4 results on '"Secomb E."'
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2. Streamlined genetic education is effective in preparing women newly diagnosed with breast cancer for decision making about treatment-focused genetic testing: A randomized controlled noninferiority trial.
- Author
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Thomson D., Quinn V.F., Meiser B., Kirk J., Tucker K.M., Watts K.J., Rahman B., Peate M., Saunders C., Geelhoed E., Gleeson M., Barlow-Stewart K., Field M., Harris M., Antill Y.C., Cicciarelli L., Crowe K., Bowen M.T., Mitchell G., Gregory P., Lipton L., McKay L., Senior J., Lobb L., Crowe P., Matthews A., Neil G., Parasyn A., Duffy J., Andrews L., Gale J., Fox J., Hart S., Smythe C., White M., Creighton L., D'arcy J., Grieve S., Secomb E., Henderson M., O'Brien J., Poliness C., Hattam A., Susman R., Ung O., DIckson R., Moore K., Bastick P., Inder S., Lynch J., Schwartz P., Zia R., Mak C., Snook K., Spillane A., Hopper J., Bowman M., Cheung D., Edirimanne S., Edwards E., Elder E., French J., Moon D., Thomson D., Quinn V.F., Meiser B., Kirk J., Tucker K.M., Watts K.J., Rahman B., Peate M., Saunders C., Geelhoed E., Gleeson M., Barlow-Stewart K., Field M., Harris M., Antill Y.C., Cicciarelli L., Crowe K., Bowen M.T., Mitchell G., Gregory P., Lipton L., McKay L., Senior J., Lobb L., Crowe P., Matthews A., Neil G., Parasyn A., Duffy J., Andrews L., Gale J., Fox J., Hart S., Smythe C., White M., Creighton L., D'arcy J., Grieve S., Secomb E., Henderson M., O'Brien J., Poliness C., Hattam A., Susman R., Ung O., DIckson R., Moore K., Bastick P., Inder S., Lynch J., Schwartz P., Zia R., Mak C., Snook K., Spillane A., Hopper J., Bowman M., Cheung D., Edirimanne S., Edwards E., Elder E., French J., and Moon D.
- Abstract
Purpose: Increasingly, women newly diagnosed with breast cancer are being offered treatment-focused genetic testing (TFGT). As the demand for TFGT increases, streamlined methods of genetic education are needed. Method(s): In this noninferiority trial, women aged <50 years with either a strong family history (FH+) or other features suggestive of a germ-line mutation (FH-) were randomized before definitive breast cancer surgery to receive TFGT education either as brief written materials (intervention group (IG)) or during a genetic counseling session at a familial cancer clinic (usual-care group (UCG)). Women completed self-report questionnaires at four time points over 12 months. Result(s): A total of 135 women were included in the analysis, all of whom opted for TFGT. Decisional conflict about TFGT choice (primary outcome) was not inferior in the IG compared with the UCG (noninferiority margin of -10; mean difference = 2.45; 95% confidence interval -2.87-7.76; P = 0.36). Costs per woman counseled in the IG were significantly lower (AUD$89) compared with the UCG (AUD$173; t(115) = 6.02; P < 0.001). Conclusion(s): A streamlined model of educating women newly diagnosed with breast cancer about TFGT seems to be a cost-effective way of delivering education while ensuring that women feel informed and supported in their decision making, thus freeing resources for other women to access TFGT.
- Published
- 2017
3. How should we discuss genetic testing with women newly diagnosed with breast cancer? Design and implementation of a randomized controlled trial of two models of delivering education about treatment-focused genetic testing to younger women newly diagnosed with breast cancer.
- Author
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Harris M., Watts K.J., Meiser B., Mitchell G., Kirk J., Saunders C., Peate M., Duffy J., Kelly P.J., Gleeson M., Barlow-Stewart K., Rahman B., Friedlander M., Tucker K., Antill Y., Gregory P., Lipton L., McKay L., Senior J., Lobb E.A., Crowe P., Matthews A., Neil G., Parasyn A., Thomson D., Zilliacus E., Andrews L., Gale J., Fox J., Hart S., Smythe C., White M., Creighton L., Crowe K., D'arcy J., Grieve S., Secomb E., Cicciarelli L., Henderson M., O'Brien J., Poliness C., Hattam A., Susman R., Ung O., Dickson R., Field M., Moore K., Bastick P., Inder S., Lynch J., Schwartz P., Zia R., Mak C., Snook K., Spillane A., Hopper J., Geelhoed L., Bowman M., Cheung D., Edirimanne S., Edwards E., Elder E., French J., Moon D., Harris M., Watts K.J., Meiser B., Mitchell G., Kirk J., Saunders C., Peate M., Duffy J., Kelly P.J., Gleeson M., Barlow-Stewart K., Rahman B., Friedlander M., Tucker K., Antill Y., Gregory P., Lipton L., McKay L., Senior J., Lobb E.A., Crowe P., Matthews A., Neil G., Parasyn A., Thomson D., Zilliacus E., Andrews L., Gale J., Fox J., Hart S., Smythe C., White M., Creighton L., Crowe K., D'arcy J., Grieve S., Secomb E., Cicciarelli L., Henderson M., O'Brien J., Poliness C., Hattam A., Susman R., Ung O., Dickson R., Field M., Moore K., Bastick P., Inder S., Lynch J., Schwartz P., Zia R., Mak C., Snook K., Spillane A., Hopper J., Geelhoed L., Bowman M., Cheung D., Edirimanne S., Edwards E., Elder E., French J., and Moon D.
