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Lochmaier PG, Boyd A, Irelan DW, Fiedler E, Lee J, Fouty B, Saleh LA, Richter W. PDE4 inhibition induces an acute and transient reduction in serum potassium in mice. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00140-4] [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: 01/28/2023]
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2
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O'Connell B, Boyd A, Kothari D, Miller N, Cornejo J, Sullivan B. Improving documentation of anticoagulation and antiplatelet recommendations after outpatientendoscopy. BMJ Open Qual 2022; 11:bmjoq-2021-001725. [PMID: 36588305 PMCID: PMC9723851 DOI: 10.1136/bmjoq-2021-001725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/04/2021] [Accepted: 10/28/2022] [Indexed: 12/12/2022] Open
Abstract
Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation of postprocedural AC/AP instructions through targeted interventions during outpatient endoscopy at a Veterans Affairs Medical Center using validated Quality Improvement methodology. We identified patients on AC/AP agents presenting for outpatient oesophagogastroduodenoscopy or colonoscopy and found restart recommendations were documented in only 59.4% of procedures at baseline. After two intervention cycles, which included provider education, nursing prompts and alterations to endoscopic documentation software, postprocedure documentation increased by 26.7%-86.1% when compared with baseline (p<0.001). These interventions, which require low-resource utilisation, could be part of standardised processes readily implemented at other institutions to help potentially reduce postprocedure patient confusion, medication errors and complications.
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Affiliation(s)
- Brendon O'Connell
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA,Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Amanda Boyd
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA,Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Darshan Kothari
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA,Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Neena Miller
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Jennifer Cornejo
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Brian Sullivan
- Division of Gastroenterology, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA,Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
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Burger J, Greenberg M, Lowrie K, Boyd A. Amanda Boyd-Respect local knowledge, communication, and traditions. Risk Anal 2022; 42:2515-2519. [PMID: 36625043 DOI: 10.1111/risa.14042] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Joanna Burger
- Cell Biology and Neurosciences, NIEHS Center of Excellence, Environmental and Occupational Health Sciences Institute (EOHSI), Ecology and Evolution Graduate Program, and Pinelands Research Station, Rutgers University, Piscataway, New Jersey, USA
- Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway, New Jersey, USA
| | - Michael Greenberg
- Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway, New Jersey, USA
| | - Karen Lowrie
- Consortium for Risk Evaluation with Stakeholder Participation (CRESP), Rutgers University, Piscataway, New Jersey, USA
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, New Jersey, USA
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Geenty P, Sivapathan S, Stefani LD, Zada M, Boyd A, Kwok F, Thomas L. A novel echocardiographic risk score predicts prognosis in AL-amyloidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.151] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prognosis in light chain (AL) amyloidosis is largely determined by the severity of cardiac involvement. Conventional (Mayo) staging includes 1) hs troponin 2) N-terminal pro-beta natriuretic peptide (NT-pro BNP) and 3)free light chain difference.
Methods
In a retrospective study of 75 AL amyloidosis patients referred to a quaternary amyloid clinic, all patients underwent comprehensive echocardiographic assessment. Echocardiographic parameters included left ventricular (LV) ejection fraction, LV mass, diastolic function, global longitudinal strain (GLS) and indexed left atrial volume (LAVI). Mortality was assessed through review of clinical records.
Results
Over a median follow up of 51 months, 29/75 (39%) of patients died. LAVI, E/e', e', LVGLS, were univariate predictors of mortality (p<0.1). LAVI was the only independent echocardiographic predictor in a multivariable model. Kaplan Meir analysis evaluated LAVI, LVGLS and E/e' using clinical cutoffs as a predictor of survival; only LAVI and LVGLS were significant. A novel “Echo score” comprising of LAVI (>42 ml/m2) and LVGLS (<−12%) was a predictor of mortality with similar prognostic performance as Mayo stage. (Echo score AUC 0.745, 95% CI 0.64–0.85 vs Mayo score AUC 0.752 95% CI 0.66–0.86, p=0.9).
Conclusion
LAVI, a simple, echocardiographic parameter was as an independent predictor of mortality in AL amyloidosis. A composite echocardiographic score combining LAVI and LVGLS stratified AL-amyloidosis patients into 3 distinct groups with similar prognostic power as Mayo stage for all-cause mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Geenty
- Westmead Hospital , Sydney , Australia
| | | | | | - M Zada
- Westmead Hospital , Sydney , Australia
| | - A Boyd
- Westmead Private Cardiology , Sydney , Australia
| | - F Kwok
- Westmead Hospital , Sydney , Australia
| | - L Thomas
- Westmead Hospital , Sydney , Australia
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Ferkh A, Tjahjadi C, Geenty P, Stefani L, Boyd A, Richards D, Mollee P, Korczyk D, Taylor M, Kwok F, Kizana E, Ng A, Thomas L. Echocardiographic Deep Phenotyping of Hypertrophic Cardiomyopathies: Amyloid, Anderson-Fabry and Hypertensive Heart Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.013] [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: 10/16/2022]
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Stefani L, Boyd A, Ferkh A, Zada M, Devine K, Trivedi S, Tchan M, Thomas L. Basal Segmental Strain as a Marker of Cardiac Involvement in Anderson-Fabry Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.226] [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: 10/16/2022]
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7
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MacDonald-Ottevanger MS, Boyd A, Prins M, van der Helm JJ, Zijlmans CWR, Hindori-Mohangoo AD, Harkisoen S, Hermelijn SM, Brinkman K, Codrington J, Roosblad J, Kort SAR, Dams ETM, van de Laar TJW, Vreden SGS. Differences in prevalence of hepatitis B virus infection and genotypes between ethnic populations in Suriname, South America. Virology 2021; 564:53-61. [PMID: 34656809 DOI: 10.1016/j.virol.2021.09.005] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Epidemiological data on hepatitis B virus (HBV) are needed to benchmark HBV elimination goals. We recently assessed prevalence of HBV infection and determinants in participants attending the Emergency Department in Paramaribo, Suriname, South America. Overall, 24.5% (95%CI = 22.7-26.4%) of participants had anti-Hepatitis B core antibodies, which was associated with older age (per year, adjusted Odds Ratio [aOR] = 1.03, 95%CI = 1.02-1.04), Afro-Surinamese (aOR = 1.84, 95%CI = 1.52-2.19) and Javanese ethnicity (aOR = 1.63, 95%CI = 1.28-2.07, compared to the grand mean). 3.2% of participants were Hepatitis B surface Ag-positive, which was also associated with older age (per year, aOR = 1.02, 95%CI = 1.00-1.04), Javanese (aOR = 4.3, 95%CI = 2.66-6.95) and Afro-Surinamese ethnicity (aOR = 2.36, 95%CI = 1.51-3.71). Sex, nosocomial or culturally-related HBV transmission risk-factors were not associated with infection. Phylogenetic analysis revealed strong ethnic clustering: Indonesian subgenotype HBV/B3 among Javanese and African subgenotypes HBV/A1, HBV/QS-A3 and HBV/E among Afro-Surinamese. Testing for HBV during adulthood should be considered for individuals living in Suriname, specifically with Javanese and Afro-Surinamese ancestry.
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Affiliation(s)
- M S MacDonald-Ottevanger
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname; Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands.
| | - A Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Stichting HIV Monitoring, Amsterdam, the Netherlands
| | - M Prins
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - J J van der Helm
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - C W R Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - A D Hindori-Mohangoo
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - S Harkisoen
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname
| | - S M Hermelijn
- Department of Medical Microbiology, Academic Hospital Paramaribo, Suriname
| | - K Brinkman
- Department of Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - J Codrington
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | - J Roosblad
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | | | - E Th M Dams
- Department of Internal Medicine, Diakonessenhuis, Paramaribo, Suriname
| | - T J W van de Laar
- Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Sanquin Research, Department of Donor Medicine Research, Amsterdam, the Netherlands
| | - S G S Vreden
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname; Foundation for Scientific Research Suriname, Paramaribo, Suriname
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Zada M, Lo Q, Trivedi S, Harapoz M, Boyd A, Devine K, Sadick N, Tchan M, Thomas L. Electrocardiographic Characteristics in Fabry Disease Patients: Impact of Impaired Longitudinal Strain and Left Ventricular Hypertrophy. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.066] [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: 10/20/2022]
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Emerson P, Stefani L, Terluk A, Boyd A, Hui R, Thomas L. Left Atrial Strain Analysis in Breast Cancer Patients Post Anthracycline (AC). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.225] [Citation(s) in RCA: 1] [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: 11/29/2022]
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10
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Balachandran V, Huang L, Garnham C, Singh T, Boyd A, Grant A. P45 Cardiopulmonary Bypass for Renal and IVC Tumour Resection–Our Experiences. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.248] [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: 11/25/2022]
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11
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Baird K, Carrasco A, Gillespie K, Boyd A. Qualitative analysis of domestic violence detection and response in a tertiary hospital. J Prim Health Care 2020; 11:178-184. [PMID: 32171361 DOI: 10.1071/hc18058] [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: 07/29/2018] [Accepted: 06/08/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Domestic and family violence is a public health problem of epidemic proportions and a significant issue facing the Australian community. It knows no boundaries, is indiscriminate to geographical location, social class, age, religious or cultural background. AIM This study aimed to analyse the processes currently used to identify and respond to domestic and family violence in a large tertiary hospital in Australia, and to classify the benefits and weaknesses of these existing systems. METHODS A qualitative method used semistructured, face-to-face and telephone interviews with key informants in 16 key areas across the hospital. Thematic analysis of the interviews was used to define the key issues and areas of interest identified by participants. RESULTS There was a dearth of existing guidelines or pathways of care for patients experiencing domestic violence. Several strengths and weaknesses were identified in relation to the protocols and systems used by the hospital, including limited training for staff and a lack of standardisation of processes, workplace instructions and clinical guidelines. With the exception of maternity services, no clinical service area used a guideline or work instruction. Most interviewees highlighted the need for the safety and protection of staff and victims as a priority. DISCUSSION Domestic and family violence is an enormous burden on the health system. However, many staff have little or no guidance on dealing with it or are unaware of existing protocols or guidelines for detection or response. Participants recommended further education and training for staff, consistent guidelines, specialist liaison and more educational and information resources for staff and patients. Further investigation and discussions with patients affected by violence is warranted to provide robust recommendations for policy change.
