1
|
Steele C, O'Reilly S. Secondary Risk Reduction Strategies in Breast Cancer Care. Ir Med J 2022; 115:541. [PMID: 35416553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Over the past three decades breast cancer survival rates have increased in Ireland. This is due to advances in cancer diagnostics and therapeutics. Cure is now anticipated for most newly diagnosed patients. Cancer survivorship however is associated with an increased risk of additional cancers and the development of other non-communicable diseases such as cardiovascular disease. At present, secondary risk reduction strategies are an integral part of cardiovascular disease management. Given the improvements in breast cancer survival, similar strategies should be implemented as part of routine early-stage breast cancer care treatment plan. Herein, we present compelling evidence to support the integration of secondary risk reduction strategies for patients as a standard of care.
Collapse
Affiliation(s)
- C Steele
- School of Medicine, University College Cork, Ireland
| | - S O'Reilly
- Department of Medical Oncology, Cork University Hospital, Ireland and Cancer Research@UCC, College of Medicine and Health, University College Cork, Ireland
| |
Collapse
|
2
|
Kaminski E, Engelhardt M, Hoff M, Steele C, Villringer A, Ragert P. Author Correction: TDCS effects on pointing task learning in young and old adults. Sci Rep 2021; 11:9871. [PMID: 33947932 PMCID: PMC8097065 DOI: 10.1038/s41598-021-88987-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E Kaminski
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Jahnallee 59, 04109, Leipzig, Germany. .,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - M Engelhardt
- Einstein Center for Neurosciences, Charite-Universitätsmedizin Berlin, Berlin, Germany.,Department of Neurosurgery, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - M Hoff
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - C Steele
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Psychology, Concordia University, Montreal, QC, Canada
| | - A Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Charité-Universitätsmedizin, Berlin, Germany
| | - P Ragert
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Jahnallee 59, 04109, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|
3
|
Denton O, Knight K, Steele C. 320 A Closed Loop Audit of Surgical Site Infection Rate in Elective Colorectal Laparotomies, Pre and Post Introduction of Jubilee Dressing Method. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Surgical site infections (SSI) are responsible for one third of all inpatient infections and are associated with increased morbidity and extended hospital stay. The colorectal department at Glasgow Royal Infirmary introduced the Jubilee dressing method in August 2019 with the aim of reducing SSI incidence.
Method
Closed loop audit of all elective colorectal laparotomies at Glasgow Royal Infirmary pre- and post-introduction of Jubilee dressing method (March – July & August – December 2019). Literature reviews informed selection of baseline characteristics relevant to SSI. Analysis by logistic regression of SSI incidence by characteristic and Jubilee dressing use.
Results
A total of 193 patients were included. There was 52% uptake of Jubilee dressing method in the implementation phase and reduction in total SSI rate from 18.25% to 14.93%. Operation duration and smoking history were the only significant factors at univariate analysis and were put forward to multivariate analysis. Of these, only operation duration made a significant contribution to SSI incidence.
Conclusions
Jubilee dressing use did not make a significant difference to SSI incidence in this sample. This intervention is likely to have small effect size and there were probable confounding factors. Multifactorial influence in SSI incidence suggests larger datasets are required to isolate independent factors.
Collapse
Affiliation(s)
- O Denton
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - K Knight
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - C Steele
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| |
Collapse
|
4
|
Parihar V, Der Merwe KV, Fagan O, Armstrong P, Crosnoi D, Steele C, O’Keeffe P, Dillon K, Parihar V. A Case of Colonic Ischaemia Masquerading as a Colonic Mass. Surg Case Rep 2020. [DOI: 10.31487/j.scr.2020.10.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Intestinal ischaemia is an uncommon vascular syndrome resulting from an acute or chronic drop in blood
supply to the bowel, with varied clinical presentations. Intestinal ischaemia can present similarly to other
conditions, leaving the clinician with a diagnostic dilemma. In this case report, we present a 69-year-old
male who presented with abdominal pain, distention, anorexia and per rectal bleeding. Endoscopy showed
a left-sided mass-like, ulcerated lesion, endoscopically thought to be colonic carcinoma. Histology later
revealed this mass to be intestinal ischaemia, with no features of invasive carcinoma. This was confirmed
at an interval endoscopy, which showed a largely healed mucosa and nil evidence of a mass. Raising
awareness of this disease and its ability to mimic other presentations, both clinically and endoscopically, is
key to establishing an early diagnosis and intervention.
Collapse
|
5
|
Steele C, Arnold A, Gehring K, Griffin D, Savell J. Sorting Beef Subprimals by Ribeye Size at the Packer Level to Maximize Utility and Product Uniformity in Foodservice and Retail Sectors. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
ObjectivesTo determine the impact of sorting beef carcasses at the packer level by ribeye area, instead of sorting subprimals by weight, to provide more consistent products for the end user via foodservice and retail channelsMaterials and MethodsInstrument grading technology was used to select 100 USDA Choice, yield grade 2 or 3 sides, and 100 USDA Select, yield grade 2 or 3 sides. Carcass sides were sorted into one of five ribeye area (REA) categories, as outlined in Tabsle 6.USDA Choice carcass sides were fabricated to remove beef rib, ribeye, lip-on (IMPS 112A) and beef loin, strip loin, boneless (IMPS 180) from each USDA Choice. Beef loin, tenderloin, full, side muscle on, partially defatted (IMPS 189B) subprimals were procured from each USDA Select side. Subprimals were weighed, trimmed to specification, and passed through a 3-D visual analysis portioning machine and to obtain scan data for a variety of portioning outcomes generated by simulation software.ResultsBased on input from our foodservice collaborators, 1.25 inches (3.18 cm) was identified, for ribeye and strip loin steaks, as the targeted optimal thickness to meet consumer expectations. After evaluation of multiple portioning outcomes, it was determined that a 14.00-ounce (396.89 g) portion, for each REA category, most consistently delivered the preferred steak thickness identified previously. REA categories 1 and 2 most frequently produced desirable thickness and portion weight outcomes in ribeye and strip loin steaks. Statistical analysis of number of portions per subprimal stratified by portion weight and portion thickness revealed differences (P < 0.05) across all REA area categories in both ribeyes and strip loins. As portion weight and thickness increased, steak portion number tended to decrease. In tenderloins, an optimal steak thickness of 1.75 to 2.00 in (4.45 to 5.08 cm) was identified as optimal. Most frequently, 8, 9, and 10-ounce (226.80, 255.15, and 283.50 g) portions met the targets for optimal portion weight and thickness parameters. For tenderloins, number of portions by portion weight showed significant differences (P < 0.05) in all ribeye area categories with the exception of 7-ounces (198.45 g) and showed no differences when stratified by portion thickness. In this investigation, USDA Choice carcasses (r = 0.76) and USDA Select carcasses (r = 0.56) expressed moderate correlation between REA area and hot carcass weight.ConclusionResults of the present study suggest strip loin, ribeye, and tenderloin subprimals from carcasses possessing a ribeye area ranging from 74.8 cm2 to 87.1 cm2 offered the greatest level of utility when portioned for use in foodservice and retail sectors. Further research is warranted to continue examining the merit of sorting carcasses by ribeye area at the packer level, but results of this study suggest that there is potential for improved consistency and utility of subprimals in the foodservice and retail sectors.Table 6.Ribeye area (REA) categories and associated acceptable REA ranges.
Collapse
|
6
|
Shillitoe B, Bangs C, Guzman D, Gennery AR, Longhurst HJ, Slatter M, Edgar DM, Thomas M, Worth A, Huissoon A, Arkwright PD, Jolles S, Bourne H, Alachkar H, Savic S, Kumararatne DS, Patel S, Baxendale H, Noorani S, Yong PFK, Waruiru C, Pavaladurai V, Kelleher P, Herriot R, Bernatonienne J, Bhole M, Steele C, Hayman G, Richter A, Gompels M, Chopra C, Garcez T, Buckland M. The United Kingdom Primary Immune Deficiency (UKPID) registry 2012 to 2017. Clin Exp Immunol 2019; 192:284-291. [PMID: 29878323 DOI: 10.1111/cei.13125] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 01/25/2023] Open
Abstract
This is the second report of the United Kingdom Primary Immunodeficiency (UKPID) registry. The registry will be a decade old in 2018 and, as of August 2017, had recruited 4758 patients encompassing 97% of immunology centres within the United Kingdom. This represents a doubling of recruitment into the registry since we reported on 2229 patients included in our first report of 2013. Minimum PID prevalence in the United Kingdom is currently 5·90/100 000 and an average incidence of PID between 1980 and 2000 of 7·6 cases per 100 000 UK live births. Data are presented on the frequency of diseases recorded, disease prevalence, diagnostic delay and treatment modality, including haematopoietic stem cell transplantation (HSCT) and gene therapy. The registry provides valuable information to clinicians, researchers, service commissioners and industry alike on PID within the United Kingdom, which may not otherwise be available without the existence of a well-established registry.
