1
|
Day C, Deetlefs M, O'Brien A, Smith J, Boyd M, Embling N, Patel S, Moody K, Ramabele T, Budge A, Tarwa T, Jim O, Maharaj T, Pandy S, Abrahams JM, Panieri A, Verhage S, Van der Merwe M, Geragotellis A, Amanjee W, Joseph C, Zhao Z, Moosa S, Bunting M, Pulani Y, Mukhari P, De Paiva M, Deyi G, Wonkam RP, Mancotywa N, Dunge A, Msimanga T, Singh A, Monnaruri O, Molale B, Butler TAG, Browde K, Muller C, Van der Walt J, Whitelaw R, Cronwright D, Sinha S, Binase U, Francis I, Boakye D, Dlamini S, Mendelson M, Peter J. Self-reported beta-lactam allergy in government and private hospitals in Cape Town, South Africa. S Afr Med J 2023; 113:69-74. [PMID: 36757070 DOI: 10.7196/samj.2023.v113i2.16760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Up to a quarter of inpatients in high-income countries (HICs) self-report beta-lactam allergy (BLA), which if incorrect,increases the use of alternative antibiotics, worsening individual health outcomes and driving bacterial resistance. In HICs, up to 95% ofself-reported BLAs are incorrect. The epidemiology of BLA in low- and middle-income African countries is unknown. OBJECTIVES To describe the epidemiology and de-labelling outcomes of self-reported BLA in hospitalised South African (SA) patients. METHODS Point-prevalence surveys were conducted at seven hospitals (adult, paediatric, government and privately funded, district andtertiary level) in Cape Town, SA, between April 2019 and June 2021. Ward prescription records and in-person interviews were conductedto identify and risk-stratify BLA patients using the validated PEN-FAST tool. De-labelling was attempted at the tertiary allergy clinic atGroote Schuur Hospital. RESULTS A total of 1 486 hospital inpatients were surveyed (1 166 adults and 320 children). Only 48 patients (3.2%) self-reported a BLA,with a higher rate in private than in government-funded hospitals (6.3% v. 2.8%; p=0.014). Using the PEN-FAST tool, only 10.4% (n=5/48)of self-reported BLA patients were classified as high risk for true penicillin hypersensitivity. Antibiotics were prescribed to 70.8% (n=34/48)of self-reported BLA patients, with 64.7% (n=22/34) receiving a beta-lactam. Despite three attempts to contact patients for de-labelling atthe allergy clinic, only 3/36 underwent in vivo testing, with no positive results, and 1 patient proceeded to a negative oral challenge. CONCLUSION Unlike HICs, self-reported BLA is low among inpatients in SA. The majority of those who self-reported BLA were low risk fortype 1 hypersensitivity, but outpatient de-labelling efforts were largely unsuccessful.
Collapse
Affiliation(s)
- C Day
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Deetlefs
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A O'Brien
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Smith
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Boyd
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - N Embling
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Patel
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - K Moody
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Ramabele
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Budge
- Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Tarwa
- Molecular Mycobacteriology Research Unit, Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - O Jim
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Maharaj
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Pandy
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J-M Abrahams
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Panieri
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Verhage
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Van der Merwe
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Geragotellis
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - W Amanjee
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Joseph
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Z Zhao
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Moosa
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Bunting
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Y Pulani
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - P Mukhari
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M De Paiva
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - G Deyi
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - R P Wonkam
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - N Mancotywa
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Dunge
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Msimanga
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Singh
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - O Monnaruri
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - B Molale
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T A G Butler
- Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - K Browde
- Division of Allergology and Clinical Immunology, Department of Paediatrics, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Muller
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - J Van der Walt
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - R Whitelaw
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - D Cronwright
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Sinha
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - U Binase
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - I Francis
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - D Boakye
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Dlamini
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Peter
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| |
Collapse
|
2
|
Drury A, O'Connell L, O'Brien A, Harkin M, Rogers L. CN62 Patient and public involvement in cancer research: The needs and perceptions of older adults living with and after cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
3
|
Chen K, Krischuns T, Varga L, Harigua-Souiai E, Paisant S, Zettor A, Chiaravalli J, Delpal A, Courtney D, O'Brien A, Baker S, Decroly E, Isel C, Agou F, Jacob Y, Blondel A, Naffakh N. A highly sensitive cell-based luciferase assay for high-throughput automated screening of SARS-CoV-2 nsp5/3CLpro inhibitors. Antiviral Res 2022; 201:105272. [PMID: 35278581 PMCID: PMC8906008 DOI: 10.1016/j.antiviral.2022.105272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/19/2022] [Accepted: 02/23/2022] [Indexed: 12/15/2022]
Abstract
Effective drugs against SARS-CoV-2 are urgently needed to treat severe cases of infection and for prophylactic use. The main viral protease (nsp5 or 3CLpro) represents an attractive and possibly broad-spectrum target for drug development as it is essential to the virus life cycle and highly conserved among betacoronaviruses. Sensitive and efficient high-throughput screening methods are key for drug discovery. Here we report the development of a gain-of-signal, highly sensitive cell-based luciferase assay to monitor SARS-CoV-2 nsp5 activity and show that it is suitable for the screening of compounds in a 384-well format. A benefit of miniaturisation and automation is that screening can be performed in parallel on a wild-type and a catalytically inactive nsp5, which improves the selectivity of the assay. We performed molecular docking-based screening on a set of 14,468 compounds from an in-house chemical database, selected 359 candidate nsp5 inhibitors and tested them experimentally. We identified two molecules which show anti-nsp5 activity, both in our cell-based assay and in vitro on purified nsp5 protein, and inhibit SARS-CoV-2 replication in A549-ACE2 cells with EC50 values in the 4–8 μM range. The here described high-throughput-compatible assay will allow the screening of large-scale compound libraries for SARS-CoV-2 nsp5 inhibitors. Moreover, we provide evidence that this assay can be adapted to other coronaviruses and viruses which rely on a viral protease.
Collapse
|
4
|
Heaney RM, Sweeney L, Flanagan F, O'Brien A, Smith C. Ipsilateral microcalcifications after breast-conserving surgery: is it possible to differentiate benign from malignant calcifications? Clin Radiol 2021; 77:216-223. [PMID: 34973807 DOI: 10.1016/j.crad.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
AIM To analyse stereotactic biopsies of microcalcifications in patients with previous ipsilateral breast-conserving surgery (BCS) to identify the positivity rate, assess for an association between the patient's primary cancer or mammographic appearances of the microcalcifications, and the risk of recurrence. MATERIALS AND METHODS Relevant patients from 2018-2020 were identified via a retrospective review of the prospectively maintained radiological procedure database. Clinicopathological features of the patients' primary tumour and new calcifications were obtained from the hospital electronic patient record system and the national integrated medical imaging system. RESULTS Thirty-one percent of recurrences post-ipsilateral BCS presented as isolated microcalcifications on mammography. Fifty-three percent of patients undergoing stereotactic biopsy of ipsilateral calcifications had recurrence. A positive margin status was associated with new or recurrent malignancy. There was no significant correlation between oestrogen-receptor status, sentinel lymph node status, adjuvant radiotherapy or chemotherapy and the risk of recurrence. Calcifications within the tumour bed were more likely to be benign while calcifications within the same quadrant but remote from the tumour bed were more likely malignant. All coarse calcifications were benign while 67% of fine linear/fine linear branching and 89% of fine pleomorphic calcifications were malignant. CONCLUSION Increased time since diagnosis, positive margin status, fine pleomorphic and fine linear calcifications in the same quadrant as the tumour bed were associated with malignancy. Patients with coarse calcifications and calcifications within the tumour bed may avoid stereotactic biopsy and undergo short-interval surveillance.
Collapse
Affiliation(s)
- R M Heaney
- Mater Misericordiae University Hospital, Dublin, D07 Y7C6, Ireland.
| | - L Sweeney
- Mater Misericordiae University Hospital, Dublin, D07 Y7C6, Ireland
| | - F Flanagan
- Mater Misericordiae University Hospital, Dublin, D07 Y7C6, Ireland
| | - A O'Brien
- Mater Misericordiae University Hospital, Dublin, D07 Y7C6, Ireland
| | - C Smith
- Mater Misericordiae University Hospital, Dublin, D07 Y7C6, Ireland
| |
Collapse
|
5
|
Okpaje B, Gabr A, Mohamed A, Teoh TK, Mustafa W, Saleh A, Ali B, Leahy A, Stapelton P, O'Connell N, Power L, O'Connell S, O'Brien A, Shanahan E, Peters C, Galvin R, O'Connor M. 234 THE IMPACT OF OLDER AGE ON CLINICAL OUTCOMES DURING THE FIRST WAVE OF THE COVID-19 PANDEMIC. Age Ageing 2021. [PMCID: PMC8690045 DOI: 10.1093/ageing/afab219.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Severe acute respiratory coronavirus 2 (SARS-CoV-2) was first recorded in Ireland in February 2020. Several studies have explored the association between age and SARS-CoV-2, showing that there were poorer outcomes in older people. Our objective was to evaluate the impact of age on outcomes such as hospital length of stay, mortality, and re-hospitalisation. Methods We performed a single-centre, retrospective observational cohort study, using an electronic microbiology database of recorded index admissions of SARS-CoV-2 positive patients aged 65 years and older during SARS-CoV-2 wave one (March 1st to May 31st 2020). PCR testing of nasopharyngeal and/or sputum samples was used to confirm positivity. Our clinical outcomes measured included hospital length of stay, mortality and re-admission rate within 6 months. Results 153 patients 65 years and above were admitted. The male to female ratio was 1.3 with 90% admitted medically. 79 patients were aged between 65–79 years; 84 patients ≥80 years; and 12 patients ≥90 years. Mortality was 25%, 31% and 42%, respectively. Median length of stay remained 14 days for ages 65–89 rising to 17.5 days for those ≥90 years. Re-hospitalisation rates at 6 months were similar for ages 65–79 and 89–89 years at 42% and 40%, respectively. One patient (14%) over 90 years was re-hospitalised. Conclusion SARS-CoV-2 has disproportionately impacted on general medical services treating older hospitalised people. In our centre, mortality for patients ≥65 years was 28.1% which compared favourably with 35.6% internationally as outlined by Victor et al. (2020) based on Spanish data. Treatment of SARS-CoV-2 is not futile in older patients with 58% of nonagenarians and 69% of octogenarians surviving, however re-hospitalisation rates are high at 40%. A targeted approach to discharge support via integrated care may ameliorate this.