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Affiliation(s)
- K Baird
- Gold Coast University Hospital, 1 Hospital Blvd, Southport, Gold Coast, Qld 4215, Australia; and School of Nursing & Midwifery, Griffith University, Logan Campus University Drive, Meadowbrook, Qld 4131, Australia; and Corresponding author.
| | - A Carrasco
- Gold Coast University Hospital, 1 Hospital Blvd, Southport, Gold Coast, Qld 4215, Australia
| | - K Gillespie
- Gold Coast University Hospital, 1 Hospital Blvd, Southport, Gold Coast, Qld 4215, Australia; and School of Nursing & Midwifery, Griffith University, Logan Campus University Drive, Meadowbrook, Qld 4131, Australia
| | - A Boyd
- Gold Coast University Hospital, 1 Hospital Blvd, Southport, Gold Coast, Qld 4215, Australia
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Surgers L, Boyd A, Rougier H, Chiarabini T, Valin N, Decré D, Royer G, Decousser J, Girard P, Lacombe K. Entérobactéries productrices de BLSE : une nouvelle infection sexuellement transmissible ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.429] [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: 10/23/2022]
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13
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Achterbergh R, Hoornenborg E, Boyd A, Coyer L, Meuzelaar S, Hogewoning A, Davidovich U, van Rooijen M, Schim van der Loeff M, Prins M, de Vries H. Changes in mental health and drug use among men who have sex with men using daily and event-driven pre-exposure prophylaxis: Results from a prospective demonstration project in Amsterdam, the Netherlands. EClinicalMedicine 2020; 26:100505. [PMID: 33089120 PMCID: PMC7564518 DOI: 10.1016/j.eclinm.2020.100505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 07/03/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at increased risk of mental health disorders and drug use. In GBMSM taking pre-exposure prophylaxis (PrEP) for HIV, the proportion engaging in risk behaviors could increase due to decreased perception in HIV risk. In turn, this could leave them further susceptible to mental health disorders. METHODS The AMsterdam PrEP study (AMPrEP) is a demonstration project offering a choice of daily PrEP or event-driven PrEP regimen at the STI clinic of the Public Health Service of Amsterdam. Eligible participants were HIV-negative GBMSM and transgender people at risk of HIV, aged ≥18 years. We assessed anxiety and depressive mood disorders (Mental Health Inventory 5), sexual compulsivity (Sexual Compulsivity Scale), alcohol use disorder (Alcohol Use Disorder Identification Test), and drug use disorder (Drug Use Disorder Identification Test) using yearly self-administered assessments (August 2015-September 2018). The proportion of mental health problems were analyzed and changes over time and between regimen were assessed using a logistic regression model. Variables associated with the development or recovery of disorders were assessed using a multistate Markov model. OUTCOMES Of 376 enrolled, we analyzed 341 participants with data at baseline and at least one follow-up visit. During a median follow-up of 2.5 years (IQR=2.3-2.7), the proportion assessed with sexual compulsivity decreased from 23% at baseline to 10% at the last visit (p<0.001) and drug use disorder decreased from 38% at baseline to 31% at the last visit (p = 0.004). No changes occurred in proportion assessed with anxiety/depressive mood disorders (20% at baseline, 18% at last visit, p = 0.358) or alcohol use disorder (28% at baseline, 22% at the last visit, p = 0.106). During follow-up, participants reported significant less use of alcohol (p<0.001), nitrites (p<0.001) and ecstasy (p<0.001). We found no differences between daily and event-driven PrEP users. The development and recovery of disorders during follow-up were highly interrelated. INTERPRETATION Mental health disorders are prevalent among those initiating PrEP. We did not find increases in mental health disorders during PrEP use, but rather a decrease in sexual compulsivity and drug use disorders. The initial prevalence of mental health disorders in our study point at the continuous need to address mental health disorders within PrEP programs. FUNDING ZonMw, H-TEAM, Internal GGD research funds, Aidsfonds, Stichting AmsterdamDiner Foundation, Gilead Sciences, Janssen Pharmaceutica, M A C AIDS Fund, and ViiV Healthcare.
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Affiliation(s)
- R.C.A. Achterbergh
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - E. Hoornenborg
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - A. Boyd
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - L. Coyer
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - S.J.A. Meuzelaar
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - A.A. Hogewoning
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - U. Davidovich
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - M.S. van Rooijen
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - M.F. Schim van der Loeff
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - M. Prins
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI&II), Meibergdreef 9, AII, the Netherlands
| | - H.J.C. de Vries
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&II), Meibergdreef 9, AII, the Netherlands
- Corresponding author at: STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, the Netherlands.
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van Dulm E, Klok S, Boyd A, Joore IK, Prins M, van Dam AP, Tramper-Stranders GA, van Duijnhoven YTHP. Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among undocumented migrants and uninsured legal residents in Amsterdam, the Netherlands: a cross-sectional study. Antimicrob Resist Infect Control 2020; 9:118. [PMID: 32727560 PMCID: PMC7391596 DOI: 10.1186/s13756-020-00785-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/21/2019] [Accepted: 07/21/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with an increased risk of infection. Colonization with MRSA is observed in < 1% of the general Dutch population. Increased risk for MRSA carriage is known to occur in several key groups, one of which is asylum seekers. However, little is known about MRSA carriage among undocumented migrants and uninsured legal residents. This study aimed to determine the prevalence of nasal MRSA carriage among these groups in Amsterdam, the Netherlands. METHODS In this cross-sectional study, between October 2018 and October 2019, undocumented migrants and uninsured legal residents aged 18 years or older who were able to understand one of the study languages were recruited at an NGO health care facility in Amsterdam, the Netherlands, for general practitioner (GP) consultations. Participants were asked questions on demographics, migration history, antibiotic use and other possible risk factors for MRSA carriage and were screened for nasal MRSA carriage by selective culturing e-swabs. Characteristics of MRSA-negative and MRSA-positive participants were compared using univariable logistic regression analysis with Firth's correction. RESULTS Of the 3822 eligible patients, 760 were screened for nasal MRSA carriage (19.9%). Of the 760 participants, over half were male (58%; 442/760) and originated mainly from Africa (35%; 267/760), Asia (30%; 229/760) and North or South America (30%; 227/760). In total, 705/760 participants (93%) were undocumented migrants and 55/760 (7%) were uninsured legal residents of Amsterdam. The overall prevalence of nasal MRSA carriage was 2.0% (15/760) (95%CI 1.1 to 3.2%), with no difference between undocumented migrants (14/705) (2.0, 95%CI 1.1 to 3.3%) and uninsured legal residents (1/55) (1.8, 95%CI 0.1 to 9.7%). Genotyping showed no clustering of the 15 isolates. MRSA carriage was not associated with sociodemographic, migration history or other possible risk factors. Nevertheless, this study had limited power to detect significant determinants. Three participants (3/15; 20%) harbored Panton-Valentine leukocidin (PVL)-positive isolates. CONCLUSION Even though our study population of undocumented migrants and uninsured legal residents had a higher prevalence of nasal MRSA carriage compared to the general Dutch population, the prevalence was relatively low compared to acknowledged other high-risk groups.
