1
|
Stimson AM, Anderson C, Holt AM, Henderson AJ. Why don't women engage in muscle strength exercise? An integrative review. Health Promot J Austr 2024. [PMID: 38566279 DOI: 10.1002/hpja.857] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
ISSUE ADDRESSED Women are 'at-risk' population for failing to meet muscle strengthening guidelines. Health benefits specific to this exercise mode include maintenance of muscle mass, which is associated with reduced risk of chronic disease and falls. Of significance is the progressive decline in muscle strength exercise participation in women aged 35-54 in Australia. This period is critical for maintaining muscle strength as it establishes foundations for older women's engagement. This integrative review examined available evidence regarding factors influencing muscle strength exercise participation, specifically in women aged 35-54. METHODS Seven databases were searched. Study inclusion criteria were: (1) peer reviewed, (2) English language, (3) sample populations of healthy female adults or general adult sample population differentiating females from males, (4) mean age between 35 and 54 years, (5) focused on muscle strength exercise and measured as the primary outcome factors of participation in muscle strength exercise. FINDINGS Five of 1895 studies met inclusion criteria. Five key factors were associated with participation in muscle strength exercise of women aged 35-54 years: perceived time constraints; knowledge and education; modality and intensity; social support and behavioural strategies. CONCLUSIONS Focused education on strength exercise and guidelines, plus initiatives and strategies that suit the needs of this cohort, are necessary to achieve health and wellbeing benefits. Responsive approaches by health professionals to these women's circumstances can potentially address current low participation levels. SO WHAT?: Creating conditions where health professionals respect a woman's exercise preferences can positively impact these women's musculoskeletal health into older age.
Collapse
Affiliation(s)
- A M Stimson
- School Nursing, Midwifery and Social Sciences, CQUniversity, Brisbane, Australia
| | - C Anderson
- School Nursing, Midwifery, University of Southern Queensland, Ipswich, Australia
| | - A-M Holt
- School of Medicine, University of Notre Dame, Freemantle, Australia
| | - A J Henderson
- School Nursing, Midwifery and Social Sciences, CQUniversity, Brisbane, Australia
| |
Collapse
|
2
|
Tikhomirov R, Oakley RH, Anderson C, Xiang Y, Al Othman S, Smith M, Yaar S, Torre E, Li J, Wilson LR, Goulding DR, Donaldson I, Harno E, Soattin L, Shiels HA, Morris GM, Zhang H, Boyett MR, Cidlowski JA, Mesirca P, Mangoni ME, D'Souza A. Cardiac GR Mediates the Diurnal Rhythm in Ventricular Arrhythmia Susceptibility. Circ Res 2024. [PMID: 38533639 DOI: 10.1161/circresaha.123.323464] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
RATIONALE Ventricular arrhythmias (VAs) demonstrate a prominent day-night rhythm, commonly presenting in the early morning. Transcriptional rhythms in cardiac ion channels accompany this phenomenon, but their role in the morning vulnerability to VAs and the underlying mechanisms are not understood. OBJECTIVE The objectives are to investigate the recruitment of transcription factors to time-of-day differentially accessible chromatin that underpins day-night ion channel rhythms and to assess the significance of this for the heart's day-night rhythm in VA susceptibility. METHODS AND RESULTS Assay for transposase-accessible chromatin with sequencing performed in mouse ventricular myocyte nuclei at the beginning of the inactive (zeitgeber time, time of lights on, start of sleep period) and active (time of lights off, start of awake period [ZT12]) periods revealed differentially accessible chromatin sites annotating to rhythmically transcribed ion channels and transcription factor binding motifs in these regions. Notably, motif enrichment for the glucocorticoid receptor (GR; transcriptional effector of corticosteroid signaling) binding site in open chromatin profiles at ZT12 was observed, in line with the well-recognized ZT12 peak in circulating corticosteroids. Molecular, electrophysiological, and in silico biophysically detailed modeling approaches demonstrated GR-mediated transcriptional control of ion channels (including Scn5a underlying the cardiac Na+ current, Kcnh2 underlying the rapid delayed rectifier K+ current, and Gja1 responsible for electrical coupling) and their contribution to the day-night rhythm in the vulnerability to VA. Strikingly, both pharmacological block of GR and cardiomyocyte-specific genetic knockout of GR blunted or abolished ion channel expression rhythms and abolished the ZT12 susceptibility to pacing-induced VA in isolated hearts. CONCLUSIONS Our study registers a day-night rhythm in chromatin accessibility that accompanies diurnal cycles in ventricular myocytes. Our approaches directly implicate the cardiac GR in the myocyte excitability rhythm and mechanistically link the ZT12 surge in glucocorticoids to intrinsic VA propensity at this time.
Collapse
Affiliation(s)
- Roman Tikhomirov
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Robert H Oakley
- National Institute of Environmental Health Sciences, National Institutes of Health (R.H.O., J.L., L.R.W., D.R.G., J.A.C.)
| | - Cali Anderson
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Yirong Xiang
- Department of Physics and Astronomy, The University of Manchester, United Kingdom. (Y.X., H.Z.)
| | - Sami Al Othman
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Matthew Smith
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Sana Yaar
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Eleonora Torre
- IGF, CNRS, INSERM, Université de Montpellier, France (E.T., P.M., M.E.M.)
| | - Jianying Li
- National Institute of Environmental Health Sciences, National Institutes of Health (R.H.O., J.L., L.R.W., D.R.G., J.A.C.)
| | - Leslie R Wilson
- National Institute of Environmental Health Sciences, National Institutes of Health (R.H.O., J.L., L.R.W., D.R.G., J.A.C.)
| | - David R Goulding
- National Institute of Environmental Health Sciences, National Institutes of Health (R.H.O., J.L., L.R.W., D.R.G., J.A.C.)
| | - Ian Donaldson
- Bioinformatics Core Facility, The University of Manchester, United Kingdom. (I.D.)
| | - Erika Harno
- Division of Diabetes, Endocrinology and Gastroenterology, The University of Manchester, United Kingdom. (E.H.)
| | - Luca Soattin
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Holly A Shiels
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
| | - Gwilym M Morris
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
- John Hunter Hospital, Newcastle, NSW, Australia (G.M.M.)
| | - Henggui Zhang
- Department of Physics and Astronomy, The University of Manchester, United Kingdom. (Y.X., H.Z.)
| | - Mark R Boyett
- Faculty of Life Sciences, University of Bradford, United Kingdom (M.R.B.)
| | - John A Cidlowski
- National Institute of Environmental Health Sciences, National Institutes of Health (R.H.O., J.L., L.R.W., D.R.G., J.A.C.)
| | - Pietro Mesirca
- IGF, CNRS, INSERM, Université de Montpellier, France (E.T., P.M., M.E.M.)
| | - Matteo E Mangoni
- IGF, CNRS, INSERM, Université de Montpellier, France (E.T., P.M., M.E.M.)
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, The University of Manchester, United Kingdom. (R.T., C.A., S.A.O., M.S., S.Y., L.S., H.A.S., G.M.M., A.D.)
- National Heart and Lung Institute, Imperial College London, United Kingdom (A.D.)
| |
Collapse
|
3
|
Korsak A, Kellett DO, Aziz Q, Anderson C, D’Souza A, Tinker A, Ackland GL, Gourine AV. Immediate and sustained increases in the activity of vagal preganglionic neurons during exercise and after exercise training. Cardiovasc Res 2023; 119:2329-2341. [PMID: 37516977 PMCID: PMC10597628 DOI: 10.1093/cvr/cvad115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 03/31/2023] [Accepted: 05/12/2023] [Indexed: 08/01/2023] Open
Abstract
AIMS The brain controls the heart by dynamic recruitment and withdrawal of cardiac parasympathetic (vagal) and sympathetic activity. Autonomic control is essential for the development of cardiovascular responses during exercise, however, the patterns of changes in the activity of the two autonomic limbs, and their functional interactions in orchestrating physiological responses during exercise, are not fully understood. The aim of this study was to characterize changes in vagal parasympathetic drive in response to exercise and exercise training by directly recording the electrical activity of vagal preganglionic neurons in experimental animals (rats). METHODS AND RESULTS Single unit recordings were made using carbon-fibre microelectrodes from the populations of vagal preganglionic neurons of the nucleus ambiguus (NA) and the dorsal vagal motor nucleus of the brainstem. It was found that (i) vagal preganglionic neurons of the NA and the dorsal vagal motor nucleus are strongly activated during bouts of acute exercise, and (ii) exercise training markedly increases the resting activity of both populations of vagal preganglionic neurons and augments the excitatory responses of NA neurons during exercise. CONCLUSIONS These data show that central vagal drive increases during exercise and provide the first direct neurophysiological evidence that exercise training increases vagal tone. The data argue against the notion of exercise-induced central vagal withdrawal during exercise. We propose that robust increases in the activity of vagal preganglionic neurons during bouts of exercise underlie activity-dependent plasticity, leading to higher resting vagal tone that confers multiple health benefits associated with regular exercise.