Collapse
Affiliation(s)
- B Okpaje
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - A Gabr
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - A Mohamed
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - T K Teoh
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| | - W Mustafa
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - A Saleh
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - B Ali
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - A Leahy
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - P Stapelton
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| | - N O'Connell
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| | - L Power
- Department of Microbiology, University Hospital Limerick, Limerick, Ireland
| | - S O'Connell
- Department of Infectious Diseases, University Hospital Limerick, Limerick, Ireland
| | - A O'Brien
- Department of Respiratory Medicine, University Hospital Limerick, Limerick, Ireland
| | - E Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - C Peters
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - R Galvin
- Department of Allied Health, University of Limerick, Limerick, Ireland
| | - M O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| |
Collapse
|
6
|
Woznitza N, Steele R, Groombridge H, Compton E, Gower S, Hussain A, Norman H, O'Brien A, Robertson K. Clinical reporting of radiographs by radiographers: Policy and practice guidance for regional imaging networks. Radiography (Lond) 2020; 27:645-649. [PMID: 32814647 DOI: 10.1016/j.radi.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Radiographer reporting is an essential component of imaging across the United Kingdom. Since the previous policy and practice guidance in 2004 the role and contribution of reporting radiographers has changed significantly. The move to imaging networks further reinforces the need for consistency in scope of practice and clinical governance for radiographer reporting. KEY FINDINGS This guidance provides a consistent, evidence-based template for planning a reporting service, resourcing, clinical governance, preceptorship, volume and frequency of reporting, a peer learning framework and expected standards. CONCLUSION Developed for North Central and East London, this framework and standards will help reduce unwarranted variation. IMPLICATIONS FOR PRACTICE Consistency in practice could help maximise the contribution of radiographer reporting.
Collapse
Affiliation(s)
- N Woznitza
- Radiology Department, Homerton University Hospital, UK; School of Allied and Public Health Professions, Canterbury Christ Church University, UK; North Central and East London Cancer Alliance, UK; Health Education England, London, UK.
| | - R Steele
- North Central and East London Cancer Alliance, UK; Radiology Department, University College London Hospitals, UK
| | - H Groombridge
- Radiology Department, University College London Hospitals, UK
| | - E Compton
- Radiology Department, Guys & St Thomas' Hospitals, UK
| | - S Gower
- Radiology Department, Kings College Hospitals, UK
| | - A Hussain
- North Central and East London Cancer Alliance, UK
| | - H Norman
- North Central and East London Cancer Alliance, UK
| | - A O'Brien
- Radiology Department, Kings College Hospitals, UK
| | - K Robertson
- NHS England and Improvement, London, UK; South East London Cancer Alliance, UK
| |
Collapse
|
7
|
Perera D, Kaneshamoorthy M, Burdon Z, O'Brien A. 54 A Quality Improvement Project on the Recording of Stool Charts. Age Ageing 2020. [DOI: 10.1093/ageing/afz186.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Change in bowel movement is a common complaint in frail patients, which can be indicative of conditions such as constipation, infection or malnutrition. Without prompt action, this can result in increased length of stay. The recording of stools can be variable. This quality improvement project was to improve stool chart completion rate and staff confidence.
Methods
We conducted two Plan-Do-Study-Act cycles over three months. We surveyed multidisciplinary staff confidence using Likert scales covering each element on the Bristol stool chart. We then reviewed patient stool charts. The first intervention was a poster. The second intervention was the addition of a sticker to the charts to help staff more easily identify them in the patient’s bedside notes. Staff-wide emails were sent to inform every one of the interventions and key stakeholders including ward managers were asked to hand this over.
Results
44 multidisciplinary staff were interviewed and 217 individual stool charts assessed over a 3 month period. 43% of stool charts were not filled in as directed after the first cycle. Posters improved staff confidence in filling out the charts from 72.3% to 92.3% after the second cycle, while 61% of stool charts came to be filled in correctly - over the initial 57%. Healthcare assistants consistently scored the highest in terms of believing charts to be up to date being whereas doctors remained the most cynical. There was little sustained change in stool chart completion rates after three PDSA cycles. Eventually, after both interventions, completion rates returned to baseline.
Conclusions
Stool chart completion rates can be improved in the short term, but sustainability is a challenge. Factors contributing to this include the variable number of agency nurses. Further improvements include teaching at the nursing induction.
Collapse
Affiliation(s)
- D Perera
- Southend University Hospital NHS Foundation Trust
| | | | - Z Burdon
- Southend University Hospital NHS Foundation Trust
| | - A O'Brien
- Southend University Hospital NHS Foundation Trust
| |
Collapse
|
8
|
McCann M, O'Brien A, Larbalestier R, Davis T. 605 Euglycaemic Diabetic Ketoacidosis Complicating Cardiac Surgery. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
MacLeod J, Aguiar C, Chanyi S, Fowlow C, O'Brien A, Brown C, Pozeg Z, Légaré J, Hassan A. THE IMPACT OF ROTATIONAL THROMBOELASTOMETRY (ROTEM) ON IN-HOSPITAL OUTCOMES AND BLOOD PRODUCT UTILIZATION FOLLOWING CARDIAC SURGERY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
10
|
Légaré JF, Hassan A, O'Brien A, Archer B, Ferguson D, Forgie R, Teskey R, McGrath B, Paddock V. Transfemoral Aortic Valve Replacement (TAVR): Is Incorporation of Interventional Radiologists into the Team Beneficial? Cardiovasc Intervent Radiol 2019; 42:1511-1512. [PMID: 31471719 DOI: 10.1007/s00270-019-02318-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 10/26/2022]
Affiliation(s)
- J F Légaré
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada. .,Cardiovascular Research New Brunswick, Saint John, NB, Canada. .,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada.
| | - A Hassan
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,Cardiovascular Research New Brunswick, Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - A O'Brien
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - B Archer
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - D Ferguson
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - R Forgie
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,Cardiovascular Research New Brunswick, Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - R Teskey
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,Cardiovascular Research New Brunswick, Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - B McGrath
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,Cardiovascular Research New Brunswick, Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| | - V Paddock
- Dalhousie University Medicine (DMNB), Saint John, NB, Canada.,Cardiovascular Research New Brunswick, Saint John, NB, Canada.,The New Brunswick Heart Centre, 400 University Ave, Saint John, NB, E2L 4L2, Canada
| |
Collapse
|
11
|
Gartner J, Langford A, O'Brien A. It is ethical to diagnose a public figure one has not personally examined - CORRIGENDUM. Br J Psychiatry 2019; 214:239. [PMID: 30518438 DOI: 10.1192/bjp.2018.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
12
|
Legare J, Hassan A, Lutchmedial S, Yip A, MacLeod J, Leblanc H, Archer B, Ferguson D, Pelletier M, Forgie R, O'Brien A, Teskey R, Paddock V. HOW INTERVENTIONAL RADIOLOGY CAN ENHANCE THE PERFORMANCE OF A TAVI TEAM: NEW BRUNSWICK HEART CENTRE EXPERIENCE. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
13
|
Aisyah DN, Shallcross L, Hully AJ, O'Brien A, Hayward A. Assessing hepatitis C spontaneous clearance and understanding associated factors-A systematic review and meta-analysis. J Viral Hepat 2018; 25:680-698. [PMID: 29345844 DOI: 10.1111/jvh.12866] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 12/14/2017] [Indexed: 12/11/2022]
Abstract
New advances in the treatment of hepatitis C provide high levels of sustained viral response but their expense limits availability in publicly funded health systems. The aim of this review was to estimate the proportion of patients who will spontaneously clear HCV, to identify factors that are associated with clearance and to support better targeting of directly acting antivirals. We searched Ovid EMBASE, Ovid MEDLINE and PubMed from 1 January 1994 to 30 June 2015 for studies reporting hepatitis C spontaneous clearance and/or demographic, clinical and behavioural factors associated with clearance. We undertook meta-analyses to estimate the odds of clearance for each predictor. Forty-three studies met the inclusion criteria, representing 20 110 individuals, and 6 of these studies included sufficient data to estimate spontaneous clearance. The proportion achieving clearance within 3, 6, 12 and 24 months following infection were, respectively, 19.8% (95% CI: 2.6%-47.5%), 27.9% (95% CI: 17.2%-41.8%), 36.1% (95% CI: 23.5%-50.9%) and 37.1% (95% CI: 23.7%-52.8%). Individuals who had not spontaneously cleared by 12 months were unlikely to do so. The likelihood of spontaneous clearance was lower in males and individuals with HIV co-infection, the absence of HBV co-infection, asymptomatic infection, black or nonindigenous race, nongenotype 1 infection, older age and alcohol or drug problems. This study suggests that patients continue to spontaneously clear HCV for at least 12 months following initial infection. However, injecting drug users are comparatively less likely to achieve clearance; thus, they should be considered a priority for early treatment given the continuing risks that these individuals pose for onwards transmission.