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Affiliation(s)
- E van Dulm
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, the Netherlands.
| | - S Klok
- NGO health care clinic Kruispost, Amsterdam, the Netherlands
| | - A Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, the Netherlands.,HIV Monitoring Foundation, Amsterdam, The Netherlands
| | - I K Joore
- Department of Infectious Diseases, Public Health Service Flevoland, Lelystad, the Netherlands
| | - M Prins
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, the Netherlands.,Division of Infectious Diseases, and Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Department of Internal Medicine, Amsterdam, the Netherlands
| | - A P van Dam
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, the Netherlands.,Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Y T H P van Duijnhoven
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, the Netherlands
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15
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Jarjour AA, Velichkova AN, Boyd A, Lord KM, Torsney C, Henderson DJ, Ffrench-Constant C. The formation of paranodal spirals at the ends of CNS myelin sheaths requires the planar polarity protein Vangl2. Glia 2020; 68:1840-1858. [PMID: 32125730 DOI: 10.1002/glia.23809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/03/2019] [Revised: 02/16/2020] [Accepted: 02/19/2020] [Indexed: 12/13/2022]
Abstract
During axonal ensheathment, noncompact myelin channels formed at lateral edges of the myelinating process become arranged into tight paranodal spirals that resemble loops when cut in cross section. These adhere to the axon, concentrating voltage-dependent sodium channels at nodes of Ranvier and patterning the surrounding axon into distinct molecular domains. The signals responsible for forming and maintaining the complex structure of paranodal myelin are poorly understood. Here, we test the hypothesis that the planar cell polarity determinant Vangl2 organizes paranodal myelin. We show that Vangl2 is concentrated at paranodes and that, following conditional knockout of Vangl2 in oligodendrocytes, the paranodal spiral loosens, accompanied by disruption to the microtubule cytoskeleton and mislocalization of autotypic adhesion molecules between loops within the spiral. Adhesion of the spiral to the axon is unaffected. This results in disruptions to axonal patterning at nodes of Ranvier, paranodal axon diameter and conduction velocity. When taken together with our previous work showing that loss of the apico-basal polarity protein Scribble has the opposite phenotype-loss of axonal adhesion but no effect on loop-loop autotypic adhesion-our results identify a novel mechanism by which polarity proteins control the shape of nodes of Ranvier and regulate conduction in the CNS.
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Affiliation(s)
- Andrew A Jarjour
- MRC Centre for Regenerative Medicine and MS Society/University of Edinburgh Centre for Translational Research, Scottish Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
| | - Atanaska N Velichkova
- Centre for Discovery Brain Sciences, The University of Edinburgh, Hugh Robson Building, Edinburgh, UK
| | - Amanda Boyd
- MRC Centre for Regenerative Medicine and MS Society/University of Edinburgh Centre for Translational Research, Scottish Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
| | - Kathryn M Lord
- MRC Centre for Regenerative Medicine and MS Society/University of Edinburgh Centre for Translational Research, Scottish Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
| | - Carole Torsney
- Centre for Discovery Brain Sciences, The University of Edinburgh, Hugh Robson Building, Edinburgh, UK
| | - Deborah J Henderson
- Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle upon Tyne, UK
| | - Charles Ffrench-Constant
- MRC Centre for Regenerative Medicine and MS Society/University of Edinburgh Centre for Translational Research, Scottish Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, UK
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16
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Affiliation(s)
- Shai Posner
- Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina
- Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Amanda Boyd
- Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina
- Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Amit Patel
- Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina
- Durham Veterans Affairs Medical Center, Durham, North Carolina
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17
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Zada M, Geenty P, Lo Q, Boyd A, Devine K, Tchan M, Sadick N, Thomas L. 133 Left Ventricular Echocardiographic Structural Parameters That Determine Major Adverse Cardiovascular Events (MACE) in Fabry Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.140] [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: 12/01/2022]
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18
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Zada M, Geenty P, Lo Q, Boyd A, Devine K, Tchan M, Sadick N, Thomas L. 107 Electrocardiographic Characteristics in Fabry Disease; Gender Based Differences. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.114] [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: 11/28/2022]
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19
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Stefani L, Koltar A, Altman M, Boyd A, Richards D, Thomas L. 340 Exercise Related Changes in LA Phasic Function as Determined by 2D Speckle Tracking. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.347] [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: 10/23/2022]
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20
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Geenty P, Sivapathan S, Deshmukh T, Brown P, Boyd A, Kwok F, Richards D, Altman M, Stewart G, Thomas L. P309 The use of echocardiographic parameters to predict clinical outcomes in AL-amyloidosis cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.162] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
AL-amyloidosis has a rapid clinical progression, with cardiac involvement associated with a particularly poor prognosis. Cardiac amyloidosis is diagnosed by either invasive biopsy or conventional echocardiographic parameters such as increased wall thickness, in the absence of other causes. More recently, novel parameters including 2D longitudinal strain have demonstrated diagnostic utility in a range of infiltrative cardiomyopathies including cardiac amyloidosis.
Aim/Method: We sought to evaluate traditional and novel echocardiographic parameters in their ability to predict adverse outcomes in a cohort of AL-amyloid patients. 80 patients who had transthoracic echocardiograms at a single centre were included. Comprehensive echocardiographic assessment was performed, including left ventricular ejection fraction (LVEF), LV Global Longitudinal Strain (GLS), LV mass (indexed to BSA). The primary endpoint was a composite of of major adverse cardiac events (MACE) and all-cause mortality, that was assessed by interrogation of the medical records on a specified censor date.
Results
At a mean follow-up (time from echo to censor date) of 5.4 ± 2.6years, 38/80 (47.5%) of patients experienced the primary endpoint of MACE or death, of which 25/80 (31%) were deaths. LVEF (59 ± 5.6%vs56 ± 6.4%, p = 0.04), GLS (17.4 ± 3.9%vs14.8 ± 4.9%, p = 0.01) basal longitudinal strain (12.3 ± 3.2%vs9.6 ± 3.9%, p = 0.002), indexed LV mass (107 ± 36g/m2vs130 ± 34g/m2, p = 0.06) and E/E’ (13.7 ± 4.9vs20.6 ± 9.6, p < 0.001) were all significantly different between patients who experienced the primary endpoint and those that didn’t. The strongest predictors of outcome were E/E’ (AUC 0.74), LV mass (AUC 0.73) and the ratio GLS:LV mass (AUC 0.73). An E/E’ of 15 had a sensitivity of 71% and specificity of 69%, while an indexed LV mass of 108 had a sensitivity and specificity of 74% and 67% respectively. GLS to LV mass as a cutoff of 0.16 had a sensitivity and specificity of 70% and 69% respectively.
Conclusion
In a cohort of 80 patients with AL-amyloid cardiomyopathy, almost half (47.5%) reached the primary composite endpoint. Diastolic dysfunction as expressed as E/E’, and LV mass were the most powerful predictors of outcome, while global longitudinal strain and LV basal strain were also reduced, and showed superiority over LV ejection fraction in predicting prognosis.
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Affiliation(s)
- P Geenty
- Westmead Hospital, Sydney, Australia
| | | | | | - P Brown
- Westmead Hospital, Sydney, Australia
| | - A Boyd
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - F Kwok
- Westmead Hospital, Sydney, Australia
| | - D Richards
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - M Altman
- Westmead Hospital, Sydney, Australia
| | - G Stewart
- Westmead Hospital, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Sydney, Australia
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21
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Geenty P, Shivapathan S, Deshmukh T, Brown P, Boyd A, Taylor M, Kwok F, Altman M, Richards D, Stewart G, Thomas L. P1543 The assessment of regional myocardial strain in classifying amyloid cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.964] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
An infiltrative cardiomyopathy is a common manifestation of AL-amyloidosis, with cardiac involvement associated with a poor prognosis. Wild-type transthyretin amyloidosis (wt-TTR), is a distinct clinical entity occurring predominantly in men > 65 yrs, that has gained interest recently due to novel treatment options. Regional strain analysis has been shown to discriminate both forms of cardiac amyloidosis from other causes of concentric left ventricular hypertrophy, with a characteristic pattern of ‘apical sparing’. Due to the significant difference in both the course of the disease and treatment options between groups, a non-invasive echocardiographic method of determining subtype would be valuable.
Aim/Method: We sought to compare traditional and novel echocardiographic parameters in a cohort of AL ( n = 80) and wild type (wt-TTR) amyloid ( n = 32) patients. All amyloid patients underwent comprehensive transthoracic echocardiography, including both conventional parameters and LV longitudinal strain. Further novel parameters were computed including the ratio of global longitudinal strain (GLS) to LV ejection fraction (LVEF), as well as GLS to indexed LV mass.
Results
wt-TTR patients had significantly greater LV mass (176 ± 59g/m2vs118 ± 37g/m2, p < 0.001), and worse diastolic dysfunction as expressed as E/E’ (21.5 ± 11vs17 ± 8, p = 0.04). LVEF was significantly lower in wt-TTR patients however remained in the normal range in both groups (53 ± 6%vs57 ± 6%, p = 0.001), whilst GLS was significantly reduced compared to AL-amyloid patients (11.5 ± 3.4%vs16.2 ± 4.6%, p < 0.001). LVEF:GLS was significantly higher in wt-TTR patients (4.93 ± 1.4vs3.87 ± 1.3, p = 0.001) reflecting a more profound reduction in strain with a relatively preserved ejection fraction. Similarly, the ratio of GLS to LV mass was significantly lower in wt-TTR amyloidosis (0.078 ± 0.05vs0.155 ± 0.07, p < 0.001), reflecting a more significant reduction in strain for a given wall thickness in wt-TTR patients. GLS:LV mass was the strongest discriminator between subtypes (AUC 0.82), with a cutoff of 0.09 giving a sensitivity and specificity of 71% and 80% respectively, for detecting wt-TTR.
