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Paterson C, Roberts C, Li J, Chapman M, Strickland K, Johnston N, Law E, Bacon R, Turner M, Mohanty I, Pranavan G, Toohey K. What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: A qualitative systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01401-5. [PMID: 37256499 DOI: 10.1007/s11764-023-01401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers. METHODS A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings. RESULTS A total of 33 studies were included which represented a total sample of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 individual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs. CONCLUSION This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with individualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services. IMPLICATIONS FOR CANCER SURVIVORS It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.
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Schubert J, Svensson M, Denstedt G, Johnston N, Cars T, Gustafsson S, Schalin L, Hagstrom E. Long-term assessment and target achievement of LDL-C and systolic blood pressure in primary care after acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hospital-based cardiac rehabilitation and risk factor control decreases the risk of recurrent events after acute coronary syndrome (ACS). Little is known on long-term assessment and target achievement after referral to primary care. Patients with diabetes, regardless of ACS, have yearly follow-up visits in primary care, whereas there is no structured follow-up after ACS for patients without diabetes.
Purpose
To describe long-term assessment and target achievement of LDL-C and systolic blood pressure (SBP) in ACS patients after referral to primary care. Further, to compare patients with and without diabetes at the time of index ACS.
Methods
A non-interventional population-based observational study of patients with first ever ACS in a Swedish region with 390,000 inhabitants. Data on clinical measurements after ACS were collected from the electronic medical records between 2012 and 2020. Patients were followed until new ACS event, death, moving out of the county, or end of study. Target levels studied were LDL-C <1.8 mmol/L and SBP <140 mmHg. The same assessments with the addition of target levels of HbA1c ≤70 mmol/mol were evaluated in patients with diabetes.
Results
Median follow-up was 2.9 years (inter quartile range [IQR]: 1.0–5.4) and 4,733 patients were detected. Median age was 72 years (IQR 63–80) and 34% were female. Follow-up data were available for 3,579 (76%) patients any time during the first, 2,891 (61%) during the second, and 2,308 (49%) during the third year after the index ACS event. The number of patients with diabetes was 1311 (28%), and of these 921, 723, and 562 could be followed for the first, second, and third year. During the first three years, 898 (19%) of all patients with available follow-up died.
The proportion of patients with assessments of LDL-C and SBP declined for each year of follow-up and target achievement was low (Table). Among patients with diabetes a larger proportion had measurements for LDL-C and SBP, while the target achievement was similar to that of the whole study population. HbA1c was measured equally frequently as SBP and was at target in 81% of patients with diabetes during the three years of follow-up (Table).
Conclusion
The proportion of patients with follow-up assessment and measurements in primary care declined each year after the index ACS event. Patients with diabetes had more frequent LDL-C and SBP measurements but the same low target achievement after an ACS compared with patients without diabetes. This could potentially be due to an increased focus on glycaemic control at these visits. A structured long-term follow-up for ACS patients in primary care might improve both assessment and target achievement and prevent recurrent ACS events.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): AmgenSwedish Heart Lung Foundation
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Abud AA, Abi B, Acciarri R, Acero MA, Adames MR, Adamov G, Adamowski M, Adams D, Adinolfi M, Aduszkiewicz A, Aguilar J, Ahmad Z, Ahmed J, Aimard B, Ali-Mohammadzadeh B, Alion T, Allison K, Monsalve SA, AlRashed M, Alt C, Alton A, Alvarez R, Amedo P, Anderson J, Andreopoulos C, Andreotti M, Andrews M, Andrianala F, Andringa S, Anfimov N, Ankowski A, Antoniassi M, Antonova M, Antoshkin A, Antusch S, Aranda-Fernandez A, Arellano L, Arnold LO, Arroyave MA, Asaadi J, Asquith L, Aurisano A, Aushev V, Autiero D, Lara VA, Ayala-Torres M, Azfar F, Back A, Back H, Back JJ, Backhouse C, Bagaturia I, Bagby L, Balashov N, Balasubramanian S, Baldi P, Baller B, Bambah B, Barao F, Barenboim G, Alzas PB, Barker G, Barkhouse W, Barnes C, Barr G, Monarca JB, Barros A, Barros N, Barrow JL, Basharina-Freshville A, Bashyal A, Basque V, Batchelor C, Chagas EBD, Battat JBR, Battisti F, Bay F, Bazetto MCQ, Alba JLLB, Beacom JF, Bechetoille E, Behera B, Beigbeder C, Bellantoni L, Bellettini G, Bellini V, Beltramello O, Benekos N, Montiel CB, Neves FB, Berger J, Berkman S, Bernardini P, Berner RM, Bersani A, Bertolucci S, Betancourt M, Rodríguez AB, Bevan A, Bezawada Y, Bezerra TJC, Bhardwaj A, Bhatnagar V, Bhattacharjee M, Bhattarai D, Bhuller S, Bhuyan B, Biagi S, Bian J, Biassoni M, Biery K, Bilki B, Bishai M, Bitadze A, Blake A, Blaszczyk F, Blazey GC, Blucher E, Boissevain J, Bolognesi S, Bolton T, Bomben L, Bonesini M, Bongrand M, Bonilla-Diaz C, Bonini F, Booth A, Boran F, Bordoni S, Borkum A, Bostan N, Bour P, Bourgeois C, Boyden D, Bracinik J, Braga D, Brailsford D, Branca A, Brandt A, Bremer J, Breton D, Brew C, Brice SJ, Brizzolari C, Bromberg C, Brooke J, Bross A, Brunetti G, Brunetti M, Buchanan N, Budd H, Butorov I, Cagnoli I, Cai T, Caiulo D, Calabrese R, Calafiura P, Calcutt J, Calin M, Calvez S, Calvo E, Caminata A, Campanelli M, Caratelli D, Carber D, Carceller JC, Carini G, Carlus B, Carneiro MF, Carniti P, Terrazas IC, Carranza H, Carroll T, Forero JFC, Castillo A, Castromonte C, Catano-Mur E, Cattadori C, Cavalier F, Cavallaro G, Cavanna F, Centro S, Cerati G, Cervelli A, Villanueva AC, Chalifour M, Chappell A, Chardonnet E, Charitonidis N, Chatterjee A, Chattopadhyay S, Neyra MSSC, Chen H, Chen M, Chen Y, Chen Z, Chen-Wishart Z, Cheon Y, Cherdack D, Chi C, Childress S, Chirco R, Chiriacescu A, Chisnall G, Cho K, Choate S, Chokheli D, Chong PS, Christensen A, Christian D, Christodoulou G, Chukanov A, Chung M, Church E, Cicero V, Clarke P, Cline G, Coan TE, Cocco AG, Coelho JAB, Colton N, Conley E, Conley R, Conrad J, Convery M, Copello S, Cova P, Cremaldi L, Cremonesi L, Crespo-Anadón JI, Crisler M, Cristaldo E, Crnkovic J, Cross R, Cudd A, Cuesta C, Cui Y, Cussans D, Dalager O, da Motta H, Da Silva Peres L, David C, David Q, Davies GS, Davini S, Dawson J, De K, De S, Debbins P, De Bonis I, Decowski MP, De Gouvêa A, De Holanda PC, De Icaza Astiz IL, Deisting A, De Jong P, Delbart A, Delepine D, Delgado M, Dell’Acqua A, Delmonte N, De Lurgio P, de Mello Neto JRT, DeMuth DM, Dennis S, Densham C, Deptuch GW, De Roeck A, De Romeri V, De Souza G, Devi R, Dharmapalan R, Dias M, Diaz F, Díaz JS, Domizio SD, Giulio LD, Ding P, Noto LD, Dirkx G, Distefano C, Diurba R, Diwan M, Djurcic Z, Doering D, Dolan S, Dolek F, Dolinski M, Domine L, Donon Y, Douglas D, Douillet D, Dragone A, Drake G, Drielsma F, Duarte L, Duchesneau D, Duffy K, Dunne P, Dutta B, Duyang H, Dvornikov O, Dwyer D, Dyshkant A, Eads M, Earle A, Edmunds D, Eisch J, Emberger L, Emery S, Englezos P, Ereditato A, Erjavec T, Escobar C, Eurin G, Evans JJ, Ewart E, Ezeribe AC, Fahey K, Falcone A, Fani’ M, Farnese C, Farzan Y, Fedoseev D, Felix J, Feng Y, Fernandez-Martinez E, Menendez PF, Morales MF, Ferraro F, Fields L, Filip P, Filthaut F, Fiorini M, Fischer V, Fitzpatrick RS, Flanagan W, Fleming B, Flight R, Fogarty S, Foreman W, Fowler J, Fox W, Franc J, Francis K, Franco D, Freeman J, Freestone J, Fried J, Friedland A, Robayo FF, Fuess S, Furic IK, Furman K, Furmanski AP, Gabrielli A, Gago A, Gallagher H, Gallas A, Gallego-Ros A, Gallice N, Galymov V, Gamberini E, Gamble T, Ganacim F, Gandhi R, Gandrajula R, Gao F, Gao S, Garcia-Gamez D, García-Peris MÁ, Gardiner S, Gastler D, Gauvreau J, Ge G, Geffroy N, Gelli B, Gendotti A, Gent S, Ghorbani-Moghaddam Z, Giammaria P, Giammaria T, Giangiacomi N, Gibin D, Gil-Botella I, Gilligan S, Girerd C, Giri AK, Gnani D, Gogota O, Gold M, Gollapinni S, Gollwitzer K, Gomes RA, Bermeo LVG, Fajardo LSG, Gonnella F, Gonzalez-Diaz D, Gonzalez-Lopez M, Goodman MC, Goodwin O, Goswami S, Gotti C, Goudzovski E, Grace C, Gran R, Granados E, Granger P, Grant A, Grant C, Gratieri D, Green P, Greenler L, Greer J, Grenard J, Griffith WC, Groh M, Grudzinski J, Grzelak K, Gu W, Guardincerri E, Guarino V, Guarise M, Guenette R, Guerard E, Guerzoni M, Guffanti D, Guglielmi A, Guo B, Gupta A, Gupta V, Guthikonda KK, Gutierrez R, Guzowski P, Guzzo MM, Gwon S, Ha C, Haaf K, Habig A, Hadavand H, Haenni R, Hahn A, Haiston J, Hamacher-Baumann P, Hamernik T, Hamilton P, Han J, Harris DA, Hartnell J, Hartnett T, Harton J, Hasegawa T, Hasnip C, Hatcher R, Hatfield KW, Hatzikoutelis A, Hayes C, Hayrapetyan K, Hays J, Hazen E, He M, Heavey A, Heeger KM, Heise J, Henry S, Morquecho MAH, Herner K, Hewes J, Hilgenberg C, Hill T, Hillier SJ, Himmel A, Hinkle E, Hirsch LR, Ho J, Hoff J, Holin A, Hoppe E, Horton-Smith GA, Hostert M, Hourlier A, Howard B, Howell R, Hoyos J, Hristova I, Hronek MS, Huang J, Hulcher Z, Iles G, Ilic N, Iliescu AM, Illingworth R, Ingratta G, Ioannisian A, Irwin B, Isenhower L, Itay R, Jackson CM, Jain V, James E, Jang W, Jargowsky B, Jediny F, Jena D, Jeong YS, Jesús-Valls C, Ji X, Jiang L, Jiménez S, Jipa A, Johnson R, Johnson W, Johnston N, Jones B, Jones S, Judah M, Jung CK, Junk T, Jwa Y, Kabirnezhad M, Kaboth A, Kadenko I, Kakorin I, Kalitkina A, Kalra D, Kamiya F, Kaneshige N, Kaplan DM, Karagiorgi G, Karaman G, Karcher A, Karolak M, Karyotakis Y, Kasai S, Kasetti SP, Kashur L, Kazaryan N, Kearns E, Keener P, Kelly KJ, Kemp E, Kemularia O, Ketchum W, Kettell SH, Khabibullin M, Khotjantsev A, Khvedelidze A, Kim D, King B, Kirby B, Kirby M, Klein J, Klustova A, Kobilarcik T, Koehler K, Koerner LW, Koh DH, Kohn S, Koller PP, Kolupaeva L, Korablev D, Kordosky M, Kosc T, Kose U, Kostelecký VA, Kothekar K, Kralik R, Kreczko L, Krennrich F, Kreslo I, Kropp W, Kroupova T, Kubota S, Kudenko Y, Kudryavtsev VA, Kulagin S, Kumar J, Kumar P, Kunze P, Kurita N, Kuruppu C, Kus V, Kutter T, Kvasnicka J, Kwak D, Lambert A, Land B, Lane CE, Lang K, Langford T, Langstaff M, Larkin J, Lasorak P, Last D, Laundrie A, Laurenti G, Lawrence A, Lazanu I, LaZur R, Lazzaroni M, Le T, Leardini S, Learned J, LeBrun P, LeCompte T, Lee C, Lee SY, Miotto GL, Lehnert R, de Oliveira MAL, Leitner M, Lepin LM, Li SW, Li Y, Liao H, Lin CS, Lin Q, Lin S, Lineros RA, Ling J, Lister A, Littlejohn BR, Liu J, Liu Y, Lockwitz S, Loew T, Lokajicek M, Lomidze I, Long K, Lord T, LoSecco