Collapse
Affiliation(s)
- B Shillitoe
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Great North Children's Hospital, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - C Bangs
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Manchester University NHS Foundation Trust, Manchester, UK
| | - D Guzman
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,UCL Centre for Immunodeficiency, Royal Free Hospital, London, UK
| | - A R Gennery
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Great North Children's Hospital, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - H J Longhurst
- Addenbrooke's Hospital, Cambridge Universities NHS Foundation Trust, Cambridge, UK
| | - M Slatter
- Great North Children's Hospital, Newcastle upon Tyne, UK.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | - M Thomas
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - A Worth
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,Great Ormond Street Hospital and Institute of Child Health, London, UK
| | - A Huissoon
- Heart of England NHS Foundation Trust, Birmingham, Birmingham, UK
| | - P D Arkwright
- Manchester University NHS Foundation Trust, Manchester, UK
| | - S Jolles
- University Hospital of Wales, Cardiff, UK
| | - H Bourne
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - H Alachkar
- Salford Royal NHS Foundation Trust, Salford, UK
| | - S Savic
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - D S Kumararatne
- Addenbrooke's Hospital, Cambridge Universities NHS Foundation Trust, Cambridge, UK
| | - S Patel
- John Radcliffe Hospital, Headington, Oxford, UK
| | - H Baxendale
- Papworth NHS Foundation Trust, Cambridge, UK
| | - S Noorani
- Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - P F K Yong
- Frimley Health NHS Foundation Trust, Frimley, UK
| | - C Waruiru
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - V Pavaladurai
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - P Kelleher
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - J Bernatonienne
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - M Bhole
- The Dudley Group NHS Foundation Trust, Dudley, UK
| | | | - G Hayman
- Epsom and St Helier University Hospitals NHS Trust, St Helier, UK
| | - A Richter
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Gompels
- North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | | | - T Garcez
- Manchester University NHS Foundation Trust, Manchester, UK
| | - M Buckland
- On behalf of the UKPIN Registry Committee, UKPIN, London, UK.,UCL Centre for Immunodeficiency, Royal Free Hospital, London, UK.,Great Ormond Street Hospital and Institute of Child Health, London, UK
| |
Collapse
|
7
|
Steele C, Arnold A, Gehring K, Griffin D, Savell J. Sorting Beef Subprimals by Ribeye Size at the Packer Level to Maximize Utility and Product Uniformity in Foodservice and Retail Sectors. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
8
|
Morrow A, Ahmad F, Steele C, McEntegart M, Murdoch D. Treating the troponin: adverse consequences of over-treatment of elevated troponin in non-coronary presentations. Scott Med J 2018; 64:10-15. [PMID: 30426853 DOI: 10.1177/0036933018809754] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Anti-platelet and anti-thrombotic therapy are well-established treatments in acute coronary syndromes. Highly sensitive assays have diminished the positive predictive value of troponin in acute coronary syndromes and increased the importance of the clinical assessment in interpreting positive results. This cohort study sought to investigate over-treatment of non-coronary troponin rises and associated adverse outcomes. METHODS AND RESULTS We reviewed 223 consecutive patients presenting to Queen Elizabeth University Hospital, Glasgow, with suspected acute coronary syndromes over a six-week period. Of these, 27 (12%) met our 'inappropriate therapy' criteria. This group had a low ischaemic risk (HEART score: 4.2 ± 1.4) (GRACE score: 117 ± 30.8) but an intermediate-high bleeding risk (CRUSADE score: 34 ± 14.5). Approximately half of the patients (14/27, 52%) reported chest pain, with only 4/27 (15%) having ischaemic ECG changes. There were three intracranial haemorrhages, each after the patient had received a single dose of aspirin, ticagrelor and fondaparinux. CONCLUSION The combination of injudicious high-sensitivity troponin testing with potent anti-platelet and anti-thrombotic therapy was associated with possible over-treatment of patients and associated harm. Emphasis on interpretation of troponin in the context of clinical presentation and improved awareness of type 2 myocardial infarction are essential to limit iatrogenic pharmacological harm.
Collapse
Affiliation(s)
- A Morrow
- 1 Core Medical Trainee, Department of Cardiology, Queen Elizabeth University Hospital Glasgow, UK
| | - F Ahmad
- 2 Specialist Registrar, Department of Cardiology, Queen Elizabeth University Hospital Glasgow, UK
| | - C Steele
- 3 Advanced Nurse Practitioner, Department of Acute Medicine, Queen Elizabeth University Hospital Glasgow, UK
| | - M McEntegart
- 4 Consultant Cardiologist, Department of Cardiology, Golden Jubilee National Hospital, UK
| | - D Murdoch
- 5 Consultant Cardiologist, Department of Cardiology, Queen Elizabeth University Hospital Glasgow, UK
| |
Collapse
|
9
|
Shih P, Steele C, Nikulin V, Villringer A, Sehm B. P56. The effect of aging on bilateral coordination: differences between mirror and non-mirror movements in a circle-drawing task. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
10
|
Hastie AT, Steele C, Dunaway CW, Moore WC, Rector BM, Ampleford E, Li H, Denlinger LC, Jarjour N, Meyers DA, Bleecker ER. Complex association patterns for inflammatory mediators in induced sputum from subjects with asthma. Clin Exp Allergy 2018. [PMID: 29520864 DOI: 10.1111/cea.13129] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The release of various inflammatory mediators into the bronchial lumen is thought to reflect both the type and degree of airway inflammation, eosinophilic Th2, and Th9, or neutrophilic Th1, and Th17, in patients with asthma. AIMS We investigated whether cytokines and chemokines differed in sputum from subjects with more severe compared with milder asthma and whether unbiased factor analysis of cytokine and chemokine groupings indicates specific inflammatory pathways. METHODS Cell-free supernatants from induced sputum were obtained from subjects with a broad range of asthma severity (n = 158) and assessed using Milliplex® Cytokines/Chemokine kits I, II and III, measuring 75 individual proteins. Each cytokine, chemokine or growth factor concentration was examined for differences between asthma severity groups, for association with leucocyte counts, and by factor analysis. RESULTS Severe asthma subjects had 9 increased and 4 decreased proteins compared to mild asthma subjects and fewer differences compared to moderate asthma. Twenty-six mediators were significantly associated with an increasing single leucocyte type: 16 with neutrophils (3 interleukins [IL], 3 CC chemokines, 4 CXC chemokines, 4 growth factors, TNF-α and CX3CL1/Fractalkine); 5 with lymphocytes (IL-7, IL-16, IL-23, IFN-α2 and CCL4/MIP1β); IL-15 and CCL15/MIP1δ with macrophages; IL-5 with eosinophils; and IL-4 and TNFSF10/TRAIL with airway epithelial cells. Factor analysis grouped 43 cytokines, chemokines and growth factors which had no missing data onto the first 10 factors, containing mixes of Th1, Th2, Th9 and Th17 inflammatory and anti-inflammatory proteins. CONCLUSIONS Sputum cytokines, chemokines and growth factors were increased in severe asthma, primarily with increased neutrophils. Factor analysis identified complex inflammatory protein interactions, suggesting airway inflammation in asthma is characterized by overlapping immune pathways. Thus, focus on a single specific inflammatory mediator or pathway may limit understanding the complexity of inflammation underlying airway changes in asthma and selection of appropriate therapy.