Collapse
Affiliation(s)
- D N Aisyah
- UCL Infectious Disease Informatics, Farr Institute of Health Informatics, London, UK.,Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - L Shallcross
- UCL Infectious Disease Informatics, Farr Institute of Health Informatics, London, UK
| | - A J Hully
- Kings College London School of Medicine, London, UK
| | - A O'Brien
- UCL Division of Medicine, London, UK
| | - A Hayward
- UCL Infectious Disease Informatics, Farr Institute of Health Informatics, London, UK.,Institute of Epidemiology and Health Care, University College London, London, UK
| |
Collapse
|
14
|
van Hedel HJA, Severini G, Scarton A, O'Brien A, Reed T, Gaebler-Spira D, Egan T, Meyer-Heim A, Graser J, Chua K, Zutter D, Schweinfurther R, Möller JC, Paredes LP, Esquenazi A, Berweck S, Schroeder S, Warken B, Chan A, Devers A, Petioky J, Paik NJ, Kim WS, Bonato P, Boninger M. Correction to: Advanced Robotic Therapy Integrated Centers (ARTIC): an international collaboration facilitating the application of rehabilitation technologies. J Neuroeng Rehabil 2018; 15:36. [PMID: 29739468 PMCID: PMC5941668 DOI: 10.1186/s12984-018-0378-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 12/05/2022] Open
Affiliation(s)
- Hubertus J A van Hedel
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland.
| | - Giacomo Severini
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, at Spaulding Rehabilitation Hospital, Charlestown, MA, USA.,University College Dublin, Dublin, Ireland
| | - A Scarton
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, at Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - A O'Brien
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, at Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - T Reed
- Acute Neurological Rehabilitation Unit, Wellington Hospital, London, UK
| | | | - T Egan
- Shirley Ryan AbilityLab, Chicago, USA
| | - A Meyer-Heim
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland
| | - J Graser
- Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Mühlebergstrasse 104, CH-8910, Affoltern am Albis, Switzerland
| | - K Chua
- Tan Tock Seng Hospital Rehabilitation Centre, Singapore, Republic of Singapore
| | - D Zutter
- Rehaklinik Zihlschlacht, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - R Schweinfurther
- Rehaklinik Zihlschlacht, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - J C Möller
- Rehaklinik Zihlschlacht, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Liliana P Paredes
- Rehaklinik Zihlschlacht, Center for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - A Esquenazi
- Department of Physical Medicine and Rehabilitation, MossRehab, Philadelphia, USA
| | - S Berweck
- Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy center for children and adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
| | - S Schroeder
- Paediatric Neurology, Developmental Medicine and Social Paediatrics, Ludwig Maximilian University, Hauner Children's Hospital, Munich, Germany
| | - B Warken
- Paediatric Neurology, Developmental Medicine and Social Paediatrics, Ludwig Maximilian University, Hauner Children's Hospital, Munich, Germany
| | - A Chan
- Sheltering Arms Physical Rehabilitation Center, Richmond, USA
| | - A Devers
- Sheltering Arms Physical Rehabilitation Center, Richmond, USA
| | - J Petioky
- Rehabilitation Centre Kladruby, Kladruby, Czech Republic
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - W S Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - P Bonato
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, at Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - M Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh and VA Pittsburgh Health Care System, Pittsburgh, USA
| | | |
Collapse
|
15
|
Alabdulghani F, O'Brien A, Brophy D. Application of cone-beam computed tomography angiography in a uterine fibroid embolization procedure: A case report. Radiol Case Rep 2018; 13:130-134. [PMID: 29487648 PMCID: PMC5826697 DOI: 10.1016/j.radcr.2017.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 09/12/2017] [Accepted: 09/25/2017] [Indexed: 11/18/2022] Open
Abstract
One of the main causes of failure in uterine fibroid embolization procedures is incomplete infarction of the fibroid due to alternate vascular supply to the fibroid which was not identified by the operator. Cone-beam computed tomography angiography was used in this case to avoid nontarget embolization via a uterine artery, as well as identify incomplete embolization of the fibroid. This prompted a search for variant vascular supply to the fibroid, which was found to be originating from the right ovarian artery. Therefore, the use of cone-beam computed tomography angiography led to a successful outcome, which otherwise may not have been achieved.
Collapse
Affiliation(s)
- F. Alabdulghani
- Department of Radiology, St. Vincent's University Hospital, Elm Park, 196 Merrion Rd, Dublin 4, Ireland
| | | | | |
Collapse
|
16
|
Kavanagh RG, O'Brien A, Tubridy N, McNeill G, Killeen RP. Transient global amnesia: clinical and imaging features. QJM 2017; 110:843-844. [PMID: 29024985 DOI: 10.1093/qjmed/hcx168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R G Kavanagh
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - A O'Brien
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - N Tubridy
- Department of Neurology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - G McNeill
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - R P Killeen
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| |
Collapse
|
17
|
Khan MI, O'Leary C, O'Brien A, Lester L, Silvari V, Duggan C, O'Shea S. Hospital Acquired Thrombosis (HAT) Prevention in an Acute Hospital; A Single Centre Cross-Sectional Study. Ir Med J 2017; 110:547. [PMID: 28665086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Evidence based guidelines are effective in reducing incidence of venous thromboembolism (VTE) which is associated with morbidly, mortality and economic burden. This study aimed to identify the proportion of inpatients who had a VTE risk assessment (RA) performed and who received thromboprophylaxis (TP), in Cork University Hospital. There was no structured RA tool at the time; information was obtained from medical and drug charts to ascertain if a RA was performed. Patients were then RA by researchers and stratified as per NICE guidelines and the proportion who received TP was calculated. One thousand and nineteen inpatients were screened. Risk was documented in 24% of cases. TP was prescribed in 43.2% of inpatients. Following application of a RA tool >80% were at high risk of VTE with low risk of bleeding with TP prescription in 46.3% of inpatients. A national collaborative effort should be encouraged to develop a standardized approach for safe RA of inpatients and prescription of TP for prevention of HAT.
Collapse
Affiliation(s)
- M I Khan
- Haematology Department, Cork University Hospital
- Clinical Research Facility, University College Cork
| | - C O'Leary
- Haematology Department, Cork University Hospital
| | - A O'Brien
- Haematology Department, Cork University Hospital
| | - L Lester
- Haematology Department, Cork University Hospital
| | - V Silvari
- Haematology Department, Cork University Hospital
| | - C Duggan
- Haematology Department, Cork University Hospital
| | - S O'Shea
- Haematology Department, Cork University Hospital
| |
Collapse
|
18
|
Khan MI, O'Leary C, O'Brien A, Silvari V, Duggan C, O'Shea S. Incidence of Hospital Acquired Thrombosis (HAT) in a Tertiary Care Hospital. Ir Med J 2017; 110:542. [PMID: 28665081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality in hospitalized patients. In spite of guidelines, VTE prophylaxis continues to be underutilised, and hospital acquired thrombosis (HAT) continues to be a problem. This study was conducted to estimate the incidence of HAT in a tertiary referral centre and to examine whether VTE risk assessment and thromboprophylaxis (TP) were implemented. Patients 18 years and above, with a radiologically-confirmed acute VTE during the study period of 15 weeks were included. Acute VTE was diagnosed in 100 patients and HAT was diagnosed in 48. There were 12,024 admissions over the study period, therefore the incidence of HAT was 0.4%. TP was prescribed in only 35% of patients, and 65% did not receive any or appropriate TP. Hospitals without active implementation of a formal risk assessment tool and TP policy are likely to continue to have increased incidence of HAT.
Collapse
Affiliation(s)
- M I Khan
- Haematology Department, Cork University Hospital
| | - C O'Leary
- Haematology Department, Cork University Hospital
| | - A O'Brien
- Clinical Research Facility, University College Cork
| | - V Silvari
- Haematology Department, Cork University Hospital
| | - C Duggan
- Haematology Department, Cork University Hospital
| | - S O'Shea
- Haematology Department, Cork University Hospital
| |
Collapse
|
19
|
Khan MI, O'Leary C, Silvari V, O'Brien A, O'Connor M, Duggan C, O'Shea S. Venous Thromboembolism - Risk Assessment Tool and Thromboprophylaxis Policy: A National Survey. Ir Med J 2017; 110:499. [PMID: 28657276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Venous Thromboembolic (VTE) events in hospitalised patients are associated with significant mortality and morbidity and a major economic burden on the health service. It is well established in the literature that active implementation of a mandatory risk assessment tool and thromboprophylaxis policy reduces the incidence of hospital associated thrombosis (HAT). This study examines the utilization of a VTE risk assessment tool and thromboprophylaxis (TP) policy in Irish hospitals that manage acute admissions. A national survey was distributed to forty acute hospitals throughout Ireland. The response rate was 78% (31/40). The results showed that only 26% (n=8/31) of acute hospitals in Ireland have a local implemented TP policy. Six (75%) of these eight had a risk assessment tool in conjunction with the TP policy. All respondents who did not report to have a TP policy and risk assessment tool agreed that they should implement VTE prevention policy at their hospital. Based on the data from this survey and evidence from the effectiveness of the VTE prevention programme introduced in the United Kingdom, there is a need for a national risk assessment and thromboprophylaxis policy in Ireland. This change in practice would have the potential to prevent or reduce the morbidity and mortality associated with hospital acquired thrombosis.