JM, Louis WC, Lu XG, Luk KB, Lunday B, Luo X, Luppi E, Lux T, Luzio VP, Maalmi J, MacFarlane D, Machado AA, Machado P, Macias CT, Macier JR, Maddalena A, Madera A, Madigan P, Magill S, Mahn K, Maio A, Major A, Maloney JA, Mandrioli G, Mandujano RC, Maneira J, Manenti L, Manly S, Mann A, Manolopoulos K, Plata MM, Manyam VN, Manzanillas L, Marchan M, Marchionni A, Marciano W, Marfatia D, Mariani C, Maricic J, Marie R, Marinho F, Marino AD, Marsden D, Marshak M, Marshall C, Marshall J, Marteau J, Martín-Albo J, Martinez N, Caicedo DAM, Miravé PM, Martynenko S, Mascagna V, Mason K, Mastbaum A, Matichard F, Matsuno S, Matthews J, Mauger C, Mauri N, Mavrokoridis K, Mawby I, Mazza R, Mazzacane A, Mazzucato E, McAskill T, McCluskey E, McConkey N, McFarland KS, McGrew C, McNab A, Mefodiev A, Mehta P, Melas P, Mena O, Mendez H, Mendez P, Méndez DP, Menegolli A, Meng G, Messier MD, Metcalf W, Mettler T, Mewes M, Meyer H, Miao T, Michna G, Miedema T, Mikola V, Milincic R, Miller G, Miller W, Mills J, Mineev O, Minotti A, Miranda OG, Miryala S, Mishra CS, Mishra SR, Mislivec A, Mitchell M, Mladenov D, Mocioiu I, Moffat K, Moggi N, Mohanta R, Mohayai TA, Mokhov N, Molina J, Bueno LM, Montagna E, Montanari A, Montanari C, Montanari D, Zetina LMM, Moon SH, Mooney M, Moor AF, Moreno D, Moretti D, Morris C, Mossey C, Mote M, Motuk E, Moura CA, Mousseau J, Mouster G, Mu W, Mualem L, Mueller J, Muether M, Mufson S, Muheim F, Muir A, Mulhearn M, Munford D, Muramatsu H, Murphy S, Musser J, Nachtman J, Nagu S, Nalbandyan M, Nandakumar R, Naples D, Narita S, Nath A, Navrer-Agasson A, Nayak N, Nebot-Guinot M, Negishi K, Nelson JK, Nesbit J, Nessi M, Newbold D, Newcomer M, Newton H, Nichol R, Nicolas-Arnaldos F, Nikolica A, Niner E, Nishimura K, Norman A, Norrick A, Northrop R, Novella P, Nowak JA, Oberling M, Ochoa-Ricoux J, Olivier A, Olshevskiy A, Onel Y, Onishchuk Y, Ott J, Pagani L, Palacio G, Palamara O, Palestini S, Paley JM, Pallavicini M, Palomares C, Vazquez WP, Pantic E, Paolone V, Papadimitriou V, Papaleo R, Papanestis A, Paramesvaran S, Parke S, Parozzi E, Parsa Z, Parvu M, Pascoli S, Pasqualini L, Pasternak J, Pater J, Patrick C, Patrizii L, Patterson RB, Patton SJ, Patzak T, Paudel A, Paulos B, Paulucci L, Pavlovic Z, Pawloski G, Payne D, Pec V, Peeters SJM, Perez AP, Pennacchio E, Penzo A, Peres OLG, Perry J, Pershey D, Pessina G, Petrillo G, Petta C, Petti R, Pia V, Piastra F, Pickering L, Pietropaolo F, Pimentel VL, Pinaroli G, Plows K, Plunkett R, Poling R, Pompa F, Pons X, Poonthottathil N, Poppi F, Pordes S, Porter J, Potekhin M, Potenza R, Potukuchi BVKS, Pozimski J, Pozzato M, Prakash S, Prakash T, Prest M, Prince S, Psihas F, Pugnere D, Qian X, Raaf JL, Radeka V, Rademacker J, Radics B, Rafique A, Raguzin E, Rai M, Rajaoalisoa M, Rakhno I, Rakotonandrasana A, Rakotondravohitra L, Rameika R, Delgado MAR, Ramson B, Rappoldi A, Raselli G, Ratoff P, Raut S, Razakamiandra RF, Rea EM, Real JS, Rebel B, Rechenmacher R, Reggiani-Guzzo M, Reichenbacher J, Reitzner SD, Sfar HR, Renshaw A, Rescia S, Resnati F, Ribas M, Riboldi S, Riccio C, Riccobene G, Rice LCJ, Ricol JS, Rigamonti A, Rigaut Y, Rincón EV, Ritchie-Yates H, Rivera D, Robert A, Rochester L, Roda M, Rodrigues P, Alonso MJR, Bonilla ER, Rondon JR, Rosauro-Alcaraz S, Rosenberg M, Rosier P, Roskovec B, Rossella M, Rossi M, Rout J, Roy P, Rubbia A, Rubbia C, Russell B, Ruterbories D, Rybnikov A, Saa-Hernandez A, Saakyan R, Sacerdoti S, Safford T, Sahu N, Sakashita K, Sala P, Samios N, Samoylov O, Sanchez MC, Sandberg V, Sanders DA, Sankey D, Santana S, Santos-Maldonado M, Saoulidou N, Sapienza P, Sarasty C, Sarcevic I, Savage G, Savinov V, Scaramelli A, Scarff A, Scarpelli A, Schefke T, Schellman H, Schifano S, Schlabach P, Schmitz D, Schneider AW, Scholberg K, Schukraft A, Segreto E, Selyunin A, Senise CR, Sensenig J, Sergi A, Sgalaberna D, Shaevitz MH, Shafaq S, Shaker F, Shamma M, Sharankova R, Sharma HR, Sharma R, Sharma RK, Shaw T, Shchablo K, Shepherd-Themistocleous C, Sheshukov A, Shin S, Shoemaker I, Shooltz D, Shrock R, Siegel H, Simard L, Sinclair J, Sinev G, Singh J, Singh J, Singh L, Singh P, Singh V, Sipos R, Sippach FW, Sirri G, Sitraka A, Siyeon K, Skarpaas K, Smith A, Smith E, Smith P, Smolik J, Smy M, Snider E, Snopok P, Snowden-Ifft D, Nunes MS, Sobel H, Soderberg M, Sokolov S, Salinas CJS, Söldner-Rembold S, Soleti SR, Solomey N, Solovov V, Sondheim WE, Sorel M, Sotnikov A, Soto-Oton J, Ugaldi FAS, Sousa A, Soustruznik K, Spagliardi F, Spanu M, Spitz J, Spooner NJC, Spurgeon K, Stancari M, Stanco L, Stanford C, Stein R, Steiner HM, Lisbôa AFS, Stewart J, Stillwell B, Stock J, Stocker F, Stokes T, Strait M, Strauss T, Strigari L, Stuart A, Suarez JG, Sunción JMS, Sullivan H, Summers D, Surdo A, Susic V, Suter L, Sutera CM, Svoboda R, Szczerbinska B, Szelc AM, Tanaka H, Tang S, Tapia A, Oregui BT, Tapper A, Tariq S, Tarpara E, Tata N, Tatar E, Tayloe R, Teklu AM, Tennessen P, Tenti M, Terao K, Ternes CA, Terranova F, Testera G, Thakore T, Thea A, Thompson JL, Thorn C, Timm SC, Tishchenko V, Tomassetti L, Tonazzo A, Torbunov D, Torti M, Tortola M, Tortorici F, Tosi N, Totani D, Toups M, Touramanis C, Travaglini R, Trevor J, Trilov S, Trzaska WH, Tsai Y, Tsai YT, Tsamalaidze Z, Tsang KV, Tsverava N, Tufanli S, Tull C, Tyley E, Tzanov M, Uboldi L, Uchida MA, Urheim J, Usher T, Uzunyan S, Vagins MR, Vahle P, Valder S, Valdiviesso GDA, Valencia E, Valentim R, Vallari Z, Vallazza E, Valle JWF, Vallecorsa S, Berg RV, de Water RGV, Forero DV, Vannerom D, Varanini F, Oliva DV, Varner G, Vasel J, Vasina S, Vasseur G, Vaughan N, Vaziri K, Ventura S, Verdugo A, Vergani S, Vermeulen MA, Verzocchi M, Vicenzi M, de Souza HV, Vignoli C, Vilela C, Viren B, Vrba T, Wachala T, Waldron AV, Wallbank M, Wallis C, Wang H, Wang J, Wang L, Wang MHLS, Wang X, Wang Y, Wang Y, Warburton K, Warner D, Wascko MO, Waters D, Watson A, Wawrowska K, Weatherly P, Weber A, Weber M, Wei H, Weinstein A, Wenman D, Wetstein M, White A, Whitehead LH, Whittington D, Wilking MJ, Wilkinson A, Wilkinson C, Williams Z, Wilson F, Wilson RJ, Wisniewski W, Wolcott J, Wongjirad T, Wood A, Wood K, Worcester E, Worcester M, Wresilo K, Wret C, Wu W, Wu W, Xiao Y, Xie F, Yaeggy B, Yandel E, Yang G, Yang K, Yang T, Yankelevich A, Yershov N, Yonehara K, Yoon YS, Young T, Yu B, Yu H, Yu H, Yu J, Yu Y, Yuan W, Zaki R, Zalesak J, Zambelli L, Zamorano B, Zani A, Zazueta L, Zeller GP, Zennamo J, Zeug K, Zhang C, Zhang S, Zhang Y, Zhao M, Zhivun E, Zhu G, Zimmerman ED, Zucchelli S, Zuklin J, Zutshi V, Zwaska R. Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2022; 82:618. [PMID: 35859696 PMCID: PMC9288420 DOI: 10.1140/epjc/s10052-022-10549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6 × 6 × 6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.
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Vanderstraeten B, Johnston N, Ketelaars J. PO-1493 Comparison of CBCT Hounsfield Unit to density conversion methods for treatment plan evaluation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bogaert E, Johnston N, Huybrechts V, Vandemaele M, Vanhoutte F, Lievens Y. PO-1620 Can auto-delineated lung lobe motion be a surrogate for tumour motion for Mid-V determination? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Calzia M, Agarwal N, Johnston N, Sippel J, Smith J. Secondary Pulmonary Alveolar Proteinosis Due to Sirolimus. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Laffan J, Hogg M, Devlin P, Mailey J, Montgomery J, Johnston N, Spence M, Walsh S. Association between social deprivation status, age of presentation, and survival following ST-segment elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Many factors influence age of presentation with and survival following ST-segment myocardial infarction (STEMI). These include age, mode of, and time-delay to emergency treatment, diabetes and smoking. We sought to assess whether overall social deprivation status is associated with age of presentation and mortality following STEMI patients treated with primary PCI.
Methods
All patients treated emergently for STEMI in a large Northern Irish tertiary hospital from 2013 – 2017 were reviewed. Social deprivation is determined as a composite score relating to income, crime etc, and assigned to small geographical regions by the Northern Ireland Statistics and Research Agency. Deprivation score was assigned to patients based on their postcode. The database was ranked by social deprivation score and divided in to quintiles. The most (Grp 1) and least (Grp 5) deprived quintiles were compared. Mortality was determined from a national electronic health record.
Results
1,192 patients were included in the analysis. Mean follow up was 52.5 months (SD 15.6), minimum follow up was 35.6 months. There was no difference in gender: 70.1% male in Grp 1 vs 75.2% male in Grp 5 (p=0.68); no difference in ECG to balloon time: mean 89.9mins (95% CI 84.9–94.9) Grp 1 vs 90.5mins (95% CI 86.2–94.9) Grp 5 (p=0.86). The more deprived group was younger: mean age 60.6 (95% CI 59.5–61.6) vs 65.2 (95% CI 64.2–66.3) (p<0.000). Crude survival measured by Log-rank test was the same between the groups (p=0.52). Following Cox-regression adjustment for age, survival was longer in the least deprived group (p=0.042).
Conclusion
Social deprivation is associated with both a younger age of presentation with, and a higher mortality following STEMI. This is important variable is often overlooked in medical literature and should be further studied.
Funding Acknowledgement
Type of funding sources: None.
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Johnston N, De Rycke J, Lievens Y, Vanderstraeten B. PO-1652 Clinical evaluation of deep learning for auto-segmentation of CT images in RT for lung cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Wilander H, Swahn E, Johnston N, Jonasson L, Pagonis C, Tornvall P, Venetsanos D, Sederholm Lawesson S. Spontaneous coronary artery dissection – contemporary management and outcome of a national cohort. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Spontaneous coronary artery dissection (SCAD) is proposed to cause 1–4% of all acute myocardial infarctions (AMI).
The aim of this study was to conduct a first description of Swedish SCAD patients regarding the prevalence of risk factors, treatment and prognosis.
Method
All patients with AMI registered in the Swedish Coronary Angiography and Angioplasty Register (SCAAR) December 2015 until December 2017 were included. The index angiographies of the SCAD patients were reevaluated by an independent angiographer at each center. Patients with non-SCAD AMI (n=31670) were used for comparison.
Results
SCAD was identified in 137 patients with AMI (100 women, 37 men). The SCAD population was younger than the non-SCAD population 53.9 (51.7–56.1) vs 68.5 (68.3–68.6) years, more often women (73.0 vs 30.7%) and presented with less risk factors: diabetes 2.9 vs 20.8%; hypertension 27.0 vs 57.6%; smoking 41.2 vs 58.1%; statin therapy 12.4 vs 36.9% and previous AMI 7.3 vs 19.6% (p<0.001 for all comparisons).