Collapse
Affiliation(s)
- Alla Korsak
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK
| | - Daniel O Kellett
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK
| | - Qadeer Aziz
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK
- Centre for Clinical Pharmacology and Precision Medicine, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Cali Anderson
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - Alicia D’Souza
- Division of Cardiovascular Sciences, University of Manchester, Manchester, UK
| | - Andrew Tinker
- Centre for Clinical Pharmacology and Precision Medicine, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Gareth L Ackland
- Translational Medicine and Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Alexander V Gourine
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK
| |
Collapse
|
4
|
Pena LC, Anderson C, Agarwal MS, Galvan E, Kelly W, Wagner TD. Retrospective Review of the Factors Limiting Optune Initiation in GBM patients. Int J Radiat Oncol Biol Phys 2023; 117:e93. [PMID: 37786216 DOI: 10.1016/j.ijrobp.2023.06.854] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Tumor Treating Fields (TTFields) are a proven treatment that prolongs survival in Glioblastoma Multiforme (GBM) patients. The duration of usage of TTFields correlates with its effectiveness. This study aims to identify socioeconomic and clinical factors that prevent GBM patients at a single institution from starting and remaining on TTFields treatment. MATERIALS/METHODS This is a retrospective review from a single institution. Data were analyzed for each patient with a diagnosis of GBM that was seen in new patient consultation with a radiation oncologist. Data from 2015 to present were available. 178 patients were included in the study. Insurance status (private vs Medicare/Medicaid vs uninsured), zip code, expected income status, race, ethnicity, preferred primary language, work status, performance status (KPS) at time of diagnosis, and family support at home (Spouse vs Other) were analyzed. For those that initiated TTFields, we examined the duration of treatment, usage rates, patient reported tolerability, and reasons for discontinuation. Early termination of treatment was defined as treatment with TTFields for less than 3 months. RESULTS Of the 178 diagnosed GBM patients, 96 (54%) were offered TTFields and 48 (27%) agreed to treatment, with 46 actually starting. Of 89 Non-Hispanic patients, 53 were offered TTFields (60%) whereas of 73 Hispanic patients, 35 were offered TTFields (48%) (no statistically significant difference). The number one reason for refusing TTFields treatment was rapid deterioration (14/48 patients). The next most common reason was the patient feeling overwhelmed by managing or wearing the device (10/48) as well as the patient's decision to participate in any other clinical trial (10/48). The 3-month dropout rate for patients who received TTFields was 35% (17/48). 5 of the 17 stopped early due to skin rash or annoyance with the device. Patient's median income and insurance status did not predict whether they would start TTFields. 33 out of 109 (31%) patients with spousal support at home started treatment with TTFields compared to 13 of 69 (19%) of those without spousal support (p = .0895, Chi-Square test). CONCLUSION TTFields were offered to more patients each successive year, but many patients had no documented discussion offering TTFields, which may indicate room for improvement at our institution. Median income and insurance status did not play a role in patient access to TTFields, most likely due to Novocure sponsorship of un- or under-insured patients. Among those who declined treatment, 21% did so because of perceived difficulty managing the device. The strongest single trend predictive of successful initiation of TTFields is spousal support at home. Further interventions may focus on improving patient support at home, such as home health nursing visits or community support.
Collapse
Affiliation(s)
- L Carranza Pena
- University of Texas Health Science Center San Antonio Joe R. & Teresa Lozano Long School of Medicine, San Antonio, TX
| | - C Anderson
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| | - M S Agarwal
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| | - E Galvan
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| | - W Kelly
- Mays Cancer Center, UT Health San Antonio, San Antonio, TX
| | - T D Wagner
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| |
Collapse
|
5
|
Dack K, Wilson A, Turner C, Anderson C, Hughes GJ. COVID-19 associated with universities in England, October 2020-February 2022. Public Health 2023; 224:106-112. [PMID: 37742583 DOI: 10.1016/j.puhe.2023.08.025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES The aim of this study was to describe the epidemiology of COVID-19 cases at universities in England (October 2020-February 2022) and investigate factors associated with rates of COVID-19 among students during autumn/winter of 2021/22. STUDY DESIGN The study was an observational retrospective study using routine contact tracing data. METHODS Estimates of COVID-19 cases among students and staff at universities were described. Student cases aged 18-24 years were calculated as a percentage of all cases within that age group. Count regression was used to explore university characteristics associated with case numbers. RESULTS We identified 102,382 cases among students and 28,639 among staff. Student cases reflected trends in the wider population of the same age group, but the observed fraction aged 18-24 years who were students was consistently below the expected level (32%). Phased reopening of universities in March-May 2021 was associated with small peaks but low absolute numbers. Russell group membership, campus universities, and higher student proportions in halls of residence were all associated with increased case numbers. CONCLUSIONS COVID-19 case numbers among students in England varied considerably. At no time were the observed case numbers as high as expected from community prevalence. Characteristics of universities associated with higher case rates can inform future guidance for higher education settings.
Collapse
Affiliation(s)
- K Dack
- Field Service, United Kingdom Health Security Agency, London, UK
| | - A Wilson
- Field Service, United Kingdom Health Security Agency, London, UK
| | - C Turner
- Field Service, United Kingdom Health Security Agency, London, UK
| | - C Anderson
- Field Service, United Kingdom Health Security Agency, London, UK
| | - G J Hughes
- Field Service, United Kingdom Health Security Agency, Leeds, UK.
| |
Collapse
|
6
|
Wilson A, Anderson C, Mindlin M, Sawyer C, Verlander NQ, Hiironen I, Forde J, Paranthaman K, Chandra NL. Characteristics of women presenting with hepatitis B at antenatal care services in London, 2008-2018. J Public Health (Oxf) 2023; 45:584-592. [PMID: 37061977 DOI: 10.1093/pubmed/fdad031] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/17/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND To support interventions to prevent mother-to-child transmission of hepatitis B and fill gaps in surveillance, the Enhanced Surveillance of Antenatal Hepatitis B (ESAHB) programme was implemented in London from 2008 to 2018 to collect demographic information on women who tested positive for hepatitis B during antenatal screening. We describe the epidemiology of hepatitis B in pregnancy, as reported to ESAHB. METHODS The characteristics of pregnant women living with hepatitis B were described and rates were calculated by year, local authority and residence deprivation decile (1 being most deprived). Poisson regression tested the association between pregnant women living with hepatitis B and deprivation decile. RESULTS Between 2008 and 2018, 8879 women living with hepatitis B in London (0.35 per 1000 women) reported 11 193 pregnancies. Annual hepatitis B rates remained stable, but there was strong evidence for an inverse association between rate and deprivation decile (P < 0.001). The majority of women in the cohort presented late to antenatal care, were born outside the UK in a hepatitis B endemic area or required an interpreter for consultations. CONCLUSIONS ESAHB provided important data to inform service quality improvements for women living with hepatitis B. This analysis highlights the link between deprivation and hepatitis B.
Collapse
Affiliation(s)
- A Wilson
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - C Anderson
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - M Mindlin
- South London Health Protection Team, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - C Sawyer
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - N Q Verlander
- Statistics, Modelling and Economics Department, Data, Analytics and Surveillance Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - I Hiironen
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - J Forde
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - K Paranthaman
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - N L Chandra
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| |
Collapse
|
7
|
Mohanna M, Roberts E, Whitty L, Gritzfeld JF, Pain CE, Girschick HJ, Preston J, Hadjittofi M, Anderson C, Ferguson PJ, Theos A, Hedrich CM. Priorities in Chronic nonbacterial osteomyelitis (CNO) - results from an international survey and roundtable discussions. Pediatr Rheumatol Online J 2023; 21:65. [PMID: 37391782 DOI: 10.1186/s12969-023-00851-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
OBJECTIVE Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder that predominantly affects children and young people. The pathophysiology and molecular mechanisms of CNO remain poorly understood, and diagnostic criteria and biomarkers are lacking. As a result, treatment is empiric and follows personal experience, case series and expert consensus plans. METHODS A survey was designed to gain insight on clinician and patient experiences of diagnosing and treating CNO and to collate opinions on research priorities. A version containing 24 questions was circulated among international expert clinicians and clinical academics (27 contacted, 21 responses). An equivalent questionnaire containing 20 questions was shared to explore the experience and priorities of CNO patients and family members (93 responses). RESULTS Responses were used to select topics for four moderated roundtable discussions at the "International Conference on CNO and autoinflammatory bone disease" (Liverpool, United Kingdom, May 25-26th, 2022). The group identified deciphering the pathophysiology of CNO to be the highest priority, followed by clinical trials, necessary outcome measures and classification criteria. Surprisingly, mental wellbeing scored behind these items. CONCLUSIONS Agreement exists among clinicians, academics, patients and families that deciphering the pathophysiology of CNO is of highest priority to inform clinical trials that will allow for the approval of medications for the treatment of CNO by regulatory agencies.