Collapse
|
20
|
Berry DP, O'Brien A, Randles S, McDermott K, Wall E, McHugh N. 0308 Imputation of medium density genotypes from custom low density genotype panel in sheep. J Anim Sci 2016. [DOI: 10.2527/jam2016-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
21
|
O'Brien A, Pope J, Anguah K, Erickson D. Mini Nutrition Assessment Score as a Potential Predictor of Pressure Ulcers in Elderly Nursing Home Patients with Dementia. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
22
|
Affiliation(s)
- A O'Brien
- School of Nursing, University of Auckland, Auckland, New Zealand
| |
Collapse
|
23
|
Mehta P, Holder S, Fisher B, Vincent T, Nadesalingam K, Maciver H, Shingler W, Bakshi J, Hassan S, D'Cruz D, Chan A, Litwic AE, McCrae F, Seth R, McCrae F, Nandagudi A, Jury E, Isenberg D, Karjigi U, Paul A, Rees F, O'Dowd E, Kinnear W, Johnson S, Lanyon P, Bakshi J, Stevens R, Narayan N, Marguerie C, Robinson H, Ffolkes L, Worsnop F, Ostlere L, Kiely P, Dharmapalaiah C, Hassan N, Nandagudi A, Bharadwaj A, Skibinska M, Gendi N, Davies EJ, Akil M, Kilding R, Ramachandran Nair J, Walsh M, Farrar W, Thompson RN, Borukhson L, McFadyen C, Singh D, Rajagopal V, Chan AML, Wearn Koh L, Christie JD, Croot L, Gayed M, Disney B, Singhal S, Grindulis K, Reynolds TD, Conway K, Williams D, Quin J, Dean G, Churchill D, Walker-Bone KE, Goff I, Reynolds G, Grove M, Patel P, Lazarus MN, Roncaroli F, Gabriel C, Kinderlerer AR, Nikiphorou E, Hall FC, Bruce E, Gray L, Krutikov M, Wig S, Bruce I, D'Agostino MA, Wakefield R, Berner Hammer H, Vittecoq O, Galeazzi M, Balint P, Filippucci E, Moller I, Iagnocco A, Naredo E, Ostergaard M, Gaillez C, Kerselaers W, Van Holder K, Le Bars M, Stone MA, Williams F, Wolber L, Karppinen J, Maatta J, Thompson B, Atchia I, Lorenzi A, Raftery G, Platt P, Platt PN, Pratt A, Turmezei TD, Treece GM, Gee AH, Poole KE, Chandratre PN, Roddy E, Clarson L, Richardson J, Hider S, Mallen C, Lieberman A, Prouse PJ, Mahendran P, Samarawickrama A, Churchill D, Walker-Bone KE, Ottery FD, Yood R, Wolfson M, Ang A, Riches P, Thomson J, Nuki G, Humphreys J, Verstappen SM, Chipping J, Hyrich K, Marshall T, Symmons DP, Roy M, Kirwan JR, Marshall RW, Matcham F, Scott IC, Rayner L, Hotopf M, Kingsley GH, Scott DL, Steer S, Ma MH, Dahanayake C, Scott IC, Kingsley G, Cope A, Scott DL, Dahanayake C, Ma MH, Scott IC, Kingsley GH, Cope A, Scott DL, Wernham A, Ward L, Carruthers D, Deeming A, Buckley C, Raza K, De Pablo P, Nikiphorou E, Carpenter L, Jayakumar K, Solymossy C, Dixey J, Young A, Singh A, Penn H, Ellerby N, Mattey DL, Packham J, Dawes P, Hider SL, Ng N, Humby F, Bombardieri M, Kelly S, Di Cicco M, Dadoun S, Hands R, Rocher V, Kidd B, Pyne D, Pitzalis C, Poore S, Hutchinson D, Low A, Lunt M, Mercer L, Galloway J, Davies R, Watson K, Dixon W, Symmons D, Hyrich K, Mercer L, Lunt M, Low A, Galloway J, Watson KD, Dixon WG, Symmons D, Hyrich KL, Low A, Lunt M, Mercer L, Bruce E, Dixon W, Hyrich K, Symmons D, Malik SP, Kelly C, Hamilton J, Heycock C, Saravanan V, Rynne M, Harris HE, Tweedie F, Skaparis Y, White M, Scott N, Samson K, Mercieca C, Clarke S, Warner AJ, Humphreys J, Lunt M, Marshall T, Symmons D, Verstappen S, Chan E, Kelly C, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Ahmad Y, Koduri G, Young A, Kelly C, Chan E, Ahmad Y, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Koduri G, Young A, Cumming J, Stannett P, Hull R, Metsios G, Stavropoulos Kalinoglou A, Veldhuijzen van Zanten JJ, Nightingale P, Koutedakis Y, Kitas GD, Nikiphorou E, Dixey J, Williams P, Kiely P, Walsh D, Carpenter L, Young A, Perry E, Kelly C, de-Soyza A, Moullaali T, Eggleton P, Hutchinson D, Veldhuijzen van Zanten JJ, Metsios G, Stavropoulos-Kalinoglou A, Sandoo A, Kitas GD, de Pablo P, Maggs F, Carruthers D, Faizal A, Pugh M, Jobanputra P, Kehoe O, Cartwright A, Askari A, El Haj A, Middleton J, Aynsley S, Hardy J, Veale D, Fearon U, Wilson G, Muthana M, Fossati G, Healy L, Nesbitt A, Becerra E, Leandro MJ, De La Torre I, Cambridge G, Nelson PN, Roden D, Shaw M, Davari Ejtehadi H, Nevill A, Freimanis G, Hooley P, Bowman S, Alavi A, Axford J, Veitch AM, Tugnet N, Rylance PB, Hawtree S, Muthana M, Aynsley S, Mark Wilkinson J, Wilson AG, Woon Kam N, Filter A, Buckley C, Pitzalis C, Bombardieri M, Croft AP, Naylor A, Zimmermann B, Hardie D, Desanti G, Jaurez M, Muller-Ladner U, Filer A, Neumann E, Buckley C, Movahedi M, Lunt M, Ray DW, Dixon WG, Burmester GR, Matucci-Cerinic M, Navarro-Blasco F, Kary S, Unnebrink K, Kupper H, Mukherjee S, Cornell P, Richards S, Rahmeh F, Thompson PW, Westlake SL, Javaid MK, Batra R, Chana J, Round G, Judge A, Taylor P, Patel S, Cooper C, Ravindran V, Bingham CO, Weinblatt ME, Mendelsohn A, Kim L, Mack M, Lu J, Baker D, Westhovens R, Hewitt J, Han C, Keystone EC, Fleischmann R, Smolen J, Emery P, Genovese M, Doyle M, Hsia EC, Hart JC, Lazarus MN, Kinderlerer AR, Harland D, Gibbons C, Pang H, Huertas C, Diamantopoulos A, Dejonckheere F, Clowse M, Wolf D, Stach C, Kosutic G, Williams S, Terpstra I, Mahadevan U, Smolen J, Emery P, Ferraccioli G, Samborski W, Berenbaum F, Davies O, Koetse W, Bennett B, Burkhardt H, Weinblatt ME, Fleischmann R, Davies O, Luijtens K, van der Heijde D, Mariette X, van Vollenhoven RF, Bykerk V, de Longueville M, Arendt C, Luijtens K, Cush J, Khan A, Maclaren Z, Dubash S, Chalam VC, Sheeran T, Price T, Baskar S, Mulherin D, Molloy C, Keay F, Heritage C, Douglas B, Fleischmann R, Weinblatt ME, Schiff MH, Khanna D, Furst DE, Maldonado MA, Li W, Sasso EH, Emerling D, Cavet G, Ford K, Mackenzie-Green B, Collins D, Price E, Williamson L, Golla J, Vagadia V, Morrison E, Tierney A, Wilson H, Hunter J, Ma MH, Scott DL, Reddy V, Moore S, Ehrenstein M, Benson C, Wray M, Cairns A, Wright G, Pendleton A, McHenry M, Taggart A, Bell A, Bosworth A, Cox M, Johnston G, Shah P, O'Brien A, Jones P, Sargeant I, Bukhari M, Nusslein H, Alten R, Galeazzi M, Lorenz HM, Boumpas D, Nurmohamed MT, Bensen W, Burmester GR, Peter HH, Rainer F, Pavelka K, Chartier M, Poncet C, Rauch C, Le Bars M, Lempp H, Hofmann D, Adu A, Congreve C, Dobson J, Rose D, Simpson C, Wykes T, Cope A, Scott DL, Ibrahim F, Schiff M, Alten R, Weinblatt ME, Nash P, Fleischmann R, Durez P, Kaine J, Delaet I, Kelly S, Maldonado M, Patel S, Genovese M, Jones G, Sebba A, Lepley D, Devenport J, Bernasconi C, Smart D, Mpofu C, Gomez-Reino JJ, Verma I, Kaur J, Syngle A, Krishan P, Vohra K, Kaur L, Garg N, Chhabara M, Gibson K, Woodburn J, Telfer S, Buckley F, Finckh A, Huizinga TW, Dejonckheere F, Jansen JP, Genovese M, Sebba A, Rubbert-Roth A, Scali JJ, Alten R, Kremer JM, Pitts L, Vernon E, van Vollenhoven RF, Sharif MI, Das S, Emery P, Maciver H, Shingler W, Helliwell P, Sokoll K, Vital EM. Case Reports * 1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGF Receptor Mutations in Benign Joint Hypermobility. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
24
|
Quintana C, Galleguillos L, Benavides E, Quintana JC, Zúñiga A, Duarte I, Klaassen J, Kolbach M, Soto RM, Iacobelli S, Alvarez M, O'Brien A. Clinical diagnostic clues in Crohn's disease: a 41-year experience. ISRN Gastroenterol 2012; 2012:285475. [PMID: 23213555 PMCID: PMC3506886 DOI: 10.5402/2012/285475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 09/23/2012] [Indexed: 01/18/2023]
Abstract
Determining the diagnosis of Crohn's disease has been highly difficult mainly during the first years of this study carried out at the Pontificia Universidad Catolica (PUC) Clinical Hospital. For instance, it has been frequently confused with Irritable bowel syndrome and sometimes misdiagnosed as ulcerative colitis, infectious colitis or enterocolitis, intestinal lymphoma, or coeliac disease. Consequently, it seems advisable to characterize what the most relevant clinical features are, in order to establish a clear concept of Crohn's disease. This difficulty may still be a problem at other medical centers in developing countries. Thus, sharing this information may contribute to a better understanding of this disease. Based on the clinical experience gained between 1963 and 2004 and reported herein, the main clinical characteristics of the disease are long-lasting day and night abdominal pain, which becomes more intense after eating and diarrhoea, sometimes associated to a mass in the abdomen, anal lesions, and other additional digestive and nondigestive clinical features. Nevertheless, the main aim of this work has been the following: is it possible to make, in an early stage, the diagnosis of Crohn's disease with a high degree of certainty exclusively with clinical data?