SCAD patients less frequently underwent percutaneous coronary intervention (PCI) 43.1 vs 70.8% (p<0.001) and received less statin treatment, 78.9 vs 91.5% (p<0.001).
There was no significant difference regarding treatment with aspirin or double antiplatelet therapy at discharge: 93 vs 89.7% (p=0.45) and 86.7 vs 84.2%, respectively (p=0,43).
There was no significant difference in one-year mortality 6.6 vs 8.2% (p=0.57).
Conclusions
With a current prevalence of 0.43% of all Swedish AMIs, data supports SCAD being an underdiagnosed condition with a prognosis resembling that of non-SCAD AMI. Furthermore, SCAD patients are younger and harbor less cardiovascular risk factors. While significant differences in management are present, current therapeutic strategies of the two groups are similar, indicating overtreatment of SCAD.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Swedish Heart-Lung foundation, ALF funding
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Sederholm Lawesson S, Venetsanos D, Fredriksson M, Jernberg T, Johnston N, Ravn-Fischer A, Alfredsson J. P1726A gender perspective on incidence, management, short- and long term outcome of cardiogenic shock complicating ST-elevation myocardial infarction - A report from the SWEDEHEART register. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiogenic shock [CS] is a severe complication of ST-elevation myocardial infarction [STEMI]. An increased use of primary percutaneous coronary intervention [PPCI] has been associated with a decline in CS incidence, and a better prognosis. Female gender has been associated with a worse prognosis in STEMI, but whether there is a gender difference in incidence and outcome of CS complicating STEMI is not known.
Purpose
The objectives of this study were to compare the genders regarding incidence, management, and prognosis of CS complicating STEMI.
Methods
Patients with STEMI and CS were identified in SWEDEHEART 2005–2014. Cardiogenic shock was defined as any of; 1) systolic blood pressure [BP] <90 mm Hg ≥30 min, 2) signs of tissue hypoperfusion, 3) cardiac index <1,8 l/min/m2, 4) ionotropic drugs and/or need of intra-aortic balloon pump. Multiple logistic and cox regression analyses were done with reperfusion therapy, in-hospital and 1-year mortality as dependent variables.
Results
Among 56072 STEMI patients 3134 CS cases were identified. Women more often than men developed CS (6.3 vs 5.2%, p<0.001). The age-adjusted incidence of CS did not change in women, whereas in men the incidence increased by 2.7% yearly. Women had a less chance of receiving reperfusion therapy, OR 0.77 (95% CI 0.65–0.92), but had neither higher in-hospital mortality (OR 1.01, 95% CI 0.85–1.19), nor higher 1-year mortality (OR 0.97, 95% CI 0.70–1.33). Upon age stratification the gender difference in reperfusion was only evident among the oldest (>80 years).
Conclusion
Women had higher risk of CS than men when stricken by STEMI, but whereas CS incidence increased in men it was stable in women. Although women had less likelihood of receiving reperfusion therapy, adjusted in-hospital, and 1-year mortality was without any gender difference. The rate of reperfusion was especially low in elderly women, where there seems to be room for improvement.
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Kolahdooz F, Nader F, Daemi M, Jang SL, Johnston N, Sharma S. Adherence to Canada's Food Guide recommendations among Alberta's multi-ethnic youths is a major concern: findings from the WHY ACT NOW project. J Hum Nutr Diet 2018; 31:658-669. [PMID: 29799655 DOI: 10.1111/jhn.12565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dietary habits formed during youth may result in the development of obesity and chronic diseases in adulthood. We aimed to determine the frequency of the consumption of foods and beverages and the degree of adherence to Canada's Food Guide recommendations among multi-ethnic youths. METHODS Participants were recruited from 12 schools in the Edmonton, Alberta area by use of posters, school newsletters and advertisements. A 30-item food frequency questionnaire was administered by a trained interviewer to assess dietary intake in a convenience sample of 557 (328 females and 229 males) youths aged 11-23 years; for the purpose of the present study, only the 14-18 years age group was considered in the analysis. Participants were divided by sex and self-identified ethnicity into four groups [Indigenous, African & Middle Eastern (AME), Asian, and European]. Statistical analysis of the data was undertaken using t-tests, Welch's analysis of variance and Games-Howell tests. P < 0.05 was considered statistically significant. RESULTS Vegetables and Fruit recommendations were the least likely to be followed, with 90.7-96.8% of participants in all groups not consuming the recommended number of servings day-1 . The mean frequency of fruit consumption was lower among Indigenous youths compared to Asian youths (0.90 versus 1.37 times day-1 ). A greater proportion of males than females (55.9% versus 44.3%) did not meet the minimum recommendations for Meat and Alternatives (P = 0.016). The percentage of youths not adhering to recommendations for Milk and Alternatives was 81.7% for Indigenous, 73.3% for AME, 78.6% for Asian and 63.5% for European youths. Indigenous youths more frequently consumed potato chips and soft drinks compared to other ethnic youths. The most frequently consumed beverage was milk (1.25 times day-1 ). CONCLUSIONS The majority of youths did not consume minimum daily recommended servings of Vegetables and Fruit, Milk and Alternatives, and/or Meat and Alternatives food groups. Evidence-based dietary interventions and public health strategies are needed.
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Esgin T, Johnston N, Rowley K, Saes de Villarreal E, Newton R. Effect of 12 weeks combined aerobic and resistance training on fitness, arterial stiffness and body composition in Indigenous Australian men and women. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.09.279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Humphries KH, Izadnegahdar M, Sedlak T, Saw J, Johnston N, Schenck-Gustafsson K, Shah RU, Regitz-Zagrosek V, Grewal J, Vaccarino V, Wei J, Bairey Merz CN. Sex differences in cardiovascular disease - Impact on care and outcomes. Front Neuroendocrinol 2017; 46:46-70. [PMID: 28428055 PMCID: PMC5506856 DOI: 10.1016/j.yfrne.2017.04.001] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/31/2017] [Accepted: 04/13/2017] [Indexed: 02/07/2023]
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Sword W, Eyles J, DeLuca P, Heaman M, Kingston D, Buist S, Johnston N, Sprague A. Place of residence and maternal health behaviours. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv173.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Howe A, Spence M, Manoharan G, Johnston N, Owens C, Dixon L, Onyekwelu N, Jeganathan R, Smith B, McEvoy M. 59 Real world TAVI outcome and prognostication: a retrospective review of a single centre experience. BRITISH HEART JOURNAL 2015. [DOI: 10.1136/heartjnl-2015-308621.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Garland JS, Alex CP, Johnston N, Yan JC, Werlin SL. Association between tracheal pepsin, a reliable marker of gastric aspiration, and head of bed elevation among ventilated neonates. J Neonatal Perinatal Med 2015; 7:185-92. [PMID: 25318633 DOI: 10.3233/npm-14814020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine the frequency of tracheal pepsin in ventilated neonates and whether the angle of head elevation was associated with tracheal pepsin. STUDY DESIGN Serial trachael samples (at 3, 7, 14, 21 and 28 days of ventilation) were obtained from intubated, ventilated very low birth weight infants. Presence of tracheal pepsin was determined by Western blot analysis using a specific anti-human pepsin antibody. RESULTS Tracheal pepsin was detected in 35/66 (53%) of the ventilated neonates (birthweight: 798 ± 268 grams [mean ± standard deviation]). Neonates whose head elevation was in the upper quartile (≥14 degrees) during the first sampling time (day 3) were less likely (4/16 vs 9/10, P = 0.0013) to have tracheal pepsin when compared to neonates whose head elevation was in the lowest quartile (≤8 degrees). CONCLUSIONS Pepsin, a marker for gastric secretion aspiration, was detected in 53% of ventilated low birth weight neonates; early elevation of the head of the bed was associated with a lower rate of tracheal pepsin.
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Cole BR, Douglas H, Soong CM, Horan P, Dixon LJ, Johnston N, Harbinson M. 11 The impact of cardiac magnetic resonance viability assessment on the management of patients with ischaemic heart disease and left ventricular dysfunction: Abstract 11 Table 1. BRITISH HEART JOURNAL 2015. [DOI: 10.1136/heartjnl-2015-307845.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Douglas H, Cole B, Soong CM, Harbinson M, Horan P, Dixon LJ, Johnston N. 12 Myocardial viability in preserved or mildly impaired left ventricular function prior to revascularisation – findings from a 3 year experience. BRITISH HEART JOURNAL 2015. [DOI: 10.1136/heartjnl-2015-307845.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Secchi F, Cannao P, Pluchinotta F, Butera G, Carminati M, Sardanelli F, Lombardi M, Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner S, Stuber M, Schwitter J, Romana P, Francesco S, Gianfranco B, Mario C, Francesco S, Massimo L, Alizadeh Sani Z, Vojdan-Parast M, Alimohammadi M, Sarafan-Sadeghi S, Seifi A, Fallahabadi H, Karami Tanha F, Jamshidi M, Hesamy M, Bonello B, Sorensen C, Fouilloux V, Gorincour G, Mace L, Fraisse A, Jacquier A, de Meester C, Amzulescu M, Bouzin C, Boileau L, Melchior J, Boulif J, Lazam S, Pasquet A, Vancrayenest D, Vanoverschelde J, Gerber B, Loudon M, Bull S, Bissell M, Joseph J, Neubauer S, Myerson S, Dorniak K, Hellmann M, Rawicz-Zegrzda D, W sierska M, Sabisz A, Szurowska E, Heiberg E, Dudziak M, Kwok T, Chin C, Dweck M, Hadamitzky M, Nadjiri J, Hendrich E, Pankalla C, Will A, Schunkert H, Martinoff S, Sonne C, Pepe A, Meloni A, Terrazzino F, Spasiano A, Filosa A, Bitti P, Tangari C, Restaino G, Resta M, Ricchi P, Meloni A, Tudisca C, Grassedonio E, Positano V, Piraino B, Romano N, Keilberg P, Midiri M, Pepe A, Meloni A, Positano V, Macchi S, Ambrosio D, De Marchi D, Chiodi E, Resta M, Salvatori C, Pepe A, Artang R, Bogachkov A, Botelho M, Bou-Ayache J, Vazquez M, Carr J, Collins J, Maret E, Ahlander B, Bjorklund P, Engvall J, Cimermancic R, Inage A, Mizuno N, Positano V, Meloni A, Santarelli M, Izzi G, Maddaloni D, De Marchi D, Salvatori C, Landini L, Pepe A, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Fraticelli V, Toia P, Renne S, Restaino G, Salvatori C, Rizzo M, Reinstadler S, Klug G, Feistritzer H, Aschauer A, Schocke M, Franz W, Metzler B, Melonil A, Positanol V, Roccamo G, Argento C, Benni M, De Marchil D, Missere M, Prezios P, Salvatoril C, Pepel A, Meloni A, Rossi G, Positano V, Cirotto C, Filati G, Toia P, Preziosi P, De Marchi D, Pepe A, Mongeon F, Fischer K, Teixeira T, Friedrich M, Marcotte F, Vincenti G, Monney P, Rutz T, Zenge M, Schmidt M, Nadar M, Chevre P, Rohner C, Schwitter J, Mouratoglou S, Kallifatidis A, Giannakoulas G, Grapsa J, Kamperidis V, Pitsiou G, Stanopoulos I, Hadjimiltiades S, Karvounis H, Ahmed N, Lawton C, Ghosh Dastidar A, Frontera A, Jackson A, Cripps T, Diab I, Duncan E, Thomas G, Bucciarelli-Ducci C, Kannoly S, Gosling O, Ninan T, Fulford J, Dalrymple-Haym M, Shore A, Bellenger N, Alegret J, Beltran R, Martin M, Mendoza M, Elisabetta C, Teresa C, Zairo F, Marcello N, Clorinda M, Bruna M, Vincenzo P, Alessia P, Giorgio B, Klug G, Feistritzer H, Reinstadler S, Mair J, Schocke M, Kremser C, Franz W, Metzler B, Aschauer S, Tufaro C, Kammerlander A, Pfaffenberger S, Marzluf B, Bonderman D, Mascherbauer J, Kliegel A, Sailer A, Brustbauer R, Sedivy R, Mayr H, Manessi M, Castelvecchio S, Votta E, Stevanella M, Menicanti L, Secchi F, Sardanelli F, Lombardi M, Redaelli A, Reiter U, Reiter G, Kovacs G, Greiser A, Olschewski H, Fuchsjager M, Kammerlander A, Tufaro C, Pfaffenberger S, Marzluf B, Aschauer S, Babayev J, Bonderman D, Mascherbauer J, Mlynarski R, Mlynarska A, Sosnowski M, Pontone G, Bertella E, Petulla M, Russo E, Innocenti E, Baggiano A, Mushtaq S, Gripari P, Andreini D, Tondo C, Nyktari E, Izgi C, Haidar S, Wage R, Keegan J, Wong T, Mohiaddin R, Durante A, Rimoldi O, Laforgia P, Gianni U, Benedetti G, Cava M, Damascelli A, Laricchia A, Ancona M, Aurelio A, Pizzetti G, Esposito A, Margonato A, Colombo A, De Cobelli F, Camici P, Zvaigzne L, Sergejenko S, Kal js O, Kannoly S, Ripley D, Swarbrick D, Gosling O, Hossain E, Chawner R, Moore J, Shore A, Bellenger N, Aquaro G, Barison A, Masci P, Todiere G, Strata E, Barison A, Di Bella G, Monasterio F, Feistritzer H, Reinstadler S, Klug