Collapse
Affiliation(s)
- A T Hastie
- Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - C Steele
- Lung Immunology of Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - C W Dunaway
- Lung Immunology of Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - W C Moore
- Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - B M Rector
- Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - E Ampleford
- Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - H Li
- University of Arizona College of Medicine, Tucson, AZ, USA
| | - L C Denlinger
- Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - N Jarjour
- Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - D A Meyers
- University of Arizona College of Medicine, Tucson, AZ, USA
| | - E R Bleecker
- University of Arizona College of Medicine, Tucson, AZ, USA
| | | |
Collapse
|
11
|
Sugrue M, Maier R, Moore EE, Boermeester M, Catena F, Coccolini F, Leppaniemi A, Peitzman A, Velmahos G, Ansaloni L, Abu-Zidan F, Balfe P, Bendinelli C, Biffl W, Bowyer M, DeMoya M, De Waele J, Di Saverio S, Drake A, Fraga GP, Hallal A, Henry C, Hodgetts T, Hsee L, Huddart S, Kirkpatrick AW, Kluger Y, Lawler L, Malangoni MA, Malbrain M, MacMahon P, Mealy K, O'Kane M, Loughlin P, Paduraru M, Pearce L, Pereira BM, Priyantha A, Sartelli M, Soreide K, Steele C, Thomas S, Vincent JL, Woods L. Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland. World J Emerg Surg 2017; 12:47. [PMID: 29075316 PMCID: PMC5651635 DOI: 10.1186/s13017-017-0158-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 08/28/2017] [Accepted: 10/13/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was therefore convened to look at resources for optimal care of emergency surgery. The aim of the Donegal Summit was to set a platform in place to develop guidelines and KPIs in emergency surgery. METHODS The project had multidisciplinary global involvement in producing consensus statements regarding emergency surgery care in key areas, and to assess feasibility of producing KPIs that could be used to monitor process and outcome of care in the future. RESULTS Forty-four key opinion leaders in emergency surgery, across 7 disciplines from 17 countries, composed evidence-based position papers on 14 key areas of emergency surgery and 112 KPIs in 20 acute conditions or emergency systems. CONCLUSIONS The summit was successful in achieving position papers and KPIs in emergency surgery. While position papers were limited by non-graded evidence and non-validated KPIs, the process set a foundation for the future advancement of emergency surgery.
Collapse
Affiliation(s)
- M Sugrue
- Department of Surgery, Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland
| | - R Maier
- Department of Surgery, University of Washington, Seattle, USA.,Harborview Medical Center, Seattle, USA
| | | | - M Boermeester
- Department of Surgery, Academic Medical Center, Amsterdam, Netherlands
| | - F Catena
- Department of Emergency Surgery, Maggiore Hospital, Parma, Italy
| | - F Coccolini
- Department of Emergency, General and Transplant Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - A Leppaniemi
- Abdominal Center, University Hospital Meilahti, Helsinki, Finland
| | - A Peitzman
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - G Velmahos
- Department of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA USA
| | - L Ansaloni
- General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - P Balfe
- Department of Surgery, St. Luke's Hospital, Kilkenny, Ireland
| | - C Bendinelli
- Department of Surgery, John Hunter Hospital, Newcastle, NSW Australia
| | - W Biffl
- Acute Care Surgery, The Queens Medical Center, Honolulu, HI USA
| | - M Bowyer
- Department of Surgery, Uniformed Services University and Walter Reed National Military Medical Center, Bethesda, MD USA
| | - M DeMoya
- Department of Trauma/Critical Care, Massachusetts General Hospital, Boston, MA USA
| | - J De Waele
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - S Di Saverio
- Maggiore Hospital of Bologna, AUSL, Bologna, Italy
| | - A Drake
- Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland
| | - G P Fraga
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - A Hallal
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - C Henry
- National Clinical Advisor for the Acute Hospitals Division, Health Service Executive, Dublin, Ireland
| | - T Hodgetts
- Trauma Governance, UK Defence Medical Services, Lichfield, UK
| | - L Hsee
- Department of Trauma and Acute Care Surgery, Auckland City Hospital, Auckland, New Zealand
| | - S Huddart
- Department of Anaesthesiology, Royal Surrey County Hospital, Guildford, UK
| | - A W Kirkpatrick
- Department of Surgery, Critical Care Medicine and Regional Trauma Service, Foothills Medical Centre, Calgary, AB Canada
| | - Y Kluger
- Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - L Lawler
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - M Malbrain
- Intensive Care Unit and High Burn Unit, ZNA "Ziekenhuis Netwerk Antwerpen" Stuivenberg and ZNA St-Erasmus hospitals, Antwerp, Belgium
| | - P MacMahon
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Mealy
- Department of Surgery, Wexford University Hospital, Wexford, Ireland
| | - M O'Kane
- Department of Pathology, Altnagelvin Hospital, Londonderry, UK
| | - P Loughlin
- Department of Surgery, Altnagelvin Hospital, Londonderry, UK
| | - M Paduraru
- Department of General and Emergency Surgery, Milton Keys, UK
| | - L Pearce
- Northwest Research Collaborative, Manchester, UK
| | - B M Pereira
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - A Priyantha
- Department of Gastroenterology, Teaching Hospital, South, Colombo, Sri Lanka
| | - M Sartelli
- Department of Surgery, Macerata Hospital, Macerata, Italy
| | - K Soreide
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - C Steele
- Department of Gastroenterology, Letterkenny University Hospital and Donegal Clinical Research Academy, Donegal, Ireland
| | - S Thomas
- Department of Trauma Services, Memorial Hospital of South Bend, Indiana, USA
| | - J L Vincent
- Department of Intensive Care, Erasme Hospital, Université libre de bruxelles, Brussels, Belgium
| | - L Woods
- Department of Acute Hospitals, Health Services Executive, Dublin, Ireland
| |
Collapse
|
12
|
Keller H, Slaughter S, Lengyel C, Carrier N, Morrison J, Vucea V, Steele C, Duizer L. SUN-P057: Improving Energy Intake and Malnutrition in Long Term Care: Using a Conceptual Model to Identify Determinants and Potential Solutions. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30569-1] [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]
|
13
|
Vucea V, Keller H, Morrison J, Duncan A, Duizer L, Steele C. MAKING THE MOST OF MEALTIMES: WHO IS PRESCRIBED MODIFIED TEXTURE FOODS IN CANADIAN LONG-TERM CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V. Vucea
- University of Waterloo, Waterloo, Ontario, Canada,
| | - H.H. Keller
- University of Waterloo, Waterloo, Ontario, Canada,
- Schlegel-University of Waterloo, Research Institute for Aging, Waterloo, Ontario, Canada,
| | | | - A.M. Duncan
- Schlegel-University of Waterloo, Research Institute for Aging, Waterloo, Ontario, Canada,
- University of Guelph, Guelph, Ontario, Canada,
| | - L. Duizer
- Schlegel-University of Waterloo, Research Institute for Aging, Waterloo, Ontario, Canada,
- University of Guelph, Guelph, Ontario, Canada,
| | - C. Steele
- Toronto Rehabilitation Institute–University Health Network, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
14
|
Keller H, Slaughter S, Carrier N, Lengyel C, Morrison J, Duizer L, Steele C. MULTI-LEVEL DETERMINANTS OF LONG-TERM CARE RESIDENT ENERGY INTAKE: MAKING THE MOST OF MEALTIMES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H.H. Keller
- Kinesiology, University of Waterloo, Waterloo, Ontario, Canada,
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada,
| | - S. Slaughter
- University of Alberta, Edmonton, Alberta, Canada,
| | - N. Carrier
- Universite de Moncton, Moncton, New Brunswick, Canada,
| | - C.O. Lengyel
- University of Manitoba, Winnipeg, Manitoba, Canada,
| | - J.M. Morrison
