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Muhammad Y, Kerr S. Comparative effects of cinnamaldehyde and cinnamyl‐containing compounds on the viability of two human melanoma cell lines, SK‐MEL19 and SK‐MEL23 (LB611). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.lb611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dukhovny S, Louik C, Kerr S, Werler M, Lin A, Mitchell A. 190: Risk factors for anophthalmia/microphthalmia. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kerr S, Catlin B. Creating a Provincial Heart Failure Competency, Assessment, Planning and Evaluation (CAPE) to Guide British Columbia's Heart Function Clinic Registered Nurses Practice. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Butchart JW, Wolfe LJ, Holmes C, Brewer L, Bennett K, Williams D, O'Halloran AM, King-Kallimanis BL, Kenny RA, McDonald C, Pearce MS, Newton JL, Kerr S, Dean KJ, Jenkinson C, Wilcock GK, McCrory C, Gallagher D, Kenny RA, Robinson SM, Canavan M, O'Keeffe ST, Jackson TA, Nicolson P, Sheehan B. Psychiatry and mental health. Age Ageing 2013. [DOI: 10.1093/ageing/aft108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Boyd MA, Kumarasamy N, Moore CL, Nwizu C, Losso MH, Mohapi L, Martin A, Kerr S, Sohn AH, Teppler H, Van de Steen O, Molina JM, Emery S, Cooper DA. Ritonavir-boosted lopinavir plus nucleoside or nucleotide reverse transcriptase inhibitors versus ritonavir-boosted lopinavir plus raltegravir for treatment of HIV-1 infection in adults with virological failure of a standard first-line ART regimen (SECOND-LINE): a randomised, open-label, non-inferiority study. Lancet 2013; 381:2091-9. [PMID: 23769235 DOI: 10.1016/s0140-6736(13)61164-2] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Uncertainty exists about the best treatment for people with HIV-1 who have virological failure with first-line combination antiretroviral therapy of a non-nucleoside analogue (NNRTI) plus two nucleoside or nucleotide analogue reverse transcriptase inhibitors (NtRTI). We compared a second-line regimen combining two new classes of drug with a WHO-recommended regimen. METHODS We did this 96-week, phase 3b/4, randomised, open-label non-inferiority trial at 37 sites worldwide. Adults with HIV-1 who had confirmed virological failure (plasma viral load >500 copies per mL) after 24 weeks or more of first-line treatment were randomly assigned (1:1) to receive ritonavir-boosted lopinavir plus two or three NtRTIs (control group) or ritonavir-boosted lopinavir plus raltegravir (raltegravir group). The randomisation sequence was computer generated with block randomisation (block size four). Neither participants nor investigators were masked to allocation. The primary endpoint was the proportion of participants with plasma viral load less than 200 copies per mL at 48 weeks in the modified intention-to-treat population, with a non-inferiority margin of 12%. This study is registered with ClinicalTrials.gov, number NCT00931463. FINDINGS We enrolled 558 patients, of whom 541 (271 in the control group, 270 in the raltegravir group) were included in the primary analysis. At 48 weeks, 219 (81%) patients in the control group compared with 223 (83%) in the raltegravir group met the primary endpoint (difference 1·8%, 95% CI -4·7 to 8·3), fulfilling the criterion for non-inferiority. 993 adverse events occurred in 271 participants in the control group versus 895 in 270 participants in the raltegravir group, the most common being gastrointestinal. INTERPRETATION The raltegravir regimen was no less efficacious than the standard of care and was safe and well tolerated. This simple NtRTI-free treatment strategy might extend the successful public health approach to management of HIV by providing simple, easy to administer, effective, safe, and tolerable second-line combination antiretroviral therapy. FUNDING University of New South Wales, Merck, AbbVie, the Foundation for AIDS Research.