Collapse
Affiliation(s)
- M Mohanna
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - E Roberts
- Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - L Whitty
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - J F Gritzfeld
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - C E Pain
- Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - H J Girschick
- Klinik Für Kinder- Und Jugendmedizin, Vivantes Netzwerk Für Gesundheit GmbH, Klinikum Im Friedrichshain, Berlin, Germany
| | - J Preston
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - M Hadjittofi
- Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - C Anderson
- Royal Hospital for Children and Young People, Edinburgh, UK
| | - P J Ferguson
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - A Theos
- Department of Human Science, CRMO Patient/Parent Partner, Georgetown University, Washington, DC, USA
| | - C M Hedrich
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
- Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
| |
Collapse
|
8
|
Anderson C, Forte G, Hu W, Zhang H, Boyett MR, D'Souza A. Non-canonical role of the sympathetic nervous system in the day-night rhythm in heart rate. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220179. [PMID: 37122216 PMCID: PMC10150211 DOI: 10.1098/rstb.2022.0179] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Although, for many decades, the day-night rhythm in resting heart rate has been attributed to the parasympathetic branch of the autonomic nervous system (high vagal tone during sleep), recently we have shown that there is a circadian clock in the cardiac pacemaker, the sinus node, and the day-night rhythm in heart rate involves an intrinsic rhythmic transcriptional remodelling of pacemaker ion channels, particularly Hcn4. We have now investigated the role of the sympathetic branch of the autonomic nervous system in this and shown it to have a non-canonical role. In mice, sustained long-term block of cardiac β-adrenergic receptors by propranolol administered in the drinking water abolished the day-night rhythm in pacemaking in the isolated sinus node. Concomitant with this, there was a loss of the normal day-night rhythm in many pacemaker ion channel transcripts. However, there was little or no change in the local circadian clock, indicating that the well-known day-night rhythm in sympathetic nerve activity is directly involved in pacemaker ion channel transcription. The day-night rhythm in pacemaking helps explain the occurrence of clinically significant bradyarrhythmias during sleep, and this study improves our understanding of this pathology. This article is part of the theme issue 'The heartbeat: its molecular basis and physiological mechanisms'.
Collapse
Affiliation(s)
- Cali Anderson
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| | - Gabriella Forte
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| | - Wei Hu
- Department of Physics and Astronomy, University of Manchester, Schuster Building, Brunswick Street, Manchester M13 9PL, UK
| | - Henggui Zhang
- Department of Physics and Astronomy, University of Manchester, Schuster Building, Brunswick Street, Manchester M13 9PL, UK
| | - Mark R Boyett
- Faculty of Life Sciences, University of Bradford, Richmond Road, Bradford BD7 1DP, UK
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester M13 9NT, UK
| |
Collapse
|
9
|
Saroha B, Hendricks N, Thatiparthi B, Al-Shaikhli S, Rey K, Anderson C. Abstract No. 229 Clinical Outcomes and Safety of Percutaneous Lung Biopsy in Outpatient Setting. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.290] [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: 02/27/2023] Open
|
10
|
Tan N, Sri D, Tsang D, Nitkunan T, Anderson C, Qazi H, Issa R, Walker R, Seth J. Robotic colposuspension for female stress urinary incontinence: A prospective series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00925-9] [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: 02/12/2023]
|
11
|
Tan N, Sri D, Tsang D, Nitkunan T, Anderson C, Qazi H, Issa R, Walker R, Seth J. Robotic-assisted laparoscopic colposuspension for female stress urinary incontinence: a prospective series. J Robot Surg 2023; 17:125-129. [PMID: 35384594 DOI: 10.1007/s11701-022-01409-6] [Citation(s) in RCA: 1] [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: 10/14/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
The suspension of use of sub-urethral mesh in the UK in 2018 has seen the resurgence of colposuspension in female SUI surgery. Open and laparoscopic colposuspension techniques are well recognised. We present data from 28 robotic-assisted laparoscopic colposuspension (RALCp) procedures, reporting on technique, safety and efficacy. Approval was obtained from the hospital New and Novel Procedures Committee. All patients had urodynamic assessment prior to surgery. Data was prospectively gathered and 24-h pad usage and Urinary Incontinence Short Form Questionnaire (ICIQ-UI-SF) scores were used to assess symptom severity and quality of life. PGII scores were used to assess patient satisfaction after the procedure. Paired T test analysis was conducted. Since May 2019, robotic colposuspension has been performed in 28 patients. The mean age and BMI were 49 and 27 (kg/m2), respectively, with a mean follow-up period of 12 months. 67.9% of patients had pure urodynamic SUI and 32.1% of patients had previous anti-SUI surgery. Average operating time was 127 min, blood loss 20 ml and length of stay 2 days. There was a significant 73% improvement in mean 24-h pad usage (p = 0.001) and an improvement in mean ICIQ-UI-SF scores from 18.1 to 9.4 (p = 0.0001). Day 1 mean pain score was 5/10. This is the largest series of its kind. Robotic colposuspension is safe and feasible with significant improvements seen in quality of life scores and number of pads used per day. It presents a minimally invasive treatment option in female SUI, however needs larger volume evaluation and longer follow-up for further evaluation.
Collapse
Affiliation(s)
- Nataniel Tan
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK.
| | - D Sri
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - D Tsang
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - T Nitkunan
- Epsom and St Helier NHS Trust, Dorking Rd, Epsom, KT18 7EG, UK
| | - C Anderson
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - H Qazi
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - R Issa
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - R Walker
- Epsom and St Helier NHS Trust, Dorking Rd, Epsom, KT18 7EG, UK
| | - J Seth
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| |
Collapse
|
12
|
Drummond S, Lim J, Boardman J, Anderson C, Dickinson D. Sleep Restriction impairs the ability to integrate multiple pieces of information into a decision. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.118] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
13
|
Anderson C, Lund JL, Park J, Brewster W, Bae-Jump V, Olshan AF, Nichols HB. Adverse Urinary System Outcomes among Older Women with Endometrial Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1508. [PMID: 35775217 DOI: 10.1158/1055-9965.epi-22-0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE OF THE STUDY Endometrial cancer and its treatment may cause damage to the urinary system, but few large-scale studies have examined the incidence of urinary-related outcomes among endometrial cancer survivors. We investigated the risk of several urinary disease diagnoses among older women with endometrial cancer compared to women without a cancer history. METHODS Women ages 66 years and older with an endometrial cancer diagnosis during 2004-2017 (N=44,386) and women without a cancer history (N=221,219) matched 5:1 on age, race/ethnicity, and state were identified in the Surveillance, Epidemiology, and End Results-Medicare linked data. ICD-9 and -10 diagnosis codes were used to identify urinary outcomes in the Medicare claims data. Cumulative incidences (IP) of urinary outcomes were estimated among women with and without endometrial cancer. Multivariable Cox proportional hazards regression models were used to estimate hazards ratios (HR) for urinary outcomes comparing women with and without endometrial cancer. HRs were also used to identify characteristics associated with urinary outcomes among endometrial cancer survivors. RESULTS Relative to women without cancer, endometrial cancer survivors had an increased risk of urinary system diagnoses, including renal failure (5-year IP: 25% vs 14%; HR=1.50; 95% CI: 1.47-1.53), chronic kidney disease (5-year IP: 20% vs 14%; HR=1.25; 95% CI: 1.22-1.28), calculus of the urinary tract (5-year IP: 7% vs 4%; HR=1.55; 95% CI: 1.50-1.61), lower urinary tract infection (5-year IP: 55% vs 33%; HR=1.75; 95% CI: 1.72, 1.78), and bladder diseases (5-year IP: 10% vs 6%; HR=1.57; 95% CI: 1.52, 1.62). These associations persisted in analyses limited to 1+ and 5+ years after endometrial cancer diagnosis. Non-Hispanic Black or Hispanic race/ethnicity, higher comorbidity index, higher stage or grade cancer, non-endometrioid histology, and treatment with chemotherapy and/or radiation were often predictors of urinary outcomes among women with endometrial cancer. CONCLUSIONS Our results suggest that, among older women, the risk of urinary outcomes is elevated after endometrial cancer. Monitoring for urinary diseases may be a critical part of long-term survivorship care for older women with an endometrial cancer history.
Collapse
|
14
|
Crosby L, Lewer D, Appleby Y, Anderson C, Hayward A, Story A. Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study. Perspect Public Health 2022; 143:89-96. [PMID: 35506684 PMCID: PMC10068400 DOI: 10.1177/17579139221093544] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many countries are seeking to eliminate tuberculosis (TB), but incidence remains high in socially excluded groups such as people experiencing homelessness. There is limited research into the effectiveness of residential respite services (RRS), which provide accomodation and social and clinical support for homeless people with active TB. METHODS We used a register of all cases of TB diagnosed in London between 1 January 2010 and 3 October 2019 to compare characteristics and outcomes of patients treated in an RRS with patients receiving standard care. The primary outcome was successful treatment completion. We used logistic regression to compare likelihood of completing treatment, and simulation to estimate the absolute change in treatment completion resulting from this service. RESULTS A total of 78 homeless patients finished an episode of TB treatment at the RRS. Patients treated in the RRS were more likely than patients treated in standard care to have clinical and social risk factors including drug resistance, history of homelessness, drug or alcohol use, and need for directly observed therapy. After adjusting for these factors, patients treated in the RRS had 2.97 times the odds of completing treatment (95% CI = 1.44-6.96). Treatment ended in failure for 8/78 patients treated in the RRS (10%, 95% CI = 5%-20%). We estimated that in the absence of the RRS, treatment would have ended in failure for 17/78 patients (95% CI = 11-25). CONCLUSION The residential respite service for homeless TB patients with complex social needs was associated with better treatment outcomes.