- Kinesiology, University of Waterloo, Waterloo, Ontario, Canada,
| | - L. Duizer
- University of Guelph, Guelph, Ontario, Canada,
| | - C. Steele
- University Health Network, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
15
|
Carrier N, Keller H, Slaughter S, Lengyel C, Steele C, Duizer L, Duncan A. LONG-TERM CARE HOME, STAFF, AND DINING ROOM CHARACTERISTICS ASSOCIATED WITH RESIDENTS’ FOOD INTAKE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N. Carrier
- Food sciences, nutrition and home economics, Université de Moncton, Shediac Cape, New Brunswick, Canada,
| | - H.H. Keller
- University of Waterloo, Waterloo, Ontario, Canada,
| | | | - C. Lengyel
- University of Manitoba, Winnipeg, Manitoba, Canada,
| | - C. Steele
- University of Toronto, Toronto, Ontario, Canada
| | - L. Duizer
- University of Guelph, Guelph, Ontario, Canada,
| | - A.M. Duncan
- University of Guelph, Guelph, Ontario, Canada,
| |
Collapse
|
16
|
Keller H, Carrier N, Lengyel C, Slaughter S, Duizer L, Steele C, Morrison J, Duncan A. ADEQUACY OF MICRONUTRIENT INTAKE IN LONG-TERM CARE RESIDENTS: MAKING THE MOST OF MEALTIMES (M3). Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H.H. Keller
- Kinesiology, University of Waterloo, Waterloo, Ontario, Canada,
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada,
| | - N. Carrier
- Universite de Moncton, Moncton, New Brunswick, Canada,
| | - C. Lengyel
- University of Manitoba, Winnipeg, Manitoba, Canada,
| | - S. Slaughter
- University of Alberta, Edmonton, Alberta, Canada,
| | - L. Duizer
- University of Guelph, Guelph, Ontario, Canada,
| | - C. Steele
- University Health Network, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada
| | - J.M. Morrison
- Kinesiology, University of Waterloo, Waterloo, Ontario, Canada,
| | - A.M. Duncan
- University of Guelph, Guelph, Ontario, Canada,
| |
Collapse
|
17
|
Namasivayam A, Morrison J, Carrier N, Lengyel C, Slaughter S, Steele C, Keller H. UNDERSTANDING THE DETERMINANTS OF FLUID INTAKE IN LONG-TERM CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A.M. Namasivayam
- University of Toronto, Toronto, Ontario, Canada,
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada,
| | | | - N. Carrier
- University of Moncton, Moncton, New Brunswick, Canada,
| | - C. Lengyel
- University of Mantioba, Winnipeg, Ontario, Canada,
| | - S. Slaughter
- University of Alberta, Edmonton, Ontario, Canada,
| | - C. Steele
- University of Toronto, Toronto, Ontario, Canada,
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada,
| | - H.H. Keller
- University of Waterloo, Waterloo, Ontario, Canada,
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| |
Collapse
|
18
|
Matheson E, Luo M, Davis G, Baggs G, Nelson J, Pereira S, Hagazi R, Ahmed N, Steele C, Deutz N. MON-P090: Effect of a Specialized Ons on Serum Markers of Nutrition and Inflammation in Hospitalized Malnourished Older Patients. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30724-5] [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: 10/21/2022]
|
19
|
Baldwin C, Moore K, Steele C, Young C, Arakji M, Dudhiya N, Gilson A, Majumdar A. The effect of food fortification with or without oral nutritional supplements on energy and protein provision and intake in nursing home residents: a service evaluation. Clin Nutr ESPEN 2015; 10:e188-e189. [PMID: 28531498 DOI: 10.1016/j.clnesp.2015.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Baldwin
- Division of Diabetes & Nutritional Sciences, King's College London, London SE1 9NH, UK
| | - K Moore
- Division of Diabetes & Nutritional Sciences, King's College London, London SE1 9NH, UK
| | - C Steele
- Division of Diabetes & Nutritional Sciences, King's College London, London SE1 9NH, UK
| | - C Young
- Department of Nutrition & Dietetics, London Metropolitan University, London N7 8DB, UK
| | - M Arakji
- Department of Nutrition & Dietetics, London Metropolitan University, London N7 8DB, UK
| | - N Dudhiya
- Department of Nutrition & Dietetics, London Metropolitan University, London N7 8DB, UK
| | - A Gilson
- Barts Health NHS Trust, Newham University Hospital, E13 8SL, UK
| | - A Majumdar
- Department of Nutrition & Dietetics, London Metropolitan University, London N7 8DB, UK
| |
Collapse
|
20
|
Sehm B, Steele C, Villringer A, Ragert P. P127. Mirror motor activity and its relation to white matter in the posterior midbody of the corpus callosum. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.254] [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: 11/16/2022]
|
21
|
Carter D, Steele C, Senior L, Johnston K, Capehorn M. Trial protocol to assess the effects of intermittent (IER) versus continuous energy restriction (CER) on weight and other risk factors in patients attending the Rotherham Institute for Obesity (RIO). Appetite 2015. [DOI: 10.1016/j.appet.2014.12.189] [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]
|
22
|
Lathrop MJ, Sage EK, Macura SL, Brooks EM, Cruz F, Bonenfant NR, Sokocevic D, MacPherson MB, Beuschel SL, Dunaway CW, Shukla A, Janes SM, Steele C, Mossman BT, Weiss DJ. Antitumor effects of TRAIL-expressing mesenchymal stromal cells in a mouse xenograft model of human mesothelioma. Cancer Gene Ther 2014; 22:44-54. [DOI: 10.1038/cgt.2014.68] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 12/27/2022]
|
23
|
Kaminski E, Hoff M, Steele C, Sehm B, Villringer A, Ragert P. P655: Impact of dual-hemisphere transcranial direct current stimulation on complex whole body motor skill learning. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50749-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
24
|
Green O, Kashani R, Santanam L, Hand T, Steele C, Victoria J, Wooten H, Li H, Rodriguez V, Hu Y, Mutic S. SU-E-J-181: Magnetic Resonance Image-Guided Radiation Therapy Workflow: Initial Clinical Experience. Med Phys 2014. [DOI: 10.1118/1.4888234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
25
|
Bujawansa S, Thondam SK, Steele C, Cuthbertson DJ, Gilkes CE, Noonan C, Bleaney CW, Macfarlane IA, Javadpour M, Daousi C. Presentation, management and outcomes in acute pituitary apoplexy: a large single-centre experience from the United Kingdom. Clin Endocrinol (Oxf) 2014; 80:419-24. [PMID: 23909507 DOI: 10.1111/cen.12307] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 06/14/2013] [Accepted: 07/30/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To study the presentation, management and outcomes and to apply retrospectively the Pituitary Apoplexy Score (PAS) (United Kingdom (UK) guidelines for management of apoplexy) to a large, single-centre series of patients with acute pituitary apoplexy. DESIGN Retrospective analysis of casenotes at a single neurosurgical centre in Liverpool, UK. RESULTS Fifty-five patients [mean age, 52·4 years; median duration of follow-up, 7 years] were identified; 45 of 55 (81%) had nonfunctioning adenomas, four acromegaly and six prolactinomas. Commonest presenting features were acute headache (87%), diplopia (47·2%) and visual field (VF) defects (36%). The most frequent ocular palsy involved the 3rd nerve (81%), followed by 6th nerve (34·6%) and multiple palsies (19%). Twenty-three patients were treated conservatively, and the rest had surgery either within 7 days of presentation or delayed elective surgery. Indications for surgery were deteriorating visual acuity and persistent field defects. Patients presenting with VF defects (n = 20) were more likely to undergo surgery (75%) than to be managed expectantly (25%). There was no difference in the rates of complete/near-complete resolution of VF deficits and cranial nerve palsies between those treated conservatively and those who underwent surgery. Endocrine outcomes were also similar. We were able to calculate the PAS for 46 patients: for the group treated with early surgery mean, PAS was 3·8 and for those managed conservatively or with delayed surgery was 1·8. CONCLUSIONS Patients without VF deficits or whose visual deficits are stable or improving can be managed expectantly without negative impact on outcomes. Clinical severity based on a PAS ≥ 4 appeared to influence management towards emergency surgical intervention.