Collapse
Affiliation(s)
- C Quintana
- Facultad de Medicina, Pontificia Universidad Catolica de Chile, 8330024 Santiago, Chile ; Facultad de Medicina, Universidad de los Andes, 7620001 Santiago, Chile
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Birks S, Altinkaya M, Altinkaya A, Pilkington G, Kurian KM, Crosby C, Hopkins K, Williams M, Donovan L, Birks S, Eason A, Bosak V, Pilkington G, Birks S, Holliday J, Corbett I, Pilkington G, Keeling M, Bambrough J, Simpson J, Higgins S, Dogra H, Pilkington G, Kurian KM, Zhang Y, Bradley M, Schmidberger C, Hafizi S, Noorani I, Price S, Dubocq A, Jaunky T, Chatelain C, Evans L, Gaissmaier T, Pilkington GJ, An Q, Hurwitz V, Logan J, Bhangoo R, Ashkan K, Gullan A, Beaney R, Brazil L, Kokkinos S, Blake R, Singleton A, Shaw A, Iyer V, Kurian KM, Jeyapalan JN, Morley IC, Hill AA, Mumin MA, Tatevossian RG, Qaddoumi I, Ellison DW, Sheer D, Frary A, Price S, Jefferies S, Harris F, Burnet N, Jena R, Watts C, Haylock B, Leow-Dyke S, Rathi N, Wong H, Dunn J, Baborie A, Crooks D, Husband D, Shenoy A, Brodbelt A, Walker C, Bahl A, Larsen J, Craven I, Metherall P, McKevitt F, Romanowski C, Hoggard N, Jellinek DA, Bell S, Murray E, Muirhead R, James A, Hanzely Z, Jackson R, Stewart W, O'Brien A, Young A, Bell S, Hanzely Z, Stewart W, Shepherd S, Cavers D, Wallace L, Hacking B, Scott S, Bowyer D, Elmahdi A, Frary AJ, O'Donovan DG, Price SJ, Kia A, Przystal JM, Nianiaris N, Mazarakis ND, Mintz PJ, Hajitou A, Karakoula K, Phipps K, Harkness W, Hayward R, Thompson D, Jacques T, Harding B, Darling J, Warr T, Leow-Dyke S, Rathi N, Haylock B, Crooks D, Jenkinson M, Walker C, Brodbelt A, Zhou L, Ercolano E, Ammoun S, Schmid MC, Barczyk M, Hanemann CO, Rowther F, Dawson T, Ashton K, Darling J, Warr T, Maherally Z, Hatherell KE, Kroese K, Hafizi S, Pilkington GJ, Singh P, McQuaid S, Al-Rashid S, Prise K, Herron B, Healy E, Shoakazemi A, Donnelly M, McConnell R, Harney J, Conkey D, McGrath E, Lunsford L, Kondziolka D, Niranjan A, Kano H, Hamilton R, Flannery T, Majani Y, Smith S, Grundy R, Rahman R, Saini S, Hall G, Davis C, Rowther F, Lawson T, Ashton K, Potter N, Goessl E, Darling J, Warr T, Brodbelt A, Jenkinson M, Walker C, Leow-Dyke S, Haylock B, Dunn J, Wilkins S, Smith T, Petinou V, Nicholl I, Singh J, Lea R, Welsby P, Spiteri I, Sottoriva A, Marko N, Tavare S, Collins P, Price SJ, Watts C, Su Z, Gerhard A, Hinz R, Roncaroli F, Coope D, Thompson G, Karabatsou K, Sofat A, Leggate J, du Plessis D, Turkheimer F, Jackson A, Brodbelt A, Jenkinson M, Das K, Crooks D, Herholz K, Price SJ, Whittle IR, Ashkan K, Grundy P, Cruickshank G, Berry V, Elder D, Iyer V, Hopkins K, Cohen N, Tavare J, Zilidis G, Tibarewal P, Spinelli L, Leslie NR, Coope DJ, Karabatsou K, Green S, Wall G, Bambrough J, Brennan P, Baily J, Diaz M, Ironside J, Sansom O, Brunton V, Frame M, Young A, Thomas O, Mohsen L, Frary A, Lupson V, McLean M, Price S, Arora M, Shaw L, Lawrence C, Alder J, Dawson T, Hall G, Rada L, Chen K, Shivane A, Ammoun S, Parkinson D, Hanemann C, Pangeni RP, Warr TJ, Morris MR, Mackinnon M, Williamson A, James A, Chalmers A, Beckett V, Joannides A, Brock R, McCarthy K, Price S, Singh A, Karakoula K, Dawson T, Ashton K, Darling J, Warr T, Kardooni H, Morris M, Rowther F, Darling J, Warr T, Watts C, Syed N, Roncaroli F, Janczar K, Singh P, O'Neil K, Nigro CL, Lattanzio L, Coley H, Hatzimichael E, Bomalaski J, Szlosarek P, Crook T, Pullen NA, Anand M, Birks S, Van Meter T, Pullen NA, Anand M, Williams S, Boissinot M, Steele L, Williams S, Chiocca EA, Lawler S, Al Rashid ST, Mashal S, Taggart L, Clarke E, Flannery T, Prise KM. Abstracts from the 2012 BNOS Conference. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
26
|
Yang R, Zhao Y, Wang X, Sun J, Jin J, Wu D, Charnigo R, O'Brien A, Zhong Z, Rendo P. Evaluation of the safety and efficacy of recombinant factor IX (nonacog alfa) in minimally treated and previously treated Chinese patients with haemophilia B. Haemophilia 2012; 18:e374-8. [PMID: 22776196 DOI: 10.1111/j.1365-2516.2012.02907.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2012] [Indexed: 11/28/2022]
Affiliation(s)
- R. Yang
- Institute of Hematology and Blood Diseases Hospital; Chinese Academy of Medical Sciences and Peking Union Medical College; Tianjin; China
| | - Y. Zhao
- Peking Union Medical College Hospital; Beijing; China
| | - X. Wang
- Ruijin Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - J. Sun
- Nanfang Hospital; Southern Medical University; Guangzhou; China
| | - J. Jin
- The First Affiliated Hospital of Medical School of Zhejiang University; Hangzhou; China
| | - D. Wu
- The First Affiliated Hospital of Soochow University; Suzhou; China
| | | | | | | | - P. Rendo
- Pfizer Inc; Collegeville; PA; USA
| |
Collapse
|
27
|
Crowe M, Inder M, Carlyle D, Wilson L, Whitehead L, Panckhurst A, O'Brien A, Joyce P. Feeling out of control: a qualitative analysis of the impact of bipolar disorder. J Psychiatr Ment Health Nurs 2012; 19:294-302. [PMID: 22074414 DOI: 10.1111/j.1365-2850.2011.01786.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Bipolar disorder is a chronic and recurrent disorder with fluctuating symptoms. Few patients with bipolar disorder experience a simple trajectory of clear-cut episodes, with recovery typically occurring slowly over time. The chronic and disabling course of the disorder has a marked impact on the person's functioning and relationships with others. The objectives of this study were to investigate the impact of bipolar disorder on the lives of people diagnosed with this disorder. The method used was a general inductive qualitative approach. Twenty-one participants were interviewed between 2008 and 2009 about how they had experienced the impact of bipolar disorder. The interviews were audio-taped and transcribed. The core theme that emerged was the participants were feeling out of control. Their own reactions and the reactions of others to the symptoms of bipolar disorder contributed to this core theme. The core theme was constituted by feeling overwhelmed, a loss of autonomy and felling flawed. Mental health nurses can help facilitate a sense of personal control for people with bipolar disorder by exploring what the symptoms mean for that person and implementing strategies to manage the symptoms, address social stigma and facilitate active involvement in treatment.