Conclusion
In this cohort, patients with wt-TTR had significantly greater increase in LV wall thickness and diastolic dysfunction, which may in part reflect their increased age (77vs62). However, GLS was also significantly reduced compared to AL-amyloid, even when accounting for LV ejection fraction and LV mass, suggesting these composite parameters may have value in determining the subtype of cardiac amyloidosis.
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Affiliation(s)
- P Geenty
- Westmead Hospital, Sydney, Australia
| | | | | | - P Brown
- Westmead Hospital, Sydney, Australia
| | - A Boyd
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - M Taylor
- Westmead Hospital, Sydney, Australia
| | - F Kwok
- Westmead Hospital, Sydney, Australia
| | - M Altman
- Westmead Hospital, Sydney, Australia
| | - D Richards
- Westmead Private Hospital, Cardiology Department, Sydney, Australia
| | - G Stewart
- Westmead Hospital, Sydney, Australia
| | - L Thomas
- Westmead Hospital, Sydney, Australia
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22
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Achterbergh RCA, Drückler S, van Rooijen MS, van Aar F, Slurink IAL, de Vries HJC, Boyd A. Sex, drugs, and sexually transmitted infections: A latent class analysis among men who have sex with men in Amsterdam and surrounding urban regions, the Netherlands. Drug Alcohol Depend 2020; 206:107526. [PMID: 31783312 DOI: 10.1016/j.drugalcdep.2019.06.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 01/04/2019] [Revised: 06/04/2019] [Accepted: 06/19/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are at high risk for sexually transmitted infections (STI) and often have sex while under the influence of drugs (sexualized drug use). We aimed to identify classes of MSM in Amsterdam and in surrounding urban regions with distinctive patterns of sexualized drug use and their association with STI. METHODS In this cross-sectional study, data on MSM were collected at STI clinics in the Netherlands between September-December 2017. Information on drug use, sociodemographics and sexual risk behavior, including lab-confirmed STI (chlamydia, gonorrhea, syphilis and HIV) was collected and compared between Amsterdam and surrounding urban regions. Latent class analysis was used to identify classes with similar drug use patterns, which were then linked to sexual behavior and STI. RESULTS We included 4461 MSM who were a median 35 years old (IQR = 27-47) and mostly Dutch (56.9 %). Use of all drugs was more often reported in Amsterdam compared to surrounding regions (p<0.001). We identified four different classes based on sexualized drug use among Amsterdam participants and three classes in surrounding regions. In both regions, polydrug use classes (compared to classes of no drug use; alcohol use; or few, various drugs) were defined by higher numbers of sexual partners (median range 8-15 vs 4-6, respectively) and higher STI prevalence (range 30.5%-31.8% vs 18.6%-22.8%, respectively). CONCLUSION Given the high prevalence of risk behavior and STIs, MSM in urban settings partaking in sexualized polydrug use might benefit from tailored outreach, screening, and safe sex and drug use interventions.
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Affiliation(s)
- R C A Achterbergh
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - S Drückler
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - M S van Rooijen
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - F van Aar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - I A L Slurink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - H J C de Vries
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AI and II), Meibergdreef 9, Amsterdam, the Netherlands
| | - A Boyd
- Research and Prevention, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, F75012 Paris, France.
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23
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Boyd A, Lewis A, Dallas S, Xenakis E, Ramsey P. Comparison of obstetric to institutional antibiograms as an approach to advance antimicrobial stewardship in maternal care. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.071] [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: 10/25/2022]
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24
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Mahdi H, Hasipek M, Guan Y, Grabowski D, Al-Sudani H, Parker Y, Boyd A, Rose P, Lindner D, Jha B. Combined therapy with HER2 and CDK4/6 inhibitors in HER2+ uterine and ovarian carcinomas: Synergistic effect with combined therapy. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.206] [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]
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25
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Mahdi H, Hasipek M, Guan Y, Grabowski D, Al-Sudani H, Parker Y, Boyd A, Rose P, Lindner D, Jha B. Dual anti-HER2 therapy in HER2+ uterine and ovarian carcinomas: Durable effect with combined therapy. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.201] [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: 11/25/2022]
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26
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Ferkh A, Brown P, O'Keefe E, Zada M, Duggins A, Thiagalingam A, Altman M, Boyd A, Byth K, Kizana E, Denniss AR, Thomas L. Clinical and echocardiographic characteristics of cardioembolic stroke. Eur J Neurol 2019; 26:1310-1317. [PMID: 31062440 DOI: 10.1111/ene.13981] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/25/2018] [Accepted: 04/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Ischaemic stroke frequently has a cardioembolic (CE) source. Clinical and echocardiographic parameters associated with CE stroke were evaluated. METHODS In all, 93 consecutive ischaemic stroke patients who underwent a transthoracic echocardiogram were retrospectively analysed; strokes were classified by TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Echocardiographic parameters related to CE stroke, including left atrial volumes and function, were compared to 73 healthy controls. RESULTS Of 93 patients (mean age 66.1 years, 56% male), nine (10%) had large artery atherosclerosis, 38 (41%) CE stroke, two (2%) small vessel disease, two (2%) other and 42 (45%) undetermined aetiology. Left atrial (LA) maximum volumes (LAVImax ) and minimum volumes (LAVImin ) were larger in the CE group than the non-CE group (45 vs. 32 ml/m2 , 32 vs. 13 ml/m2 , respectively, P < 0.001), whilst LA function indices including LA emptying fraction and LA function index (LAFI) were lower in the CE group (34% vs. 55%, and 0.12 vs. 0.35, respectively, P < 0.001). Adjusting for clinical characteristics, LAFI ≤0.3 was an independent predictor of CE stroke (adjusted odds ratio 5.3, P = 0.001). Additionally, LAVImax and LAVImin were larger (61 vs. 44 and 32 vs. 24 ml/m2 respectively, P < 0.01) and LAFI significantly lower (0.34 vs. 0.52, P < 0.001) in the undetermined aetiology group versus healthy controls. CONCLUSIONS Left atrial enlargement with reduced LA function was associated with CE stroke and LAFI was the best independent predictor. LA parameters were also altered in the undetermined aetiology group, suggesting an underlying LA myopathy in this subset.
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Affiliation(s)
- A Ferkh
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - P Brown
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - E O'Keefe
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - M Zada
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - A Duggins
- Neurology Department, Westmead Hospital, Sydney, NSW, Australia
| | - A Thiagalingam
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - M Altman
- Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - A Boyd
- University of Sydney, Camperdown, NSW, Australia
| | - K Byth
- University of Sydney, Camperdown, NSW, Australia
| | - E Kizana
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia.,Westmead Institute of Medical Research, Sydney, NSW, Australia
| | - A R Denniss
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia
| | - L Thomas
- University of Sydney, Camperdown, NSW, Australia.,Cardiology Department, Westmead Hospital, Sydney, NSW, Australia.,South Western Clinical School, University of New South Wales, Sydney, NSW, Australia
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27
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Geenty P, Sivapathan S, Deshmukh T, Boyd A, Brown P, Altman M, Kwok F, Stewart G, Richards D, Thomas L. Right Ventricular Dysfunction in AL-Amyloidosis Cardiomyopathy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.318] [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: 10/26/2022]
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28
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Boyd A, Moh R, Maylin S, Abdou Chekaraou M, Mahjoub N, Gabillard D, Anglaret X, Eholié SP, Delaugerre C, Danel C, Zoulim F, Lacombe K. Precore G1896A mutation is associated with reduced rates of HBsAg seroclearance in treated HIV hepatitis B virus co-infected patients from Western Africa. J Viral Hepat 2018; 25:1121-1131. [PMID: 29660214 DOI: 10.1111/jvh.12914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/17/2017] [Accepted: 03/20/2018] [Indexed: 12/22/2022]
Abstract
The nucleotide substitution G1896A on the precore (pc) region has been implicated in virological and serological responses during treatment in hepatitis B virus (HBV)-infected patients. Whether this mutation affects the therapeutic course of HIV-HBV co-infected patients, especially from Western Africa, is unknown. In this prospective cohort study, 86 antiretroviral (ARV)-naïve HIV-HBV co-infected patients from Côte d'Ivoire, initiating ARV-treatment containing lamivudine (n = 53) or tenofovir (n = 33), had available baseline pc sequences. Association of the pcG1896A mutation with time to undetectable HBV-DNA, hepatitis B "e" antigen (HBeAg) seroclearance (in HBeAg-positive patients), and hepatitis B surface antigen (HBsAg) seroclearance was evaluated using Cox proportional hazards regression. At ARV-initiation, median HBV-DNA was 6.04 log10 copies/mL (IQR = 3.70-7.93) with 97.7% harbouring HBV genotype E. Baseline pcG1896A mutation was identified in 51 (59.3%) patients, who were more commonly HBeAg-negative (P < .001) and had basal core promotor A1762T/G1764A mutations (P < .001). Patients were followed for a median 36 months (IQR = 24-36). Cumulative proportion of undetectable HBV-DNA was significantly higher in patients with baseline mutation (pcG1896A = 86.6% vs no pcG1896A = 66.9%, P = .04), but not after adjusting for baseline HBV-DNA levels and anti-HBV agent (P = .2). No difference in cumulative proportion of HBeAg seroclearance was observed between mutation groups (pcG1896A = 57.1% vs no pcG1896A = 54.3%, P = .7). Significantly higher cumulative proportion of HBsAg seroclearance was observed in patients without this mutation (pcG1896A = 0% vs no pcG1896A = 36.9%, P < .001), even after adjusting for baseline HBsAg quantification and anti-HBV agent (P < .001). In conclusion, lacking the pcG1896A mutation before ARV initiation appeared to increase HBsAg seroclearance rates during treatment. The therapeutic implications of this mutation need further exploration in this setting.