Collapse
Affiliation(s)
- S Bujawansa
- Department of Endocrinology & Diabetes, University Hospital Aintree, Liverpool, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Aghi M, Vogelbaum MA, Jolly DJ, Robbins JM, Ostertag D, Ibanez CE, Gruber HE, Kasahara N, Bankiewicz K, Cloughesy TF, Chang SM, Butowski N, Kesari S, Chen C, Mikkelsen T, Landolfi J, Chiocca EA, Elder JB, Foltz G, Pertschuk D, Anaizi A, Taylor C, Kosty J, Zimmer L, Theodosopoulos P, Anaizi A, Gantwerker E, Pensak M, Theodosopoulos P, Anaizi A, Grewal S, Theodosopoulos P, Zimmer L, Anaizi A, Pensak M, Theodosopoulos P, Arakawa Y, Kang Y, Murata D, Fujimoto KI, Miyamoto S, Blagia M, Paulis M, Orunesu G, Serra S, Akers J, Ramakrishnan V, Kim R, Skog J, Nakano I, Pingle S, Kalinina J, Kesari S, Breakfield X, Hochberg F, Van Meir E, Carter B, Chen C, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran F, Calaminus G, Hamer PDW, Hendriks E, Mandonnet E, Barkhof F, Zwinderman K, Duffau H, Esquenazi Y, Johnson J, Tandon N, Esquenazi Y, Friedman E, Lin Y, Zhu JJ, Tandon N, Fujimaki T, Kobayashi M, Wakiya K, Ohta M, Adachi J, Fukuoka K, Suzuki T, Yanagisawa T, Matsutani M, Mishima K, Sasaki J, Nishikawa R, Hoffermann M, Bruckmann L, Ali KM, Asslaber M, Payer F, von Campe G, Jungk C, Beigel B, Abb V, Herold-Mende C, Unterberg A, Kim JH, Cho YH, Kim CJ, Mardor Y, Nissim O, Grober Y, Guez D, Last D, Daniels D, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Zach L, Marupudi N, Mittal S, Michaud K, Cantin L, Cottin S, Dandurand C, Mohammadi A, Hawasli A, Rodriguez A, Schroeder J, Laxton A, Elson P, Tatter S, Barnett G, Leuthardt E, Moriuchi S, Dehara M, Fukunaga T, Hagiwara Y, Soda H, Imakita M, Nitta M, Maruyama T, Iseki H, Ikuta S, Tamura M, Chernov M, Okamoto S, Okada Y, Muragaki Y, Ohue S, Kohno S, Inoue A, Yamashita D, Kumon Y, Ohnishi T, Oppido P, Villani V, Vidiri A, Pace A, Pompili A, Carapella C, Orringer D, Lau D, Niknafs Y, Piquer J, Llacer JL, Rovira V, Riesgo P, Cremades A, Rotta R, Levine N, Prabhu S, Sawaya R, Weinberg J, Rao G, Tummala S, Tilley C, Rovin R, Kassam A, Schwartz C, Romagna A, Thon N, Tonn JC, Schwarz SB, Kreth FW, Sonoda Y, Shibahara I, Saito R, Kanamori M, Kumabe T, Tominaga T, Steele C, Lawrence J, Rovin R, Winn R, Rachinger W, Simon M, Dutzmann S, Feigl G, Kremenevskaya N, Thon N, Tonn JC, Whelan H, Kelly M, Jogel S, Kaufmann B, Foy A, Lew S, Quirk B, Yong RL, Wu T, Mihatov N, Shen MJ, Brown MA, Zaghloul KA, Park GE, Park JK. SURGICAL THERAPIES. Neuro Oncol 2013; 15:iii217-iii225. [PMCID: PMC3823906 DOI: 10.1093/neuonc/not191] [Citation(s) in RCA: 3] [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: 01/19/2024] Open
|
27
|
Kaminski E, Hoff M, Sehm B, Taubert M, Conde V, Steele C, Villringer A, Ragert P. P 92. Effect of transcranial direct current stimulation (tDCS) on complex motor skill learning. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.170] [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]
|
28
|
Kiyotani C, Uno T, Ogiwara H, Morota N, Nakazawa A, Tsutsumi Y, Masaki H, Mori T, Sanz JAS, Guibelalde M, Tavera A, Herandez I, Ibanez J, Brell M, Mas A, Muller HL, Gebhardt U, Warmuth-Metz M, Pietsch T, Sorensen N, Kortmann RD, Stapleton S, Gonzalez I, Steinbrueck S, Rodriguez L, Tuite G, Krzyzankova M, Mertsch S, Jeibmann A, Kordes U, Wolff J, Paulus W, Hasselblatt M, Nonaka Y, Hara S, Fukazawa S, Shimizu K, Ben-Arush M, Postovsky S, Toledano H, Peretz-Nahum M, Fujimura J, Sakaguchi S, Kondo A, Saito Y, Shimoji K, Ohara Y, Arakawa A, Saito M, Shimizu T, Benesch M, von Bueren AO, Dantonello T, von Hoff K, Pietsch T, Leuschner I, Claviez A, Bierbach U, Kropshofer G, Korinthenberg R, Graf N, Suttorp M, Kortmann RD, Friedrich C, Klingebiel T, Koscielniak E, Rutkowski S, Mesa M, Sanchez M, Mejia J, Pena G, Dussan R, Cabeza M, Storino A, Dincer F, Roffidal T, Powell M, Berrak S, Wolff JE, Fouyssac F, Delaunay C, Vignaud JM, Schmitt E, Klein O, Mansuy L, Chastagner P, Cruz O, Guillen A, Garcia G, Alamar M, Candela S, Roussos I, Garzon M, Sunol M, Muchart J, Rebollo M, Mora J, Wolff J, Diez B, Muggeri A, Arakaki N, Meli F, Sevlever G, Tsitouras V, Pettorini B, Fellows G, Blair J, Didi M, Daousi C, Steele C, Javadpour M, Sinha A, Hishii M, Kondo A, Fujimura J, Sakaguchi S, Ishii H, Shimoji K, Miyajima M, Arai H, Dvir R, Sayar D, Levin D, Ben-Sirah L, Constantini S, Elhasid R, Gertsch E, Foreman N, Valera ET, Brassesco MS, Machado HR, Oliveira RS, Santos AC, Terra VC, Barros MV, Scrideli CA, Tone LG, Merino D, Pienkowska M, Shlien A, Tabori U, Gilbertson R, Malkin D, Jeeva I, Chang B, Long V, Picton S, Burton D, Clark S, Kwok C, Mokete B, Rafiq O, Simmons I, Shing MMK, Li CK, Chan GCF, Ha SY, Yuen HL, Luk CW, Li CK, Ling SC, Li RCH, Yoon JH, Park HJ, Shin HJ, Park BK, Kim JY, Jung HL, Ra YS, Ghim TT, Wolff J, Hasselblatt M, Hartung S, Powell M, Garami M, Traunecker H, Thall P, Mahajan A, Kordes U, Sumerauer D, Grillner P, Orrego A, Mosskin M, Gustavsson B, Holm S, Peters N, Rogers M, Chowdry S, Selman W, Mitchell A, Bangert B, Ahuja S, Laschinger K, Gold D, Stearns D, Wright K, Gupta K, Klimo P, Ellison D, Keating G, Eckel L, Giannini C, Wetjen N, Patton A, Zaky W, McComb G, Finlay J, Grimm J, Wong K, Dhall G, Zaky W, Gilles F, Grimm J, Dhall G, Finlay J, Ormandy D, Alston R, Estlin E, Gattamaneni R, Birch J, Kamaly-Asl I, Hemenway M, Foreman N, Rush S, Reginald YA, Nicolin G, Bartel U, Buncic JR, Aguilera D, Flamini R, Mazewski C, Schniederjan M, Hayes L, Boydston W, MacDonald T, Fleming A, Jabado N, Saint-Martin C, Albrecht S, Ramsay DA, Farmer JP, Bendel A, Hansen M, Dugan S, Mendelsohn N. RARE TUMORS. Neuro Oncol 2012; 14:i148-i156. [PMCID: PMC3483354 DOI: 10.1093/neuonc/nos108] [Citation(s) in RCA: 3] [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: 07/27/2023] Open
|
29
|
|
30
|
|
31
|
Nguyen N, Pilewski J, Kreindler J, Steele C, Ray A, Alcorn J, Ziegler S, Hartigan E, Kurs-Laskey M, Rockette H, Kolls J. Immune Tolerance to Aspergillus fumigatus versus Allergic Bronchopulmonary Aspergillosis: roles of TSLP, OX40L, and Vitamin D. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
32
|
Mason P, Porter SC, Berry SE, Stillman P, Steele C, Kirby A, Griffin BA, Minihane AM. Saturated fatty acid consumption: outlining the scale of the problem and assessing the solutions. NUTR BULL 2009. [DOI: 10.1111/j.1467-3010.2008.01737.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
33
|
Antle BJ, Mills W, Steele C, Kalnins I, Rossen B. An exploratory study of parents' approaches to health promotion in families of adolescents with physical disabilities. Child Care Health Dev 2008; 34:185-93. [PMID: 18257791 DOI: 10.1111/j.1365-2214.2007.00782.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [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: 11/30/2022]
Abstract
BACKGROUND The life expectancy of children with physical disabilities now extends into adulthood and has been accompanied by the transfer of rehabilitation services from institutions to the home. Thus, families must increasingly partner with health service providers to promote their child's health and prevent the development of secondary conditions that may contribute to heart disease, stroke, respiratory diseases, low endurance and emotional difficulties. AIM To investigate within a family context the health promotion efforts of parents on behalf of a child with a physical disability. METHOD The Long Interview Method was used to interview 15 families (11 two-parent and 4 single-parent) having a child 11-16 years of age with a physical disability including cerebral palsy (7), spina bifida (3), muscular dystrophy (3) and other conditions (2). RESULTS Parents' health promotion efforts were characterized by three main themes. First, parents emphasized traditional lifestyle health behaviours including nutrition, physical activity, tobacco, alcohol and drug use, and personal hygiene. Second, parents tried to foster their adolescent's social life and friendships. They expressed particular concern about how, and if, their child would develop a sense of purpose and have a productive future. Third, parents invested a great deal of effort into observing daily routines, making arrangements for their child's social inclusion and supporting their child in a way that balanced independence with safety and energy conservation. CONCLUSIONS Parents recognize that their child with a physical disability faces greater obstacles, and work hard at health promotion. Healthcare workers need to work with parents to: (1) provide information about specific lifestyle health behaviours including nutrition, physical activity and sexuality; (2) advocate for resources to foster social inclusion; and (3) discuss family strategies that balance parental involvement with their child's need for independence and energy conservation for daily activities.