Collapse
Affiliation(s)
- L Crosby
- Collaborative Centre for Inclusion Health, UCL, London, UK.,Research Department of Primary Care and Population Health, UCL, London, UK
| | - D Lewer
- Collaborative Centre for Inclusion Health, University College London, London, UK.,National Infections Service, Public Health England, London, UK
| | - Y Appleby
- Find & Treat, University College London Hospitals, London, UK
| | - C Anderson
- National Infections Service, Public Health England, London, UK
| | - A Hayward
- Collaborative Centre for Inclusion Health, UCL, London, UK
| | - A Story
- Collaborative Centre for Inclusion Health, UCL, London, UK.,Find & Treat, University College London Hospitals, London, UK
| |
Collapse
|
15
|
Schnabel A, Nashawi M, Anderson C, Felsenstein S, Lamoudi M, Poole-Cowley J, Lindell E, Oates B, Fowlie P, Walsh J, Ellis T, Hahn G, Goldspink A, Martin N, Mahmood K, Hospach T, Lj M, Hedrich CM. TNF-inhibitors or bisphosphonates in chronic nonbacterial osteomyelitis? - Results of an international retrospective multicenter study. Clin Immunol 2022; 238:109018. [PMID: 35460903 DOI: 10.1016/j.clim.2022.109018] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022]
Abstract
Chronic nonbacterial osteomyelitis (CNO) can cause significant morbidity, including bone pain and damage. In the absence of clinical trials, treatments include non-steroidal anti-inflammatory drugs, corticosteroids, TNF-inhibitors (TNFi) and/or bisphosphonates. In a retrospective chart review in the United Kingdom and Germany, we investigated response to TNFi and/or pamidronate. Ninety-one patients were included, receiving pamidronate (n = 47), TNFi (n = 22) or both sequentially (n = 22). Patients with fatigue [p = 0.003] and/or arthritis [p = 0.002] were more frequently treated with TNFi than pamidronate. Both therapies were associated with clinical remission at 6 months, and reduction of bone lesions on MRI at 12 months. While not reaching statistical significance, pamidronate resulted in faster resolution of MRI lesions. Fewer flares were observed with TNFi. Failure to respond to pamidronate was associated with female sex [p = 0.027], more lesions on MRI [p = 0.01] and higher CRP levels [p = 0.03]. Randomized clinical trials are needed to confirm observations and generate evidence.
Collapse
Affiliation(s)
- A Schnabel
- Pädiatrische Rheumatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
| | - M Nashawi
- Pädiatrische Rheumatologie, Klinikum Stuttgart, Germany; Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - C Anderson
- Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - S Felsenstein
- Department of Infectious Disease and Immunology, Alder Hey Children's NHS Foundation Trust, United Kingdom
| | - M Lamoudi
- Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - J Poole-Cowley
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - E Lindell
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - B Oates
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - P Fowlie
- Ninewells Hospital, Dundee, United Kingdom
| | - J Walsh
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - T Ellis
- Pädiatrische Rheumatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - G Hahn
- Department of Radiology, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - A Goldspink
- Raigmore Hospital, Inverness, United Kingdom
| | - N Martin
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - K Mahmood
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - T Hospach
- Pädiatrische Rheumatologie, Klinikum Stuttgart, Germany
| | - McCann Lj
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - C M Hedrich
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom; Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom.
| |
Collapse
|
16
|
Leung L, Sri D, Seth J, Sharma D, Tay A, Gonsalves M, Qazi H, Anderson C, Issa R. Robotic-Assisted Bladder Diverticulectomy (RABD): A safe alternative to open approach. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
17
|
Hussain F, Sonani H, Anderson C, Varshney N. Duodenal Duplication Cyst in adult male; An Extremely Rare Entity and a Diagnostic Pitfall leading to Whipple procedure. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.116] [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: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Whipple procedure is a complex, invasive operation and has high morbidity and mortality. It is the most commonly indicated treatment for treating malignant tumors, however, it can be also used for benign entities as well including biliary stricture, chronic pancreatitis, choledochal cyst, inflammatory pseudotumour, and duodenal angiodysplasia.
Methods/Case Report
We report a case of a 50-year-old man who presented with symptoms of gastric outlet obstruction. Esophagogastroduodenoscopy and CT scan showed an obstruction at the level of the second part of the duodenum with proximal dilation. Subsequently, a Whipple procedure was performed based on high clinical suspicion of duodenal cancer. Gross examination revealed a unilocular thick walled cyst (4.2 cm) in the duodenum. Histopathologic examination showed a cyst lined by duodenal mucosa with thick smooth muscle wall and focal ectopic gastric tissue. This was finally diagnosed as a duodenal cyst consistent with duplication cyst.
Results (if a Case Study enter NA)
NA
Conclusion
Duplication cysts are rare congenital abnormality predominantly diagnosed in infancy and childhood. They are most commonly located in the distal ileum, followed by the esophagus and ileocecal region, and are extremely rare in duodenum. Differential diagnosis includes choledochocele, pancreatic pseudocyst, and cystic tumors of the pancreas, mesenteric cysts, and duodenal diverticulums. Treatment options include total excision, cystojejunostomy, and endoscopic marsupialization but occasionally may lead to more invasive measures such as the Whipple procedure. Although duodenal duplication cysts can have variable clinical presentation and radiological findings, making preoperative diagnosis very challenging, it is still pertinent to be aware of this entity for the optimal patient care.
Collapse
Affiliation(s)
- F Hussain
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| | - H Sonani
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| | - C Anderson
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| | - N Varshney
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| |
Collapse
|
18
|
Fugar S, Deka K, Anderson C, Lama Von Buchwald C, Geroux R, Al-Amoodi M, White J, Kavinsky C. Invasive and Doppler Transvalvular gradients after transcatheter aortic valve replacement. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1685] [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
Differences in mean gradients after Transcatheter valve replacement (TAVR) vary depending on the valve type and the modality used to measure the gradients. Currently there is a paucity of data on the relationship between invasive and doppler derived gradients after TAVR.
Purpose
We sort to assess the difference in doppler, and catheter derived aortic valve gradients after TAVR
Methods
This is a single center retrospective study using consecutive patients who presented for TAVR on account of native aortic valve stenosis at our institution from May 2012 till December 2020. Patients with both intraoperative invasive and postoperative doppler derived pressure gradients were included in the analysis. Student T-test were used to compare mean gradients. Pearson's correlation test was used to examine the correlation between measured gradients.
Results
A total of 587 patients were included in our study. Fifty one percent were male and 462 (78.7%) underwent TAVR with a balloon expandable valve. In the entire cohort the mean gradient measured invasively was significantly lower than those measured by echo doppler (4.48±3.25 vs. 5.57±3.11, P<0.001). There, however, was a positive correlation between invasive and doppler measured gradients (figure 1). In those who received balloon expandable valves, the invasive gradient was 4.39±3.30 and the doppler derived gradient was 5.47±3.04 (P<0.001), while in those self-expanding valves, the invasive gradient was 4.81±3.04 and doppler derived gradient was 5.94±3.36 (P<0.001).
Conclusion
Post TAVR gradients were all significantly lower when measured invasively as compared to those measured using doppler. Self-expanding valves overall had higher residual gradients. Further studies are needed to assess the correlations between invasively measured gradients and clinical outcomes post TAVR.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- S Fugar
- Rush University Medical Center, Chicago, United States of America
| | - K Deka
- Rush University Medical Center, Chicago, United States of America
| | - C Anderson
- Rush University Medical Center, Chicago, United States of America
| | | | - R Geroux
- Rush University Medical Center, Chicago, United States of America
| | - M Al-Amoodi
- Rush University Medical Center, Chicago, United States of America
| | - J White
- Rush University Medical Center, Chicago, United States of America
| | - C Kavinsky
- Rush University Medical Center, Chicago, United States of America
| |
Collapse
|
19
|
Garweg C, Bordachar P, Boveda S, Roberts P, Johansen J, Iacopino S, Clementy N, Winter S, Anderson C, Butler K, El-Chami M. Real-world experience on the safety and effectiveness of Micra TPS in patients with pre-existing in situ CIEDs. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0614] [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
The Micra pre-market study showed that the Micra transcatheter pacing system could be safely implanted in patients with pacing indications. Patients with pre-existing cardiac implantable electronic devices (CIED) were excluded from this clinical trial; however, this group of patients might benefit from a leadless pacemaker especially when a lead fails or after incidence of system-related infections.
