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Ronald Epstein

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https://www.readbyqxmd.com/read/28506538/epitope-specific-immunotherapy-targeting-cd4-positive-t-cells-in-coeliac-disease-two-randomised-double-blind-placebo-controlled-phase-1-studies
#1
Gautam Goel, Tim King, A James Daveson, Jane M Andrews, Janakan Krishnarajah, Richard Krause, Gregor J E Brown, Ronald Fogel, Charles F Barish, Roger Epstein, Timothy P Kinney, Philip B Miner, Jason A Tye-Din, Adam Girardin, Juha Taavela, Alina Popp, John Sidney, Markku Mäki, Kaela E Goldstein, Patrick H Griffin, Suyue Wang, John L Dzuris, Leslie J Williams, Alessandro Sette, Ramnik J Xavier, Ludvig M Sollid, Bana Jabri, Robert P Anderson
BACKGROUND: A gluten-free diet is the only means to manage coeliac disease, a permanent immune intolerance to gluten. We developed a therapeutic vaccine, Nexvax2, designed to treat coeliac disease. Nexvax2 is an adjuvant-free mix of three peptides that include immunodominant epitopes for gluten-specific CD4-positive T cells. The vaccine is intended to engage and render gluten-specific CD4-positive T cells unresponsive to further antigenic stimulation. We assessed the safety and pharmacodynamics of the vaccine in patients with coeliac disease on a gluten-free diet...
May 11, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28466666/european-and-russian-physician-awareness-of-best-management-approaches-for-infections-due-to-antibiotic-resistant-gram-negative-bacteria
#2
Paurus Irani, Tehseen Salimi, Robert Epstein, Megan Leone-Perkins, Ronald Aubert, Mona Khalid, Emma Epstein, J Russell Teagarden
OBJECTIVES: The rapid spread of infections due to antibiotic-resistant, Gram-negative bacteria in Europe and surrounding regions requires a heightened level of awareness among physicians within their practice settings. METHODS: We surveyed 800 physicians who treat these infections across France, Germany, Spain, Italy, and Russia to assess their awareness of best management approaches. RESULTS: We found that more than two-thirds do not consider themselves highly aware of best management practices...
May 3, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28349411/what-s-the-opposite-of-burnout
#3
Ronald M Epstein
No abstract text is available yet for this article.
March 27, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28277698/does-educating-patients-about-the-early-palliative-care-study-increase-preferences-for-outpatient-palliative-cancer-care-findings-from-project-empower
#4
Michael Hoerger, Laura M Perry, Robert Gramling, Ronald M Epstein, Paul R Duberstein
OBJECTIVES: Randomized controlled trials, especially the Early Palliative Care Study (Temel et al., 2010), have shown that early outpatient palliative cancer care can improve quality of life for patients with advanced cancer or serious symptoms. However, fear and misconceptions drive avoidance of palliative care. Drawing from an empowerment perspective, we examined whether educating patients about evidence from the Early Palliative Care Study would increase preferences for palliative care...
June 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28239644/hla-dq-%C3%AE-1-alleles-associated-with-epstein-barr-virus-ebv-infectivity-and-ebv-gp42-binding-to-cells
#5
Qingxue Li, Wei Bu, Erin Gabriel, Fiona Aguilar, Yo Hoshino, Hiroko Miyadera, Christoph Hess, Ronald L Hornung, Amitava Roy, Jeffrey I Cohen
Epstein-Barr virus (EBV) infects B cells and ~95% of adults are infected. EBV glycoprotein gp42 is essential for entry of virus into B cells. EBV gp42 binds to the β1 chain of HLA-DQ, -DR, and -DP on B cells, and uses these molecules for infection. To investigate if certain HLA-DQ alleles are associated with EBV seronegativity, we recruited ~3,300 healthy adult blood donors, identified 106 EBV-seronegative individuals, and randomly selected a control group of EBV-seropositive donors from the donor pool. A larger than expected proportion of EBV-seronegative subjects were HLA-DQ β1 *04/*05 and *06/*06, and to a lesser extent, *02/*03, compared with the control group, while a larger than expected portion of EBV-seropositive persons were HLA-DQ β1 *02/*02...
February 23, 2017: JCI Insight
https://www.readbyqxmd.com/read/28167571/pharmacoepidemiology-of-clinically-relevant-hypothyroidism-and-hypertension-from-sunitinib-and-sorafenib
#6
Christine M Walko, Ronald E Aubert, Ninh M La-Beck, Gosia Clore, Vivian Herrera, Helen Kourlas, Robert S Epstein, Howard L McLeod
BACKGROUND: Thyroid dysfunction and hypertension (HTN) have been sporadically reported with sunitinib (SUN) and sorafenib (SOR). Determination of the side effect incidence will enhance monitoring and management recommendations. METHODS: An observational cohort study was performed using deidentified pharmacy claims data from a 3-year period to evaluate patients prescribed SUN, SOR, or capecitabine (CAP; comparison group). The primary outcome was time to first prescription for thyroid replacement or HTN treatment...
