Search

Your search keyword '"Bell, Teresa M."' showing total 201 results
Start Over Author "Bell, Teresa M."
201 results on '"Bell, Teresa M."'

3. Three cachexia phenotypes and the impact of fat‐only loss on survival in FOLFIRINOX therapy for pancreatic cancer

Author

Kays, Joshua K, Shahda, Safi, Stanley, Melissa, Bell, Teresa M, O'Neill, Bert H, Kohli, Marc D, Couch, Marion E, Koniaris, Leonidas G, and Zimmers, Teresa A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Prevention, Rare Diseases, Digestive Diseases, Cancer, Nutrition, Pancreatic Cancer, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, 2.1 Biological and endogenous factors, Aetiology, Good Health and Well Being, Adipose Tissue, Aged, Antineoplastic Combined Chemotherapy Protocols, Body Composition, Body Weights and Measures, Cachexia, Carcinoma, Pancreatic Ductal, Female, Fluorouracil, Humans, Irinotecan, Leucovorin, Male, Middle Aged, Oxaliplatin, Pancreatic Neoplasms, Phenotype, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Pancreatic cancer, Sarcopenia, FOLFIRINOX, Muscle wasting, Physiology, Human Movement and Sports Sciences, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise
Abstract

BackgroundBy the traditional definition of unintended weight loss, cachexia develops in ~80% of patients with pancreatic ductal adenocarcinoma (PDAC). Here, we measure the longitudinal body composition changes in patients with advanced PDAC undergoing 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin therapy.MethodsWe performed a retrospective review of 53 patients with advanced PDAC on 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin as first line therapy at Indiana University Hospital from July 2010 to August 2015. Demographic, clinical, and survival data were collected. Body composition measurement by computed tomography (CT), trend, univariate, and multivariate analysis were performed.ResultsAmong all patients, three cachexia phenotypes were identified. The majority of patients, 64%, had Muscle and Fat Wasting (MFW), while 17% had Fat-Only Wasting (FW) and 19% had No Wasting (NW). NW had significantly improved overall median survival (OMS) of 22.6 months vs. 13.0 months for FW and 12.2 months for MFW (P = 0.02). FW (HR = 5.2; 95% confidence interval = 1.5-17.3) and MFW (HR = 1.8; 95% confidence interval = 1.1-2.9) were associated with an increased risk of mortality compared with NW. OMS and risk of mortality did not differ between FW and MFW. Progression of disease, sarcopenic obesity at diagnosis, and primary tail tumours were also associated with decreased OMS. On multivariate analysis, cachexia phenotype and chemotherapy response were independently associated with survival. Notably, CT-based body composition analysis detected tissue loss of >5% in 81% of patients, while the traditional definition of >5% body weight loss identified 56.6%.ConclusionsDistinct cachexia phenotypes were observed in this homogeneous population of patients with equivalent stage, diagnosis, and first-line treatment. This suggests cellular, molecular, or genetic heterogeneity of host or tumour. Survival among patients with FW was as poor as for MFW, indicating adipose tissue plays a crucial role in cachexia and PDAC mortality. Adipose tissue should be studied for its mechanistic contributions to cachexia.

Published
2018

9. User-Guided Enhancements to a Technology-Facilitated Resilience Program to Address Opioid Risks Following Traumatic Injury in Youth: Qualitative Interview Study

Author

Adams, Zachary W, primary, Marriott, Brigid R, additional, Karra, Swathi, additional, Linhart-Musikant, Elizabeth, additional, Raymond, Jodi L, additional, Fischer, Lydia J, additional, Bixler, Kristina A, additional, Bell, Teresa M, additional, Bryan, Eric A, additional, and Hulvershorn, Leslie A, additional

Published
2023
Full Text
View/download PDF

22. User-Guided Enhancements to a Technology-Facilitated Resilience Program to Address Opioid Risks Following Traumatic Injury in Youth: Qualitative Interview Study (Preprint)

Author

Adams, Zachary W, primary, Marriott, Brigid R, additional, Karra, Swathi, additional, Linhart-Musikant, Elizabeth, additional, Raymond, Jodi L, additional, Fischer, Lydia J, additional, Bixler, Kristina A, additional, Bell, Teresa M, additional, Bryan, Eric A, additional, and Hulvershorn, Leslie A, additional

Published
2022
Full Text
View/download PDF

31. Clinical indicators of hemorrhagic shock in pregnancy

Author

Jenkins, Peter C, Stokes, Samantha M, Fakoyeho, Stephen, Bell, Teresa M, and Zarzaur, Ben L

Subjects
hemorrahgic shock, Brief Report, shock management, pregnancy
Abstract

Background Several hemodynamic parameters have been promoted to help establish a rapid diagnosis of hemorrhagic shock, but they have not been well validated in the pregnant population. In this study, we examined the association between three measures of shock and early blood transfusion requirements among pregnant trauma patients. Methods This study included 81 pregnant trauma patients admitted to a level 1 trauma center (2010–2015). In separate logistic regression models, we tested the relationship between exposure variables—initial systolic blood pressure (SBP), shock index (SI), and rate over pressure evaluation (ROPE)—and the outcome of transfusion of blood products within 24 hours of admission. To test the predictive ability of each measure, we used receiver operating characteristic (ROC) curves. Results A total of 10% of patients received blood products in the patient cohort. No patients had an initial SBP≤90, so the SBP measure was excluded from analysis. We found that patients with SI>1 were significantly more likely to receive blood transfusions compared with patients with SI3 was not associated with blood transfusion compared with ROPE≤3 (OR 2.92; 95% CI 0.28 to 30.42). Furthermore, comparison of area under the ROC curve for SI (0.68) and ROPE (0.54) suggested that SI was more predictive than ROPE of blood transfusion. Conclusion We found that an elevated SI was more closely associated with early blood product transfusion than SBP and ROPE in injured pregnant patients. Level of evidence Prognostic, level III

Published
2017

Catalog

Books, media, physical & digital resources
See catalog results