G, Kremser C, Schocke M, Franz W, Metzler B, Levelt E, Mahmod M, Ntusi N, Ariga R, Upton R, Piechnick S, Francis J, Schneider J, Stoll V, Davis A, Karamitsos T, Leeson P, Holloway C, Clarke K, Neubauer S, Karwat K, Tomala M, Miszalski-Jamka K, Mrozi ska S, Kowalczyk M, Mazur W, Kereiakes D, Nessler J, Zmudka K, Ja wiec P, Miszalski-Jamka T, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ganzoui I, Ben Miled A, Mnif N, Rodriguez Palomares J, Ortiz J, Bucciarelli-Ducci C, Tejedor P, Lee D, Wu E, Bonow R, Khanji M, Castiello T, Westwood M, Petersen S, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Storti S, Grassedonio E, Renne S, Missere M, Positano V, Rizzo M, Meloni A, Quota A, Smacchia M, Paci C, Positano V, Vallone A, Valeri G, Chiodi E, keilberg P, Pepe A, Barison A, De Marchi D, Gargani L, Aquaro G, Guiducci S, Pugliese N, Lombardi M, Pingitore A, Cole B, Douglas H, Rodden S, Horan P, Harbinson M, Johnston N, Dixon L, Choudhary P, Hsu C, Grieve S, Semsarian C, Richmond D, Celermajer D, Puranik R, Hinojar Baydes R, Varma N, Goodman B, Khan S, Arroyo Ucar E, Dabir D, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Ucar E, Ngah N, Kuo N, D'Cruz D, Gaddum N, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Foote L, Arroyo Ucar E, Dabir D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Morocutti G, Gianfagna P, Zanuttini D, Piccoli G, Proclemer A, Nucifora G, Prati G, Vitrella G, Allocca G, Buttignoni S, Muser D, Morocutti G, Delise P, Proclemer A, Sinagra G, Silva G, Almeida A, David C, Francisco A, Magalhaes A, Placido R, Menezes M, Guimaraes T, Mendes A, Nunes Diogo A, Aneq M, Maret E, Engvall J, Douglas H, Cole B, Rodden S, Horan P, Harbinson M, Dixon L, Johnston N, Papavassiliu T, Sandberg R, Schimpf R, Schoenberg S, Borggrefe M, Doesch C, Khan S, Tamin S, Tan L, Joshi S, Khan S, Memon S, Tamin S, Tan L, Joshi S, Tangcharoen T, Prasertkulchai W, Yamwong S, Sritara P, Hinojar R, Foote L, Arroyo Ucar E, Binti Ngah N, Cruz D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Masci P, Barison A, Rebellato L, Piccoli G, Daleffe E, Zanuttini D, Facchin D, Lombardi M, Proclemer A, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M, Agoston-Coldea L, Marjanovic Z, Hadj Khelifa S, Kachenoura N, Lupu S, Soulat G, Farge-Bancel D, Mousseaux E, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ben Miled A, Mnif N, Dastidar A, Ahmed N, Frontera A, Lawton C, Augustine D, McAlindon E, Bucciarelli-Ducci C, Vasconcelos M, Leite S, Sousa C, Pinho T, Rangel I, Madureira A, Ramos I, Maciel M, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Todiere G, Pisciella L, Barison A, Zachara E, Federica R, Emdin M, Aquaro G, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Baydes R, Ucar E, Foote L, Dabir D, Mahmoud I, Jackson T, Schaeffter T, Higgins D, Nagel E, Puntmann V, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M. These abstracts have been selected for VIEWING only as ePosters and in print. ePosters will be available on Screen A & B throughout the meeting, Print Posters at the times indicated below. Please refer to the PROGRAM for more details. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ainslie B, Alexander N, Johnston N, Bradley J, Pomeroy AC, Jackson PL, Otter KA. Predicting spatial patterns of eagle migration using a mesoscale atmospheric model: a case study associated with a mountain-ridge wind development. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:17-30. [PMID: 23325041 DOI: 10.1007/s00484-012-0620-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 06/01/2023]
Abstract
High resolution numerical atmospheric modeling around a mountain ridge in Northeastern British Columbia (BC), Canada was performed in order to examine the influence of meteorology and topography on Golden Eagle migration pathways at the meso-scale (tens of km). During three eagle fall migration periods (2007-2009), local meteorological conditions on the day of peak bird counts were modeled using the Regional Atmospheric Modeling System (RAMS) mesoscale model. Hourly local surface wind speed, wind direction, temperature, pressure and relative humidity were also monitored during these migration periods. Eagle migration flight paths were observed from the ground and converted to three-dimensional tracks using ArcGIS. The observed eagle migration flight paths were compared with the modeled vertical velocity wind fields. Flight tracks across the study area were also simulated using the modeled vertical velocity field in a migration model based on a fluid-flow analogy. It was found that both the large-scale weather conditions and the horizontal wind fields across the study area were broadly similar on each of the modeled migration days. Nonetheless, the location and density of flight tracks across the domain varied between days, with the 2007 event producing more tracks to the southwest of the observation location than the other 2 days. The modeled wind fields suggest that it is not possible for the eagles to traverse the study area without leaving updraft regions, but birds do converge on the locations of updrafts as they move through the area. Statistical associations between observed eagles positions and the vertical velocity field suggest that to the northwest (and to a lesser extent the southwest) of the main study ridge (Johnson col), eagles can always find updrafts but that they must pass through downdraft regions in the NE and SE as they make their way across the study area. Finally, the simulated flight tracks based on the fluid-flow model and the vertical velocity fields are in general agreement with the observed flight track patterns. Our results suggest that use of high resolution meteorological fields to locate the occurrence of updrafts in proposed ridge-line wind installations could aid in predicting, and mitigating for, convergence points in raptor migrations.
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Fayez R, AlMuntashery A, Bodie G, Almamar A, Gill R, Raîche I, Mueller C, AlMuntashery A, Fayez R, AlMuntashery A, Moustarah F, Khokhotva M, Anvari M, Kwong J, Elkassem S, Bonrath E, Zevin B, Sockalingam S, Smith C, Smith C, Whitlock K, Gill R, Suri M, Palter V, Wakeam E, Khan R, Martelli V, Malik A, Young P, Daigle C, McCreery G, Seth R, Paskar D, Sudarshan M, Richardson D, Haggar F, Davis V, Rivard J, Agzarian J, Racz J, Winocour J, Zilbert N, Decker C, Neumann K, Gosney J, Wissanji H, Chadi S, Alhabboubi M, Partridge E, Alhabboubi M, Olszewski M, Chan R, Nadler A, Hameed U, Brotherhood H, Menezes A, MacDonald B, Rakovich G, Hilsden R, Merani S, Davis P, Davis P, Cools-Lartigue J, Ojah J, Julien F, Carter D, Pitt D, Banks B, Rudovics A, Ravichandran P, Anantha R, Aad I, Kholdebarin R, Aird L, Wong S, Payne J, Hallet J, Farries L, Raiche I, Botkin C, Morency D, Berger-Richardson D, Isa A, Dupuis I, Schweigert M, Koubi S, Ernjakovic M, Grant K, Cools-Lartigue J, Carrott P, Stafford T, Malthaner R, Sudarshan M, Hanna W, Lee L, Markar S, Razzak R, Bharadwaj S, Ashrafi A, Ouellette D, Fergusson D, Forster A, Boushey R, Porter G, Johnson P, Gomes T, Chan B, Auer R, Moloo H, Mamdani M, Markar S, Al-Omran M, Al-Obaid O, Boushey R, Lim DR, Min BS, Baik SH, Gordon P, Kim NK, Lo A, Pinsk I, Bottoni D, Brown C, Raval M, Cheng H, Wong C, Johnston N, Farrokhyar F, Stephen W, Kelly S, Lindsay L, Forbes S, Knickle C, Bouchard A, Parry N, Leslie K, Ott M, Coughlin S, Gazala S, Gazala S, Donahoe L, Walker K, Li C, Alnasser S, Schweigert M, Schweigert M, Zhuruk A, Hanouf A, Vanounou T, Karanicolas P, Aubin JM, Yeung J, Dumitra S, Simoneau E, Vanounou T, Howe B, Hawel J, Jang JH, Bertens K, Rekman J, Wei A, Dumitra S, Koubi S, Ouellet JF, Wei A, Covelli A, Maniar R, Sun S, Davis V, Brackstone M, Boissonneault R, Kim S, Baliski C, Gazala S, Hameed U, Sudarshan M, Arnaout A, Wedman D, Nostedt M, Hebbard P, Shetty S, Dixon M, Wei A, Dixon M, Kazazian K, Lemke M, Wells B, Musselman R, Zih FSW, Menezes A, Nassif M, Leon-Carlyle M, Wei A, Krotneva S, Bradley N, Trabulsi N, Trabulsi N, Chin-Lenn L, Cheng H, Petrucci A, Sandhu L, Neville A, Lee L, Li C, Yang I, Prabhu KL, Melich G, Knowles S, Richardson D, Borowiec A, Hallet J, Boissonneault R, Kolozsvari N, Hallet J, Tuttle P, VanHouwelingen L, Haggar F, Boulanger-Gobeil C, Chan B, Chan B, Richardson D, Musselman R, Melich G, Phang P, Goldstein L, Wen C, Lebrun A, Chadi S, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, Fayez R, Demyttenaere S, Christou N, Court O, Bonrath E, Hagen J, Okrainec A, Sullivan P, Grantcharov T, Sharma A, Karmali S, Birch D, Majumdar S, Wang X, Tuepah R, Klarenbach S, Birch D, Karmali S, Sharma A, Padwal R, Smith C, Haggar F, Moloo H, Poulin E, Martel G, Yelle JD, Mamazza J, Jackson T, Penner T, Pitzul K, Urbach D, Okrainec A, Villeneuve S, Roy M, Fayez R, Demyttenaere S, Christou N, Court O, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, Fayez R, Demyttenaere S, Court O, Christou N, Biertho L, Hould FS, Lebel S, Lescelleur O, Marceau S, Marceau P, Biron S, Grantcharov T, Sharma A, Yusuf S, Okrainec A, Pitzul K, Urbach D, Jackson T, Lindsay D, Sullivan P, Smith L, Zevin B, Dedy N, Grantcharov T, Bonrath E, Aggarwal R, Grantcharov T, Cassin S, Crawford S, Pitzul K, Khan A, Hawa R, Jackson T, Okrainec A, Brar B, Mamazza J, Raîche I, Yelle JD, Haggar F, Moloo H, Brar B, Haggar F, Dent R, Mamazza J, Raîche I, Moloo H, Gill R, Ali T, Shi X, Birch D, Karmali S, Whitlock K, Shi X, Sarkhosh K, Birch D, Karmali S, Turner J, Nation P, Wizzard P, Brubaker P, Gisalet D, Wales P, Grantcharov T, Tien H, Spencer F, Brenneman F, Kowal J, Wiseman S, Fraser S, Vedel I, Deban M, Holcroft C, Monette M, Monette J, Bergman S, Bell C, Stukel T, Urbach D, Mueller T, Lucykx V, Lukowski C, Compston C, Churchill T, Khadaroo R, Grantcharov T, Vogt K, Dubois L, Gray D, Ananth A, Tai LH, Lam T, Falls T, Souza C, Bell J, Auer R, Crawford S, Parry N, Leslie K, Alhabboubi M, St-Louis E, Deckelbaum D, Razek T, Feldman L, Khwaja K, Porter G, Johnson P, Boushey R, Moloo H, Raiche I, Mamazza J, Schiller D, Eurich D, Sawyer M, Vergis A, Unger B, Hardy K, Andrew C, Gillman L, Park J, Prodger J, Kelly W, Kelly S, Prodger D, Ewara E, Martin J, Sarma S, Chu M, Schlachta C, Zaric G, Al-Ali K, Briggs K, George R, Murnaghan M, Leung A, Regehr G, Moulton CA, Mahmud S, Metcalfe J, McKay A, Park J, Hochman D, Burkle F, Redmond A, McQueen K, Desrosiers E, Gilbert A, Leslie K, Ott M, Sudarshan M, Jessula S, Alburakan A, Deckelbaum D, Razek T, Iqbal S, Khwaja K, Aikins C, Sudarshan M, Deckelbaum D, Iqbal S, Khwaja K, Razek T, Roberts N, Moulton CA, Murnaghan M, Cil T, Marshall J, Pederson K, Erichsen S, White J, Aarts MA, Okrainec A, Victor J, Pearsall E, McLeod R, Jackson T, Okrainec A, Penner T, Urbach D, Karimuddin A, Hall C, Bawan S, Malik S, Hayashi A, Gill R, McAlister C, Zhang N, DesRosiers E, Mills A, Crozier M, Lee L, Maxwell J, Partridge E, Chad S, Steigerwald S, Mapiour D, Roberts D, MacPherson C, Donahoe L, Mercer D, Hopman W, Latulippe JF, Knowles S, Moffat B, Parry N, Leslie K, Switzer N, Khadaroo R, Tul Y, Widder S, Molinari M, Levy A, Johnson P, Bailey J, Molinari M, Hayden J, Johnson P, Benlolo S, Marcus V, Ferri L, Finley R, Anderson D, Gagné JP, Chan S, Wong S, Li J, Michael A, Choi D, Liu E, Hoogenes J, Dath D, Aubin JM, Mew D, McConnell Y, Classen D, Kanthan S, Croome K, Kovacs M, Lazo-Langner A, Hernandez-Alejandro R, Vogt K, Crawford S, Parry N, Leslie K, Khoshgoo N, Iwasiow B, Keijzer R, Brown C, Isa D, Pace D, Widder S, Tul Y, Primrose M, Hudson D, Khadaroo R, Lauzier F, Mailloux O, Trottier V, ARchambault P, Zarychanski R, Turgeon A, Mailloux O, Hardy P, Muirhead R, Masters J, Haggar F, Poulin HME, Martel G, Mamazza J, Milbrandt C, Keijzer R, Sideris L, Grenier-Vallée P, Latulippe JF, Dubé P, Kurashima Y, Kaneva P, Feldman L, Fried G, Vassiliou M, Kwan AL, Fraser S, Solymosi N, Rauh N, Dubecz A, Renz M, Ofner D, Stein H, Borgaonkar M, Crystal P, Easson A, Escallon J, Reedijk M, Cil T, Leong W, McCready D, Clifton J, Mayo J, Finley R, Noreau-Nguyen M, Mulder D, Ferri L, Markar S, Hong J, Low D, Maslow A, Davignon K, Ng T, Tan L, Aruranian J, Kosa S, Ferri L, Murphy G, Allison F, Moshonov H, Darling G, Waddell T, De Perrot M, Cypel M, Yasufuku K, Keshavjee S, Paul N, Pierre A, Darling G, Pedneault C, Marcus V, Mulder D, Ferri L, Low D, Roa W, Löbenberg R, McEwan S, Bédard E, Louie B, Farivar A, McHugh S, Aye R, Tan-Tam C, De Vera M, Bond R, Ong S, Johal B, Schellenberg D, Po M, Nissar S, Lund C, Ahmadi S, Wakil N, Rakovich G, Beauchamps G, Preston S, Baker C, Low D, Campbell G, Malthaner R, Bethune D, Henteleff H, Johnston M, Buduhan G, Coughlin HE, Roth L, Bhandari M, Malthaner R, Johnson J, Kutsogiannis J, Bédard E, Rammohan K, Stewart K, Bédard E, Buduhan G, Gruchy J, Xu Z, Buduhan G, Ferri L, Mulder D, Ncuti A, Neville A, Kaneva P, Watson D, Vassiliou M, Carli F, Feldman L, Av R, Mayrand