circulation. To exemplify the clinical utility of our studies, we then showed a temporal association between clinical progression and emergence of androgen receptor (AR) mutations activated by glucocorticoids in about 20% of patients progressing on abiraterone and prednisolone or dexamethasone...
September 17, 2014: Science Translational Medicine
N Pezaro, J S Doody, B Green, M B Thompson
Most egg-laying vertebrates hatch without depleting the entire yolk reserve. The residual yolk is internalized before emergence from the egg is completed and the yolk is subsequently metabolized during early neonatal life. Here we provide the first description of the mechanism of yolk internalization in non-avian reptiles. We describe the hatching of two lizard species (Physignathus lesueurii and Varanus rosenbergii) and provide a step-by-step account of sequence of events leading to yolk internalization and emergence from the egg...
March 2013: Evolution & Development
Arnoud J Templeton, Carmel Pezaro, Aurelius Omlin, Mairéad G McNamara, Raya Leibowitz-Amit, Francisco E Vera-Badillo, Gerhardt Attard, Johann S de Bono, Ian F Tannock, Eitan Amir
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), a marker of inflammation, has been reported to be a poor prognostic indicator in prostate cancer. Here we explore the use of the NLR to establish a simple prognostic score for men with metastatic castration-resistant prostate cancer (mCRPC) treated with docetaxel. METHODS: In the training cohort, the NLR and other known prognostic variables were evaluated among a cohort of chemotherapy-naïve patients treated with thrice-weekly docetaxel at the Princess Margaret Cancer Centre...
November 1, 2014: Cancer
C Pezaro, H H Woo, I D Davis
Population screening with prostate-specific antigen (PSA) for detection of prostate cancer is a topic associated with ongoing dissent and confusion within the oncology and wider medical community. The PSA blood test has been used in various stages of prostate cancer management, including screening and the assessment of future risk of prostate cancer development, detection of recurrent disease after local therapy and in the management of advanced disease. However, PSA-based decision-making in prostate cancer has significant shortcomings...
May 2014: Internal Medicine Journal
Aurelius Omlin, Carmel Pezaro, Silke Gillessen Sommer
In the last three years, five novel treatments have been shown to improve survival in metastatic castration-resistant prostate cancer (CRPC). These novel treatments have distinct mechanisms of action: tubulin-binding chemotherapy (cabazitaxel); immunotherapy (sipuleucel-T); CYP-17 inhibition (abiraterone); androgen receptor (AR) blockade (enzalutamide); and radioisotope therapy (radium-223). For a number of years, docetaxel was the only treatment with a proven survival benefit for patients with CRPC. Therefore, somewhat artificially, three treatment spaces for drug development in CRPC have emerged: pre-docetaxel; docetaxel combinations; and post-docetaxel...
February 2014: Therapeutic Advances in Urology
R Leibowitz-Amit, A J Templeton, A Omlin, C Pezaro, E G Atenafu, D Keizman, F Vera-Badillo, J-A Seah, G Attard, J J Knox, S S Sridhar, I F Tannock, J S de Bono, A M Joshua
BACKGROUND: Abiraterone acetate (abiraterone) prolongs overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC). This study's objective was to retrospectively identify factors associated with prostate-specific antigen (PSA) response to abiraterone and validate them in an independent cohort. We hypothesized that the neutrophil/lymphocyte ratio (NLR), thought to be an indirect manifestation of tumor-promoting inflammation, may be associated with response to abiraterone...
March 2014: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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