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Frleta M, King V, Reilly J, Kerr S, Gilchrist D, Tornehave D, Neisig A, Lundsgaard D, Miller A, McInnes I. AB0095 IL-21R signature in synovial tissue and blood of patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kerr S, Lawrence M, Darbyshire C, Middleton AR, Fitzsimmons L. Tobacco and alcohol-related interventions for people with mild/moderate intellectual disabilities: a systematic review of the literature. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:393-408. [PMID: 22458301 DOI: 10.1111/j.1365-2788.2012.01543.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The behavioural determinants of health among people with mild/moderate intellectual disabilities (ID) are of increasing concern. With the closure of long-stay institutions, more people with ID are living in the community. As they lead more ordinary and less restricted lives, people with ID may be exposed to social and environmental pressures that encourage them to adopt behaviours that impact negatively on their health. Levels of smoking and alcohol consumption in this client group are of particular concern. METHODS We undertook a mixed method review of the literature, aiming to assess the Feasibility, Appropriateness, Meaningfulness and Effectiveness (FAME) of interventions designed to address the use of tobacco and/or alcohol in people with mild/moderate ID. Key electronic databases were searched (e.g., Medline, Cochrane Register of Controlled Trials, PsycINFO) from 1996 to 2011. The search was developed using appropriate subject headings and key words (e.g., intellectual disability, tobacco use, alcohol drinking, health promotion). On completion of the database searches, inclusion/exclusion criteria, based on an adaptation of the PICO framework (Population, Intervention, Comparison, Outcomes), were applied. Methodological quality was assessed using a seven-point rating scale. RESULTS Database searches identified 501 unique records, of which nine satisfied the inclusion criteria. Four focused on tobacco, three on alcohol and two on both tobacco and alcohol. Located in the U.K., the U.S.A. and Australia, the studies aimed to increase knowledge levels and/or change behaviour (e.g., to encourage smoking cessation). One was a randomised controlled trial, one a quasi-experiment and the others were before and after studies and/or case studies. Methodological quality was poor or moderate. The combined studies had a sample size of 341, with ages ranging from 14 to 54 years. The interventions were delivered by professionals (e.g., in health, social care, education) during sessions that spanned a period of three weeks to one academic year. The studies highlighted a number of important issues linked to the appropriateness of interventions for this client group (e.g., use of pictures, quizzes, role play, incentives); however, in the majority of cases the interventions appeared to lack a theoretical framework (e.g., behaviour change theory). The appropriateness of the outcome measures for use with this client group was not tested. One study discussed feasibility (teachers delivering lessons on alcohol and tobacco) and only one was informative in terms of effectiveness, i.e., increasing knowledge of the health and social dangers of smoking and excessive alcohol consumption. CONCLUSIONS This review is the first to systematically collate evidence on tobacco and alcohol-related interventions for people with ID. While there is currently little evidence to guide practice, the review delivers clear insights for the development of interventions and presents a strong case for more robust research methods. In particular there is a need to test the effectiveness of interventions in large-scale, well-designed trials and to ensure that outcome measures are developed/tailored appropriately for this client group.