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Affiliation(s)
- A Boyd
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - R Moh
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,Department of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire.,Medical School, University Felix Houphouet Boigny, Abidjan, Côte d'Ivoire
| | - S Maylin
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France.,Université Paris-Diderot, Paris, France
| | | | - N Mahjoub
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France
| | - D Gabillard
- INSERM, U1219, Bordeaux, France.,University of Bordeaux, ISPED, Bordeaux, France
| | - X Anglaret
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,INSERM, U1219, Bordeaux, France.,University of Bordeaux, ISPED, Bordeaux, France
| | - S P Eholié
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,Department of Infectious and Tropical Diseases, Treichville University Teaching Hospital, Abidjan, Côte d'Ivoire.,Medical School, University Felix Houphouet Boigny, Abidjan, Côte d'Ivoire
| | - C Delaugerre
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France.,Université Paris-Diderot, Paris, France.,INSERM U941, Paris, France
| | - C Danel
- Programme PAC-CI, ANRS Research Site, Treichville University Hospital, Abidjan, Côte d'Ivoire.,INSERM, U1219, Bordeaux, France.,University of Bordeaux, ISPED, Bordeaux, France
| | - F Zoulim
- INSERM U1052- Cancer Research Center of Lyon (CRCL), Lyon, France.,University of Lyon, UMR_S1052, CRCL, Lyon, France.,Department of Hepatology, Hospices Civils de Lyon, Lyon, France
| | - K Lacombe
- Department of Infectious and Tropical Diseases, Saint-Antoine Hospital, AP-HP, Paris, France.,INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Hôpital Saint Antoine, AP-HP, Sorbonne Université, Paris, France
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29
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St Romain P, Boyd A, Zheng J, Chow SC, Burbridge R, Wild D. Radiofrequency ablation (RFA) vs. argon plasma coagulation (APC) for the management of gastric antral vascular ectasia (GAVE) in patients with and without cirrhosis: results from a retrospective analysis of a large cohort of patients treated at a single center. Endosc Int Open 2018; 6:E266-E270. [PMID: 29497685 PMCID: PMC5829995 DOI: 10.1055/s-0043-123187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/08/2017] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION AND STUDY AIMS Gastric antral vascular ectasia (GAVE) is a mucosal abnormality associated with multiple conditions, most notably cirrhosis and systemic sclerosis, that causes indolent gastrointestinal bleeding. It is primarily managed with endoscopic therapy. Traditionally, GAVE is endoscopically ablated using argon plasma coagulation (APC) but radiofrequency ablation (RFA) is emerging as an alternative modality. No prior comparison of the 2 modalities has been published. PATIENTS AND METHODS After receiving IRB approval, we reviewed our electronic health records to identify all patients who underwent endoscopic evaluation for GAVE between January, 2011 and October, 2016. We compared important variables between APC and RFA, as well as between cirrhosis and non-cirrhosis, using the Chi-square test and the Wilcoxon two-sample test as appropriate. RESULTS During our study period, 81 patients were endoscopically evaluated for GAVE. 24 patients were treated with APC alone, 28 with RFA alone and 25 patients received both treatment modalities. CONCLUSIONS RFA and APC were both effective in treating bleeding from GAVE. Though we found subtle differences, patients underwent a similar number of treatment sessions and had similar procedure times and a similar time between sessions no matter the treatment modality used.
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Affiliation(s)
- Paul St Romain
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, United States,Corresponding author Paul St. Romain Duke University Medical CenterDepartment of Medicine, Division of Gastroenterology03142 Orange ZoneDurham, NC 27710+1-919-684-8857
| | - Amanda Boyd
- Division of Internal Medicine, Duke University Medical Center, Durham, North Carolina, United States
| | - Jiayin Zheng
- Division of Biostatistics, Duke University Medical Center, Durham, North Carolina, United States
| | - Shein-Chung Chow
- Division of Biostatistics, Duke University Medical Center, Durham, North Carolina, United States
| | - Rebecca Burbridge
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, United States
| | - Daniel Wild
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, United States
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30
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Bergholt MS, Serio A, McKenzie JS, Boyd A, Soares RF, Tillner J, Chiappini C, Wu V, Dannhorn A, Takats Z, Williams A, Stevens MM. Correlated Heterospectral Lipidomics for Biomolecular Profiling of Remyelination in Multiple Sclerosis. ACS Cent Sci 2018; 4:39-51. [PMID: 29392175 PMCID: PMC5785772 DOI: 10.1021/acscentsci.7b00367] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Indexed: 05/22/2023]
Abstract
Analyzing lipid composition and distribution within the brain is important to study white matter pathologies that present focal demyelination lesions, such as multiple sclerosis. Some lesions can endogenously re-form myelin sheaths. Therapies aim to enhance this repair process in order to reduce neurodegeneration and disability progression in patients. In this context, a lipidomic analysis providing both precise molecular classification and well-defined localization is crucial to detect changes in myelin lipid content. Here we develop a correlated heterospectral lipidomic (HSL) approach based on coregistered Raman spectroscopy, desorption electrospray ionization mass spectrometry (DESI-MS), and immunofluorescence imaging. We employ HSL to study the structural and compositional lipid profile of demyelination and remyelination in an induced focal demyelination mouse model and in multiple sclerosis lesions from patients ex vivo. Pixelwise coregistration of Raman spectroscopy and DESI-MS imaging generated a heterospectral map used to interrelate biomolecular structure and composition of myelin. Multivariate regression analysis enabled Raman-based assessment of highly specific lipid subtypes in complex tissue for the first time. This method revealed the temporal dynamics of remyelination and provided the first indication that newly formed myelin has a different lipid composition compared to normal myelin. HSL enables detailed molecular myelin characterization that can substantially improve upon the current understanding of remyelination in multiple sclerosis and provides a strategy to assess remyelination treatments in animal models.
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Affiliation(s)
- Mads S. Bergholt
- Department
of Materials, Imperial College London, London SW7 2AZ, United Kingdom
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
- Institute
of Biomedical Engineering, Imperial College
London, London SW7 2AZ, United Kingdom
| | - Andrea Serio
- Department
of Materials, Imperial College London, London SW7 2AZ, United Kingdom
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
- Institute
of Biomedical Engineering, Imperial College
London, London SW7 2AZ, United Kingdom
| | - James S. McKenzie
- Computational
and Systems Medicine, Imperial College London, London SW7 2AZ, United Kingdom
| | - Amanda Boyd
- MRC
Centre for Regenerative Medicine, University
of Edinburgh, Edinburgh EH16 4UU, United Kingdom
| | - Renata F. Soares
- Computational
and Systems Medicine, Imperial College London, London SW7 2AZ, United Kingdom
| | - Jocelyn Tillner
- Computational
and Systems Medicine, Imperial College London, London SW7 2AZ, United Kingdom
| | - Ciro Chiappini
- Department
of Materials, Imperial College London, London SW7 2AZ, United Kingdom
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
- Institute
of Biomedical Engineering, Imperial College
London, London SW7 2AZ, United Kingdom
| | - Vincen Wu
- Computational
and Systems Medicine, Imperial College London, London SW7 2AZ, United Kingdom
| | - Andreas Dannhorn
- Computational
and Systems Medicine, Imperial College London, London SW7 2AZ, United Kingdom
| | - Zoltan Takats
- Computational
and Systems Medicine, Imperial College London, London SW7 2AZ, United Kingdom
- E-mail:
| | - Anna Williams
- MRC
Centre for Regenerative Medicine, University
of Edinburgh, Edinburgh EH16 4UU, United Kingdom
- E-mail:
| | - Molly M. Stevens
- Department
of Materials, Imperial College London, London SW7 2AZ, United Kingdom
- Department
of Bioengineering, Imperial College London, London SW7 2AZ, United Kingdom
- Institute
of Biomedical Engineering, Imperial College
London, London SW7 2AZ, United Kingdom
- E-mail:
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Sivapathan S, Boyd A, Deshmukh T, Kwok F, Altman M, Stewart G, Richards D, Denniss A, Thomas L. Relative Apical Sparing Using Longitudinal Strain to Diagnose Cardiac Amyloidosis. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.505] [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: 11/29/2022]
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Sivapathan S, Boyd A, Deshmukh T, Kwok F, Altman M, Stewart G, Richards D, Robert Denniss A, Thomas L. Multi-Layer Strain as a Useful Technique to Identify Cardiac Amyloidosis. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.478] [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: 11/30/2022]
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Boyd A. MS 19.04 Shine a Light on Lung Cancer: The Evolution. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.264] [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]
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Steininger K, Boyd A, Dupke S, Krznaric I, Carganico A, Munteanu M, Neifer S, Schuetze M, Obermeier M, Arasteh K, Baumgarten A, Ingiliz P. HIV-positive men who have sex with men are at high risk of development of significant liver fibrosis after an episode of acute hepatitis C. J Viral Hepat 2017; 24:832-839. [PMID: 28439936 DOI: 10.1111/jvh.12707] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 09/28/2016] [Accepted: 02/01/2017] [Indexed: 12/17/2022]
Abstract
Acute hepatitis C virus infection remains a major health concern in human immunodeficiency virus(HIV)-infected men who have sex with men (MSM). New direct-acting antiviral agent (DAA) combination therapy has not yet been approved for the treatment for acute hepatitis C virus(HCV), thereby potentially causing deferral of HCV treatment. Therefore, we aimed to study the course of liver disease after an episode of acute HCV. This study is a retrospective single-centre cohort of HIV-positive MSM with acute HCV infection. Liver fibrosis was estimated by Fibroscan® and Fibrotest® . Liver-related and non-liver-related outcomes were documented. Overall 213 episodes of acute HCV infection in 178 men were documented. Median follow-up for all included patients was 38.7 months. Spontaneous HCV clearance was found in 10.8% of patients, which was significantly associated with older age, lower HCV RNA levels, and higher ALT levels upon initial acute HCV diagnosis. Treatment with interferon-based therapy was initiated in 86.3% of cases, resulting in a sustained virological response(SVR) rate of 70.7%. After 3 years' follow-up, significant liver fibrosis of METAVIR F2 stage or higher was found in 39.4% of patients after first acute HCV diagnosis. Higher age, physician-declared alcoholism, and nonresponse to acute HCV therapy were independently associated with higher fibrosis stages. Ten patients died during the observation period (IR 1.4/100 patient-years) and four during interferon treatment. Significant liver fibrosis is a common finding in HIV-positive MSM following acute HCV infection despite high treatment uptake and cure rates, suggesting the need for close liver disease monitoring particularly if HCV treatment is deferred.