S, Franco E, Ferri L, Dubecz A, Renz M, Stadlhuber R, Ofner D, Stein H, Renz M, Dubecz A, Solymosi N, Thumfart L, Ofner D, Stein H, Croome K, Leeper R, Hernandez R, Livingstone S, Sapp J, Woodhall D, Alwayn I, Bergman S, Lam-McCulloch J, Balaa F, Jayaraman S, Quan D, Wei A, Guyatt G, Rekman J, Fairfull-Smith R, Mimeault R, Balaa F, Martel G, Boehnert M, Bazerbachi F, Knaak J, Selzner N, McGilvray I, Rotstein O, Adeyi O, Levy G, Keshavjee S, Grant D, Selzner M, Khalil JA, Jamal M, Chaudhury P, Zogopoulos G, Petrakos P, Tchervenkov J, Barkun J, Jamal M, Hassanain M, Chaudhury P, Wong S, Salman A, Tran T, Metrakos P, Groeschl R, Geller D, Marsh J, Gamblin T, Croome K, Croome K, Quan D, Hernandez R, Kim P, Greig PD, Gallinger S, Moulton CA, Wei A, Fischer S, Cleary S, Vogt K, Hernandez-Alejandro R, Gray D, Aubin J, Fairfull-Smith J, Mimeault R, Balaa F, Martel G, Devitt K, Ramjaun A, Gallingher S, Alabbad S, Constantinos D, Hassanein M, Barkun J, Metrakos P, Paraskevas S, Chaudhury P, Tchervenkov J, Borgaonkar M, Tanyingoh D, Dixon E, Kaplan G, Myers R, Howard T, Sutherland F, Zyromski N, Ball C, Coburn N, Moulton CA, Cleary S, Law C, Greig P, Steven G, Baxter N, Fitch M, Wright F, Hochman D, Wirtzfeld D, McKay A, Yaffe C, Yip B, Silverman R, Park J, McConnell Y, Temple W, Mack L, Schiller D, Bathe O, Sawyer M, Scott L, Vandenberg T, Perera F, Potvin K, Chambers A, Loungnarath R, DeBroux É, Lavertu S, Donath D, Ayoub JP, Tehfé M, Richard C, Cornacchi S, Heller B, Farrokhyar F, Babra M, Lovrics P, Liberto C, Ghosh S, McLean R, Schiller D, Jackson T, Okrainec A, Penner T, Urbach D, Dumitra S, Duplisea J, Wexler S, Seely J, Smylie J, Knight K, Robertson S, Watters J, Zhang T, Arneout A, Hochman D, Wirtzfeld D, McKay A, Yip B, Yaffe C, Silverman R, Park J, Baxter N, Yun L, Rakovitch E, Wright F, Warner E, McCready D, Hodgson N, Quan M, Natarajan B, Govindarajan V, Thomas P, Loggie B, Brar S, Mahar A, Law C, Coburn N, Devitt K, Wiebe M, Bathe O, McLeod R, Baxter N, Gagliardi A, Kennedy E, Urbach D, Brar S, Mahar A, Law C, Coburn N, Zih F, Rosario C, Dennis J, Gingras AC, Swallow C, Ko YJ, Rowsell C, Law C, Saskin R, Quan ML, Xie M, McLaughlin K, Marginean C, Moyana T, Moloo H, Boushey R, Auer R, Razik R, Haase E, Mathieson A, Smith A, Swallow C, Barnes A, Scheer A, Moloo H, Boushey R, Sabri E, Auer R, Reidel K, Trabulsi N, Meterissian S, Tamblyn R, Mayo N, Meguerditchian A, Brown J, Hamm J, Phang P, Raval M, Brown C, Devitt K, Wiebe M, Bathe O, McLeod R, Taylor B, Urbach D, Reidel K, Mayo N, Tamblyn R, Meguerditchian A, Hamm J, Wiseman S, Patakfalvi L, Nassif M, Turcotte R, Nichols A, Meguerditchian A, Riedel K, Winslade N, Grégoire JP, Meterissian S, Abrahamovicz M, Megueerditchian A, Pasieka J, McMillan C, Lipa J, Snell L, Sudarshan M, Dumitra S, Duplisea J, Wexler S, Meterissian S, Tomlinson G, Kennedy E, Wei A, Baxter N, Urbach D, Liberman A, Charlebois P, Stein B, Ncuti A, Vassiliou M, Fried G, Feldman L, Capretti G, Power A, Liberman A, Charlebois P, Stein B, Kaneva P, Carli F, Fried G, Feldman L, Carli F, Charlebois P, Stein B, Liberman A, Kaneva P, Augustin B, Gamsa A, Kim DJ, Vassiliou M, Feldman L, Boushey R, Moloo H, Vu L, Chan S, Phang P, Gown A, Jones S, Wiseman S, Jeong DH, Hur H, Baik SH, Kim NK, Faria J, Min BS, Lumb K, Colquhoun P, Porter G, Johnson P, Baxter N, Schmocker S, Huang H, Victor J, Krzyzanowska MK, Brierley J, McLeod R, Kennedy E, Milot H, Desrosiers E, Lebrun A, Drolet S, Bouchard A, Grégoire R, Vuong T, Loungnarath R, DeBroux E, Liberman A, Charlebois P, Stein B, Richard C, Capretti G, Kaneva P, Neville A, Carli F, Liberman S, Charlebois P, Stein B, Vassiliou M, Fried G, Feldman L, Milot H, Drolet S, Bouchard A, Grégoire R, Powell R, Fowler A, Mathieson A, Martin K, Vogt K, Ott M, Pereira G, Einarsdottir K, Moloo H, Boushey R, Mamazza J, Bouchard A, Gagné J, Grégoire R, Thibault C, Bouchard P, Gomes T, Musselman R, Auer R, Moloo H, Mamdani M, Al-Omran M, Boushey R, AlObeed O, Armstrong J. Canadian Surgery Forum1 Is laparoscopic sleeve gastrectomy a reasonable stand-alone procedure for super morbidly obese patients?2 Postoperative monitoring requirements of patients with obstructive sleep apnea undergoing bariatric surgery3 Role of relaparoscopy in the diagnosis and treatment of bariatric complications in the early postoperative period4 Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding5 Prioritization and willingness to pay for bariatric surgery: the patient perspective6 Ventral hernia at the time of laparoscopic gastric bypass surgery: Should it be repaired?7 Linear stapled gastrojejunostomy with transverse handsewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y bypass8 Laparoscopic biliopancreatic diversion with duodenal switch as second stage for super super morbidly obese patients. Do all patients benefit?9 Sleeve gastrectomy in the super super morbidly obese (BMI > 60 kg/m2): a Canadian experience10 Laparoscopic gastric bypass for the treatment of refractory idiopathic gastroparesis: a report of 2 cases11 Duodeno-ileal switch as a primary bariatric and metabolic surgical option for the severely obese patient with comorbidities: review of a single-institution case series of duodeno-ileal intestinal bypass12 Management of large paraesophageal hernias in morbidly obese patients with laparoscopic sleeve gastrectomy: a case series13 Early results of the Ontario bariatric surgical program: using the bariatric registry14 Improving access to bariatric surgical care: Is universal health care the answer?15 Early and liberal postoperative exploration can reduce morbidity and mortality in patients undergoing bariatric surgery16 Withdrawn17 Identification and assessment of technical errors in laparoscopic Roux-en-Y gastric bypass18 A valid and reliable tool for assessment of surgical skill in laparoscopic Roux-en-Y gastric bypass19 Psychiatric predictors of presurgery drop-out following suitability assessment for bariatric surgery20 Predictors of outcomes following Roux-en-Y gastric bypass surgery at The Ottawa Hospital21 Prophylactic management of cholelithiasis in bariatric patients: Is routine cholecystectomy warranted?22 Early outcomes of Roux-en-Y gastric bypass in a publicly funded obesity program23 Similar incidence of gastrojejunal anastomotic stricture formation with hand-sewn and 21 mm circular stapler techniques during Roux-en-Y gastric bypass24 (CAGS Basic Science Award) Exogenous glucagon-like peptide-1 improves clinical, morphological and histological outcomes of intestinal adaptation in a distal-intestinal resection piglet model of short bowel syndrome25 (CAGS Clinical Research Award) Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial26 Negative-pressure wound therapy (iVAC) on closed, high-risk incisions following abdominal wall reconstruction27 The impact of seed granting on research in the University of British Columbia Department of Surgery28 Quality of surgical care is inadequate for elderly patients29 Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada30 Oncostatin M receptor deficiency results in increased mortality in an intestinal ischemia reperfusion model in mice31 Laparoscopic repair of large paraesophageal hernias with anterior gastropexy: a multicentre trial32 Response to preoperative medical therapy predicts success of laparoscopic splenectomy for immune thrombocytopenic purpura33 Perioperative sepsis, but not hemorrhagic shock, promotes the development of cancer metastases in a murine model34 Measuring the impact of implementing an acute care surgery service on the management of acute biliary disease35 Patient flow and efficiency in an acute care surgery service36 The relationship between treatment factors and postoperative complications after radical surgery for rectal cancer37 Risk of ventral hernia after laparoscopic colon surgery38 Urinary metabolomics as a tool for early detection of Barrett’s and esophageal cancer39 Construct validity of individual and summary performance metrics associated with a computer-based laparo-scopic simulator40 Impact of a city-wide health system reorganization on emergency department visits in hospitals in surrounding communities41 Transcatheter aortic valve implantation for the nonoperative management of aortic stenosis: a cost-effectiveness analysis42 Breast cancer: racial differences in age of onset. A potential confounder in Canadian screening recommendations43 Risk taking in surgery: in and out of the comfort zone44 A tumour board in the office: Track those cancer patients!45 Increased patient BMI is not associated with advanced colon cancer stage or grade on presentation: a retrospective chart review46 Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies. Report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict47 Learning the CanMEDS role of professional: a pilot project of supervised discussion groups addressing the hidden curriculum48 Assessing the changing scope of training in Canadian general surgery programs: expected versus actual experience49 Predicting need for surgical management for massive gastrointestinal hemorrhage50 International health care experience: using CanMEDS to evaluate learning outcomes following a surgical mission in Mampong, Ghana51 The open abdomen: risk factors for mortality and rates of closure52 How surgeons think: an exploration of mental practice in surgical preparation53 The surgery wiki: a novel method for delivery of under-graduate surgical education54 Understanding surgical residents’ postoperative practices before implementing an enhanced recovery after surgery (ERAS) guideline at the University of Toronto55 From laparoscopic transabdominal to posterior retroperitoneal adrenalectomy: a paradigm shift in operative approach56 A retrospective audit of outcomes in patients over the age of 80 undergoing acute care abdominal surgery57 Canadian general surgery residents’ perspectives on work-hour regulations58 Timing of surgical intervention and its outcomes in acute appendicitis59 Preparing surgical trainees to deal with adverse events. An outline of learning issues60 Acute care surgical service: surgeon agreement at the time of handover61 Predicting discharge of elderly patients to prehospitalization residence following emergency general surgery62 Morbidity and mortality after emergency abdominal surgery in octo- and nonagenarians63 The impact of acute abdominal illness and urgent admission to hospital on the living situation of elderly patients64 A comparison of laparoscopic versus open subtotal gastrectomy for antral gastric adenocarcinoma: a North American perspective65 Minimally invasive excision of ectopic mediastinal parathyroid adenomas66 Perioperative outcomes of laparoscopic hernia repair in a tertiary care centre: a single institution’s experience67 Evaluation of a student-run, practical and didactic curriculum for preclerkship medical students68 Joseph Lister: Father of Modern Surgery69 Comparisons of melanoma sentinel lymph node biopsy prediction nomograms in a cohort of Canadian patients70 Local experience with myocutaneous flaps after extensive pelvic surgery71 The treatment of noncirrhotic splanchnic vein thrombosis: Is anticoagulation enough?72 Implementation of an acute care surgery service does not affect wait-times for elective cancer surgeries: an institutional experience73 Use of human collagen mesh for closure of a large abdominal wall defect, after colon cancer surgery, a case report74 The role of miR-200b in pulmonary hypoplasia associated with congenital diaphragmatic hernia75 Systematic review and meta-analysis of electrocautery versus scalpel for incising epidermis and dermis76 Accuracy of sentinel lymph node biopsy for early breast cancer in the community setting in St. John’s, New-foundland: results of a retrospective review77 Acute surgical outcomes in the 80 plus population78 The liberal use of platelets transfusions in the acute phase of trauma resuscitation: a systematic review79 Implementation of an acute care surgical on call program in a Canadian community hospital80 Short-term outcomes following paraesophageal hernia repair in the elderly patient81 First experience with single incision surgery: feasibility in the pediatric population and cost evaluation82 The impact of the establishment of an acute care surgery unit on the outcomes of appendectomies and cholecystectomies83 Description and preliminary evaluation of a low-cost simulator for training and evaluation of flexible endoscopic skills84 Tumour lysis syndrome in metastatic colon cancer: a case report85 Acute care surgery service model implementation study at a single institution86 Colonic disasters approached by emergent subtotal and total colectomy: lessons learned from 120 consecutive cases87 Acellular collagen matrix stent to protect bowel anastomoses88 Lessons we learned from preoperative MRI-guided wire localization