February 2017: Oncologist
https://www.readbyqxmd.com/read/28156512/a-cluster-randomized-trial-of-a-patient-centered-communication-intervention-in-advanced-cancer-the-values-and-options-in-cancer-care-voice-study
#7
Richard L Kravitz, Paul Duberstein, Daniel J Tancredi, Guibo Xing, Ronald M Epstein
2 Background: Observational studies demonstrate links between patient-centered communication, prognosis discordance, quality of life (QoL) and aggressive treatments near the end of life, yet there are few randomized evaluations of communication interventions in advanced cancer. METHODS: We completed a cluster randomized controlled trial in cancer clinics in Western NY and Northern CA with medical oncologists (n = 38 randomized to intervention or control) and their community-dwelling adult patients with advanced non-hematologic cancer (n = 265; 194 with enrolled caregivers)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28135140/promoting-end-of-life-discussions-in-advanced-cancer-effects-of-patient-coaching-and-question-prompt-lists
#8
Rachel A Rodenbach, Kim Brandes, Kevin Fiscella, Richard L Kravitz, Phyllis N Butow, Adam Walczak, Paul R Duberstein, Peter Sullivan, Beth Hoh, Guibo Xing, Sandy Plumb, Ronald M Epstein
Purpose To build on results of a cluster randomized controlled trial (RCT) of a combined patient-oncologist intervention to improve communication in advanced cancer, we conducted a post hoc analysis of the patient intervention component, a previsit patient coaching session that used a question prompt list (QPL). We hypothesized that intervention-group participants would bring up more QPL-related topics, particularly prognosis-related topics, during the subsequent oncologist visit. Patients and Methods This cluster RCT with 170 patients who had advanced nonhematologic cancer (and their caregivers) recruited from practices of 24 participating oncologists in western New York...
March 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27982024/epstein-barr-virus-positive-follicular-lymphoma
#9
Nicholas Mackrides, German Campuzano-Zuluaga, Yvan Maque-Acosta, Adrienne Moul, Nouf Hijazi, Francis Offiong Ikpatt, Ronald Levy, Ramiro E Verdun, Kranthi Kunkalla, Yasodha Natkunam, Izidore S Lossos, Francisco Vega, Jennifer Chapman
Epstein-Barr virus (EBV) -associated follicular lymphoma is only rarely reported. Herein, we report the largest series analyzing prevalence and clinicopathologic characteristics of EBV-associated follicular lymphoma occurring in unselected cases. Out of 382 analyzed cases, 10 EBV-positive follicular lymphomas were identified (prevalence=2.6%, 95% confidence interval 1.3-4.0%). All EBV-positive follicular lymphomas showed EBV-encoded small RNA-positive lymphoma cells present in a follicular distribution. Of these, eight also had tissue available for testing of expression of latent membrane protein 1 (LMP1), out of which six (75%) were positive...
April 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/27960086/integrated-epi-genomic-analyses-identify-subgroup-specific-therapeutic-targets-in-cns-rhabdoid-tumors
#10
Jonathon Torchia, Brian Golbourn, Shengrui Feng, King Ching Ho, Patrick Sin-Chan, Alexandre Vasiljevic, Joseph D Norman, Paul Guilhamon, Livia Garzia, Natalia R Agamez, Mei Lu, Tiffany S Chan, Daniel Picard, Pasqualino de Antonellis, Dong-Anh Khuong-Quang, Aline C Planello, Constanze Zeller, Dalia Barsyte-Lovejoy, Lucie Lafay-Cousin, Louis Letourneau, Mathieu Bourgey, Man Yu, Deena M A Gendoo, Misko Dzamba, Mark Barszczyk, Tiago Medina, Alexandra N Riemenschneider, A Sorana Morrissy, Young-Shin Ra, Vijay Ramaswamy, Marc Remke, Christopher P Dunham, Stephen Yip, Ho-Keung Ng, Jian-Qiang Lu, Vivek Mehta, Steffen Albrecht, Jose Pimentel, Jennifer A Chan, Gino R Somers, Claudia C Faria, Lucia Roque, Maryam Fouladi, Lindsey M Hoffman, Andrew S Moore, Yin Wang, Seung Ah Choi, Jordan R Hansford, Daniel Catchpoole, Diane K Birks, Nicholas K Foreman, Doug Strother, Almos Klekner, Laszló Bognár, Miklós Garami, Péter Hauser, Tibor Hortobágyi, Beverly Wilson, Juliette Hukin, Anne-Sophie Carret, Timothy E Van Meter, Eugene I Hwang, Amar Gajjar, Shih-Hwa Chiou, Hideo Nakamura, Helen Toledano, Iris Fried, Daniel Fults, Takafumi Wataya, Chris Fryer, David D Eisenstat, Katrin Scheinemann, Adam J Fleming, Donna L