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McGhee DJM, Royle PL, Counsell CE, Abbas A, Sethi P, Manku L, Narayan A, Clegg K, Bardai A, Brown SHM, Hafeez U, Abdelhafiz AH, McGovern A, Breckenridge A, Seenan P, Samani A, Das S, Khan S, Puffett AJ, Morgan J, Ross G, Cantlay A, Khan N, Bhalla A, Sweeting M, Nimmo CAMD, Fleet J, Igbedioh C, Harari D, Downey CL, Handforth C, Stothard C, Cracknell A, Barnes C, Shaw L, Bainbridge L, Crabtree L, Clark T, Root S, Aitken E, Haroon K, Sudlow M, Hanley K, Welsh S, Hill E, Falconer A, Miller H, Martin B, Tidy E, Pendlebury S, Thompson S, Burnett E, Taylor H, Lonan J, Adler B, McCallion J, Sykes E, Bancroft R, Tullo ES, Young TJ, Clift E, Flavin B, Roberts HC, Sayer AA, Belludi G, Aithal S, Verma A, Singh I, Barne M, Wilkinson I, Sakoane R, Singh N, Wilkinson I, Cottee M, Irani TS, Martinovic O, Abdulla AJJ, Irani TS, Abdulla AJJ, Riglin J, Husk J, Lowe D, Treml J, Vasilakis JN, Buttery A, Reid J, Healy P, Grant-Casey J, Pendry K, Richards J, Singh A, Jarrett D, Hewitt J, Slevin J, Barwell G, Youde J, Kennedy C, Romero-Ortuno R, O'Shea D, Robinson D, O'Shea D, Kenny RA, O'Connell J, Kennedy C, Romero-Ortuno R, O'Shea D, Robinson D, O'Shea D, Robinson D, O'Connell J, Topp JD, Topp JD, Warburton K, Simpson L, Bryce K, Suntharalingam S, Grosser K, D'Silva A, Southern L, Bielawski C, Cook L, Sutton GM, Flanagan L, Storr A, Charlton L, Kerr S, Robinson L, Shaw F, Finch LK, Weerasuriya N, Walker M, Sahota O, Logan P, Brown F, Rossiter F, Baxter M, Mucci E, Brown A, Jackson SHD, de Savary N, Hasan S, Jones H, Birrell J, Hockley J, Hensey N, Meiring R, Athavale N, Simms J, Brown S, West A, Diem P, Simms J, Brown S, West A, Diem P, Davies R, Kings R, Coleman H, Stevens D, Campbell C, Hope S, Morris A, Ong T, Harwood R, Dasgupta D, Mitchell S, Dimmock V, Collin F, Wood E, Green V, Hendrickse-Welsh N, Singh N, Cracknell A, Eccles J, Beezer J, Garside M, Baxter J. Clinical effectiveness. Age Ageing 2013. [DOI: 10.1093/ageing/aft016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Clarke A, Kerr S, Honeybrook A, Cooper DA, Avihingsanon A, Duncombe C, Phanuphak P, Ruxrungtham K, Ananworanich J, Kaldor J. Adherence and Risk Behaviour in Patients with HIV Infection Receiving Antiretroviral Therapy in Bangkok. Open Virol J 2012; 6:23-8. [PMID: 22423306 PMCID: PMC3296110 DOI: 10.2174/1874357901206010023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/24/2012] [Accepted: 01/25/2012] [Indexed: 11/22/2022] Open
Abstract
It could be postulated that due to lifestyle factors, patients with poor antiretroviral therapy (ART) adherence may also have risky sexual behaviour potentially leading to HIV transmission. There are limited data regarding unprotected sex risk and ART adherence in resource limited settings and our study set out to investigate these in an HIV clinic in Bangkok. Patients completed an anonymous questionnaire regarding their relationship details, ART adherence, sexual behaviour, alcohol and drug use and HIV transmission beliefs. Laboratory findings and medical history were also collected. Unprotected sex risk (USR) was defined as inconsistent condom use with a partner of negative or unknown HIV status. Five hundred and twelve patients completed the questionnaire. Fifty seven per cent of patients reported having taken ARV >95% of the time in the last month and 58% had been sexually active in the previous 30 days. Only 27 patients (5%) were classified as having USR in our cohort. Multivariate analysis showed USR was associated with female gender (OR 2.9, 95% CI 1.2-7.0, p0.02) but not with adherence, age, type or number of partners, recreational drug or alcohol use nor beliefs about HIV transmission whilst taking ART. Levels of USR in this resource limited setting were reassuringly low and not associated with poor ART adherence; as all USR patients had undetectable viral loads onward HIV transmission risk is likely to be low but not negligible. Nonetheless condom negotiation techniques, particularly in women, may be useful in this group.