of breast lesions: the University Health Network (UHN) experience89 Interim cost comparison for the use of platinum micro-coils in the operative localization of small peripheral lung nodules90 Routine barium esophagram has minimal impact on the postoperative management of patients undergoing esophagectomy for esophageal cancer91 Iron deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair92 A randomized comparison of different ventilation strategies during thoracotomy and lung resection93 The Canadian Lung Volume Reduction Surgery study: an 8-year follow-up94 A comparison of minimally invasive versus open Ivor-Lewis esophagectomy95 A new paradigm in the follow-up after curative resection for lung cancer: minimal-dose CT scan allows for early detection of asymptomatic cancer activity96 Predictors of lymph node metastasis in early esophageal adenocarcinoma: Is endoscopic resection worth the risk?97 How well can thoracic surgery residents operate? Comparing resident and program director opinions98 The impact of extremes of age on short- and long-term outcomes following surgical resection of esophageal malignancy99 Epidermal growth factor receptor targeted gold nanoparticles for the enhanced radiation treatment of non–small cell lung cancer100 Laparoscopic Heller myotomy results in excellent outcomes in all subtypes of achalasia as defined by the Chicago classification101 Neoadjuvant chemoradiation versus surgery in managing esophageal cancer102 Quality of life postesophagectomy for cancer!103 The implementation, evolution and translocation of standardized clinical pathways can improve perioperative outcomes following surgical treatment of esophageal cancer104 A tissue-mimicking phantom for applications in thoracic surgical simulation105 Sublobar resection compared with lobectomy for early stage non–small cell lung cancer: a single institution study106 Not all reviews are equal: the quality of systematic reviews and meta-analyses in thoracic surgery107 Do postoperative complications affect health-related quality of life after video-assisted thoracoscopic lobectomy for patients with lung cancer? A cohort study108 Thoracoscopic plication for palliation of dyspnea secondary to unilateral diaphragmatic paralysis: A worthwhile venture?109 Thoracic surgery experience in Canadian general surgery residency programs110 Perioperative morbidity and pathologic response rates following neoadjuvant chemotherapy and chemoradiation for locally advanced esophageal carcinoma111 An enhanced recovery pathway reduces length of stay after esophagectomy112 Predictors of dysplastic and neoplastic progression of Barrett’s esophagus113 Recurrent esophageal cancer complicated by tracheoesophageal fistula: management by means of palliative airway stenting114 Pancreaticopleural fistula-induced empyema thoracis: principles and results of surgical management115 Prognostic factors of early postoperative mortality following right extended hepatectomy116 Optimizing steatotic livers for transplantation using a cell-penetrating peptide CPP-fused heme oxygenase117 Video outlining the technical steps for a robot-assisted laparoscopic pancreaticoduodenectomy118 Establishment of a collaborative group to conduct innovative clinical trials in Canada119 Hepatic resection for metastatic malignant melanoma: a systematic review and meta-analysis120 Acellular normothermic ex vivo liver perfusion for donor liver preservation121 Pancreatic cancer and predictors of survival: comparing the CA 19–9/bilirubin ratio with the McGill Brisbane Scoring System122 Staged liver resections for bilobar hepatic colorectal metastases: a single centre experience123 Economic model of observation versus immediate resection of hepatic adenomas124 Resection of colorectal liver metastasis in the elderly125 Acceptable long-term survival in patients undergoing liver resection for metastases from noncolorectal, non-neuroendocrine, nonsarcoma malignancies126 Patient and clinicopathological features and prognosis of CK19+ hepatocellular carcinomas: a case–control study127 The management of blunt hepatic trauma in the age of angioembolization: a single centre experience128 Liver resections for noncolorectal and non-neuroendocrine metastases: an evaluation of oncologic outcomes129 Developing an evidence-based clinical pathway for patients undergoing pancreaticoduodenectomy130 Hepatitis C infection and hepatocellular carcinoma in liver transplant: a 20 year experience131 The effect of medication on the risk of post-ERCP pancreatitis132 Temporal trends in the use of diagnostic imaging for patients with hepato-pancreato-biliary (HPB) conditions: How much ionizing radiation are we really using?196 A phase II study of aggressive metastasectomy for intra-and extrahepatic metastases from colorectal cancer133 Why do women choose mastectomy for breast cancer treatment? A conceptual framework for understanding surgical decision-making in early-stage breast cancer134 Synoptic operative reporting: documentation of quality of care data for rectal cancer surgery135 Learning curve analysis for cytoreductive surgery: a useful application of the cumulative sum (CUSUM) method136 Pancreatic cancer is strongly associated with a unique urinary metabolomic signature137 Concurrent neoadjuvant chemo/radiation in locally advanced breast cancer138 Impact of positron emission tomography on clinical staging of newly diagnosed rectal cancer: a specialized single centre retrospective study139 An evaluation of intraoperative Faxitron microradiography versus conventional specimen radiography for the excision of nonpalpable breast lesions140 Comparison of breast cancer treatment wait-times in the Southern Interior of British Columbia in 2006 and 2010141 Factors affecting lymph nodes harvest in colorectal carcinoma142 Laparoscopic adrenalectomy for metastases143 You have a message! Social networking as a motivator for fundamentals of laparoscopic surgery (FLS) training144 The evaluation and validation of a rapid diagnostic and support clinic for women assessment for breast cancer145 Oncoplastic breast surgery: oncologic benefits and limitations146 A qualitative study on rectal cancer patients’ preferences for location of surgical care147 The effect of surgery on local recurrence in young women with breast cancer148 Elevated IL-6 and IL-8 levels in tumour microenvironment is not associated with increased serum levels in humans with Pseudomyxoma peritonei and peritoneal mesothelioma149 Conversion from laparoscopic to open approach during gastrectomy: a population-based analysis150 A scoping review of surgical process improvement tools (SPITs) in cancer surgery151 Splenectomy during gastric cancer surgery: a population-based study152 Defining the polo-like kinase 4 (Plk4) interactome in cancer cell protrusions153 Neoadjuvant imatinib mesylate for locally advanced gastrointestinal stromal tumours154 Implementing results from ACOSOG Z0011: Practice-changing or practice-affirming?155 Should lymph node retrieval be a surgical quality indicator in colon cancer?156 Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer157 Clinical research in surgical oncology: an analysis of clinicaltrials.gov158 Radiation therapy after breast conserving surgery: When are we missing the mark?159 The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery160 Quality improvement in gastrointestinal cancer surgery: expert panel recommendations for priority research areas161 Factors influencing the quality of local management of ductal carcinoma in situ: a cohort study162 Papillary thyroid microcarcinoma: Does size matter?163 Hyperthermic isolated limb perfusion for extremity soft tissue sarcomas: systematic review of clinical efficacy and quality assessment of reported trials164 Adherence to antiestrogen therapy in seniors with breast cancer: How well are we doing?165 Parathyroid carcinoma: Challenging the surgical dogma?166 A qualitative assessment of the journey to delayed breast reconstruction195 The role of yoga therapy in breast cancer patients167 Outcomes reported in comparative studies of surgical interventions168 Enhanced recovery pathways decrease length of stay following colorectal surgery, but how quickly do patients actually recover?169 The impact of complications on bed utilization after elective colorectal resection170 Impact of trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study171 Complex fistula-in-ano: Should the plug be abandoned in favour of the LIFT or BioLIFT?172 Prognostic utility of cyclooxygenase-2 expression by colon and rectal cancer173 Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is complex and time-consuming: analysis of learning curves for a novice minimally invasive surgeon174 Intraoperative quality assessment following double stapled circular colorectal anastomosis175 Improving patient outcomes through quality assessment of rectal cancer care176 Are physicians willing to accept a decrease in treatment effectiveness for improved functional outcomes for low rectal cancer?177 Turnbull-Cutait delayed coloanal anastomosis for the treatment of distal rectal cancer: a prospective cohort study178 Preoperative high-dose rate brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum179 Impact of an enhanced recovery program on short-term outcomes after scheduled laparoscopic colon resection180 The clinical results of the Turnbull-Cutait delayed coloanal anastomosis: a systematic review181 Is a vertical rectus abdominus flap (VRAM) necessary? An analysis of perineal wound complications182 Fistula plug versus endorectal anal advancement flap for the treatment of high transsphincteric cryptoglandular anal fistulas: a systematic review and meta-analysis183 Maternal and neonatal outcomes following colorectal cancer surgery184 Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option185 Trends in colon cancer in Ontario: 2002–2009186 Validation of electronically derived short-term outcomes in colorectal surgery187 A population-based assessment of transanal and endoscopic resection for adenocarcinoma of the rectum188 Laparoscopic colorectal surgery in the emergency setting: trends in the province of Ontario from 2002 to 2009189 Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with case series of internal hernia through pelvic mesh which was placed in attempt to prevent perineal hernia190 Effect of rectal cancer treatments on quality of life191 The use of antibacterial sutures as an adjunctive preventative strategy for surgical site infection in Canada: an economic analysis192 Impact of socioeconomic status on colorectal cancer screening and stage at presentation: preliminary results of a population-based study from an urban Canadian centre193 Initial perioperative results of the first transanal endoscopic microsurgery (TEM) program in the province of Quebec194 Use of negative pressure wound therapy decreases perineal wound infections following abdominal perineal resection. Can J Surg 2012; 55:S63-S135. [DOI: 10.1503/cjs.016712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Bettelheim KA, Luke RKJ, Johnston N, Pearce JL, Goldwater PN. A possible murine model for investigation of pathogenesis of sudden infant death syndrome. Curr Microbiol 2011; 64:276-82. [PMID: 22179128 DOI: 10.1007/s00284-011-0065-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
Several studies have indicated a possible causative role of toxigenic bacteria in sudden infant death syndrome (SIDS). This study examined the effect of toxigenic E. coli on pregnant and infant mice to determine if these animals could be used as a model for SIDS pathogenesis. Strains of E. coli from the intestinal contents of infants who have died of SIDS or other causes and from the faeces of healthy infants were collected over a broad time scale. The isolates were tested for their ability to produce then known toxins of E. coli and were serotyped (O and H antigens). Certain serotypes (e.g. O1:H- and O25:H1) emerged significantly more frequently from cases of SIDS than from healthy infants and isolates of these types were generally toxigenic in Vero-cell cultures but whose verotoxicity was not related to classical Shiga or other known toxins. This mouse model was developed to test the effects of these toxigenic and also non-toxigenic strains. Four apparently healthy pups aged between 17 and 21 days died unobserved overnight but no pups of the 54 control mice died suddenly (P = 0.0247, Fisher's exact test). These were considered to represent sudden unexpected deaths. Pathological effects compatible with those in SIDS were observed in mouse pups exposed to toxigenic strains indicating this model may be suitable for further study into the pathogenesis of unexpected deaths in infancy. Providing an animal model of SIDS would promote a much better avenue for studying the pathogenesis of this enigmatic condition.