Objective
To determine the outcome of patients with a pre-existing CIED or lead that remains in situ at the time of Micra implant attempt.
Methods
Patients who had a pre-existing CIED and/or lead at the time of Micra implantation attempt were identified from the Micra Post-Approval Registry and Micra Acute Performance studies. Baseline characteristics were summarized, and a Fine-Gray competing risk model was used to compare risk for major complication through 24 months for patients with and without a pre-existing CIED.
Results
Of the 2323 patients included in the analysis, 111 patients had a pre-existing CIED or lead at the time of Micra implantation attempt that remained in situ. Types of pre-existing devices included 81 pacemakers (45 single chamber, 32 dual chamber, 4 of unknown type), 10 ICDs (2 single chamber, 2 dual chamber, 6 unknown type), 10 CRT devices (6 CRT-P, 4 CRT-D), 3 generators of unknown type, and 7 patients had only leads remaining. Patients with pre-existing devices were younger and less likely to have a pacing indication of bradyarrhythmia with atrial fibrillation compared to patients without pre-existing devices (p<0.001 for both). Patients with prior devices were more likely to have a condition precluding implant of a transvenous pacemaker (67.6% vs. 21.3%, p<0.001). The presence of a pre-existing CIED did not impact the outcome of the Micra TPS implant procedure: implant success was >99% for both cohorts. Mean follow-up duration was 21.2±14.3 months (range 0–56) for pre-existing devices patients and 23.3±15.8 months (range 0–62) for other patients. The rate of major complications through 24 months was 1.8% for patients with and 3.8% for patients without prior devices (p=0.36). There were no major complications related to device malfunction or device-device interaction. There were 6 system revisions in 4 patients with preexisting devices and 52 revisions in 51 patients without preexisting devices. Pacing thresholds for patients with and without prior devices were similar at implant (0.72 and 0.63, respectively; p=0.31) and remained stable through 12 months.
Conclusion
Micra can be safely and successfully implanted in patients with a pre-existing CIED remaining in situ. It should be considered a treatment option for patients in whom CIED extraction may be deemed high risk.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Medtronic, Inc. Risk of major complications
Collapse
Affiliation(s)
- C Garweg
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - P Bordachar
- University Hospital of Bordeaux, Bordeaux, France
| | - S Boveda
- Clinic Pasteur, Toulouse, France
| | - P.R Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - S Iacopino
- Maria Cecilia Hospital, Cotignola, Italy
| | - N Clementy
- University Hospital of Tours, Tours, France
| | - S Winter
- St. Vinzenz-Hospital, Cologne, Germany
| | - C Anderson
- Medtronic, Mounds View, United States of America
| | - K Butler
- Medtronic, Mounds View, United States of America
| | - M.F El-Chami
- Emory University Hospital, Atlanta, United States of America
| |
Collapse
|
20
|
Al-Menhali AS, Anderson C, Gourine AV, Abramov AY, D'Souza A, Jaganjac M. Proteomic Analysis of Cardiac Adaptation to Exercise by High Resolution Mass Spectrometry. Front Mol Biosci 2021; 8:723858. [PMID: 34540898 PMCID: PMC8440823 DOI: 10.3389/fmolb.2021.723858] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/11/2021] [Accepted: 08/05/2021] [Indexed: 12/14/2022] Open
Abstract
Regular exercise has many health benefits, among which is a significant reduction of cardiovascular risk. Although many beneficial effects of exercise are well described, the exact mechanisms by which exercise confers cardiovascular benefits are yet to be fully understood. In the current study, we have used high resolution mass spectrometry to determine the proteomic responses of the heart to exercise training in mice. The impact of exercise-induced oxidative stress on modifications of cardiomyocyte proteins with lipid peroxidation biomarker 4-hydroxynonenal (4-HNE) was examined as well. Fourteen male mice were randomized into the control (sedentary) group and the exercise group that was subjected to a swim exercise training program for 5 days a week for 5 months. Proteins were isolated from the left ventricular tissue, fractionated and digested for shotgun proteomics. Peptides were separated by nanoliquid chromatography and analyzed on an Orbitrap Fusion mass spectrometer using high-energy collision–induced dissociation and electron transfer dissociation fragmentation. We identified distinct ventricular protein signatures established in response to exercise training. Comparative proteomics identified 23 proteins that were upregulated and 37 proteins that were downregulated with exercise, in addition to 65 proteins that were identified only in ventricular tissue samples of exercised mice. Most of the proteins specific to exercised mice are involved in respiratory electron transport and/or implicated in glutathione conjugation. Additionally, 10 proteins were found to be modified with 4-HNE. This study provides new data on the effects of exercise on the cardiac proteome and contributes to our understanding of the molecular mechanisms underlying the beneficial effects of exercise on the heart.
Collapse
Affiliation(s)
- Afnan Saleh Al-Menhali
- Division of Medicine, University College London, London, United Kingdom.,Qatar Analytics and BioResearch Lab, Anti Doping Lab Qatar, Doha, Qatar
| | - Cali Anderson
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Alexander V Gourine
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Andrey Y Abramov
- Department of Clinical and Movement Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Morana Jaganjac
- Division of Medicine, University College London, London, United Kingdom.,Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| |
Collapse
|
21
|
Mesirca P, Nakao S, Nissen SD, Forte G, Anderson C, Trussell T, Li J, Cox C, Zi M, Logantha S, Yaar S, Cartensen H, Bidaud I, Stuart L, Soattin L, Morris GM, da Costa Martins PA, Cartwright EJ, Oceandy D, Mangoni ME, Jespersen T, Buhl R, Dobrzynski H, Boyett MR, D'Souza A. Intrinsic Electrical Remodeling Underlies Atrioventricular Block in Athletes. Circ Res 2021; 129:e1-e20. [PMID: 33849278 DOI: 10.1161/circresaha.119.316386] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Pietro Mesirca
- IGF, Université de Montpellier, CNRS, INSERM, France (P.M., I.B., M.E.M.)
| | - Shu Nakao
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
- Department of Biomedical Sciences, Ritsumeikan University, Japan (S.N.)
| | - Sarah Dalgas Nissen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (S.D.N., H.C., R.B.), University of Copenhagen, Denmark
| | - Gabriella Forte
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Cali Anderson
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Tariq Trussell
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Jue Li
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Charlotte Cox
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Min Zi
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Sunil Logantha
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool, United Kingdom (S.L.)
| | - Sana Yaar
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Helena Cartensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (S.D.N., H.C., R.B.), University of Copenhagen, Denmark
| | - Isabelle Bidaud
- IGF, Université de Montpellier, CNRS, INSERM, France (P.M., I.B., M.E.M.)
| | - Luke Stuart
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | | | - Gwilym M Morris
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | | | - Elizabeth J Cartwright
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Delvac Oceandy
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| | - Matteo E Mangoni
- IGF, Université de Montpellier, CNRS, INSERM, France (P.M., I.B., M.E.M.)
| | - Thomas Jespersen
- Department of Biomedical Sciences (T.J., M.R.B.), University of Copenhagen, Denmark
| | - Rikke Buhl
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences (S.D.N., H.C., R.B.), University of Copenhagen, Denmark
| | - Halina Dobrzynski
- Department of Anatomy, Jagiellonian University Medical College, Poland (H.D.)
| | - Mark R Boyett
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
- Department of Biomedical Sciences (T.J., M.R.B.), University of Copenhagen, Denmark
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, United Kingdom (S.N., G.F., C.A., T.T., J.L., C.C., M.Z., S.L., S.Y., L. Stuart, L. Soattin, G.M.M., E.J.C., D.O., H.D., M.R.B., A.D.)
| |
Collapse
|
22
|
Barney J, Estee J, Lynch WG, Isobe T, Jhang G, Kurata-Nishimura M, McIntosh AB, Murakami T, Shane R, Tangwancharoen S, Tsang MB, Cerizza G, Kaneko M, Lee JW, Tsang CY, Wang R, Anderson C, Baba H, Chajecki Z, Famiano M, Hodges-Showalter R, Hong B, Kobayashi T, Lasko P, Łukasik J, Nakatsuka N, Olsen R, Otsu H, Pawłowski P, Pelczar K, Sakurai H, Santamaria C, Setiawan H, Taketani A, Winkelbauer JR, Xiao Z, Yennello SJ, Yurkon J, Zhang Y. The SπRIT time projection chamber. Rev Sci Instrum 2021; 92:063302. [PMID: 34243507 DOI: 10.1063/5.0041191] [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] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/23/2021] [Indexed: 06/13/2023]
Abstract
The Superconducting Analyzer for MUlti-particles from RAdioIsotope (SAMURAI) Pion-Reconstruction and Ion-Tracker Time Projection Chamber (SπRIT TPC) was designed to enable measurements of heavy ion collisions with the SAMURAI spectrometer at the RIKEN radioactive isotope beam factory and provides constraints on the equation of state of neutron-rich nuclear matter. The SπRIT TPC has a 50.5 cm drift length and an 86.4 × 134.4 cm2 pad plane with 12 096 pads that are equipped with the generic electronics for TPCs. The SπRIT TPC allows for an excellent reconstruction of particles and provides isotopic resolution for pions and other light charged particles across a wide range of energy losses and momenta. The details of the SπRIT TPC are presented, along with discussion of the TPC performance based on cosmic rays and charged particles emitted in heavy ion collisions.