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Bunupuradah T, Puthanakit T, Kosalaraksa P, Kerr S, Boonrak P, Prasitsuebsai W, Lumbiganon P, Mengthaisong T, Phasomsap C, Pancharoen C, Ruxrungtham K, Ananworanich J. Immunologic and virologic failure after first-line NNRTI-based antiretroviral therapy in Thai HIV-infected children. AIDS Res Ther 2011; 8:40. [PMID: 22026962 PMCID: PMC3215920 DOI: 10.1186/1742-6405-8-40] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 10/26/2011] [Indexed: 11/16/2022] Open
Abstract
Background There are limited data of immunologic and virologic failure in Asian HIV-infected children using non-nucleoside reverse transcriptase inhibitor (NNRTI)-based highly active antiretroviral therapy (HAART). We examined the incidence rate of immunologic failure (IF) and virologic failure (VF) and the accuracy of using IF to predict VF in Thai HIV-infected children using first-line NNRTI-based HAART. Methods Antiretroviral (ART)-naïve HIV-infected children from 2 prospective cohorts treated with NNRTI-based HAART during 2001-2008 were included. CD4 counts were performed every 12 weeks and plasma HIV-RNA measured every 24 weeks. Immune recovery was defined as CD4%≥25%. IF was defined as persistent decline of ≥5% in CD4% in children with CD4%<15% at baseline or decrease in CD4 count ≥30% from baseline. VF was defined as HIV-RNA>1,000 copies/ml after at least 24 weeks of HAART. Clinical and laboratory parameter changes were assessed using a paired t-test, and a time to event approach was used to assess predictors of VF. Sensitivity and specificity of IF were calculated against VF. Results 107 ART-naive HIV-infected children were included, 52% female, % CDC clinical classification N:A:B:C 4:44:30:22%. Baseline data were median (IQR) age 6.2 (4.2-8.9) years, CD4% 7 (3-15), HIV-RNA 5.0 (4.9-5.5) log10copies/ml. Nevirapine (NVP) and efavirenz (EFV)-based HAART were started in 70% and 30%, respectively. At 96 weeks, none had progressed to a CDC clinical classification of AIDS and one had died from pneumonia. Overall, significant improvement of weight for age z-score (p = 0.014), height for age z-score, hemoglobin, and CD4 were seen (all p < 0.001). The median (IQR) CD4% at 96 weeks was 25 (18-30)%. Eighty-nine percent of children had immune recovery (CD4%≥25%) and 75% of children had HIV-RNA <1.7log10copies/ml. Thirty five (32.7%) children experienced VF within 96 weeks. Of these, 24 (68.6%) and 31 (88.6%) children had VF in the first 24 and 48 weeks respectively. Only 1 (0.9%) child experienced IF within 96 weeks and the sensitivity (95%CI) of IF to VF was 4 (0.1-20.4)% and specificity was 100 (93.9-100)%. Conclusion Immunologic failure, as defined here, had low sensitivity compared to VF and should not be recommended to detect treatment failure. Plasma HIV-RNA should be performed twice, at weeks 24 and 48, to detect early treatment failure. Trial Registration Clinicaltrials.gov identification number NCT00476606
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Peterson C, Alkar A, Smith S, Kerr S, Hall J, Moore D, Kasimanickam R. Effects of one versus two doses of prostaglandin F2alpha on AI pregnancy rates in a 5-day, progesterone-based, CO-Synch protocol in crossbred beef heifers. Theriogenology 2011; 75:1536-42. [DOI: 10.1016/j.theriogenology.2010.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Revised: 12/20/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
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Klinklom A, Puthanakit T, Gorowara M, Phasomsap C, Kerr S, Sriheara C, Ananworanich J, Burger D, Ruxrungtham K, Pancharoen C. Low dose lopinavir/ritonavir tablet achieves adequate pharmacokinetic parameters in HIV-infected Thai adolescents. Antivir Ther 2011; 17:283-9. [DOI: 10.3851/imp1958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2011] [Indexed: 10/15/2022]
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Dhannapuneni RRV, Gladman G, Kerr S, Venugopal P, Alphonso N, Corno AF. Complete atrioventricular septal defect: Outcome of pulmonary artery banding improved by adjustable device. J Thorac Cardiovasc Surg 2011; 141:179-82. [DOI: 10.1016/j.jtcvs.2010.03.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Revised: 02/22/2010] [Accepted: 03/14/2010] [Indexed: 10/19/2022]