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Poon S, Goodman S, Yan R, Eagle K, Bugiardini R, Huynh T, Grondin F, Johnston N, Schenck-Gustafsson K, Bierman A, Yan A. 249 Sex-related differences in the treatment and outcomes of canadian acute coronary syndrome patients over the past decade. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Johnston N, O'Byrne P, Kolb M. The promise of electronic data capture in respiratory medicine. Eur Respir J 2011; 37:228-30. [PMID: 21282805 DOI: 10.1183/09031936.00141310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Pearson JP, Parikh S, Orlando RC, Johnston N, Allen J, Tinling SP, Johnston N, Belafsky P, Arevalo LF, Sharma N, Castell DO, Fox M, Harding SM, Morice AH, Watson MG, Shields MD, Bateman N, McCallion WA, van Wijk MP, Wenzl TG, Karkos PD, Belafsky PC. Review article: reflux and its consequences--the laryngeal, pulmonary and oesophageal manifestations. Conference held in conjunction with the 9th International Symposium on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21-23 April 2010. Aliment Pharmacol Ther 2011; 33 Suppl 1:1-71. [PMID: 21366630 DOI: 10.1111/j.1365-2036.2011.04581.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical oesophageal symptoms such as heartburn and regurgitation often overlap with atypical symptoms that impact upon the respiratory system and airways. This is referred to as extra-oesophageal reflux disease (EERD), or laryngopharyngeal reflux (LPR), which manifests as chronic cough, laryngitis, hoarseness, voice disorders and asthma. AIM The 'Reflux and its consequences' conference was held in Hull in 2010 and brought together a multidisciplinary group of experts all with a common interest in the many manifestations of reflux disease to present recent research and clinical progress in GERD and EERD. In particular new techniques for diagnosing reflux were showcased at the conference. METHODS Both clinical and non-clinical key opinion leaders were invited to write a review on key areas presented at the `Reflux and its consequences' conference for inclusion in this supplement. RESULTS AND CONCLUSION Eleven chapters contained in this supplement reflected the sessions of the conference and included discussion of the nature of the refluxate (acid, pepsin, bile acids and non-acid reflux); mechanisms of tissue damage and protection in the oesophagus, laryngopharynx and airways. Clinical conditions with a reflux aetiology including asthma, chronic cough, airway disease, LPR, and paediatric EERD were reviewed. In addition methods for diagnosis of reflux disease and treatment strategies, especially with reference to non-acid reflux, were considered.
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Johnston N, Schenck-Gustafsson K, Lagerqvist B. Are we using cardiovascular medications and coronary angiography appropriately in men and women with chest pain? Eur Heart J 2011; 32:1331-6. [DOI: 10.1093/eurheartj/ehr009] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Jenkins SMM, Johnston N, Hawkins NM, Messow CM, Shand J, Hogg KJ, Eteiba H, McKillop G, Goodfield NER, McConnachie A, Dunn FG. Limited clinical utility of CT coronary angiography in a district hospital setting. QJM 2011; 104:49-57. [PMID: 20847015 DOI: 10.1093/qjmed/hcq163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies have demonstrated considerable accuracy of multi-slice CT coronary angiography (MSCT-CA) in comparison to invasive coronary angiography (I-CA) for evaluating coronary artery disease (CAD). The extent to which published MSCT-CA accuracy parameters are transferable to routine practice beyond high-volume tertiary centres is unknown. AIM To determine the accuracy of MSCT-CA for the detection of CAD in a Scottish district general hospital. DESIGN Prospective study of diagnostic accuracy. METHOD One hundred patients with suspected CAD recruited from two Glasgow hospitals underwent both MSCT-CA (Philips Brilliance 40 × 0.625 collimation, 50-200 ms temporal resolution) and I-CA. Studies were reported by independent, blinded radiologists and cardiologists and compared using the AHA 15-segment model. RESULTS Of 100 patients [55 male, 45 female, mean (SD) age 58.0 (10.7) years], 59 and 41% had low-intermediate and high pre-test probabilities of significant CAD, respectively. Mean (SD) heart rate during MSCT-CA was 68.8 (9.0) bpm. Fifty-seven per cent of patients had coronary artery calcification and 35% were obese. Patient prevalence of CAD was 38%. Per-patient sensitivity, specificity, positive and negative (NPV) predictive values for MSCT-CA were 92.1, 47.5, 52.2 and 90.6%, respectively. NPV was reduced to 75.0% in the high pre-test probability group. Specificity was compromised in patients with sub-optimally controlled heart rates, calcified arteries and elevated BMI. CONCLUSION Forty-Slice MSCT-CA has a high NPV for ruling out significant CAD when performed in a district hospital setting in patients with low-intermediate pre-test probability and minimal arterial calcification. Specificity is compromised by clinically appropriate strategies for dealing with unevaluable studies. Effective heart rate control during MSCT-CA is imperative. National guidelines should be utilized to govern patient selection and direct MSCT-CA reporter training to ensure quality control.
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Schofield DJ, Fletcher SL, Johnston N. Baby boomer pharmacists: ageing and projections of retirement. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2010. [DOI: 10.1211/ijpp.15.3.0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Objective
To identify ageing and retirement patterns of the pharmacy workforce since 1986 and the implications of those changes for future workforce planning.
Method
Australian Bureau of Statistics census data from 1986 to 2001 were used to examine ageing of the pharmacy workforce and attrition of pharmacists aged 50 years and over. The number of pharmacists to retire was projected over the next 20 years.
Key findings
The Australian pharmacy workforce has aged significantly since 1986 (P < 0.01). Forty-one per cent of pharmacists practising in 2001 are predicted to retire by 2026. Baby boomer pharmacists were more likely to work long hours (49+ per week) in 2001 than in 1986, and than generation X pharmacists in 2001. The proportion of women in pharmacy has increased from 39% in 1986 to over 50% in 2001. Women are still more likely to work part-time than males, although they are less likely to do so than they were in 1986. Conversely, the proportion of male pharmacists working part-time is rising.
Conclusions
With baby boomer and older cohorts currently making up 65% of the pharmacy workforce, their retirement will place increased pressure on a profession already facing severe shortages. The growing proportion of female pharmacists and their generally lower workforce participation mean the potential for continued pharmacy shortages.
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Leach P, Childs C, Evans J, Johnston N, Protheroe R, King A. Transfer times for patients with extradural and subdural haematomas to neurosurgery in Greater Manchester. Br J Neurosurg 2009; 21:11-5. [PMID: 17453768 DOI: 10.1080/02688690701210562] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Delay in transfer of patients with acute extradural (EDH) or subdural (SDH) haematoma to definitive neurosurgical evacuation has a detrimental effect on outcome. From July 2003 to December 2005 we undertook a prospective analysis of patients admitted to our unit for neurosurgical evacuation of their haematoma, who were transferred from non-neurosurgical hospitals. Data was collected for: 1) overall transfer time, 2) time taken from injury or deterioration to CT scan, 3) time from CT scan to arrival at our unit, and 4) time from arrival at our unit to surgery. Overall 81 patients were eligible, of which 39 had an EDH and 42 a SDH. The median transfer times for EDH and SDH were 5.25 hours and 6.0 hours respectively. This paper discusses the factors that may prolong delays in the transfer of patients between hospitals and the way in which our unit is trying to improve the local service for the population of Greater Manchester.
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Low J, Johnston N, Morris C. A reply. Anaesthesia 2008. [DOI: 10.1111/j.1365-2044.2008.05692_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Low J, Morris C, Johnston N. A reply. Anaesthesia 2008. [DOI: 10.1111/j.1365-2044.2008.05691_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Patel RK, Mark PB, Johnston N, McGeoch R, Lindsay M, Kingsmore DB, Dargie HJ, Jardine AG. Prognostic value of cardiovascular screening in potential renal transplant recipients: a single-center prospective observational study. Am J Transplant 2008; 8:1673-83. [PMID: 18510627 DOI: 10.1111/j.1600-6143.2008.02281.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We assessed the outcome of pretransplant cardiac assessment in a single center. Three hundred patients with end-stage renal disease underwent electrocardiogram, Bruce exercise testing (ETT) and ventricular assessment by cardiac MRI. Patients with high index of suspicion of coronary artery disease (CAD) underwent coronary angiography and percutaneous coronary intervention (PCI) if indicated. Two hundred and twenty-two patients were accepted onto the renal transplant waiting list; 80 patients were transplanted during the follow-up period and 60 died (7 following transplantation). Successful transplantation was associated with improved survival (mean survival 4.5 +/- 0.6 years vs. listed not transplanted 4.1 +/- 1.4 years vs. not listed 3.1 +/- 1.7 years; p < 0.001). Ninety-nine patients underwent coronary angiography; 65 had normal or low-grade CAD and 34 obstructive CAD. Seventeen patients (5.6%) were treated by PCI. There was no apparent survival difference between patients who underwent PCI or coronary artery bypass graft compared to those who underwent angiography without intervention or no angiography (p = 0.67). Factors associated with nonlisting for renal transplantation included burden of preexisting cardiovascular disease, poor exercise tolerance and severity of CAD. Pretransplant cardiovascular screening provides prognostic information and information that can be used to restrict access to transplantation. However, if the aim is to identify and treat CAD, the benefits are far from clear.
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Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, Jeejeebhoy KN. What is subjective global assessment of nutritional status? 1987. Classical article. NUTR HOSP 2008; 23:400-407. [PMID: 18702178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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Patel RK, Mark PB, Johnston N, McGeoch R, Lindsay M, Kingsmore DB, Dargie HJ, Jardine AG. Prognostic value of cardiovascular screening in potential renal transplant recipients: a single-center prospective observational study. Am J Transplant 2008. [PMID: 18510627 DOI: 10.1111/j.1600-6143.2008.02281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We assessed the outcome of pretransplant cardiac assessment in a single center. Three hundred patients with end-stage renal disease underwent electrocardiogram, Bruce exercise testing (ETT) and ventricular assessment by cardiac MRI. Patients with high index of suspicion of coronary artery disease (CAD) underwent coronary angiography and percutaneous coronary intervention (PCI) if indicated. Two hundred and twenty-two patients were accepted onto the renal transplant waiting list; 80 patients were transplanted during the follow-up period and 60 died (7 following transplantation). Successful transplantation was associated with improved survival (mean survival 4.5 +/- 0.6 years vs. listed not transplanted 4.1 +/- 1.4 years vs. not listed 3.1 +/- 1.7 years; p < 0.001). Ninety-nine patients underwent coronary angiography; 65 had normal or low-grade CAD and 34 obstructive CAD. Seventeen patients (5.6%) were treated by PCI. There was no apparent survival difference between patients who underwent PCI or coronary artery bypass graft compared to those who underwent angiography without intervention or no angiography (p = 0.67). Factors associated with nonlisting for renal transplantation included burden of preexisting cardiovascular disease, poor exercise tolerance and severity of CAD. Pretransplant cardiovascular screening provides prognostic information and information that can be used to restrict access to transplantation. However, if the aim is to identify and treat CAD, the benefits are far from clear.
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Low J, Johnston N, Morris C. A reply. Anaesthesia 2008. [DOI: 10.1111/j.1365-2044.2008.05529_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Johnston N, Dargie H, Jardine A. Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease. Heart 2008; 94:1080-8. [DOI: 10.1136/hrt.2007.136739] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Wright RJ, Macleod KM, Perros P, Johnston N, Webb DJ, Frier BM. Plasma endothelin response to acute hypoglycaemia in adults with Type 1 diabetes. Diabet Med 2007; 24:1039-42. [PMID: 17559427 DOI: 10.1111/j.1464-5491.2007.02199.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To determine whether acute insulin-induced hypoglycaemia provokes a detectable alteration in peripheral plasma endothelin (ET) concentrations in humans with Type 1 diabetes. METHODS Serial plasma concentrations of ET were measured in 20 patients with Type 1 diabetes during controlled hypoglycaemia induced by intravenous infusion of soluble insulin. RESULTS A significant increase was observed in plasma ET concentrations, from 3.80 +/- 0.31 pg/ml at baseline to 6.72 +/- 1.47 pg/ml at 60 min after the onset of the hypoglycaemic reaction (P < 0.05). CONCLUSIONS Acute insulin-induced hypoglycaemia induces a rise in plasma endothelin concentrations in people with Type 1 diabetes. This finding is consistent with a putative role for ET in the mediation of hypoglycaemia-induced vasoconstriction, and the possible precipitation of macrovascular or microvascular events.