Collapse
Affiliation(s)
- M Crowe
- Department of Psychological Medicine, Centre for Postgraduate Nursing, University of Otago, Christchurch, New Zealand.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Campbell R, Hofmann D, Hatch S, Gordon P, Lempp H, Das L, Blumbergs P, Limaye V, Vermaak E, McHugh N, Edwards MH, Jameson K, Sayer AA, Dennison E, Cooper C, Salvador FB, Huertas C, Isenberg D, Jackson EJ, Middleton A, Churchill D, Walker-Bone K, Worsley PR, Mottram S, Warner M, Morrissey D, Gadola S, Carr A, Cooper C, Stokes M, Srivastava RN, Sanghi D, Srivastava RN, Sanghi D, Elbaz A, Mor A, Segal G, Drexler M, Norman D, Peled E, Rozen N, Goryachev Y, Debbi EM, Haim A, Rozen N, Wolf A, Debi R, Mor A, Segal G, Debbi EM, Cohen MS, Igolnikov I, Bar Ziv Y, Benkovich V, Bernfeld B, Rozen N, Elbaz A, Collins J, Moots RJ, Clegg PD, Milner PI, Ejtehadi HD, Nelson PN, Wenham C, Balamoody S, Hodgson R, Conaghan P, Wilkie R, Blagojevic M, Jordan KP, Mcbeth J, Peffers MJ, Beynon RJ, Thornton DJ, Clegg PD, Chapman R, Chapman V, Walsh D, Kelly S, Hui M, Zhang W, Doherty S, Rees F, Muir K, Maciewicz R, Doherty M, Snelling S, Davidson RK, Swingler T, Price A, Clark I, Stockley E, Hathway G, Faas H, Auer D, Chapman V, Hirsch G, Hale E, Kitas G, Klocke R, Abraham A, Pearce MS, Mann KD, Francis RM, Birrell F, Tucker M, Mellon SJ, Jones L, Price AJ, Dieppe PA, Gill HS, Ashraf S, Chapman V, Walsh DA, McCollum D, McCabe C, Grieve S, Shipley J, Gorodkin R, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Rajak R, Bennett C, Williams A, Martin JC, Abdulkader R, MacNicol C, Brixey K, Stephenson S, Clunie G, Andrews RN, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Clark EM, Gould VC, Carter L, Morrison L, Tobias JH, Pye SR, Vanderschueren D, O'Neill TW, Lee DM, Jans I, Billen J, Gielen E, Laurent M, Claessens F, Adams JE, Ward KA, Bartfai G, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi I, Kula K, Lean ME, Pendleton N, Punab M, Wu FC, Boonen S, Mercieca C, Webb J, Shipley J, Bhalla A, Fairbanks S, Moss KE, Collins C, Sedgwick P, Clark EM, Gould VC, Morrison L, Tobias JH, Parker J, Greenbank C, Evans B, Oldroyd AG, Bukhari M, Harvey NC, Cole ZA, Crozier SR, Ntani G, Mahon PA, Robinson SM, Inskip HM, Godfrey KM, Dennison EM, Cooper C, Bridges M, Ruddick S, Holroyd CR, Mahon P, Crozier SR, Godfrey K, Inskip HM, Cooper C, Harvey NC, Bridges M, Ruddick S, McNeilly T, McNally C, Beringer T, Finch M, Coda A, Davidson J, Walsh J, Fowlie P, Carline T, Santos D, Patil P, Rawcliffe C, Olaleye A, Moore S, Fox A, Sen D, Ioannou Y, Nisar S, Rankin K, Birch M, Finnegan S, Rooney M, Gibson DS, Malviya A, Ferris CM, Rushton SP, Foster HE, Hanson H, Muthumayandi K, Deehan DJ, Birt L, Poland F, MacGregor A, Armon K, Pfeil M, McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Gibson DS, Finnegan S, Newell K, Evans A, Manning G, Scaife C, McAllister C, Pennington SR, Duncan M, Moore T, Rooney M, Pericleous C, Croca SC, Giles I, Alber K, Yong H, Isenberg D, Midgely A, Beresford MW, Rahman A, Ioannou Y, Rzewuska M, Mallen C, Strauss VY, Belcher J, Peat G, Byng-Maddick R, Wijendra M, Penn H, Roddy E, Muller S, Hayward R, Mallen C, Kamlow F, Pakozdi A, Jawad A, Green DJ, Muller S, Mallen C, Hider SL, Singh Bawa S, Bawa S, Turton A, Palmer M, Grieve S, Lewis J, Moss T, McCabe C, Goodchild CE, Tang N, Scott D, Salkovskis P, Selvan S, Williamson L, Selvan S, Williamson L, Thalayasingam N, Higgins M, Saravanan V, Rynne M, Hamilton JD, Heycock C, Kelly C, Norton S, Sacker A, Done J, Young A, Smolen JS, Fleischmann RM, Emery P, van Vollenhoven RF, Guerette B, Santra S, Kupper H, Redden L, Kavanaugh A, Keystone EC, van der Heijde D, Weinblatt ME, Mozaffarian N, Guerette B, Kupper H, Liu S, Kavanaugh A, Zhang N, Wilkinson S, Riaz M, Ostor AJ, Nisar MK, Burmester G, Mariette X, Navarro-Blasco F, Oezer U, Kary S, Unnebrink K, Kupper H, Jobanputra P, Maggs F, Deeming A, Carruthers D, Rankin E, Jordan A, Faizal A, Goddard C, Pugh M, Bowman S, Brailsford S, Nightingale P, Tugnet N, Cooper SC, Douglas KM, Edwin Lim CS, Bee Lian Low S, Joy C, Hill L, Davies P, Mukherjee S, Cornell P, Westlake SL, Richards S, Rahmeh F, Thompson PW, Breedveld F, Keystone E, van der Heijde D, Landewe R, Smolen JS, Guerette B, McIlraith M, Kupper H, Liu S, Kavanaugh A, Byng-Maddick R, Penn H, Abdulkader R, Dharmapalaiah C, Shand L, Rose G, Clunie G, Watts R, Eldashan A, Dasgupta B, Borg FA, Bell GM, Anderson AE, Harry RA, Stoop JN, Hilkens CM, Isaacs J, Dickinson A, McColl E, Banik S, Smith L, France J, Bawa S, Rutherford A, Scott Russell A, Smith J, Jassim I, Withrington R, Bacon P, De Lord D, McGregor L, Morrison I, Stirling A, Porter DR, Saunders SA, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Baguley E, Patel Y, Alzabin S, Abraham S, Taher TE, Palfeeman A, Hull D, McNamee K, Jawad A, Pathan E, Kinderlerer A, Taylor P, Williams RO, Mageed RA, Iaremenko O, Mikitenko G, Ferrari M, Kamalati T, Pitzalis C, Tugnet N, Pearce F, Tosounidou S, Obrenovic K, Erb N, Packham J, Sandhu R, White C, Cardy CM, Justice E, Frank M, Li L, Lloyd M, Ahmed A, Readhead S, Ala A, Fittall M, Manson J, Ioannou Y, Sibilia J, Marc Flipo R, Combe B, Gaillez C, Le Bars M, Poncet C, Elegbe A, Westhovens R, Hassanzadeh R, Mangan C, France J, Bawa S, Weinblatt ME, Fleischmann R, van Vollenhoven R, Emery P, Huizinga TWJ, Goldermann R, Duncan B, Timoshanko J, Luijtens K, Davies O, Dougados M, Hewitt J, Owlia M, Dougados M, Gaillez C, Le Bars M, Poncet C, Elegbe A, Schiff M, Alten R, Kaine JL, Keystone E, Nash PT, Delaet I, Qi K, Genovese MC, Clark J, Kardash S, Wong E, Hull R, McCrae F, Shaban R, Thomas L, Young-Min S, Ledingham J, Genovese MC, Covarrubias Cobos A, Leon G, Mysler EF, Keiserman MW, Valente RM, Nash PT, Abraham Simon Campos J, Porawska W, Box JH, Legerton CW, Nasonov EL, Durez P, Pappu R, Delaet I, Teng J, Alten R, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Choy E, McAuliffe S, Roberts K, Sargeant I, Emery P, Sarzi-Puttini P, Moots RJ, Andrianakos A, Sheeran TP, Choquette D, Finckh A, Desjuzeur ML, Gemmen EK, Mpofu C, Gottenberg JE, Bukhari M, Shah P, Kitas G, Cox M, Nye A, O'Brien A, Jones P, Sargeant I, Jones GT, Paudyal P, MacPherson H, Sim J, Doherty M, Ernst E, Fisken M, Lewith G, Tadman J, Macfarlane GJ, Mariette X, Bertin P, Arendt C, Terpstra I, VanLunen B, de Longueville M, Zhou H, Cai A, Lacy E, Kay J, Keystone E, Matteson E, Hu C, Hsia E, Doyle M, Rahman M, Shealy D, Scott DL, Ibrahim F, Abozaid H, Choy E, Hassell A, Plant M, Richards S, Walker D, Simpson G, Kowalczyk A, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Nash PT, Ludivico CL, Delaet I, Qi K, Murthy B, Corbo M, Kaine JL, Emery P, Smolen JS, Samborski W, Berenbaum F, Davies O, Ambrugeat J, Bennett B, Burkhardt H, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Bykerk V, Ostor AJ, Roman Ivorra J, Wollenhaupt J, Stancati A, Bernasconi C, Sibilia J, Scott DGI, Claydon P, Ellis C, Buchan S, Pope J, Fleischmann R, Dougados M, Bingham CO, Massarotti EM, Wollenhaupt J, Duncan B, Coteur G, Weinblatt M, Hull D, Ball C, Abraham S, Ainsworth T, Kermik J, Woodham J, Haq I, Quesada-Masachs E, Carolina Diaz A, Avila G, Acosta I, Sans X, Alegre C, Marsal S, McWilliams D, Kiely PD, Young A, Walsh DA, Fleischmann R, Bolce R, Wang J, Ingham M, Dehoratius R, Decktor D, Rao V, Pavlov A, Klearman M, Musselman D, Giles J, Bathon J, Sattar N, Lee J, Baxter D, McLaren JS, Gordon MM, Thant KZ, Williams EL, Earl S, White P, Williams J, Westlake SL, Ledingham J, Jan AK, Bhatti AI, Stafford C, Carolan M, Ramakrishnan SA. Muscle disorders * 111. The impact of fatigue in patients with idiopathic inflammatory myopathy: a mixed method study. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Bar J, Gorn-hundermann I, Reid S, O'Brien A, Niknejad N, Goss GD, Dimitroulakos J. Activating transcription factor 3 (ATF3) as a potential biomarker of platinum sensitivity in non-small cell lung cancer (NSCLC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
30
|
Al-Raweshidy YH, Sinha DM, Coward LJ, Guyler PC, O'Brien A. Locked in and out: a case of emerging basilar artery obstruction secondary to vertebral artery dissection thrombolysed with intravenous rt-PA. Case Reports 2011; 2011:bcr.12.2010.3584. [DOI: 10.1136/bcr.12.2010.3584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
31
|
Kumthip K, Pantip C, Chusri P, Thongsawat S, O'Brien A, Nelson KE, Maneekarn N. Correlation between mutations in the core and NS5A genes of hepatitis C virus genotypes 1a, 1b, 3a, 3b, 6f and the response to pegylated interferon and ribavirin combination therapy. J Viral Hepat 2011; 18:e117-25. [PMID: 20955493 DOI: 10.1111/j.1365-2893.2010.01379.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Several studies have reported correlation between mutations in core and NS5A proteins of hepatitis C virus (HCV) and response to interferon (IFN) therapy. In particular, mutations in NS5A protein have been shown to correlate with responsiveness to IFN treatment of HCV-1b in Japanese patients. This study investigated whether amino acid (aa) mutations in the core and NS5A proteins of HCV-1a, 1b, 3a, 3b and 6f correlated with the response to pegylated interferon (Peg-IFN) plus ribavirin (RBV) therapy in Thai patients. The entire sequences of core and NS5A of HCV from 76 HCV-infected patients were analysed in comparison with corresponding reference sequences. The data revealed that the number of aa mutations in full-length NS5A, its C-terminus, IFN sensitivity-determining region, variable region 3 (V3) and V3 plus flanking region of HCV-1b NS5A protein were significantly higher in responders than in the treatment failure group (P = 0.010, 0.031, 0.046, 0.020 and 0.006, respectively). Similar results were found in a putative protein kinase R binding domain region in HCV-6f NS5A protein (P = 0.022). Moreover, specific aa substitutions in NS5A that appeared to be associated with responders or the treatment failure group were observed at positions 78 and 305 for HCV-1b (P = 0.028), 64 and 52 for HCV-1a (P = 0.033) and 6f (P = 0.045). Nevertheless, analysis of aa sequences of core protein revealed highly conserved sequences among HCV genotypes and no significant differences between the viruses from responders and the treatment failure group. Our findings indicate that mutations in aa residues of NS5A of HCV-1a, 1b and 6f correlated well with responsiveness to Peg-IFN and RBV combination therapy.