Johnston, Jean Michaud, Shayna Zelcer, Robert Hammond, Samina Afzal, David A Ramsay, Nongnuch Sirachainan, Suradej Hongeng, Noppadol Larbcharoensub, Richard G Grundy, Rishi R Lulla, Jason R Fangusaro, Harriet Druker, Ute Bartels, Ronald Grant, David Malkin, C Jane McGlade, Theodore Nicolaides, Tarik Tihan, Joanna Phillips, Jacek Majewski, Alexandre Montpetit, Guillaume Bourque, Gary D Bader, Alyssa T Reddy, G Yancey Gillespie, Monika Warmuth-Metz, Stefan Rutkowski, Uri Tabori, Mathieu Lupien, Michael Brudno, Ulrich Schüller, Torsten Pietsch, Alexander R Judkins, Cynthia E Hawkins, Eric Bouffet, Seung-Ki Kim, Peter B Dirks, Michael D Taylor, Anat Erdreich-Epstein, Cheryl H Arrowsmith, Daniel D De Carvalho, James T Rutka, Nada Jabado, Annie Huang
We recently reported that atypical teratoid rhabdoid tumors (ATRTs) comprise at least two transcriptional subtypes with different clinical outcomes; however, the mechanisms underlying therapeutic heterogeneity remained unclear. In this study, we analyzed 191 primary ATRTs and 10 ATRT cell lines to define the genomic and epigenomic landscape of ATRTs and identify subgroup-specific therapeutic targets. We found ATRTs segregated into three epigenetic subgroups with distinct genomic profiles, SMARCB1 genotypes, and chromatin landscape that correlated with differential cellular responses to a panel of signaling and epigenetic inhibitors...
December 12, 2016: Cancer Cell
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#11
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27692468/doing-something-about-physician-burnout
#12
COMMENT
Ronald M Epstein, Michael R Privitera
No abstract text is available yet for this article.
November 5, 2016: Lancet
https://www.readbyqxmd.com/read/27612178/effect-of-a-patient-centered-communication-intervention-on-oncologist-patient-communication-quality-of-life-and-health-care-utilization-in-advanced-cancer-the-voice-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Ronald M Epstein, Paul R Duberstein, Joshua J Fenton, Kevin Fiscella, Michael Hoerger, Daniel J Tancredi, Guibo Xing, Robert Gramling, Supriya Mohile, Peter Franks, Paul Kaesberg, Sandy Plumb, Camille S Cipri, Richard L Street, Cleveland G Shields, Anthony L Back, Phyllis Butow, Adam Walczak, Martin Tattersall, Alison Venuti, Peter Sullivan, Mark Robinson, Beth Hoh, Linda Lewis, Richard L Kravitz
Importance: Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. Objective: To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life...
January 1, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/27484705/rapid-reconstitution-of-cd4-t-cells-and-nk-cells-protects-against-cmv-reactivation-after-allogeneic-stem-cell-transplantation
#14
Julia Drylewicz, Ingrid M M Schellens, Rogier Gaiser, Nening M Nanlohy, Esther D Quakkelaar, Henny Otten, Suzanne van Dorp, Ronald Jacobi, Leonie Ran, Sanne Spijkers, Dan Koning, Rob Schuurman, Ellen Meijer, Floortje L Pietersma, Jurgen Kuball, Debbie van Baarle
BACKGROUND: Epstein-Barr virus and Cytomegalovirus reactivations frequently occur after allogeneic stem cell transplantation (SCT). METHODS: Here we investigated the role of immune cell reconstitution in the onset and subsequent severity of EBV- and CMV-reactivation. To this end, 116 patients were prospectively sampled for absolute T cell (CD4 and CD8), B-cell (CD19) and NK-cell (CD16 and CD56) numbers weekly post-SCT during the first 3 months and thereafter monthly until 6 months post-SCT...
2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27415765/determinants-of-patient-oncologist-prognostic-discordance-in-advanced-cancer
#15
Robert Gramling, Kevin Fiscella, Guibo Xing, Michael Hoerger, Paul Duberstein, Sandy Plumb, Supriya Mohile, Joshua J Fenton, Daniel J Tancredi, Richard L Kravitz, Ronald M Epstein
Importance: Patients with advanced cancer often report expectations for survival that differ from their oncologists' expectations. Whether patients know that their survival expectations differ from those of their oncologists remains unknown. This distinction is important because knowingly expressing differences of opinion is important for shared decision making, whereas patients not knowing that their understanding differs from that of their treating physician is a potential marker of inadequate communication...