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Birchall M, Rees L, Phillips A, Johnston N, Postma G, Koufman J, Bailey M. MHC molecule expression in laryngeal epithelium of patients with laryngopharyngeal reflux compared to normal subjects. Clin Otolaryngol 2006. [DOI: 10.1111/j.1365-2273.2006.01341_4.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mark PB, Johnston N, Groenning BA, Foster JE, Blyth KG, Martin TN, Steedman T, Dargie HJ, Jardine AG. Redefinition of uremic cardiomyopathy by contrast-enhanced cardiac magnetic resonance imaging. Kidney Int 2006; 69:1839-45. [PMID: 16508657 DOI: 10.1038/sj.ki.5000249] [Citation(s) in RCA: 180] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patients with end stage renal failure (ESRF) have an increased risk of premature cardiovascular disease. Left ventricular (LV) abnormalities, so called 'uremic cardiomyopathy', are associated with poorer outcome. Cardiac magnetic resonance imaging (CMR) accurately defines LV dimensions and identifies underlying myocardial pathology. We studied the relationship between LV function and myocardial pathology in ESRF patients with CMR. A total of 134 patients with ESRF underwent CMR. LV function was assessed with further images acquired after gadolinium-diethylentriaminepentaacetic acid (DTPA). The presence of myocardial fibrosis was indicated by late gadolinium enhancement (LGE). Two main myocardial pathologies were identified. A total of 19 patients (14.2%) displayed 'subendocardial LGE' representing myocardial infarction, which was associated with conventional cardiovascular risk factors including a history of ischemic heart disease (IHD) (P < 0.001), hypercholesterolemia (P < 0.05), and diabetes (P < 0.01). Patients with subendocardial LGE had greater LV mass (P < 0.05), LV dilation (P < 0.01), and LV systolic dysfunction (P < 0.001) compared to patients with no evidence of LGE. The second pattern, 'diffuse LGE', seen in 19 patients (14.2%) appeared to represent regional areas of diffuse myocardial fibrosis. Diffuse LGE was associated with greater LV mass compared to patients without LGE (P < 0.01) but not systolic dysfunction. In total, 28.4% of all patients exhibited evidence of myocardial fibrosis demonstrated by LGE. In contrast to published literature describing three forms of uremic cardiomyopathy - left ventricular hypertrophy (LVH), dilation, and systolic dysfunction, we have shown that LVH is the predominant cardiomyopathy specific to uremia, while LV dilation and systolic dysfunction are due to underlying (possibly silent) ischemic heart disease.
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MESH Headings
- Adult
- Aged
- Cardiomyopathies/diagnosis
- Cardiomyopathies/physiopathology
- Cardiomyopathy, Dilated/diagnosis
- Cardiomyopathy, Dilated/physiopathology
- Contrast Media/administration & dosage
- Coronary Angiography/methods
- Female
- Fibrosis/pathology
- Gadolinium DTPA
- Humans
- Hypercholesterolemia/blood
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/physiopathology
- Image Enhancement
- Kidney Failure, Chronic/diagnosis
- Kidney Failure, Chronic/physiopathology
- Magnetic Resonance Imaging, Cine
- Male
- Middle Aged
- Myocardial Infarction/diagnosis
- Myocardial Infarction/physiopathology
- Prospective Studies
- Renal Replacement Therapy/methods
- Risk Factors
- Systole/physiology
- Ventricular Dysfunction, Left/diagnosis
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
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Hopkins TV, Floyd J, Loy T, Johnston N, Shahab N. Rituximab is an effective treatment in cutaneous histiocyte predominant T-cell rich B-cell lymphoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abraham EH, Shrivastav B, Salikhova AY, Sterling KM, Johnston N, Guidotti G, Scala S, Litman T, Chan KC, Arceci RJ, Steiglitz K, Herscher L, Okunieff P. Cellular and biophysical evidence for interactions between adenosine triphosphate and P-glycoprotein substrates: functional implications for adenosine triphosphate/drug cotransport in P-glycoprotein overexpressing tumor cells and in P-glycoprotein low-level expressing erythrocytes. Blood Cells Mol Dis 2001; 27:181-200. [PMID: 11358379 DOI: 10.1006/bcmd.2000.0373] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
P-glycoprotein is involved with the removal of drugs, most of them cations, from the plasma membrane and cytoplasm. Pgp is also associated with movement of ATP, an anion, from the cytoplasm to the extracellular space. The central question of this study is whether drug and ATP transport associated with the expression of Pgp are in any way coupled. We have measured the stoichiometry of transport coupling between drug and ATP release. The drug and ATP transport that is inhibitable by the sulfonylurea compound, glyburide (P. E. Golstein, A. Boom, J. van Geffel, P. Jacobs, B. Masereel, and R. Beauwens, Pfluger's Arch. 437, 652, 1999), permits determination of the transport coupling ratio, which is close to 1:1. In view of this result, we asked whether ATP interacts directly with Pgp substrates. We show by measuring the movement of Pgp substrates in electric fields that ATP and drug movement are coupled. The results are compatible with the view that substrates for Pgp efflux are driven by the movement of ATP through electrostatic interaction and effective ATP-drug complex formation with net anionic character. This mechanism not only pertains to drug efflux from tumor cells overexpressing Pgp, but also provides a framework for understanding the role of erythrocytes in drug resistance. The erythrocyte consists of a membrane surrounding a millimolar pool of ATP. Mammalian RBCs have no nucleus or DNA drug/toxin targets. From the perspective of drug/ATP complex formation, the RBC serves as an important electrochemical sink for toxins. The presence in the erythrocyte membrane of approximately 100 Pgp copies per RBC provides a mechanism for eventual toxin clearance. The RBC transport of toxins permits their removal from sensitive structures and ultimate clearance from the organism via the liver and/or kidneys.
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Abraham EH, Sterling KM, Kim RJ, Salikhova AY, Huffman HB, Crockett MA, Johnston N, Parker HW, Boyle WE, Hartov A, Demidenko E, Efird J, Kahn J, Grubman SA, Jefferson DM, Robson SC, Thakar JH, Lorico A, Rappa G, Sartorelli AC, Okunieff P. Erythrocyte membrane ATP binding cassette (ABC) proteins: MRP1 and CFTR as well as CD39 (ecto-apyrase) involved in RBC ATP transport and elevated blood plasma ATP of cystic fibrosis. Blood Cells Mol Dis 2001; 27:165-80. [PMID: 11358378 DOI: 10.1006/bcmd.2000.0357] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In addition to the better-known roles of the erythrocyte in the transport of oxygen and carbon dioxide, the concept that the red blood cell is involved in the transport and release of ATP has been evolving (J. Luthje, Blut 59, 367, 1989; G. R. Bergfeld and T. Forrester, Cardiovasc. Res. 26, 40, 1992; M. L. Ellsworth et al., Am. J. Physiol. 269, H2155, 1995; R. S. Sprague et al., Am. J. Physiol. 275, H1726, 1998). Membrane proteins involved in the release of ATP from erythrocytes now appear to include members of the ATP binding cassette (ABC) family (C. F. Higgins, Annu. Rev. Cell Biol. 8, 67, 1992; C. F. Higgins, Cell 82, 693, 1995). In addition to defining physiologically the presence of ABC proteins in RBCs, accumulating gel electrophoretic evidence suggests that the cystic fibrosis transmembrane conductance regulator (CFTR) and the multidrug resistance-associated protein (MRP1), respectively, constitute significant proteins in the red blood cell membrane. As such, this finding makes the mature erythrocyte compartment a major mammalian repository of these important ABC proteins. Because of its relative structural simplicity and ready accessibility, the erythrocyte offers an ideal system to explore details of the physiological functions of ABC proteins. Moreover, the presence of different ABC proteins in a single membrane implies that interaction among these proteins and with other membrane proteins may be the norm and not the exception in terms of modulation of their functions.
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Johnston N. Psychological testing and pilot licensing. THE INTERNATIONAL JOURNAL OF AVIATION PSYCHOLOGY 2001; 6:179-97. [PMID: 11539294 DOI: 10.1207/s15327108ijap0602_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article reviews contemporary trends in the psychological testing of pilots. It is written in the particular context of draft European Joint Aviation Authorities licensing proposals which, in certain circumstances, envisage psychological testing for pilot licensing purposes. The article aims to clarify issues relating to the validity, reliability, and value of pilot psychological testing in this particular context. It is first suggested that the entire domain is characterized by terminological and methodological confusion. The economic and other benefits of psychological testing are contrasted with the potential risks, including abuse and the use of tests in circumstances for which they were never designed. Reference also is made to cultural differences that potentially may impact on the practical realities of psychological testing--especially within the European context, where the debate is presently at its most intense.
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45
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Johnston N. Inductions vs. postdates. AWHONN LIFELINES 2001; 5:11. [PMID: 11982250 DOI: 10.1111/j.1552-6356.2001.tb01268.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Torrey EF, Webster M, Knable M, Johnston N, Yolken RH. The stanley foundation brain collection and neuropathology consortium. Schizophr Res 2000; 44:151-5. [PMID: 10913747 DOI: 10.1016/s0920-9964(99)00192-9] [Citation(s) in RCA: 445] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Stanley Foundation brain collection is an attempt to supplement existing brain collections for the purpose of promoting research on schizophrenia and bipolar disorder. Specimens are collected with the permission of the families in a standardized manner, with half of each specimen being frozen and half fixed in formalin. The Neuropathology Consortium is a subset of 60 specimens from the collection, well-matched groups of 15 each with diagnoses of schizophrenia, bipolar disorder, major depressive disorder without psychotic features, and normal controls. More than 75000 sections and blocks from the Consortium have been sent to over 50 research groups worldwide to carry out a wide variety of assessments. These data will be integrated to provide a more complete picture of the neuropathology of these disorders.
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47
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Burke FJ, Johnston N, Wiggs RB, Hall AF. An alternative hypothesis from veterinary science for the pathogenesis of noncarious cervical lesions. QUINTESSENCE INTERNATIONAL (BERLIN, GERMANY : 1985) 2000; 31:475-82. [PMID: 11203969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
An alternative hypothesis to abrasion and erosion for the pathogenesis of noncarious cervical lesions was put forward in 1984; the so-called occlusal theory suggested that tensile stresses from occlusal overload could be involved in the pathogenesis of noncarious cervical lesions and that bending stresses applied to teeth could cause disruption of the surface enamel, resulting in increased susceptibility to dissolution and abrasion at the affected sites and in the development of wedge-shaped lesions. This theory has gained increased acceptance in recent years, although absolute scientific evidence has been scant. These lesions also occur in animals, in particular, the domestic cat, in which they are called feline odontoclastic resorptive lesions. A variety of theories about pathogenesis of these lesions have been put forward, but there is some evidence that occlusal overload may be a contributory factor in the development of an inflammatory response in the periodontal membrane and the presence of enzymes associated with resorption in the gingival crevice. Further investigation may help define a common etiology between the pathogenesis of feline odontoclastic resorptive lesions and noncarious cervical lesions.
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48
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Johnston N, Jessen ME, DiMaio M, Douglass DS. The emergency use of recombinant hirudin in cardiopulmonary bypass. THE JOURNAL OF EXTRA-CORPOREAL TECHNOLOGY 1999; 31:211-5. [PMID: 10915479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The most common anticoagulant used for cardiopulmonary bypass is heparin. An alternate form of anticoagulant therapy is needed for patients who have immune-mediated heparin-associated thrombocytopenia (HIT). Thrombocytopenia causes bleeding and may lead to serious arterial and venous thrombosis. HIT or heparin-induced thrombocytopenia with thrombosis type II (HITT) are both described as adverse reactions to heparin. They are diagnosed with a platelet count less than a 100,000/mcl for 2 consecutive days. HITT, the severe form, is characterized with the thrombocytopenia in combination with thromboembolic complications, such as strokes, myocardial infarctions, and limb ischemia. Two cases are presented in which r-hirudin was used for anticoagulation for aortocoronary bypass surgery and mitral valve replacement. The activated partial prothrombin time (aPTT) was used to monitor coagulation. In the first case, the aPTT was maintained greater than 100 seconds, and at the termination of cardiopulmonary bypass, some clot was noted in the cardiopulmonary bypass circuit. In the second case, a longer cardiopulmonary bypass run was anticipated, the hirudin bolus and infusion rate were increased, and the aPTT was maintained at greater than 200 sec. Adequate coagulation resulted, and, at the end of bypass, no clot was noted. These case studies seem to suggest a higher dosage of r-hirudin may be required for the use of cardiopulmonary bypass and a need to maintain aPTT values greater than 200 sec to help monitor anticoagulation.
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Gehrs M, Johnston N, Chavez F, Malone P, Lefebre N. Hospital-community job exchange: an innovative nursing staff development experiment. JOURNAL OF NURSING STAFF DEVELOPMENT : JNSD 1997; 13:226-30. [PMID: 9287632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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50
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Garley D, Gallop R, Johnston N, Pipitone J. Children of the mentally ill: a qualitative focus group approach. J Psychiatr Ment Health Nurs 1997; 4:97-103. [PMID: 9224005 DOI: 10.1046/j.1365-2850.1997.00036.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Children of the mentally ill constitute a group neglected by mental health care providers. Increased rates of psychopathology, impaired attention processes, disturbances in interpersonal relationships, and reduced overall adaptive functioning are reported as significant outcomes for offspring of parents with a mood disorder. While epidemiological studies underscoring the risks from a hereditary standpoint are many, there are few studies examining the subjective experience of living with a depressed parent. Findings from this pilot study elucidate the subjective experience of preadolescents/adolescents living with an affectively ill parent, applying a qualitative focus group design. Videotaped sessions were analysed using methods consistent with qualitative research. 'Struggle to understand the illness', 'managing the illness', 'recognizing the signs', and 'impact of parent's hospitalization' emerged as central themes, capturing the essence of participants' experiences. The first two themes were further divided into subthemes. Findings illuminate the need to broaden nursing interventions and research, to include family perspectives, particularly when parental mental illness is a factor.
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