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Affiliation(s)
- K Steininger
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - A Boyd
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM UMR_S 1136, Paris, France
| | - S Dupke
- Center for Infectiology, Berlin, Germany
| | - I Krznaric
- Center for Infectiology, Berlin, Germany
| | | | | | - S Neifer
- Center for Microbiology Dr. Neifer, Berlin, Germany
| | | | | | - K Arasteh
- Department of Infectiology, Vivantes Auguste-Viktoria-Hospital, Berlin, Germany
| | | | - P Ingiliz
- Center for Infectiology, Berlin, Germany
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Finn RT, Boyd A, Lin L, Gellad ZF. Bolus Administration of Fentanyl and Midazolam for Colonoscopy Increases Endoscopy Unit Efficiency and Safety Compared With Titrated Sedation. Clin Gastroenterol Hepatol 2017; 15:1419-1426.e2. [PMID: 28365484 DOI: 10.1016/j.cgh.2017.03.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/14/2016] [Revised: 02/23/2017] [Accepted: 03/02/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Guidelines recommend slow titration of sedatives for moderate sedation. Bolus sedation, in which a larger weight-based dose of medication is given upfront, has been shown in a single trial to be beneficial. We evaluated the effects of bolus sedation on procedural safety, efficiency, and patient experience. METHODS We performed a retrospective analysis of colonoscopies performed between April 2010 and April 2011 at Duke Medical Center. Colonoscopies before October 2010 were performed with nurse-directed titration of sedative (n = 966); colonoscopies performed after October 2010 were performed with physician-directed administration of bolus sedative (n = 699). We compared sedation and recovery times, medication doses, and adverse events between groups. We also compared patient satisfaction in a subset of patients from each group. Data were compared using the chi-square test for categorical variables and Wilcoxon rank sum test for continuous and ordinal categorical variables. RESULTS Patients in the bolus group had a shorter sedation time (6.0 min) than patients in the titration group (13.0 min; P < .01) and a slightly longer colonoscopy time (25.0 min vs 24.0 min in the titration group; P < .01). Recovery time did not differ significantly between groups (53.0 min in the bolus group vs 52.1 min in the titration group; P = .07). Patients in the bolus group received lower weight-adjusted doses of fentanyl (1.71 μg/kg vs 1.89 μg/kg in the titration group) and midazolam (0.065 mg/kg vs 0.075 mg/kg in the titration group). A smaller proportion of patients in the bolus sedative group developed hypotension (12.7% vs 17.9% in the titration group; P < .01). These findings persisted even after adjustment for baseline patient age, race, sex, smoking status, alcohol use, body mass index, and American Society of Anesthesiologists' classification. CONCLUSIONS In a retrospective study of patients undergoing colonoscopy, we found that compared with titrated administration of sedative, bolus dosing improves endoscopy unit efficiency and safety and decreases the amount of sedative required. This benefit does not come at the expense of the patient experience.
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Affiliation(s)
- R Thomas Finn
- Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina
| | - Amanda Boyd
- Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina
| | - Li Lin
- Duke Clinical Research Institute, Durham, North Carolina
| | - Ziad F Gellad
- Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina.
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Smith MA, Boyd A, Chan A, Clout S, des Brisay P, Dolson S, Eagalle T, Espinola S, Fairweather A, Frank S, Fruetel C, Garrido Cortes C, Hall J, Ho C, Matczak E, McCubbin S, McPhee M, Pare KA, Paris K, Richard E, Roblin M, Russell C, Snyder R, Trombley C, Schmitt T, Vandermeer C, Warne C, Welch N, Xavier-Blower C. Investigating the effect of forestry on leaf-litter arthropods (Algonquin Park, Ontario, Canada). PLoS One 2017; 12:e0178568. [PMID: 28575022 PMCID: PMC5456079 DOI: 10.1371/journal.pone.0178568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/15/2017] [Indexed: 12/13/2022] Open
Abstract
Arthropods are the most diverse taxonomic group of terrestrial eukaryotes and are sensitive to physical alterations in their environment such as those caused by forestry. With their enormous diversity and physical omnipresence, arthropods could be powerful indicators of the effects of disturbance following forestry. When arthropods have been used to measure the effects of disturbance, the total diversity of some groups is often found to increase following forestry. However, these findings are frequently derived using a coarse taxonomic grain (family or order) to accommodate for various taxonomic impediments (including cryptic diversity and poorly resourced taxonomists). Our intent with this work was to determine the diversity of arthropods in and around Algonquin Park, and how this diversity was influenced by disturbance (in this case, forestry within the past 25 years). We used DNA barcode-derived diversity estimates (Barcode Index Number (BIN) richness) to avoid taxonomic impediments and as a source of genetic information with which we could conduct phylogenetic estimates of diversity (PD). Diversity patterns elucidated with PD are often, but not always congruent with taxonomic estimates-and departures from these expectations can help clarify disturbance effects that are hidden from richness studies alone. We found that BIN richness and PD were greater in disturbed (forested) areas, however when we controlled for the expected relationship between PD and BIN richness, we found that cut sites contained less PD than expected and that this diversity was more phylogenetically clustered than would be predicted by taxonomic richness. While disturbance may cause an evident increase in diversity, this diversity may not reflect the full evolutionary history of the assemblage within that area and thus a subtle effect of disturbance can be found decades following forestry.
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Affiliation(s)
- M Alex Smith
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Amanda Boyd
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Amelia Chan
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Simonne Clout
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Paulson des Brisay
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Sarah Dolson
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Thanushi Eagalle
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Sean Espinola
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Aaron Fairweather
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Sydney Frank
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Christopher Fruetel
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | | | - James Hall
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Chris Ho
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Eryk Matczak
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Sandra McCubbin
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Megan McPhee
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Kate A Pare
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Kelsie Paris
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Ellen Richard
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Morgan Roblin
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Cassandra Russell
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Ryan Snyder
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Carolyn Trombley
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Tyler Schmitt
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Caitlin Vandermeer
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Connor Warne
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
| | - Natasha Welch
- Department of Integrative Biology, University of Guelph, Guelph, Ontario, Canada
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Mulholland C, Mongan D, Boyd A, Shannon C. CAN WE PREVENT PSYCHOSIS? INNOVATIVE SERVICE OFFERS NEW HOPE. Ulster Med J 2017. [PMID: 29535494 PMCID: PMC5846005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- C Mulholland
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| | - D Mongan
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| | - A Boyd
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
| | - C Shannon
- Holywell Hospital, Steeple Road, Antrim, BT41 2RJ
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Dombrowski Y, O'Hagan T, Dittmer M, Penalva R, Mayoral SR, Bankhead P, Fleville S, Eleftheriadis G, Zhao C, Naughton M, Hassan R, Moffat J, Falconer J, Boyd A, Hamilton P, Allen IV, Kissenpfennig A, Moynagh PN, Evergren E, Perbal B, Williams AC, Ingram RJ, Chan JR, Franklin RJM, Fitzgerald DC. Regulatory T cells promote myelin regeneration in the central nervous system. Nat Neurosci 2017; 20:674-680. [PMID: 28288125 PMCID: PMC5409501 DOI: 10.1038/nn.4528] [Citation(s) in RCA: 287] [Impact Index Per Article: 41.0] [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] [Received: 08/22/2016] [Accepted: 02/03/2017] [Indexed: 02/08/2023]
Abstract
Regeneration of CNS myelin involves differentiation of oligodendrocytes from oligodendrocyte progenitor cells. In multiple sclerosis, remyelination can fail despite abundant oligodendrocyte progenitor cells, suggesting impairment of oligodendrocyte differentiation. T cells infiltrate the CNS in multiple sclerosis, yet little is known about T cell functions in remyelination. We report that regulatory T cells (Treg) promote oligodendrocyte differentiation and (re)myelination. Treg-deficient mice exhibited substantially impaired remyelination and oligodendrocyte differentiation, which was rescued by adoptive transfer of Treg. In brain slice cultures, Treg accelerated developmental myelination and remyelination, even in the absence of overt inflammation. Treg directly promoted oligodendrocyte progenitor cell differentiation and myelination in vitro. We identified CCN3 as a Treg-derived mediator of oligodendrocyte differentiation and myelination in vitro. These findings reveal a new regenerative function of Treg in the CNS, distinct from immunomodulation. Although the cells were originally named 'Treg' to reflect immunoregulatory roles, this also captures emerging, regenerative Treg functions.