Collapse
Affiliation(s)
- J Barney
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - J Estee
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - W G Lynch
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - T Isobe
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - G Jhang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | | | - A B McIntosh
- Cyclotron Institute, Texas A&M University, College Station, Texas 77843, USA
| | - T Murakami
- Department of Physics, Kyoto University, Kita-shirakawa, Kyoto 606-8502, Japan
| | - R Shane
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - S Tangwancharoen
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - M B Tsang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - G Cerizza
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - M Kaneko
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - J W Lee
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - C Y Tsang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - R Wang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - C Anderson
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - H Baba
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - Z Chajecki
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008, USA
| | - M Famiano
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008, USA
| | - R Hodges-Showalter
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - B Hong
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - P Lasko
- Institute of Nuclear Physics PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - J Łukasik
- Institute of Nuclear Physics PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - N Nakatsuka
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - R Olsen
- Gran Sasso National Laboratory-INFN, Via G. Acitelli 22, 67100 Assergi, L'Aquila AQ, Italy
| | - H Otsu
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - P Pawłowski
- Institute of Nuclear Physics PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - K Pelczar
- Gran Sasso National Laboratory-INFN, Via G. Acitelli 22, 67100 Assergi, L'Aquila AQ, Italy
| | - H Sakurai
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - C Santamaria
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - H Setiawan
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - A Taketani
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - J R Winkelbauer
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - Z Xiao
- Department of Physics, Tsinghua University, Beijing 100084, People's Republic of China
| | - S J Yennello
- Cyclotron Institute, Texas A&M University, College Station, Texas 77843, USA
| | - J Yurkon
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - Y Zhang
- Department of Physics, Tsinghua University, Beijing 100084, People's Republic of China
| |
Collapse
|
23
|
Garweg C, Clementy N, Mondoloy P, Winter S, Bordachar P, Sharman D, Jung W, Eschalier R, Theis C, Defaye P, Anderson C, Pol A, Roberts PR. A leadless pacemaker in the real-world setting: Patient profile and performance over time. Europace 2021. [DOI: 10.1093/europace/euab116.389] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Medtronic, Inc.
OnBehalf
Micra Acute Performance EMEA Investigators
Background
The first in-man implant of the Micra leadless pacemaker occurred in December 2013. While prior trials demonstrated a high implant success rate and favorable safety and efficacy results; whether the patient population and outcomes have changed over time is not well studied.
Purpose
To characterize the evolution of patient profile and outcomes for patients receiving a leadless pacemaker through the pre-market and post-market environment.
Methods
Patients undergoing a Micra leadless pacemaker implant attempt from the initial Micra Investigational Device Exemption [IDE] and current Micra studies (Micra post-approval registry [PAR], Micra acute performance [MAP] study) were analyzed. Patient characteristics and pericardial effusions regardless of severity were summarized.
Results
The 3466 patients included in the analysis underwent a Micra implant attempt and were enrolled during consecutive timeframes: patients from the Micra IDE study (n = 726) underwent a Micra implant attempt from 2013-2015, patients from the PAR (n = 1814) from 2015-2018, and patients from Micra MAP cohort (n = 926) from 2018 – 2020. Implant success was >99.0% in all 3 studies. Median age ranged from 78 – 79 years among the 3 studies without significant difference. There were more patients requiring dialysis in the MAP cohort compared to the PAR or IDE cohorts (10.3%, 7.9%, and 3.9%, respectively; P < 0.001), but fewer patients with congestive heart failure (8.3%, 13.1%, and 18.0%; P < 0.001). Pacing indication was significantly different between the studies, with fewer patients in MAP having an indication of bradyarrhythmia associated with atrial fibrillation (AF) and more having an indication associated with atrioventricular block without AF (P < 0.001). The number of patients considered to be precluded for a transvenous pacemaker implant increased significantly from the initial IDE study to the PAR and MAP studies (6.2%, 23.9%, and 44.1%, respectively, P < 0.001). Implant site placement was mostly apical for the IDE but shifted to mostly septal placement in the PAR and MAP (septal placement: 33.3%, 64.0%, and 79.5%, respectively). The rate of pericardial effusion regardless of severity was 1.79% (n = 13) in the IDE, 0.83% (n = 15) in the PAR, and 0.97% (n = 9) in MAP (figure). Mean pacing thresholds among MAP EMEA patients were low (0.61 ± 0.40V) at implant and remained stable through 12 months (0.62 +/- 0.41V).
Conclusion
Despite patient differences over time, the Micra leadless pacemaker was implanted with a high success rate and a low perforation rate, in-line with prior reports. Abstract Figure. Pericardial effusion rate by study
Collapse
Affiliation(s)
- C Garweg
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - N Clementy
- Centre Hospitalier Régional Universitaire de Tours, France, Tours, France
| | - P Mondoloy
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - S Winter
- St. Vinzenz Hospital (Köln), Cologne, Germany
| | - P Bordachar
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - D Sharman
- Northampton General Hospital (Cliftonville), Cliftonville, Northampton, United Kingdom of Great Britain & Northern Ireland
| | - W Jung
- Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany
| | - R Eschalier
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Theis
- Robert Bosch Hospital, Stuttgart, Germany
| | | | - C Anderson
- Medtronic, Mounds View, United States of America
| | - A Pol
- Bakken Research Center, Maastricht, Netherlands (The)
| | - PR Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
24
|
Anderson C, Bae-Jump V, Broaddus RR, Olshan AF, Nichols HB. Long-term Patterns of Excess Mortality among Endometrial Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1055-9965.epi-21-0212] [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: 11/16/2022] Open
Abstract
Abstract
Purpose of the study: Examining long-term patterns of mortality among cancer survivors compared to the general population may inform planning for surveillance and follow-up care. We investigated excess mortality after endometrial cancer using conditional relative survival estimates and standardized mortality ratios (SMRs). Methods: Women diagnosed with endometrial cancer during 2000–2017 (N = 183,153) were identified in the Surveillance, Epidemiology, and End Results (SEER) database. SMRs were calculated as observed deaths among endometrial cancer survivors over expected deaths among demographically similar women in the general U.S. population. Five-year relative survival was estimated at diagnosis and each additional year survived up to 12 years post-diagnosis, conditional on survival up to that year. Results: For the full cohort, 5-year relative survival was 87.7%, 96.2%, and 97.1% at 1, 5, and 10 years post- diagnosis. respectively. Conditional 5-year relative survival first exceeded 95%, reflecting minimal excess mortality compared to the general population, at 4 years post-diagnosis overall, but occurred later for Black women (8 years) compared to White (4 years), and also later for women with regional/distant stage, grade 3 disease, or non- endometrioid histology. The overall SMR for all-cause mortality decreased from 5.90 (95% CI: 5.81–5.99) in the first year after diagnosis to 1.16 (95% CI: 1.13–1.19) at 10+ years; SMRs were consistently higher for non-White women and those with higher stage or grade disease. Conclusions: Overall, endometrial cancer survivors had only a small survival deficit beyond 4 years post- diagnosis. However, excess mortality was greater in magnitude and persisted longer into survivorship for Black women and those with more advanced disease.
Collapse
|
25
|
Abstract
Abstract
Introduction
Significant alterations occur in human physiology and the way medications function in space (1). Understanding the efficacy and pitfalls of pharmacological intervention and developing space-related pharmacy services is therefore integral to ensuring a sustained presence for human spaceflight. In contemporary society, the pharmacist plays a significant role in a person’s health. However, pharmacist input towards the spaceflight participant’s health is minimal to nil.
Aim: T
o explore stakeholder perspectives towards the role of Astropharmacy in the space sector.
Methods
Pharmacists (n = 18) across the globe and space sector participants (n = 18) from governmental, commercial, and space tourism sectors participated, via 27 qualitative interviews and three focus groups. Participants were recruited via purposive and snowball sampling. A six-step thematic analysis was used and mapped into the Job Characteristics Model (JCM). JCM is a theory within work design, aiming to promote work experiences and personal outcomes. There are five job dimensions – skill variety, task identity, task significance, autonomy, and feedback which influence three psychological states required for a well-designed job. The three psychological states are meaningfulness, responsibility, and knowledge of work results, which lead to positive work and personal experiences (2).