Collapse
Affiliation(s)
- B J Antle
- Department of Social Work, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
34
|
Steele C, Steel D, Bone H, McParland L, Green L, Fraser S. Managing 'suspicious glaucomatous discs' identified during digital-photography-based diabetic retinopathy screening. Ophthalmic Physiol Opt 2006; 26:19-25. [PMID: 16390478 DOI: 10.1111/j.1475-1313.2005.00361.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE An audit to demonstrate the outcome of patients identified with suspicious glaucomatous discs within a digital-photography-based diabetic retinopathy screening programme. METHODS Primary care based digital photographic screening was performed utilising mydriasis and two-field digital photography for all patients with diabetes. Patients identified with discs suspicious of glaucomatous optic neuropathy (GON) were initially referred to an accredited community-based optometrist for further assessment. Some patients were then referred to secondary care where appropriate. RESULTS From 1st April 2002 to 31st March 2003 a total of 3868 patients were screened for diabetic retinopathy. This audit revealed that 55 subjects were identified by retinal screeners as having discs suspicious of glaucoma. A total of 29 were already under glaucoma clinic review. A total of 23/26 remaining were referred for an assessment by an accredited optometrist. Of these 13 were normal, 6 were referred to secondary care and 4 failed to attend. The three remaining were referred directly to secondary care. CONCLUSIONS All nine referrals to secondary care were deemed appropriate by a glaucoma specialist. This suggests that the system described does not lead to over-referral of suspicious discs - although the issue of how many glaucomatous discs are missed during screening (false negatives) will only be answered in the longer term.
Collapse
|
35
|
Yano J, Lilly EA, Steele C, Fortenberry D, Fidel PL. Oral and vaginal epithelial cell anti-Candida activity is acid labile and does not require live epithelial cells. ACTA ACUST UNITED AC 2005; 20:199-205. [PMID: 15943762 PMCID: PMC1361270 DOI: 10.1111/j.1399-302x.2005.00212.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Candida albicans is the causative agent of oral and vaginal candidiasis. Innate host defenses against C. albicans are important against each infection. Among these are oral and vaginal epithelial cells that have anti-Candida activity. The mechanism of action includes a requirement for cell contact with no role for soluble factors, and a putative role for carbohydrates based on the sensitivity of the activity to periodic acid. METHODS Periodic acid treatment of epithelial cells as well as the property of partial resistance of antifungal activity to fixation was used to further dissect the mechanism of action. RESULTS The results herein effectively now challenge a role for carbohydrates alone. Firstly, the putative carbohydrate(s) released into supernatants of periodic acid-treated epithelial cells could not compete with fresh epithelial cells for activity, and equivalent abrogation of activity was observed by periodic acid-treated cells irrespective of the amount of carbohydrate released. Instead, the similar abrogation of activity following treatment with other acids or when cocultured under acidic conditions suggests that the activity is acid-labile. Finally, while activity requires intact epithelial cells, it does not require live cells; activity was minimally affected by fixing epithelial cells prior to coculture where the majority of cells remained impermeable to Trypan blue but were defined as non-viable by positive nuclear staining with propidium iodide. CONCLUSION These results suggest that antifungal activity is dependent on contact by intact, but not necessarily live, epithelial cells through an acid-labile mechanism.
Collapse
Affiliation(s)
- J Yano
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, 70112, USA
| | | | | | | | | |
Collapse
|
36
|
Sheehan KM, Steele C, Sheahan K, O'Grady A, Leader MB, Murray FE, Kay EW. Association between cyclooxygenase-2-expressing macrophages, ulceration and microvessel density in colorectal cancer. Histopathology 2005; 46:287-95. [PMID: 15720414 DOI: 10.1111/j.1365-2559.2005.02083.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIM In colorectal carcinomas, cyclooxygenase-2 (COX-2) is expressed predominantly by epithelial cells and is implicated in tumour progression. Tumour-associated macrophages may influence tumour growth, proliferative rate and angiogenesis and also express COX-2 when activated. Thus they may play an important stromal-epithelial role in carcinogenesis. Tauhe aim of this study was to define the relationship between microvessel density (MVD), tumour COX-2 and macrophage COX-2 expression. METHODS AND RESULTS Sixty-five cases of formalin-fixed paraffin-embedded colorectal cancer were included in the study. Tissues were immunostained for COX-2, CD68 (macrophage marker) and CD34 (endothelial marker to assess MVD). Thirty-six cases were grossly ulcerated cancers and 29 cases showed focal/microscopic ulceration. Macrophages were in high concentration at the base of ulcerated areas, and were also diffusely dispersed within tumoral stroma. However, the pattern of macrophage COX-2 expression revealed two populations of macrophages--those deep within the tumour (negative for COX-2) and those at the base of ulcers (positive for COX-2). In all cases, the tumour epithelial cells expressed COX-2. MVD was higher at the base of ulcers, adjacent to COX-2+ macrophages, and was lower deep within the tumour. CONCLUSIONS In colorectal cancers, macrophages may have a dual role. Those concentrated at the base of the ulcers, where there is an associated high MVD, may induce angiogenesis, but their function may be in a healing/repair process. The lack of COX-2+ macrophages and lower MVD deep within the tumour suggests that it may be the epithelial COX-2 component that is important in tumour progression.
Collapse
Affiliation(s)
- K M Sheehan
- Department of Pathology, Beaumont Hospital, and Royal College of Surgeons in Ireland, Dublin, Ireland.
| | | | | | | | | | | | | |
Collapse
|
37
|
Sheehan KM, Cahill RA, McGreal G, Steele C, Byrne MF, Kirwan WO, Kay EW, Fitzgerald DJ, Redmond HP, Murray FE. Cyclooxygenase-2 expression in primary human colorectal cancers and bone marrow micrometastases. Dig Liver Dis 2004; 36:392-7. [PMID: 15248379 DOI: 10.1016/j.dld.2004.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Both the expressions of the inducible form of cyclooxygenase-2 and the presence of bone marrow micrometastases are poor prognostic markers in patients with colorectal carcinoma. AIMS As cyclooxygenase-2 expression in these tumours is associated with increased metastatic potential in vitro, our objectives were to determine the relationship between cyclooxygenase-2 and haematogenous spread to bone marrow. PATIENTS AND METHODS Thirty-two patients with resection of colorectal carcinoma were evaluated (median age: 69.5 years). Bone marrow was obtained from all patients from both iliac crests before manipulation of the primary tumour. The tumours were of varying stages at diagnosis (5 Dukes' A, 14 Dukes' B, 11 Dukes' C and 2 Dukes' D). Tumour sections were stained for cyclooxygenase-2 using the avidin-biotin immunohistochemical technique. Extent of staining was graded depending on the percentage of epithelial cells staining positive for cyclooxygenase-2. Micrometastases were detected by staining contaminant cytokeratin-18 positive cells in the bone marrow aspirates by either immunohistochemical (ARAAP) or immunological (flow cytometry) methods. Fisher's exact probability test was used to calculate statistical significance. RESULTS Cyclooxygenase-2 expression in the primary tumour was detected in 72% of the patients. Twelve (38%) patients had bone marrow micrometastases detected by either immunohistochemistry or flow cytometry. Of the 12 patients who had bone marrow micrometastases, 8 tumours demonstrated increased expression of cyclooxygenase-2 protein (66.6%). In contrast, 9 out of the 20 (45%) patients in whom micrometastases were not detected expressed increased levels of cyclooxygenase-2 (P = 0.29). When dividing the patients into subgroups of localised (Dukes' A and B) versus disseminated (Dukes' C and D) disease, there was no further association between cyclooxygenase-2 expression and bone marrow micrometastases (P = 0.179 and 1.0). CONCLUSION In this pilot study, there was no association between cyclooxygenase-2 expression and bone marrow micrometastases in patients with otherwise localised or disseminated disease.