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Avihingsanon A, Lewin SR, Kerr S, Chang JJ, Piyawat K, Napissanant N, Matthews GV, Dore GJ, Bowden S, Lange J, Ruxrungtham K. Efficacy of tenofovir disoproxil fumarate/emtricitabine compared with emtricitabine alone in antiretroviral-naive HIV-HBV coinfection in Thailand. Antivir Ther 2010; 15:917-22. [PMID: 20834105 DOI: 10.3851/imp1645] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Therapy for chronic hepatitis B with tenofovir disoproxil fumarate (TDF) and lamivudine (3TC) or emtricitabine (FTC) is currently recommended for HIV-HBV coinfection. However, there is limited randomized data on the efficacy of combined therapy with TDF and FTC, especially in antiretroviral (ARV)-naive patients. METHODS This was a prospective randomized clinical trial comparing the efficacy of HBV monotherapy with FTC versus TDF/FTC combination therapy in ARV-naive HIV-HBV coinfection. HIV-HBV-coinfected patients initiating ARV were randomized to either FTC/zidovudine/efavirenz (EFV; n=6) or TDF/FTC/EFV (n=10). The primary end point was the time-weighted area under the curve (TWAUC) of HBV DNA at 48 weeks. RESULTS The median baseline CD4(+) T-cell count was 64 cells/μl (interquartile range [IQR] 36-172), plasma HIV type-1 RNA was 4.90 log(10) copies/ml (IQR 4.58-5.44) and plasma HBV DNA was 8.76 log(10) copies/ml (IQR -8.45-8.82). A total of 11/16 (69%) patients were hepatitis B e antigen (HBeAg)-positive. The median TWAUC decrease in HBV DNA was -5.32 log(10) copies/ml in the TDF/FTC group compared with -3.25 log(10) copies/ml in the FTC group (P=0.03). At week 48, 90% of the TDF/FTC group and 33% of the FTC group had plasma HBV DNA<170 copies/ml (P=0.036, intention-to-treat analysis). HBeAg loss was observed in 4/11 (36%) HBeAg-positive patients. Hepatic flares were observed in 3/16 (19%) of patients. CONCLUSIONS TDF/FTC combination therapy resulted in a significantly greater decrease in HBV DNA than FTC monotherapy, with a greater proportion of patients with undetectable HBV DNA at week 48. Our study supports the current recommendation of ARV containing TDF/FTC as the treatment of choice for patients with HIV-HBV coinfection.
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Hemachandra A, Puls RL, Sirivichayakul S, Kerr S, Thantiworasit P, Ubolyam S, Cooper DA, Emery S, Phanuphak P, Kelleher A, Ruxrungtham K. An HIV-1 clade A/E DNA prime, recombinant fowlpox virus boost vaccine is safe, but non-immunogenic in a randomized phase I/IIa trial in Thai volunteers at low risk of HIV infection. HUMAN VACCINES 2010; 6:835-40. [PMID: 20864808 DOI: 10.4161/hv.6.10.12635] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previously demonstrated safe and highly immunogenic in non-human primates, this study assessed DNA (pHIS-HIV-AE) prime, recombinant fowlpox (rFPV-HIV-AE) boost vaccines in humans. RESULTS Eight participants (6 active vaccine, 2 placebo) received all vaccinations; local and systemic reactions were mild to moderate. The percentage CD4(+) and CD8(+) T cells responding to HIV-1 Gag antigens by ICS (mean ± SD) was 0.16 ± 0.12 and 0.10 ± 0.12 for active and 0.01 ± 0.01 and 0.00 ± 0.00 for placebo vaccine respectively. The percentage of T cells responding did not reach pre-defined thresholds to be considered positive responses. Consequently, the Data Safety Monitoring Board recommended cessation of further recruitment. Existing volunteers were followed to 52 weeks. METHODS Vectors expressing homologous HIV-1 clade A/E gag, pol, env and regulatory genes or matched placebo were administered intramuscularly at weeks 0, 4, 8 (6 mg pHIS-HIV-AE) and week 12 (3.0 x 10(8) pfu rFPV-HIV-AE) in this randomized, double-blind, placebo-controlled phase I/IIa study in healthy Thai adults at low risk of HIV infection. Immunogenicity was determined by interferon-gamma and IL-2 expression using intracellular cytokine staining assay (ICS), 13 weeks after randomization. Interim analysis was performed when eight volunteers reached 16 weeks follow-up. CONCLUSIONS Vaccine candidates were generally well tolerated, but showed limited immunogenicity. Better vaccines and delivery systems are required.