Collapse
Affiliation(s)
- K Kumthip
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | | | | | | |
Collapse
|
32
|
Ghosh D, O'Brien A, Wickham C, Davidson T, Keshtgar M. P249 The Sentinella® experience – a new tool for sentinel node biopsy in breast cancer. Breast 2011. [DOI: 10.1016/s0960-9776(11)70195-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
33
|
O'Brien A, Dimitroulakos J. 327 Activating transcription factor 3 as a novel regulator and predictor of cisplatin response in human cancers. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72034-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
34
|
Ghosh D, O'Brien A, Beck D, Wickham C, Davidson T, Keshtgar M. Sentinella®: A new portable intra-operative gamma camera for Sentinel Node localisation. Eur J Surg Oncol 2010. [DOI: 10.1016/j.ejso.2010.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
35
|
Liaw SY, Chen FG, Klainin P, Brammer J, O'Brien A, Samarasekera DD. Developing clinical competency in crisis event management: an integrated simulation problem-based learning activity. Adv Health Sci Educ Theory Pract 2010; 15:403-13. [PMID: 19916052 DOI: 10.1007/s10459-009-9208-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2008] [Accepted: 11/02/2009] [Indexed: 05/14/2023]
Abstract
This study aimed to evaluate the integration of a simulation based learning activity on nursing students' clinical crisis management performance in a problem-based learning (PBL) curriculum. It was hypothesized that the clinical performance of first year nursing students who participated in a simulated learning activity during the PBL session would be superior to those who completed the conventional problem-based session. The students were allocated into either simulation with problem-based discussion (SPBD) or problem-based discussion (PBD) for scenarios on respiratory and cardiac distress. Following completion of each scenario, students from both groups were invited to sit an optional individual test involving a systematic assessment and immediate management of a simulated patient facing a crisis event. A total of thirty students participated in the first post test related to a respiratory scenario and thirty-three participated in the second post test related to a cardiac scenario. Their clinical performances were scored using a checklist. Mean test scores for students completing the SPBD were significantly higher than those who completing the PBD for both the first post test (SPBD 20.08, PBD 18.19) and second post test (SPBD 27.56, PBD 23.07). Incorporation of simulation learning activities into problem-based discussion appeared to be an effective educational strategy for teaching nursing students to assess and manage crisis events.
Collapse
Affiliation(s)
- S Y Liaw
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
| | | | | | | | | | | |
Collapse
|
36
|
Traer EJ, Loganathan T, Sinha DM, Guyler PC, O'Brien A. Fell off of a horse--journey from Emergency Department to Stroke clinic. BMJ Case Rep 2010; 2010:2010/jul15_3/bcr0320102819. [PMID: 22752943 DOI: 10.1136/bcr.03.2010.2819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The authors present a case of a young woman who presented with transient episodes of left-sided weakness after she fell off a horse. She attended Emergency Department twice before being referred to the Stroke clinic, where she was diagnosed with carotid artery dissection.
Collapse
Affiliation(s)
- E J Traer
- Department of Stroke Medicine, Southend University Hospital, Southend, UK
| | | | | | | | | |
Collapse
|
37
|
Weberpals JI, Tu D, Squire J, Islam S, Amin S, Pelletier L, O'Brien A, Hoskins P, Eisenhauer EA. Breast cancer protein expression as a prognostic marker in sporadic epithelial ovarian cancer (EOC): An NCIC CTG OV.16 correlative study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
38
|
Stafyla V, Wickham C, Ghosh D, O'Brien A, Page J, MacCool D, Davidson T, Keshtgar M. 310 A novel approach in sentinel node localisation in breast cancer: the UK experience in the use of Sentinella® the portable gamma camera in operating theatre. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
39
|
Abstract
Section 136 of the Mental Health Act 1983 (amended) provides police officers in the United Kingdom with the authority to remove individuals who appear to be suffering from a mental illness from any public place to a designated 'place of safety' for appropriate assessment. A considerable amount of research has been dedicated to investigate who is detained under this section and how it is implemented. A review of the literature revealed a high prevalence of schizophrenia, personality disorders and mania in individuals detained under Section 136 and an over-representation of black detainees. Several studies also reported poor communication between different agencies and poor levels of knowledge regarding the implementation of the section. There is a lack of qualitative research exploring detainee and professional experience of Section 136 and in particular the patient pathway to mental health care via Section 136 experienced by black detainees. Implications for clinical practice, multi-agency collaboration and future research are discussed.
Collapse
Affiliation(s)
- R D Borschmann
- Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
| | | | | | | | | |
Collapse
|
40
|
|
41
|
Boland M, O'Herlihy B, O'Brien A, MacDonald P, Crowley D, Kelleher K. Managing pandemic (H1N1) 2009. Ir Med J 2009; 102:267-268. [PMID: 19873871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- M Boland
- Department of Public Health, HSE East, Dr Steevens Hospital, Dublin.
| | | | | | | | | | | |
Collapse
|
42
|
Weberpals JI, O'Brien A, Garbuio K, Clark-Knowles K, Dimitroulakos J. Investigation of HDAC inhibition targeting of BRCA1 expression as a mechanism to enhance platinum sensitivity in breast and ovarian cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e22017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22017 Background: The improved outcome of Breast-Cancer 1 (BRCA1)-deficient breast and ovarian cancer may be linked to the impaired ability to repair double strand breaks caused by DNA-damaging chemotherapy (CTX), such as platinum compounds. Therapeutically relevant agents that target BRCA1 expression to sensitize tumors to platinum have not been identified. In this study, we explore the effect of histone deacetylase inhibition (HDACi) on platinum sensitivity and BRCA1 expression in a breast and ovarian cancer cell line model. Methods: The efficacy of HDACi to potentiate the cytotoxicity of platinum-based chemotherapeutics was evaluated in a range of breast and ovarian tumor cell lines using the MTT cell viability assay and confirmed by flow cytometry. BRCA1 mRNA and protein expression was determined by Q-PCR and Western blot, respectively. The effect on DNA damage was measured by immunofluorescence staining and flow cytometry for γH2A.X foci, a hallmark for the presence of DNA double strand breaks. Results: Baseline BRCA1 expression was variable in two ovarian (A2780s, cisplatin-sensitive and A2780cp, cisplatin-resistant) and four breast cancer cell lines (MCF7, T47D, BT549 and HCC1937) with minimal and absent protein expression in BT549 and HCC1937, respectively. The addition of the HDACi, M344 increased the sensitivity of cells to cisplatin and carboplatin treatment in those cell lines with significant BRCA1 levels. Expression of BRCA1 protein decreased in response to the addition of HDACi to platinum in all cell lines. BRCA1 mRNA levels decreased with the addition of HDACi to platinum in all breast cancer lines and in A2780cp. A2780s and MCF7 cells subjected to combination platinum and HDACi treatment demonstrated increased levels of DNA damage, as assessed by the presence of phosphorylated γH2A.X foci. Conclusions: This study supports a novel mechanism of HDAC inhibition to sensitize breast and ovarian cancer cells to platinum via inhibition of the DNA repair protein BRCA1. BRCA1 expression changes may represent a novel biomarker to assess the activity of this combinational therapeutic approach in clinical evaluations of breast and ovarian cancer patients. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- J. I. Weberpals
- Ottawa Hospital, Ottawa Health Research Institute, Ottawa, ON, Canada; Ottawa Health Research Institute, Ottawa, ON, Canada
| | - A. O'Brien
- Ottawa Hospital, Ottawa Health Research Institute, Ottawa, ON, Canada; Ottawa Health Research Institute, Ottawa, ON, Canada
| | - K. Garbuio
- Ottawa Hospital, Ottawa Health Research Institute, Ottawa, ON, Canada; Ottawa Health Research Institute, Ottawa, ON, Canada
| | - K. Clark-Knowles
- Ottawa Hospital, Ottawa Health Research Institute, Ottawa, ON, Canada; Ottawa Health Research Institute, Ottawa, ON, Canada
| | - J. Dimitroulakos
- Ottawa Hospital, Ottawa Health Research Institute, Ottawa, ON, Canada; Ottawa Health Research Institute, Ottawa, ON, Canada
| |
Collapse
|
43
|
Abstract
AIMS To highlight that clinicians should not solely rely on serum prostate specific antigen (PSA) elevation to assume hormone resistant prostate cancer status, in patients on long-acting luteinising hormone releasing hormone (LHRH) agonist injection for prostate cancer. METHODS A retrospective observational report. RESULTS Three not uncommon case scenarios of falsely raised PSA were encountered with the use of LHRH injections. In these case scenarios, serum testosterone level has served as a useful indicator of compliance to LHRH therapy. CONCLUSION Where there are suspicions of non-compliance or inappropriate LHRH administration, the clinician should make a detailed evaluation of the patient's therapy. Unnecessary anxiety in patients and inappropriate referral for further aggressive cancer therapy could be avoided.