November 1, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27306639/systemic-lupus-erythematosus
#16
Arvind Kaul, Caroline Gordon, Mary K Crow, Zahi Touma, Murray B Urowitz, Ronald van Vollenhoven, Guillermo Ruiz-Irastorza, Graham Hughes
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect many organs, including the skin, joints, the central nervous system and the kidneys. Women of childbearing age and certain racial groups are typically predisposed to developing the condition. Rare, inherited, single-gene complement deficiencies are strongly associated with SLE, but the disease is inherited in a polygenic manner in most patients. Genetic interactions with environmental factors, particularly UV light exposure, Epstein-Barr virus infection and hormonal factors, might initiate the disease, resulting in immune dysregulation at the level of cytokines, T cells, B cells and macrophages...
June 16, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27234988/effectiveness-of-a-clinician-intervention-to-improve-physical-activity-discussions-in-underserved-adults
#17
Jennifer K Carroll, Susan A Flocke, Mechelle R Sanders, Lisa Lowenstein, Kevin Fiscella, Ronald M Epstein
BACKGROUND: Physical activity (PA) counselling is challenging in primary care. It is unknown whether clinician training on the 5As (Ask, Advise, Agree, Assist, Arrange) improves PA counselling skills. OBJECTIVE: To evaluate the effect of a clinician training intervention on PA counselling for underserved adults using the 5As framework. METHODS: Pragmatic pilot clinical trial was used in the study. Clinicians (n = 13) were randomly assigned to two groups...
October 2016: Family Practice
https://www.readbyqxmd.com/read/27175311/chronic-physical-stress-does-not-interact-with-epstein-barr-virus-ebv-encoded-dutpase-to-alter-the-sickness-response
#18
Taryn G Aubrecht, Zachary M Weil, Bachir Abi Salloum, Maria Eugenia Ariza, Marshall Williams, Brenda Reader, Ronald Glaser, John Sheridan, Randy J Nelson
Most adult humans have been infected with Epstein-Barr virus (EBV), which is thought to contribute to the development of chronic fatigue syndrome. Stress is known to influence the immune system and can exacerbate the sickness response. Although a role for psychological stress in the sickness response, particularly in combination with EBV-encoded deoxyuridine triphosphate nucleotidohydrolase (dUTPase) has been established, and the role of physical stressors in these interactions remains unspecified. In this study, we seek to determine the interaction of chronic physical (swim) stress and EBV-encoded dUTPase injection...
October 2015: Journal of Behavioral and Brain Science
https://www.readbyqxmd.com/read/27169477/association-of-gata2-deficiency-with-severe-primary-epstein-barr-virus-ebv-infection-and-ebv-associated-cancers
#19
Jeffrey I Cohen, Lesia Dropulic, Amy P Hsu, Christa S Zerbe, Tammy Krogmann, Kennichi Dowdell, Ronald L Hornung, Jana Lovell, Nancy Hardy, Dennis Hickstein, Edward W Cowen, Katherine R Calvo, Stefania Pittaluga, Steven M Holland
BACKGROUND: Most patients infected with Epstein-Barr virus (EBV) are asymptomatic, have nonspecific symptoms, or have self-limiting infectious mononucleosis. EBV, however, may result in severe primary disease or cancer. METHODS: We report EBV diseases associated with GATA2 deficiency at one institution and describe the hematology, virology, and cytokine findings. RESULTS: Seven patients with GATA2 deficiency developed severe EBV disease. Three presented with EBV infectious mononucleosis requiring hospitalization, 1 had chronic active EBV disease (B-cell type), 1 had EBV-associated hydroa vacciniforme-like lymphoma with hemophagocytic lymphohistiocytosis, and 2 had EBV-positive smooth muscle tumors...
July 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27156659/eloquent-silences-a-musical-and-lexical-analysis-of-conversation-between-oncologists-and-their-patients
#20
Josef Bartels, Rachel Rodenbach, Katherine Ciesinski, Robert Gramling, Kevin Fiscella, Ronald Epstein
OBJECTIVE: Silences in doctor-patient communication can be "connectional" and communicative, in contrast to silences that indicate awkwardness or distraction. Musical and lexical analyses can identify and characterize connectional silences in consultations between oncologists and patients. METHODS: Two medical students and a professor of voice screened all 1211 silences over 2s in length from 124 oncology office visits. We developed a "strength of connection" taxonomy and examined ten connectional silences for lexical and musical features including pitch, volume, and speaker turn-taking rhythm...
October 2016: Patient Education and Counseling
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