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Frith J, Kerr S, Robinson L, Elliott C, Ghazala C, Wilton K, Pairman J, Jones DEJ, Newton JL. Primary biliary cirrhosis is associated with falls and significant fall related injury. QJM 2010; 103:153-61. [PMID: 20061369 DOI: 10.1093/qjmed/hcp188] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Osteoporosis and autonomic dysfunction are prevalent in the autoimmune liver disease primary biliary cirrhosis (PBC). Postural hypotension is one consequence of autonomic dysfunction and is a recognized risk factor for falls, which, alongside osteoporosis could lead to significant injury and fractures. AIM To determine the prevalence and sequelae of falls in PBC and to identify modifiable risk factors. DESIGN Cross-sectional, geographical, population census of PBC and two control groups: primary sclerosing cholangitis and a community dwelling population. Multidisciplinary falls assessment of a representative group of PBC. METHODS Symptom assessment tools, completed by the three cohorts, determined the prevalence of falls, injuries and associated symptoms. Multidisciplinary assessments, adhering to NICE guidelines, identified modifiable fall associations. RESULTS Significantly more of the PBC population had fallen (72% P < 0.001) than both control groups. Fifty-five percent had fallen in the last year (P < 0.001), and 22% more than once in the last year (P < 0.01). Seventy percent of PBC fallers were injured, 27% fractured a bone and 19% were admitted to hospital, all significantly more common than controls. Postural dizziness was significantly worse in fallers (P < 0.001), as were balance (P < 0.001) and lower limb strength (P = 0.002). Lower limb strength was independently associated with number of falls in previous year (beta = 0.184, P < 0.001). CONCLUSION Falls and resultant injury are prevalent in PBC and more common than previously recognized. Addressing postural dizziness, poor balance and lower limb weakness using a multidisciplinary approach has the potential to reduce falls, morbidity and mortality and as a result improve quality of life.
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Chen M, LeDuc B, Kerr S, Howe D, Williams DA. Identification of Human UGT2B7 as the Major Isoform Involved in the O-Glucuronidation of Chloramphenicol. Drug Metab Dispos 2009; 38:368-75. [DOI: 10.1124/dmd.109.029900] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Holmes C, Cunningham C, Zotova E, Woolford J, Dean C, Kerr S, Culliford D, Perry VH. Systemic inflammation and disease progression in Alzheimer disease. Neurology 2009; 73:768-74. [PMID: 19738171 PMCID: PMC2848584 DOI: 10.1212/wnl.0b013e3181b6bb95] [Citation(s) in RCA: 757] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Acute and chronic systemic inflammation are characterized by the systemic production of the proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha) that plays a role in immune to brain communication. Previous preclinical research shows that acute systemic inflammation contributes to an exacerbation of neurodegeneration by activation of primed microglial cells. OBJECTIVE To determine whether acute episodes of systemic inflammation associated with increased TNF-alpha would be associated with long-term cognitive decline in a prospective cohort study of subjects with Alzheimer disease. METHODS Three hundred community-dwelling subjects with mild to severe Alzheimer disease were cognitively assessed, and a blood sample was taken for systemic inflammatory markers. Each subject's main caregiver was interviewed to assess the presence of incident systemic inflammatory events. Assessments of both patient and caregiver were repeated at 2, 4, and 6 months. RESULTS Acute systemic inflammatory events, found in around half of all subjects, were associated with an increase in the serum levels of proinflammatory cytokine TNF-alpha and a 2-fold increase in the rate of cognitive decline over a 6-month period. High baseline levels of TNF-alpha were associated with a 4-fold increase in the rate of cognitive decline. Subjects who had low levels of serum TNF-alpha throughout the study showed no cognitive decline over the 6-month period. CONCLUSIONS Both acute and chronic systemic inflammation, associated with increases in serum tumor necrosis factor alpha, is associated with an increase in cognitive decline in Alzheimer disease.