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Affiliation(s)
- Yvonne Dombrowski
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Thomas O'Hagan
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Marie Dittmer
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Rosana Penalva
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Sonia R Mayoral
- Department of Neurology and Program in Neurosciences, University of California, San Francisco, California, USA
| | - Peter Bankhead
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Samara Fleville
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - George Eleftheriadis
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Chao Zhao
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Clifford Allbutt Building, Cambridge Biomedical Campus, University of Cambridge, UK
| | - Michelle Naughton
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Rachel Hassan
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Jill Moffat
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - John Falconer
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Amanda Boyd
- Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, UK
| | - Peter Hamilton
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Ingrid V Allen
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Adrien Kissenpfennig
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Paul N Moynagh
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK.,Institute of Immunology, Department of Biology, National University of Ireland Maynooth, Ireland
| | - Emma Evergren
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Bernard Perbal
- Université Côte d'Azur, CNRS, GREDEG, Nice, France.,International CCN Society, Paris, France
| | - Anna C Williams
- Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, UK
| | - Rebecca J Ingram
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
| | - Jonah R Chan
- Department of Neurology and Program in Neurosciences, University of California, San Francisco, California, USA
| | - Robin J M Franklin
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Clifford Allbutt Building, Cambridge Biomedical Campus, University of Cambridge, UK
| | - Denise C Fitzgerald
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Northern Ireland, UK
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Medina-Rodríguez EM, Bribián A, Boyd A, Palomo V, Pastor J, Lagares A, Gil C, Martínez A, Williams A, de Castro F. Promoting in vivo remyelination with small molecules: a neuroreparative pharmacological treatment for Multiple Sclerosis. Sci Rep 2017; 7:43545. [PMID: 28256546 PMCID: PMC5335257 DOI: 10.1038/srep43545] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/25/2017] [Indexed: 12/22/2022] Open
Abstract
Multiple Sclerosis (MS) is a neurodegenerative disease where immune-driven demyelination occurs with inefficient remyelination, but therapies are limited, especially those to enhance repair. Here, we show that the dual phosphodiesterase (PDE)7- glycogen synthase kinase (GSK)3 inhibitor, VP3.15, a heterocyclic small molecule with good pharmacokinetic properties and safety profile, improves in vivo remyelination in mouse and increases both adult mouse and adult human oligodendrocyte progenitor cell (OPC) differentiation, in addition to its immune regulatory action. The dual inhibition is synergistic, as increasing intracellular levels of cAMP by cyclic nucleotide PDE inhibition both suppresses the immune response and increases remyelination, and in addition, inhibition of GSK3 limits experimental autoimmune encephalomyelitis in mice. This combination of an advantageous effect on the immune response and an enhancement of repair, plus demonstration of its activity on adult human OPCs, leads us to propose dual PDE7-GSK3 inhibition, and specifically VP3.15, as a neuroprotective and neuroreparative disease-modifying treatment for MS.
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Affiliation(s)
- Eva María Medina-Rodríguez
- Grupo de Neurobiología del Desarrollo-GNDe, Hospital Nacional de Parapléjicos, Finca la Peraleda s/n, E- 45071, Toledo, Spain
| | - Ana Bribián
- Grupo de Neurobiología del Desarrollo-GNDe, Hospital Nacional de Parapléjicos, Finca la Peraleda s/n, E- 45071, Toledo, Spain
- Instituto Cajal-CSIC, Avda. Dr. Arce 37, E-28002, Madrid, Spain
| | - Amanda Boyd
- MRC-Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, EH164UU, Edinburgh, UK
| | - Valle Palomo
- Centro de Investigaciones Biológicas, CIB-CSIC, Calle Ramiro de Maeztu 9, E-28040, Madrid, Spain
| | - Jesús Pastor
- Servicio de Neurofisiología Clínica, Hospital La Princesa, Calle Diego de León 62, E-28006,Madrid, Spain
| | - Alfonso Lagares
- Servicio de Neurocirugía, Hospital 12 de Octubre, Avda. de Córdoba s/n, E-28041,Madrid, Spain
| | - Carmen Gil
- Centro de Investigaciones Biológicas, CIB-CSIC, Calle Ramiro de Maeztu 9, E-28040, Madrid, Spain
| | - Ana Martínez
- Centro de Investigaciones Biológicas, CIB-CSIC, Calle Ramiro de Maeztu 9, E-28040, Madrid, Spain
| | - Anna Williams
- MRC-Centre for Regenerative Medicine, University of Edinburgh, 5 Little France Drive, EH164UU, Edinburgh, UK
| | - Fernando de Castro
- Grupo de Neurobiología del Desarrollo-GNDe, Hospital Nacional de Parapléjicos, Finca la Peraleda s/n, E- 45071, Toledo, Spain
- Instituto Cajal-CSIC, Avda. Dr. Arce 37, E-28002, Madrid, Spain
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40
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Surgers L, Boyd A, Boelle PY, Lalande V, Jolivot PA, Girard PM, Arlet G, Cambier C, Homor A, Decre D, Meynard JL. Clinical and microbiological determinants of severe and fatal outcomes in patients infected with Enterobacteriaceae producing extended-spectrum β-lactamase. Eur J Clin Microbiol Infect Dis 2017; 36:1261-1268. [PMID: 28181033 DOI: 10.1007/s10096-017-2932-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/27/2017] [Indexed: 12/14/2022]
Abstract
Although extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have become a worldwide public health concern, little is known regarding the clinical course of colonized or infected individuals. Our objective was to characterize the determinants of fatal outcomes related to ESBL-producing microorganisms at a large hospital in Paris, France. In 2012-2013, all consecutive patients with clinical samples testing positive for ESBL-producing Enterobacteriaceae at Saint-Antoine Hospital were identified. Patient clinical data were obtained at hospital entry, while information on intensive care unit (ICU) admissions and death were prospectively collected. Risk-factors for fatal 1-year outcomes were assessed using logistic regression. In total, 643/4684 (13%) ESBL-positive samples were observed, corresponding to 516 episodes (n = 206, 40% treated) among 330 patients. Most episodes were nosocomial-related (n = 347/516, 67%) involving Escherichia coli (n = 232/516, 45%) or Klebsiella pneumoniae (n = 164/516, 32%). Empirical antibiotic therapy was adequate in 89/206 (43%) infections, while the median length of hospital stay was 30 days [interquartile range (IQR) = 11-55] and 39/201 (19%) were admitted to the ICU. Overall, 104/241 patients (43%) with available data died within 1 year. In the multivariable analysis, 1-year death was associated with age >80 years (p = 0.01), concomitant comorbidity (p = 0.001), nosocomial-acquired infection (p = 0.002), and being infected rather than colonized (p < 0.001). In this series of patients with identified samples of ESBL-producing Enterobacteriaceae, hospital burden was large and 1-year mortality rates high. Understanding which patients in this setting would benefit from broad-spectrum empirical antibiotic therapy should be further examined.