Results
Three key themes were generated: medication management, medication research, and regulation/licensing. Medication management encompassed safeguarding the space traveller’s health, like space tourists, by conducting medication reviews (pre-and post-flight), medication advice (digital astro-telepharmacy information services during spaceflight) and developing personalised medication. Medication management also included ensuring shelf-life and continuous medication supply for deep space exploration. Medication research included novel drug development, innovative manufacturing, and understanding clinical applications of the pharmacokinetic and pharmacodynamic changes of medications in space. Innovative manufacturing like 3-D printing raises questions regarding the need for regulations/licensing of medications use and manufacturing in space. Based on the JCM our findings indicate that Astropharmacy possesses diverse duties eliciting meaningfulness, with clear responsibility and observable workplace results promoting task significance, and both the medication and patient focus promoting task identity. Autonomy was blurred within Astropharmacy as a degree of autonomy is needed due to the field’s novelty, but workforce regulations by governmental space agencies are expected. Lastly, workplace feedback can be achieved in Astropharmacy through performance reviews.
Conclusion
The Astropharmacy role is perceived to involve medication management, medication research and regulation/licensing of medications for space. The work design of astropharmacy is well-reflected in the JCM, implying that a novel and energising opportunity for the pharmacy profession is forthcoming. Although the data generated by qualitative research are not generalizable to other settings, these themes represent the first study to investigate the space sector qualitatively in the context of pharmacy, providing rich foundational data for future research. Consequently, the amalgamation of two previously distinct workplace domains may be a conceivable reality for the future of pharmacy practice.
References
1. Blue RS, Bayuse TM et al. Supplying a pharmacy for NASA exploration spaceflight: challenges and current understanding. Npj Microgravity. 2019;5(1):1–12.
2. Hackman RJ, Oldham G. Motivation through the design of work: Test of a theory. Organizational Behavior and Human Performance. 1976;16(2):250–279.
Collapse
Affiliation(s)
- L Sawyers
- University of Nottingham, School of Pharmacy
| | - C Anderson
- University of Nottingham, School of Pharmacy
| | - M Boyd
- University of Nottingham, School of Pharmacy
| | - P Williams
- University of Nottingham, School of Pharmacy
| | - L S Toh
- University of Nottingham, School of Pharmacy
| |
Collapse
|
26
|
Iqbal A, Toh LS, Knaggs RD, Anderson C. Factors promoting self-medication and irrational use of opioids in chronic non-malignant pain management in Pakistan: A qualitative in-depth investigation. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.039] [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: 11/12/2022]
Abstract
Abstract
Introduction
In many Lower and Middle-Income Countries (LMICs) people self-medicate, with non-prescription and prescription drugs both of which are easily available over the counter (1). One of the most common causes for self-medication is chronic pain (2). The role of community pharmacists becomes critical especially in LMICs where medicines are freely available and pharmacists are directly involved in supply of opioid medicines. Unresolved, prolonged chronic non-malignant pain (CNMP) may lead to self-medication with opioid analgesics and can cause irrational use of opioids. The complications of self-medication with opioids are vast in terms of both scarce resources and adverse clinical consequences such as adverse drug reactions, drug interactions and mortality associated with the diversion from intended use of opioid medicines. Self- medication with opioid analgesics in LMICs have not been explored before.
Aim
This study was designed to explore the factors that might contribute in promoting self-medication and irrational opioid medicine use in CNMP management and exploring potential roles of community pharmacists in stopping/avoiding self-medication with opioids in one LMIC, Pakistan.
Method
Qualitative interviews involving various stakeholders such as pharmacy policy makers (n=10) and people suffering from CNMP (n=12) were conducted. Additionally, focus groups were conducted with community pharmacists (n=38) and doctors (n=30). A semi-structured interview guide was drafted after an extensive literature review and was used for individual interviews and focus groups for each stakeholder respectively. The study duration was from December 2019 to July 2020. Critical case sampling, a type of purposive sampling, was done in order to promote applicability to other cases. Data was analysed using a CAQDAS software N-vivo 12, using thematic analysis. Ethical approval was obtained.
Results
Non-availability of community pharmacists in all pharmacies and lack of medication review services are amongst the major factors that are contributing towards self-medication of opioid medicines. Additionally, lack of awareness of people about opioid medicines and absence of strict laws regarding sale of opioid medicines under a valid prescription allows easy availability and promotes aberrant drug seeking behaviour. These factors contribute towards people not seeking professional health care services for the management of CNMP and continue self-medicating with opioid medicines. As a result, they do not get effective analgesic relief and waste limited financial resources. The major themes and sub-themes are presented in Table 1.
Conclusion
Self-medication with opioid medicines can cause irrational, inappropriate, and ineffective use of medicines and can additionally burden the limited financial resources available for health care needs. This in-depth exploratory study identifies many barriers that can promote self-medication with opioids and recognises a need for a multi-faceted intervention involving community pharmacists to promote rational opioid medicine use. However, major limitations of the proposed intervention identified from this study are the absence of integrated health systems and under-utilisation of community pharmacy workforce. The government needs to invest in infrastructure development, develop new health policies regarding medicine sale and build the role and capacity of pharmacy workforce to perform specialised roles in public safety especially in opioid medicines.
References
1. Bennadi D. Self-medication: A current challenge. Journal of basic and clinical pharmacy. 2013;5(1):19.
2. Kaushal J, Gupta MC, Jindal P, Verma S. Self-medication patterns and drug use behavior in housewives belonging to the middle income group in a city in northern India. Indian journal of community medicine: official publication of Indian association of preventive & social medicine. 2012;37(1):16.
Collapse
Affiliation(s)
- A Iqbal
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
| | - L S Toh
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
| | - R D Knaggs
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
- Primary Integrated Community Solutions, Nottingham, United Kingdom
| | - C Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
| |
Collapse
|
27
|
Bidaud I, D'Souza A, Forte G, Torre E, Greuet D, Thirard S, Anderson C, Chung You Chong A, Torrente AG, Roussel J, Wickman K, Boyett MR, Mangoni ME, Mesirca P. Genetic Ablation of G Protein-Gated Inwardly Rectifying K + Channels Prevents Training-Induced Sinus Bradycardia. Front Physiol 2021; 11:519382. [PMID: 33551824 PMCID: PMC7857143 DOI: 10.3389/fphys.2020.519382] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Endurance athletes are prone to bradyarrhythmias, which in the long-term may underscore the increased incidence of pacemaker implantation reported in this population. Our previous work in rodent models has shown training-induced sinus bradycardia to be due to microRNA (miR)-mediated transcriptional remodeling of the HCN4 channel, leading to a reduction of the "funny" (I f) current in the sinoatrial node (SAN). Objective: To test if genetic ablation of G-protein-gated inwardly rectifying potassium channel, also known as I KACh channels prevents sinus bradycardia induced by intensive exercise training in mice. Methods: Control wild-type (WT) and mice lacking GIRK4 (Girk4 -/-), an integral subunit of I KACh were assigned to trained or sedentary groups. Mice in the trained group underwent 1-h exercise swimming twice a day for 28 days, 7 days per week. We performed electrocardiogram recordings and echocardiography in both groups at baseline, during and after the training period. At training cessation, mice were euthanized and SAN tissues were isolated for patch clamp recordings in isolated SAN cells and molecular profiling by quantitative PCR (qPCR) and western blotting. Results: At swimming cessation trained WT mice presented with a significantly lower resting HR that was reversible by acute I KACh block whereas Girk4 -/- mice failed to develop a training-induced sinus bradycardia. In line with HR reduction, action potential rate, density of I f, as well as of T- and L-type Ca2+ currents (I CaT and I CaL ) were significantly reduced only in SAN cells obtained from WT-trained mice. I f reduction in WT mice was concomitant with downregulation of HCN4 transcript and protein, attributable to increased expression of corresponding repressor microRNAs (miRs) whereas reduced I CaL in WT mice was associated with reduced Cav1.3 protein levels. Strikingly, I KACh ablation suppressed all training-induced molecular remodeling observed in WT mice. Conclusion: Genetic ablation of cardiac I KACh in mice prevents exercise-induced sinus bradycardia by suppressing training induced remodeling of inward currents I f, I CaT and I CaL due in part to the prevention of miR-mediated transcriptional remodeling of HCN4 and likely post transcriptional remodeling of Cav1.3. Strategies targeting cardiac I KACh may therefore represent an alternative to pacemaker implantation for bradyarrhythmias seen in some veteran athletes.