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Péronnet F, Abdelaoui M, Lavoie C, Marrao C, Kerr S, Massicotte D, Giesbrecht G. Effect of a 20-day ski trek on fuel selection during prolonged exercise at low workload with ingestion of 13C-glucose. Eur J Appl Physiol 2009; 106:41-9. [DOI: 10.1007/s00421-009-0987-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2009] [Indexed: 10/21/2022]
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Risica PM, Kerr S, Lawson E, Belhumeur R, Ankoma A. Self-report of sugar-sweetened beverage and fast food consumption by annual household income. MEDICINE AND HEALTH, RHODE ISLAND 2009; 92:63-64. [PMID: 19288689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Chen M, Howe D, Leduc B, Kerr S, Williams DA. Identification and characterization of two chloramphenicol glucuronides from thein vitroglucuronidation of chloramphenicol in human liver microsomes. Xenobiotica 2008; 37:954-71. [PMID: 17896323 DOI: 10.1080/00498250701620734] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study reports the development of a specific and sensitive liquid chromatography coupled with tandem mass spectrometry detection (LC-MS/MS) assay for the quantification of the in vitro O-glucuronidation of chloramphenicol (CP), the determination of the kinetic parameters for the O-glucuronidation of CP in pooled human liver microsomes (HLM), the biosynthesis of the CP glucuronides (CPGlu), and identification of the structures of CPGlu by (1)H-nuclear magnetic resonance (NMR) and MS. Two glucuronyl derived metabolites of CP were obtained from the incubation of alamethicin-activated HLM with CP and uridine 5'-diphosphoglucuronic acid (UDPGA) in pH 7.4 TRIS buffer. Their identification and structural confirmation were achieved by beta-glucuronidase hydrolysis, in the presence and absence of UDPGA, and by (1)H-NMR and LC-MS/MS. These two metabolites were biosynthesized, isolated, and purified using high-performance liquid chromatography (HPLC). Their structures were further identified as the 1-O-CPGlu (the minor glucuronide formed at the secondary alcohol of CP) and 3-O-CPGlu (the major glucuronide formed at the primary alcohol of CP) by LC-MS/MS and two-dimensional NMR. The enzymatic kinetic parameters K(m) and V(max) in HLM for the 3-O-CPGlu were determined to be 650 microM and 0.26 nmoles min(-1) mg(-1), respectively, and for the 1-O-CPGlu to be 301 microM and 0.014 nmoles min(-1) mg(-1), respectively. This study also provides a sensitive and specific method for the measurement of in vitro CP-UDP-glucuronosyltransferase (UGT) activity.