Collapse
Affiliation(s)
- K M Sheehan
- Department of Pathology, Beaumont Hospital and Royal College of Surgeons, Beaumont Road, Dublin 9, Ireland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Leigh JE, Steele C, Wormley F, Fidel PL. Salivary cytokine profiles in the immunocompetent individual with Candida-associated denture stomatitis. Oral Microbiol Immunol 2002; 17:311-4. [PMID: 12354213 DOI: 10.1034/j.1399-302x.2002.170508.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cell-mediated immunity conferred by CD4+ T helper cells is considered the predominant host defense against mucosal Candida infections, with Thelper (Th1)-type responses associated with resistance to infection and Th2-type responses associated with susceptibility to infection. Oropharyngeal candidiasis, the most common oral opportunistic infection in HIV-infected persons, is associated with a Th2-type cytokine profile in saliva. To obtain more direct evidence for a role of salivary cytokines in susceptibility to oropharyngeal candidiasis during immunosuppression, we evaluated Th1/Th2-type cytokines in the saliva of those with denture stomatitis, a form of oropharyngeal candidiasis not related to immunosuppression. Results showed that HIV-negative denture wearers with and without denture stomatitis demonstrated a mixed Th1/Th2 cytokine profile with no significant differences found between the groups. These results suggest that a local Th cytokine dichotomy in saliva is not associated with susceptibility to denture stomatitis in immunocompetent persons.
Collapse
Affiliation(s)
- J E Leigh
- Center of Excellence in Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, New Orleans, LA 70119, USA
| | | | | | | |
Collapse
|
39
|
Cárdenas-Freytag L, Steele C, Wormley FL, Cheng E, Clements JD, Fidel PL. Partial protection against experimental vaginal candidiasis after mucosal vaccination with heat-killed Candida albicans and the mucosal adjuvant LT(R192G). Med Mycol 2002. [DOI: 10.1080/714031116] [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] Open
|
40
|
Cárdenas-Freytag L, Steele C, Wormley FL, Cheng E, Clements JD, Fidel PL. Partial protection against experimental vaginal candidiasis after mucosal vaccination with heat-killed Candida albicans and the mucosal adjuvant LT(R192G). Med Mycol 2002; 40:291-9. [PMID: 12146759 DOI: 10.1080/mmy.40.3.291.299] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The effectiveness of a mucosal vaccine composed of heat-killed Candida albicans (HK-CA) or C. albicans culture filtrate (CaCF) in conjunction with the mucosal adjuvant LT(R192G) against vulvovaginal candidiasis was examined in an estrogen-dependent murine model. Mice vaccinated intranasally with HK-CA + LT(R192G) exhibited a significant but short-lived protection accompanied by a vigorous delayed-type hypersensitivity response as well as high titers of circulating C. albicans-specific antibodies. Surprisingly, the levels of antigen-specific antibodies in the vaginal secretions of protected mice were negligible and no correlates of vaginal-associated Type 1 or Type 2 cytokines were observed. Vaginal priming with C. albicans before vaccination did not alter the protective outcome. Immunization with CaCF + LT(R192G) induced a discrete level of protection when administered intrarectally but not intranasally. These results suggest that mucosal vaccination can afford partial protection against vulvovaginal candidiasis, but the precise immune mechanisms responsible for protection are complex and as yet, not well understood.
Collapse
MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Administration, Intranasal
- Administration, Rectal
- Animals
- Antibodies, Fungal/blood
- Bacterial Toxins/administration & dosage
- Candida albicans/immunology
- Candida albicans/isolation & purification
- Candidiasis, Vulvovaginal/blood
- Candidiasis, Vulvovaginal/immunology
- Candidiasis, Vulvovaginal/prevention & control
- Culture Media, Conditioned
- Disease Models, Animal
- Enterotoxins/administration & dosage
- Escherichia coli Proteins
- Estradiol/administration & dosage
- Estradiol/analogs & derivatives
- Female
- Fungal Vaccines/administration & dosage
- Hypersensitivity, Delayed/etiology
- Mice
- Mice, Inbred CBA
- Time Factors
- Vaccination
- Vaccines, Inactivated/administration & dosage
- Vagina/microbiology
Collapse
Affiliation(s)
- L Cárdenas-Freytag
- Department of Microbiology and Immunology, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.
| | | | | | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND There is continuing concern over the lack of attention to the nutritional needs of older people in hospitals. A 2-year audit project was undertaken to examine the nutritional care of inpatients in Leicestershire Community Hospitals. METHOD The methods used included analysis of menu cycles; observation of meal and drink provision, wastage, supplement usage and portion sizes; and patient satisfaction questionnaire examination. RESULTS Patient menus were nutritionally inadequate for energy, fibre and vitamin D, and protein levels were variable. The percentage of meal wastage and inadequate portion sizes were of concern. Patient satisfaction results were overall positive. CONCLUSION Patient energy intakes are a major concern with low calorie provision from menus exacerbated by a deficit in recommended portion sizes and a high percentage of meal wastage. Routine audits need to be implemented to monitor both portion size and meal wastage, and to address patient satisfaction issues to improve the overall intakes of patients. Multidisciplinary team input is required to address the above issues and additional recommendations to promote nutrition as a key component in clinical care.
Collapse
Affiliation(s)
- K Hamilton
- Leicestershire Nutrition & Dietetic Service, Mansion House, Groby Road, Leicester LE3 9QP, UK
| | | | | | | |
Collapse
|
42
|
Barousse MM, Steele C, Dunlap K, Espinosa T, Boikov D, Sobel JD, Fidel PL. Growth inhibition of Candida albicans by human vaginal epithelial cells. J Infect Dis 2001; 184:1489-93. [PMID: 11709796 DOI: 10.1086/324532] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Vulvovaginal candidiasis (VVC) is a common mucosal infection caused by Candida species in women of childbearing age. Although acute VVC affects a large number of women and is often precipitated by hormonal fluctuations involving high estrogen levels, recurrent VVC (RVVC) affects another 5%-10% of women without any known predisposing factors. We have recently reported that vaginal epithelial cells from nonhuman primates and mice inhibit the growth of Candida albicans in vitro, which may represent an innate host defense mechanism against C. albicans at the vaginal mucosa. In the present study, we show that vaginal epithelial cells collected from healthy women with no history of VVC also exhibit anti-Candida activity, with no differences in activity at various stages of the menstrual cycle. Women diagnosed with RVVC, on the other hand, have reduced epithelial cell anti-Candida activity. These results are further evidence that vaginal epithelial cells provide an innate host resistance mechanism against Candida and that reduced activity may contribute to RVVC.
Collapse
Affiliation(s)
- M M Barousse
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
| | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
Candida albicans is both a commensal and a pathogen at the oral mucosa. Although an intricate network of host defense mechanisms are expected for protection against oropharyngeal candidiasis, anti-Candida host defense mechanisms at the oral mucosa are poorly understood. Our laboratory recently showed that primary epithelial cells from human oral mucosa, as well as an oral epithelial cell line, inhibit the growth of blastoconidia and/or hyphal phases of several Candida species in vitro with a requirement for cell contact and with no demonstrable role for soluble factors. In the present study, we show that oral epithelial cell-mediated anti-Candida activity is resistant to gamma-irradiation and is not mediated by phagocytosis, nitric oxide, hydrogen peroxide, and superoxide oxidative inhibitory pathways or by nonoxidative components such as soluble defensin and calprotectin peptides. In contrast, epithelial cell-mediated anti-Candida activity was sensitive to heat, paraformaldehyde fixation, and detergents, but these treatments were accompanied by a significant loss in epithelial cell viability. Treatments that removed existing membrane protein or lipid moieties in the presence or absence of protein synthesis inhibitors had no effect on epithelial cell inhibitory activity. In contrast, the epithelial cell-mediated anti-Candida activity was abrogated after treatment of the epithelial cells with periodic acid, suggesting a role for carbohydrates. Adherence of C. albicans to oral epithelial cells was unaffected, indicating that the carbohydrate moiety is exclusively associated with the growth inhibition activity. Subsequent studies that evaluated specific membrane carbohydrate moieties, however, showed no role for sulfated polysaccharides, sialic acid residues, or glucose- and mannose-containing carbohydrates. These results suggest that oral epithelial cell-mediated anti-Candida activity occurs exclusively with viable epithelial cells through contact with C. albicans by an as-yet-undefined carbohydrate moiety.