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Affiliation(s)
- L Surgers
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France. .,Sorbonne University, UPMC Univ Paris 06 CR7, Paris, France. .,INSERM U1135, CIMI, Team E13, Paris, France.
| | - A Boyd
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 75013, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - P-Y Boelle
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 75013, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.,Département de Santé Publique, Hôpital Saint Antoine, APHP, Paris, France
| | - V Lalande
- Département de Bactériologie, Hôpital Saint-Antoine, APHP, Paris, France
| | - P-A Jolivot
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France
| | - P-M Girard
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France.,Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, 75013, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - G Arlet
- Sorbonne University, UPMC Univ Paris 06 CR7, Paris, France.,INSERM U1135, CIMI, Team E13, Paris, France.,Département de Bactériologie, Hôpital Saint-Antoine, APHP, Paris, France
| | - C Cambier
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France
| | - A Homor
- Département de Bactériologie, Hôpital Saint-Antoine, APHP, Paris, France
| | - D Decre
- Sorbonne University, UPMC Univ Paris 06 CR7, Paris, France.,INSERM U1135, CIMI, Team E13, Paris, France.,Département de Bactériologie, Hôpital Saint-Antoine, APHP, Paris, France
| | - J-L Meynard
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, 75012, Paris, France
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Tabibian N, Swehli E, Boyd A, Umbreen A, Tabibian JH. Abdominal adhesions: A practical review of an often overlooked entity. Ann Med Surg (Lond) 2017; 15:9-13. [PMID: 28203370 PMCID: PMC5295619 DOI: 10.1016/j.amsu.2017.01.021] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/27/2017] [Accepted: 01/29/2017] [Indexed: 12/13/2022] Open
Abstract
Formation of intra-abdominal adhesions is a common consequence of abdomino-pelvic surgery, radiation therapy, and inflammatory processes. In a small but clinically significant proportion of patients, adhesive disease may develop, wherein adhesions lead to a variety of chronic symptoms such as abdominal distension, pain, nausea, and abnormal bowel movement pattern which can be daily, intermittent, or episodic. Due to the chronic and troublesome nature of these symptoms, adhesive disease may be life-altering in many patients, particularly when not recognized and appropriately addressed, as is the case not infrequently. In addition, there is a paucity of literature regarding the evaluation and management of patients with suspected abdominal adhesive disease. Therefore, in this concise review, we provide a clinically practical synopsis of the etiopathogenesis, symptoms, differential diagnosis, evaluation, and treatment of abdominal adhesive disease.
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Affiliation(s)
- N Tabibian
- Kaweah Delta Medical Center, Department of Family Medicine Residency Program, Visalia, CA, USA
| | - E Swehli
- Kaweah Delta Medical Center, Department of Family Medicine Residency Program, Visalia, CA, USA
| | - A Boyd
- Kaweah Delta Medical Center, Department of Family Medicine Residency Program, Visalia, CA, USA
| | - A Umbreen
- Kaweah Delta Medical Center, Department of Family Medicine Residency Program, Visalia, CA, USA
| | - J H Tabibian
- UC Davis Medical Center, Division of Gastroenterology and Hepatology, Sacramento, CA, USA
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Gan G, Kadappu K, Boyd A, Goonetilleke N, Eshoo S, Thomas L. Correlation Between Diastolic Dysfunction and Exercise Capacity in Chronic Kidney Disease. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.486] [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]
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Gan G, Kadappu K, Boyd A, Eshoo S, Thomas L. The Relationship of Echocardiographic Parameters to Functional Exercise Capacity in the Setting of Diabetic Nephropathy. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.533] [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: 11/28/2022]
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Maia-Leite L, Catez E, Boyd A, Lang S, Haddour N, Curjol A, Nuernberg M, Duvivier C, Desvarieux M, Kirstetter M, Girard P, Boccara F, Cohen A. Aortic stiffness aging is influenced by past profound immunodeficiency in HIV-infected individuals. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30282-3] [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: 12/01/2022]
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Boyd A, Piroth L, Maylin S, Maynard-Muet M, Lebossé F, Bouix C, Lascoux-Combe C, Mahjoub N, Girard PM, Delaugerre C, Carrat F, Lacombe K, Miailhes P. Intensification with pegylated interferon during treatment with tenofovir in HIV-hepatitis B virus co-infected patients. J Viral Hepat 2016; 23:1017-1026. [PMID: 27486094 DOI: 10.1111/jvh.12581] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 03/15/2016] [Accepted: 06/23/2016] [Indexed: 02/06/2023]
Abstract
In hepatitis B "e" antigen (HBeAg) positive patients with hepatitis B virus (HBV) mono-infection, intensification of nucleos(t)ide analogue treatment with pegylated interferon (PegIFN) could help induce higher HBeAg seroclearance rates. Our aim was to determine the long-term effect of adding PegIFN to tenofovir (TDF)-containing antiretroviral therapy on seroclearance in HBeAg-positive patients co-infected with the human immunodeficiency virus (HIV) and HBV. In this prospective matched cohort study, 46 patients with 1-year PegIFN intensification during TDF-containing antiretroviral therapy (TDF+PegIFN) were matched 1:1 to controls undergoing TDF without PegIFN (TDF) using a time-dependent propensity score based on age, CD4+ count and liver cirrhosis status. Kinetics of HBeAg quantification (qHBeAg) and hepatitis B surface antigen quantification (qHBsAg) were estimated using mixed-effect linear regression and time to HBeAg seroclearance or HBsAg seroclearance was modelled using proportional hazards regression. At baseline, previous TDF exposure was a median 39.8 months (IQR=21.4-59.4) and median qHBeAg and qHBsAg levels were 6.9 PEIU/mL and 3.72 log10 IU/mL, respectively (P>.5 between groups). Median follow-up was 33.4 months (IQR=19.0-36.3). During intensification, faster average declines of qHBeAg (-0.066 vs -0.027 PEIU/mL/month, P=.001) and qHBsAg (-0.049 vs -0.026 log10 IU/mL/month, P=.09) were observed in patients undergoing TDF+PegIFN vs TDF, respectively. After intensification, qHBeAg and qHBsAg decline was no different between groups (P=.7 and P=.9, respectively). Overall, no differences were observed in HBeAg seroclearance (TDF+PegIFN=13.2 vs TDF=12.6/100 person·years, P=.5) or HBsAg seroclearance rates (TDF+PegIFN=1.8 vs TDF=1.3/100 person·years, P=.7). In conclusion, PegIFN intensification in HBeAg-positive co-infected patients did not lead to increased rates of HBeAg or HBsAg clearance, despite faster declines of antigen levels while on PegIFN.
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Affiliation(s)
- A Boyd
- INSERM, UMR_S1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - L Piroth
- Département d'Infectiologie, CHU and UMR 1347, Université de Bourgogne, Dijon, France
| | - S Maylin
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France.,Université Paris-Diderot, Paris, France
| | - M Maynard-Muet
- Service d'Hépatologie, Hôpital Croix-Rousse, Hospices Civils de Lyon, INSERM U1052, Lyon, France
| | - F Lebossé
- Service d'Hépatologie, Hôpital Croix-Rousse, Hospices Civils de Lyon, INSERM U1052, Lyon, France
| | - C Bouix
- Service d'Hépatologie, Hôpital Croix-Rousse, Hospices Civils de Lyon, INSERM U1052, Lyon, France
| | - C Lascoux-Combe
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, AP-HP, Paris, France
| | - N Mahjoub
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France
| | - P-M Girard
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, AP-HP, Paris, France.,Institut Pierre Louis d'Epidémiologie et de Santé Publique, UPMC Univ Paris 06, UMR_S 1136, Sorbonne Universités, Paris, France
| | - C Delaugerre
- Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, Paris, France.,Université Paris-Diderot, Paris, France.,INSERM U941, Paris, France
| | - F Carrat
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, UPMC Univ Paris 06, UMR_S 1136, Sorbonne Universités, Paris, France.,Département de Santé Publique, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - K Lacombe
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, AP-HP, Paris, France.,Institut Pierre Louis d'Epidémiologie et de Santé Publique, UPMC Univ Paris 06, UMR_S 1136, Sorbonne Universités, Paris, France
| | - P Miailhes
- Centre de Recherche sur le Cancer de Lyon, Equipes 15 et 16, INSERM, Unité 1052, UMR 5286, CNRS, Lyon, France.,Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
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Kristeleit R, Miller R, Sellers L, Brown N, Gougis P, Boyd A, Morris G, Payne H, Hughes S, Forster M, Linch M. A first-in-human (FIH) phase I/II, dose escalation, pharmacokinetic (PK) study to assess the safety and tolerability of VAL-201 in patients with advanced prostate cancer (APC) and other advanced solid tumours. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw368.31] [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
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Audrey S, Brown L, Campbell R, Boyd A, Macleod J. OP71 Young people’s views about consenting to data linkage: Findings from the PEARL qualitative study. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.71] [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: 11/04/2022]
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Cornish RP, John A, Boyd A, Tilling K, Macleod J. P115 Case definitions for common mental health disorders among adolescents using electronic primary care data: a comparison with self-reported data from the Avon Longitudinal Study of Parents and Children. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.212] [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]
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Teyhan A, Cornish R, Boyd A, Sissons Joshi M, Macleod J. P11 The impact of cycle proficiency training on cycle-related behaviours and accidents in adolescence: findings from ALSPAC, a UK longitudinal cohort. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.110] [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]
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Khanna A, Stringer B, Ensbey K, Jahaan Z, Boyd A, McDonald K, Day B, Pimanda J. 117PD Clinical relevance of DNA damage modulator checkpoint kinase 1 (CHK1) and cancerous inhibitor of protein phosphatase 2A (CIP2A) in human gliomas. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv520.01] [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: 11/14/2022] Open
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