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Parry SW, Reeve P, Lawson J, Shaw FE, Davison J, Norton M, Frearson R, Kerr S, Newton JL. The Newcastle protocols 2008: an update on head-up tilt table testing and the management of vasovagal syncope and related disorders. Heart 2008; 95:416-20. [PMID: 18701533 DOI: 10.1136/hrt.2007.136457] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Berchane NS, Andrews MJ, Kerr S, Slater NKH, Jebrail FF. On the mechanical properties of bovine serum albumin (BSA) adhesives. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:1831-1838. [PMID: 18197367 DOI: 10.1007/s10856-007-3360-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 12/28/2007] [Indexed: 05/25/2023]
Abstract
Biological adhesives, natural and synthetic, are of current active interest. These adhesives offer significant advantages over traditional sealant techniques, in particular, they are easier to use, and can play an integral part in the healing mechanism of tissue. Thus, biological adhesives can play a major role in medical applications if they possess adequate mechanical behavior and stability over time. In this work, we report on the method of preparation of bovine serum albumin (BSA) into a biological adhesive. We present quantitative measurements that show the effect of BSA concentration and cross-linker content on the bonding strength of BSA adhesive to wood. A comparison is then made with synthetic poly(glycidyl methacrylate) (PGMA) adhesive, and a commercial cyanoacrylate glue, which was used as a control adhesive. In addition, BSA samples were prepared and characterized for their water content, tensile strength, and elasticity. We show that on dry surface, BSA adhesive exhibits a high bonding strength that is comparable with non-biological commercial cyanoacrylate glues, and synthetic PGMA adhesive. Tensile testing on wet wood showed a slight increase in the bonding strength of BSA adhesive, a considerable decrease in the bonding strength of cyanoacrylate glue, and negligible adhesion of PGMA. Tests performed on BSA samples demonstrate that initial BSA concentration and final water content have a significant effect on the stress-strain behavior of the samples.
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Avihingsanon A, van der Lugt J, Kerr S, Gorowara M, Chanmano S, Cooper DA, Phanuphak P, Burger D, Ruxrungtham K. Impact of age on pharmacokinetics of boosted atazanavir 300/100 in Thai HIV-infected patients. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Boom J, Kösters E, Duncombe C, Kerr S, Hirschel B, Ruxrungtham K, de Mast Q, Kosalaraksa P, Ulbolyam S, Jupimai T, Ananworanich J. Ferritin levels during structured treatment interruption of highly active antiretroviral therapy. HIV Med 2007; 8:388-95. [PMID: 17661847 DOI: 10.1111/j.1468-1293.2007.00481.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The aim of the study was to investigate the influence of highly active antiretroviral therapy (HAART) on iron status and, conversely, the influence of iron status on the response to HAART. METHODS Ferritin levels were retrospectively determined in stored plasma from 138 HAART-naïve, moderately immunosuppressed HIV-infected Thai patients participating in a structured treatment interruption trial. Ferritin levels were determined at three predefined time-points: (1) HAART initiation; (2) HAART discontinuation; and (3) HAART resumption. RESULTS At baseline, 31% and 16% of the HIV-infected patients included in the study had high (>200 ng/mL) and low (<30 ng/mL) ferritin levels, respectively. Ninety-five per cent of patients with low ferritin levels were female. Ferritin decreased significantly during the interruption phase of HAART (-8.8 ng/mL; P=0.0005) but remained elevated in 62% of the patients with high baseline levels. A low baseline ferritin level was associated with a shorter time (P=0.041) to reach the CD4 cell target for HAART interruption (350 cells/microL), compared with a normal or high baseline ferritin level. Moreover, in a multivariate model, the relative risk (RR) of arriving at this CD4 cell target was significantly higher [RR 1.81; 95% confidence interval (CI) 1.05-3.14] in patients with low baseline ferritin. It is unlikely that inflammation affected ferritin in our patients, as mean levels of C-reactive protein were not elevated in patients with either high or low ferritin levels. CONCLUSIONS Both high and low ferritin levels were highly prevalent in moderately immunosuppressed HIV-positive Thai patients. Structured treatment interruption of HAART resulted in a significant decrease in overall ferritin levels. Furthermore, subjects with low baseline ferritin levels had a faster and greater CD4 response to HAART, suggesting a potential beneficial effect of iron deficiency on immunological recovery after initiation of HAART.
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