Collapse
Affiliation(s)
- V Koo
- Department of Urology, Craigavon Area Hospital, Portadown, UK.
| | | | | |
Collapse
|
44
|
Recht M, Nemes L, Matysiak M, Manco-Johnson M, Lusher J, Smith M, Mannucci P, Hay C, Abshire T, O'Brien A, Hayward B, Udata C, Roth DA, Arkin S. Clinical evaluation of moroctocog alfa (AF-CC), a new generation of B-domain deleted recombinant factor VIII (BDDrFVIII) for treatment of haemophilia A: demonstration of safety, efficacy, and pharmacokinetic equivalence to full-length recombinant factor VIII. Haemophilia 2009; 15:869-80. [PMID: 19473411 DOI: 10.1111/j.1365-2516.2009.02027.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BDDrFVIII is a B-domain deleted recombinant factor VIII (rFVIII) product for haemophilia A. Manufacture uniquely includes purification chromatography by synthetic-affinity ligand rather than murine-based monoclonal antibody, as well as an albumin-free cell culture process. BDDrFVIII was studied in 204 patients, including 62 subjects <16 years old, in two studies. A double-blind, randomized, pharmacokinetic (PK) crossover study, utilizing a central laboratory assay (one-stage (OS)) for both drug potency assignment and plasma FVIII-activity measurements, demonstrated that BDDrFVIII was PK-equivalent to a full-length rFVIII. Favourable efficacy and safety were observed: during defined routine prophylaxis in a patient population significant for preexisting target joints, nearly half (45.7%) of patients had no bleeding, and a low-annualized bleed rate (ABR) was achieved (median 1.9); 92.5% of haemorrhages (n = 187) required < or =2 infusions. Three subjects (1.5%, across both studies) developed de novo inhibitors (low-titre, transient), and the primary safety endpoint, based on a prospective Bayesian analysis, demonstrated the absence of neoantigenicity for BDDrFVIII. The PK-equivalence, based on central testing to align test and reference articles, and the novel Bayesian analysis of inhibitor safety in these investigations reflect robust experimental designs with relevance to future studies. This extensive dataset demonstrates the safety and efficacy of BDDrFVIII for haemophilia A.
Collapse
Affiliation(s)
- M Recht
- Hemophilia Treatment Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Sayres DS, Moyer EJ, Hanisco TF, St Clair JM, Keutsch FN, O'Brien A, Allen NT, Lapson L, Demusz JN, Rivero M, Martin T, Greenberg M, Tuozzolo C, Engel GS, Kroll JH, Paul JB, Anderson JG. A new cavity based absorption instrument for detection of water isotopologues in the upper troposphere and lower stratosphere. Rev Sci Instrum 2009; 80:044102. [PMID: 19405676 DOI: 10.1063/1.3117349] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We describe here the Harvard integrated cavity output spectroscopy (ICOS) isotope instrument, a mid-IR infrared spectrometer using ICOS to make in situ measurements of the primary isotopologues of water vapor (H(2)O, HDO, and H(2) (18)O) in the upper troposphere and lower stratosphere (UTLS). The long path length provided by ICOS provides the sensitivity and accuracy necessary to measure these or other trace atmospheric species at concentrations in the ppbv range. The Harvard ICOS isotope instrument has been integrated onto NASA's WB-57 high-altitude research aircraft and to date has flown successfully in four field campaigns from winter 2004-2005 to the present. Off-axis alignment and a fully passive cavity ensure maximum robustness against the vibrationally hostile aircraft environment. The very simple instrument design permitted by off-axis ICOS is also helpful in minimizing contamination necessary for accurate measurements in the dry UTLS region. The instrument is calibrated in the laboratory via two separate water addition systems and crosscalibrated against other instruments. Calibrations have established an accuracy of 5% for all species. The instrument has demonstrated measurement precision of 0.14 ppmv, 0.10 ppbv, and 0.16 ppbv in 4 s averages for H(2)O, HDO, and H(2) (18)O, respectively. At a water vapor mixing ratio of 5 ppmv the isotopologue ratio precision is 50[per thousand] and 30[per thousand] for deltaD and delta(18)O, respectively.
Collapse
Affiliation(s)
- David S Sayres
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, Massachusetts 02138, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Boland BM, Collins CG, Christiansen E, O'Brien A, Duignan J. Three synchronous gastrointestinal tumours. Ir J Med Sci 2009; 180:897-900. [PMID: 19291353 DOI: 10.1007/s11845-009-0295-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 01/15/2009] [Indexed: 01/25/2023]
Abstract
Mucinous cystadenomas of the appendix are rare, with significant malignant potential [Lo and Sarr in Hepatogastroenterology 50(50):432-437, 2003]. Carcinoid tumours are similarly uncommon, rarely occurring in Meckel's diverticula but are still the commonest tumour of Meckel's diverticulae [Nies et al. in Dis Colon Rectum 35(6):589-596, 1992; Modlin and Lye in Cancer 97(4):934-959, 2003; Sutter et al. in Schweiz Med Wochenschr Suppl 89:20S-24S, 1997; Weber and McFadden DW in J Clin Gastroenterol 11(6):682-686, 1989]. A 77-year-old woman presented to our clinic with a 6-week history of non-specific lower abdominal pain. A pelvic ultrasound showed an 8 × 3 × 2.5 cm mass in the right iliac fossa. Colonoscopy and CT confirmed this mass and also revealed a left colonic tumor. At laparotomy, three tumours were identified; in the appendix, a Meckel's diverticulum, and the descending colon. A subtotal colectomy and diverticulectomy were performed. Histology confirmed a T3N0 Dukes B colonic adenocarcinoma, a carcinoid of Meckel's diverticulum and a mucinous adenoma of the appendix. The patient is tumor free to date, 5 years after presentation. The presence of three synchronous tumours of different histological origin in the gastrointestinal tract has not previously been described in the literature.
Collapse
Affiliation(s)
- B M Boland
- Department of Surgery, St Michaels Hospital, Dun Laoghaire, Co Dublin, Ireland.
| | | | | | | | | |
Collapse
|
47
|
Weberpals JI, Clark-Knowles K, O'Brien A, Antoniouk O, Garbuio K, Dimitroulakos J. The evaluation of BRCA1 and ERCC1 expression as predictors of platinum response in ovarian cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
48
|
Hewlett S, Clarke B, O'Brien A, Hammond A, Ryan S, Kay L, Richards P, Almeida C. Rheumatology education for undergraduate nursing, physiotherapy and occupational therapy students in the UK: standards, challenges and solutions. Rheumatology (Oxford) 2008; 47:1025-30. [PMID: 18443005 PMCID: PMC2430217 DOI: 10.1093/rheumatology/ken139] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Rheumatological conditions are common, thus nurses (Ns) occupational therapists (OTs) and physiotherapists (PTs) require at least basic rheumatology knowledge upon qualifying. The aim of this study was to develop a core set of teaching topics and potential ways of delivering them. METHODS A modified Delphi technique was used for clinicians to develop preliminary core sets of teaching topics for each profession. Telephone interviews with educationalists explored their views on these, and challenges and solutions for delivering them. Inter-professional workshops enabled clinicians and educationalists to finalize the core set together, and generate methods for delivery. RESULTS Thirty-nine rheumatology clinicians (12N, 14OT, 13PT) completed the Delphi consensus, proposing three preliminary core sets (N71 items, OT29, PT26). Nineteen educationalists (6N, 7OT, 6PT) participated in telephone interviews, raising concerns about disease-specific vs generic teaching and proposing many methods for delivery. Three inter-professional workshops involved 34 participants (clinicians: N12, OT9, PT5; educationalists: N2, OT3, PT2; Patient 1) who reached consensus on a single core set comprising six teaching units: Anatomy and Physiology; Assessment; Management and Intervention; Psychosocial Issues; Patient Education; and the Multi-disciplinary Team, recommending some topics within the units receive greater depth for some professions. An innovative range of delivery options was generated plus two brief interventions: a Rheumatology Chat Show and a Rheumatology Road Show. CONCLUSIONS Working together, clinicians and educationalists proposed a realistic core set of rheumatology topics for undergraduate health professionals. They proposed innovative delivery methods, with collaboration between educationalists, clinicians and patients strongly recommended. These potential interventions need testing.
Collapse
Affiliation(s)
- S Hewlett
- School of Nursing, University of the West of England, Bristol BS2 8HW, UK.
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Hussein W, Dalouk KA, O'Brien A. Negative predictive value of CTPA in pulmonary embolism in an Irish population. Ir Med J 2008; 101:92-93. [PMID: 18543431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
|
50
|
Davison AG, Monaghan M, Brown D, Eraut CD, O'Brien A, Paul K, Townsend J, Elston C, Ward L, Steeples S, Cubitt L. Hospital at home for chronic obstructive pulmonary disease: an integrated hospital and community based generic intermediate care service for prevention and early discharge. Chron Respir Dis 2007; 3:181-5. [PMID: 17190120 DOI: 10.1177/1479972306070074] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Recent randomized controlled studies have reported success for hospital at home for prevention and early discharge of chronic obstructive pulmonary disease (COPD) patients using hospital based respiratory nurse specialists. This observational study reports results using an integrated hospital and community based generic intermediate care service. The length of care, readmission within 60 days and death within 60 days in the early discharge (9.37 days, 21.1%, 7%) and the prevention of admission (five to six days, 34.1%, 3.8%) are similar to previous studies. We suggest that this generic community model of service may allow hospital at home services for COPD to be introduced in more areas.
Collapse
Affiliation(s)
- A G Davison
- Southend Associated University Hospital, Westcliff on Sea, Essex, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|