Collapse
Affiliation(s)
- C Steele
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA
| | | | | | | | | |
Collapse
|
44
|
Fehlings D, Rang M, Glazier J, Steele C. Botulinum toxin type A injections in the spastic upper extremity of children with hemiplegia: child characteristics that predict a positive outcome. Eur J Neurol 2001; 8 Suppl 5:145-9. [PMID: 11851743 DOI: 10.1046/j.1468-1331.2001.00047.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Evidence is increasing to suggest that botulinum toxin type A (BTX-A) plays a role in the management of upper extremity spasticity in the paediatric population. However, little information is available on the clinical characteristics of the child that predict a response to this intervention. Our research group previously published a randomized controlled trial demonstrating that BTX-A injection improves function of the upper extremity of children with spastic hemiplegia. In the present paper, we evaluate the child characteristics that predict a positive response to the BTX-A injections in the randomized treatment group. The treatment group was divided into positive functional responders and nonresponders using a cut score of a change of 10 points on the Quality of Upper Extremity Skills Test (QUEST). A two-way analysis of variance procedure was done comparing the following baseline characteristics: function as scored on the QUEST and the Pediatric Evaluation of Disability Inventory (PEDI) self-care domain, grip strength, upper extremity spasticity and age. Grip strength was significantly higher in responders with a P-value of 0.001. Young age approached significance with a P-value of 0.05. Correlation of change scores on the QUEST with baseline characteristics in the treatment group yielded similar results. BTX-A causes a reduction in spasticity and strength; we postulate that if the hand is weak initially, BTX-A can decrease hand function. Two case reports are presented that highlight the importance of grip strength and age.
Collapse
Affiliation(s)
- D Fehlings
- Division of Neurology, Department of Pediatrics, Bloorview MacMillan Centre and The Hospital for Sick Children, Toronto, Canada.
| | | | | | | |
Collapse
|
45
|
Wormley FL, Steele C, Wozniak K, Fujihashi K, McGhee JR, Fidel PL. Resistance of T-cell receptor delta-chain-deficient mice to experimental Candida albicans vaginitis. Infect Immun 2001; 69:7162-4. [PMID: 11598094 PMCID: PMC100112 DOI: 10.1128/iai.69.11.7162-7164.2001] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Conditions consistent with tolerance or immunoregulation have been observed in experimental Candida albicans vaginal infections. The present study investigated the role of gamma/delta T cells in experimental vaginal candidiasis. Results showed that T-cell receptor delta-chain-knockout mice had significantly less vaginal fungal burden when compared to wild-type mice, suggesting an immunoregulatory role for gamma/delta T cells in Candida vaginitis.
Collapse
MESH Headings
- Animals
- Candidiasis/immunology
- Disease Models, Animal
- Female
- Hypersensitivity, Delayed/immunology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Nitrogen Oxides/metabolism
- Receptors, Antigen, T-Cell, gamma-delta/genetics
- Receptors, Antigen, T-Cell, gamma-delta/immunology
- T-Lymphocytes/immunology
- Th1 Cells/immunology
- Th2 Cells/immunology
- Vaginitis/immunology
Collapse
Affiliation(s)
- F L Wormley
- Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA
| | | | | | | | | | | |
Collapse
|
46
|
Carlson MC, Brandt J, Steele C, Baker A, Stern Y, Lyketsos CG. Predictor index of mortality in dementia patients upon entry into long-term care. J Gerontol A Biol Sci Med Sci 2001; 56:M567-70. [PMID: 11524449 DOI: 10.1093/gerona/56.9.m567] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to develop an algorithm that predicts survival in patients with dementia upon entry into long-term care. There are, as yet, no predictive equations developed for those in the late stages of Alzheimer's disease (AD). METHODS This was a prospective, observational study of 132 patients with dementia (61% with AD) followed for up to 5.0 years (median of 41.0 months) after admission to a long-term care facility for dementia patients. Information on demographic characteristics, physical health, and cognitive, emotional, and behavioral characteristics was collected shortly after admission and entered as predictors of time until death in Cox regressions. Findings were used to derive an index predicting mortality. RESULTS There were 60 deaths among the 132 patients (45.4% mortality), with an average survival of 22.4 months in those who died. Better physical health and the presence of delusions were associated with longer survival. These two variables were aggregated into the Copper Ridge Index (CRI). Each one-point increase on the CRI was associated with a four-fold greater likelihood of death over 5 years. CONCLUSIONS A predictive equation incorporating measures of general physical health and delusions accurately predicted time to death in dementia patients in long-term care.
Collapse
Affiliation(s)
- M C Carlson
- Neuropsychiatry and Memory Group, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
| | | | | | | | | | | |
Collapse
|
47
|
Abstract
Wegener's granulomatosis is a rare necrotizing vasculitis usually affecting the respiratory tract and kidneys. The aetiology is unknown and it usually occurs in patients over the age of 40. Involvement of the gastrointestinal tract in Wegener's granulomatosis is relatively rare and usually occurs long after the onset of initial symptoms. Acute colitis as a presenting feature of Wegener's granulomatosis is very rare with only a few reports in the literature. We describe a young woman who presented initially to hospital with gastrointestinal features and then developed a severe colitis and severe gastrointestinal haemorrhage. This preceded the development of respiratory tract features with severe pulmonary haemorrhage, haemoptysis and the development of rapidly progressive renal failure and nasal septal perforation. Following treatment with intravenous steroids and cyclophosphamide, gastrointestinal symptoms and signs improved dramatically, as did her pulmonary disease. She still remains dialysis dependent, due to end-stage renal disease secondary to glomerulonephritis.
Collapse
Affiliation(s)
- C Steele
- Department of Gastroenterology and Hepatology, Beaumont Hospital, Dublin 9, Ireland
| | | | | | | |
Collapse
|
48
|
Abstract
We examined the effect of stereotype threat on blood pressure reactivity. Compared with European Americans, and African Americans under little or no stereotype threat, African Americans under stereotype threat exhibited larger increases in mean arterial blood pressure during an academic test, and performed more poorly on difficult test items. We discuss the significance of these findings for understanding the incidence of hypertension among African Americans.
Collapse
Affiliation(s)
- J Blascovich
- Department of Psychology, University of California, Santa Barbara 93106, USA
| | | | | | | |
Collapse
|
49
|
Jackson G, Bobak A, Chorlton I, Fowler G, Hall R, Khimji H, Matthews H, Stapleton J, Steele C, Stillman P, Sutherland G, Swanton RH. Smoking cessation: a consensus statement with special reference to primary care. Int J Clin Pract 2001; 55:385-92. [PMID: 11501228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Nicotine addiction is a serious medical condition that needs to be treated like any other chronic disease. Primary care must play a key role in smoking cessation and offering help should be a routine part of primary care practice. As the most frequent opportunity for intervention lies within primary care, GPs should ensure that they raise the issue of stopping smoking at least annually with their smoking patients. When the smoker is ready to stop, the initial personal involvement of the GP is likely to increase the chance of a successful quit attempt. Follow-up may be with another healthcare professional. The support of healthcare professionals for the smoker who is motivated to quit, combined with appropriate pharmacotherapy, can substantially increase the chances of a successful quit attempt. Secondary care staff should also make every effort to help people to stop smoking and should communicate effectively with primary care--opportunities during hospitalisation are frequently missed. Specialist smoking cessation clinics have an essential role in providing more intensive specialist treatment and the expertise to partner and support the primary care effort. Smoking cessation is one of the most cost-effective healthcare interventions that can be made.
Collapse
Affiliation(s)
- G Jackson
- Cardiothoracic Centre, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
We examined the effect of stereotype threat on blood pressure reactivity. Compared with European Americans, and African Americans under little or no stereotype threat, African Americans under stereotype threat exhibited larger increases in mean arterial blood pressure during an academic test, and performed more poorly on difficult test items. We discuss the significance of these findings for understanding the incidence of hypertension among African Americans.
Collapse
Affiliation(s)
- J Blascovich
- Department of Psychology, University of California, Santa Barbara 93106, USA
| | | | | | | |
Collapse
|