- Abstract
Background: Germline BRCA1 and BRCA2 mutation testing offered shortly after a breast cancer diagnosis to inform women's treatment choices - treatment-focused genetic testing 'TFGT' - has entered clinical practice in specialist centers and is likely to be soon commonplace in acute breast cancer management, especially for younger women. Yet the optimal way to deliver information about TFGT to younger women newly diagnosed with breast cancer is not known, particularly for those who were not suspected of having a hereditary breast cancer syndrome prior to their cancer diagnosis. Also, little is known about the behavioral and psychosocial impact or cost effectiveness of educating patients about TFGT. This trial aims to examine the impact and efficiency of two models of educating younger women newly diagnosed with breast cancer about genetic testing in order to provide evidence for a safe and effective future clinical pathway for this service.Design/methods: In this non-inferiority randomized controlled trial, 140 women newly diagnosed with breast cancer (aged less than 50 years) are being recruited from nine cancer centers in Australia. Eligible women with either a significant family history of breast and/or ovarian cancer or with other high risk features suggestive of a mutation detection rate of > 10% are invited by their surgeon prior to mastectomy or radiotherapy. After completing the first questionnaire, participants are randomized to receive either: (a) an educational pamphlet about genetic testing (intervention) or (b) a genetic counseling appointment at a family cancer center (standard care). Each participant is offered genetic testing for germline BRCA mutations. Decision-related and psychosocial outcomes are assessed over 12 months and include decisional conflict (primary outcome);uptake of bilateral mastectomy and/or risk-reducing salpingo-oophorectomy; cancer-specific- and general distress; family involvement in decision making; and decision regret. A process
- Published
- 2012
4. Peroxisome proliferator-activated receptor ligands reduce aortic dilatation in a mouse model of aortic aneurysm.
- Author
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Golledge J, Cullen B, Rush C, Moran CS, Secomb E, Wood F, Daugherty A, Campbell JH, and Norman PE
- Subjects
- Angiotensin II, Animals, Aortic Aneurysm, Abdominal metabolism, Aortic Aneurysm, Abdominal pathology, Apolipoproteins E deficiency, Fenofibrate pharmacology, Immunohistochemistry, Ligands, Macrophages pathology, Male, Mice, Osteopontin metabolism, Pioglitazone, Thiazolidinediones pharmacology, Up-Regulation, Aortic Aneurysm, Abdominal drug therapy, Fenofibrate therapeutic use, Peroxisome Proliferator-Activated Receptors metabolism, Thiazolidinediones therapeutic use
- Abstract
Objective: Osteopontin (OPN) is associated with human abdominal aortic aneurysms (AAA) and in vitro studies suggest that this cytokine is downregulated by peroxisome proliferator-activated receptor (PPAR) ligation. We examined the effect of two PPAR ligands within a mouse model of aortic aneurysm., Methods: At 11 weeks of age apolipoprotein E deficient (ApoE(-/-)) mice were given pioglitazone (n=27), fenofibrate (n=27) or vehicle (n=27) in their drinking water. From 13 weeks of age mice received angiotensin II (1 microg/kg/min) infusion via subcutaneous pumps until death or 17 weeks when the aortas were harvested and maximum aortic diameters were recorded. Suprarenal aortic segments were assessed for OPN concentration and macrophage accumulation. Saline infused mice served as negative controls (n=22)., Results: Angiotensin II induced marked dilatation in the suprarenal aorta (>2-fold increase compared to controls) associated with upregulation of the cytokines OPN and macrophage infiltration. Suprarenal aortic expansion was significantly reduced by administration of pioglitazone (mean diameter 1.61+/-0.11 mm, p=0.011) and fenofibrate (mean diameter 1.51+/-0.13 mm, p=0.001) compared to the vehicle control group (mean diameter 2.10+/-0.14 mm). Immunostaining for macrophages was reduced in mice treated with pioglitazone (median staining area 6.2%, interquartile range 4.1-7.2, p<0.001) and fenofibrate (median staining area 4.0%, interquartile range 2.2-6.1, p<0.001) compared to mice receiving vehicle control (median staining area 13.2%, interquartile range 8.4-20.0)., Conclusion: These findings suggest the potential value of peroxisome proliferator-activated receptor ligation as a therapy for human AAAs., (Copyright 2009 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2010
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