Collapse
Affiliation(s)
- Isabelle Bidaud
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.,LabEx Ion Channels Science and Therapeutics, Montpellier, France
| | - Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Gabriella Forte
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Eleonora Torre
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.,LabEx Ion Channels Science and Therapeutics, Montpellier, France
| | - Denis Greuet
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Steeve Thirard
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Cali Anderson
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Antony Chung You Chong
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.,LabEx Ion Channels Science and Therapeutics, Montpellier, France
| | - Angelo G Torrente
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.,LabEx Ion Channels Science and Therapeutics, Montpellier, France
| | - Julien Roussel
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Kevin Wickman
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
| | - Mark R Boyett
- Division of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Matteo E Mangoni
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.,LabEx Ion Channels Science and Therapeutics, Montpellier, France
| | - Pietro Mesirca
- Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France.,LabEx Ion Channels Science and Therapeutics, Montpellier, France
| |
Collapse
|
28
|
D'Souza A, Wang Y, Anderson C, Bucchi A, Baruscotti M, Olieslagers S, Mesirca P, Johnsen AB, Mastitskaya S, Ni H, Zhang Y, Black N, Cox C, Wegner S, Bano-Otalora B, Petit C, Gill E, Logantha SJRJ, Dobrzynski H, Ashton N, Hart G, Zhang R, Zhang H, Cartwright EJ, Wisloff U, Mangoni ME, da Costa Martins PA, Piggins HD, DiFrancesco D, Boyett MR. A circadian clock in the sinus node mediates day-night rhythms in Hcn4 and heart rate. Heart Rhythm 2020; 18:801-810. [PMID: 33278629 PMCID: PMC8073545 DOI: 10.1016/j.hrthm.2020.11.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/09/2020] [Accepted: 11/21/2020] [Indexed: 11/26/2022]
Abstract
Background Heart rate follows a diurnal variation, and slow heart rhythms occur primarily at night. Objective The lower heart rate during sleep is assumed to be neural in origin, but here we tested whether a day-night difference in intrinsic pacemaking is involved. Methods In vivo and in vitro electrocardiographic recordings, vagotomy, transgenics, quantitative polymerase chain reaction, Western blotting, immunohistochemistry, patch clamp, reporter bioluminescence recordings, and chromatin immunoprecipitation were used. Results The day-night difference in the average heart rate of mice was independent of fluctuations in average locomotor activity and persisted under pharmacological, surgical, and transgenic interruption of autonomic input to the heart. Spontaneous beating rate of isolated (ie, denervated) sinus node (SN) preparations exhibited a day-night rhythm concomitant with rhythmic messenger RNA expression of ion channels including hyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4). In vitro studies demonstrated 24-hour rhythms in the human HCN4 promoter and the corresponding funny current. The day-night heart rate difference in mice was abolished by HCN block, both in vivo and in the isolated SN. Rhythmic expression of canonical circadian clock transcription factors, for example, Brain and muscle ARNT-Like 1 (BMAL1) and Cryptochrome (CRY) was identified in the SN and disruption of the local clock (by cardiomyocyte-specific knockout of Bmal1) abolished the day-night difference in Hcn4 and intrinsic heart rate. Chromatin immunoprecipitation revealed specific BMAL1 binding sites on Hcn4, linking the local clock with intrinsic rate control. Conclusion The circadian variation in heart rate involves SN local clock–dependent Hcn4 rhythmicity. Data reveal a novel regulator of heart rate and mechanistic insight into bradycardia during sleep.
Collapse
Affiliation(s)
- Alicia D'Souza
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
| | - Yanwen Wang
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Cali Anderson
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Annalisa Bucchi
- Department of Biosciences, University of Milan, Milan, Italy
| | | | - Servé Olieslagers
- Department of Cardiology, Maastricht University, Maastricht, The Netherlands
| | - Pietro Mesirca
- Institut de Génomique Fonctionnelle, Université de Montpellie, CNRS, Montpellier, France
| | - Anne Berit Johnsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Svetlana Mastitskaya
- Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Haibo Ni
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Yu Zhang
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Nicholas Black
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Charlotte Cox
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Sven Wegner
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Beatriz Bano-Otalora
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Cheryl Petit
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Eleanor Gill
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Sunil Jit R J Logantha
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Liverpool Centre for Cardiovascular Sciences, University of Liverpool, Liverpool, UK
| | - Halina Dobrzynski
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Nick Ashton
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - George Hart
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Rai Zhang
- School of Civil, Aerospace and Mechanical Engineering, University of Bristol, Bristol, United Kingdom
| | - Henggui Zhang
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Elizabeth J Cartwright
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Ulrik Wisloff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Matteo E Mangoni
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Hugh D Piggins
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Dario DiFrancesco
- Department of Biosciences, University of Milan, Milan, Italy; IBF-CNR, Milan, Italy
| | - Mark R Boyett
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
29
|
Pendyala P, Almeldin D, Andrews T, Maloney-Patel N, August D, Anderson C, Jabbour S, Chundury A. Exploring the Dose-response Relationship in Locally Advanced Rectal Cancer Utilizing Dosimetric Parameters. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1900] [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]
|
30
|
Schiavone S, Anderson C, Mons U, Winkler V. Prevalence of second-hand tobacco smoke in relation to smoke-free legislation in the European Union. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1263] [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: 11/12/2022] Open
Abstract
Abstract
Background
Second-hand smoke (SHS) is still an important public health problem. With joining the Framework Convention on Tobacco Control (FCTC), all parties acknowledged the health risks of SHS and agreed to implement policies to protect their populations from SHS in public places. The aim of this study was to explore the SHS exposure in restaurants and bars as well as its associations with smoke-free legislation in the European Union.
Methods
Data of Eurobarometer surveys 2014 and 2017 were used to estimate prevalence of SHS exposure. We also extracted data on individual confounders such as smoking status, gender, sex, age and information on social economic status. Additionally, we collected data on country specific data on smoking regulations in restaurants and bars from the Tobacco Control Scale to analyse associations with SHS exposure using multilevel logistic regression. Smoking regulations were categorized into the following three categories: partial ban, comprehensive ban with minor exceptions, and complete ban.
Results
Preliminary results on the prevalence of SHS in restaurants showed a decrease from 11.8% (95% confidence intervals (CI) 11.2-12.5) in 2014 to 8.8% (95% CI 8.3-9.3) in 2017. The crude multilevel model controlling only for smoking prevalence resulted in an odds ratio of 0.39 (95% CI 0.19-0.77) for comprehensive ban with minor exceptions and 0.28 (95% CI 0.16-0.50) for complete ban versus partial ban. Odds ratios remained at significant levels when controlling for all available confounders.
Conclusions
Between 2014 and 2017, SHS exposure in restaurants decreased significantly. Furthermore, strong associations with smoking regulations were observed suggesting a high compliance. Many tobacco control policies have been introduced during the last years but several countries need to strengthen their smoke-free tobacco control policies to further reduce SHS exposure preventing death, disease and disability.
Key messages
SHS exposure remains a significant public health challenge. The implementation of effective measures could be strengthened through a convergence of tobacco control strategies and policies among European Union member states.
Collapse
Affiliation(s)
- S Schiavone
- Department of Experimental Medicine, University of Campania, Naples, Italy
| | - C Anderson
- Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - U Mons
- Cancer Prevention Unit, German Cancer Research Center, Heidelberg, Germany
| | - V Winkler
- Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
31
|
Moore K, Bookman M, Sehouli J, Miller A, Anderson C, Scambia G, Myers T, Taskiran C, Robison K, Maenpaa J, Willmott L, Colombo N, Thomes-Pepin J, Gold M, Aghajanian C, Wu F, Molinero L, Khor V, Lin Y, Pignata S. LBA31 Primary results from IMagyn050/GOG 3015/ENGOT-OV39, a double-blind placebo (pbo)-controlled randomised phase III trial of bevacizumab (bev)-containing therapy +/- atezolizumab (atezo) for newly diagnosed stage III/IV ovarian cancer (OC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
32
|
Abstract
A number of studies have investigated anticipatory behaviour in animals as a measure of sensitivity to reward or as an expression of emotional state. A common feature of many studies is that they base inferences on seemingly arbitrary measures, for example, the frequency of behavioural
transitions (ie number of times an animal switches between different behaviours). This paper critically reviews the literature and discusses various hypotheses for why specific behavioural responses occur in the anticipatory period between the signal and reward in conditioned animals. We argue
that the specific behaviours shown may be the result of superstitious learning and thus highly variable, leaving behavioural transitions as the only response that can be scored consistently, and that sometimes these responses may relate more to frustration than to a positive emotional state.
Finally, we propose new research approaches to avoid potential confounds and improve future studies on this topic.
Collapse
|
33
|
Ilson D, Moughan J, Safran H, Wigle D, Depetrillo T, Haddock M, Hong T, Leichman L, Rajdev L, Resnick M, Kachnic L, Seaward S, Mamon H, Pardo DD, Anderson C, Shen X, Sharma A, Katz A, Salo J, Leonard K, Crane C. O-10 Trastuzumab with trimodality treatment for esophageal adenocarcinoma with HER2 overexpression: NRG Oncology/RTOG 1010. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
34
|
White B, Billari W, Musiol J, Anderson C. 3:09 PM Abstract No. 43 Below-the-ankle interventions for critical limb ischemia: safety and efficacy in an office-based practice. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.066] [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: 11/16/2022] Open
|
35
|
Ramesh R, Kalin L, Hantush M, Rezaeinzadeh M, Anderson C. Challenges Calibrating Hydrology for Groundwater-Fed Wetlands: a Headwater Wetland Case Study. Environ Model Assess (Dordr) 2020; 25:355-371. [PMID: 35574564 PMCID: PMC9104761 DOI: 10.1007/s10666-019-09684-8] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/10/2019] [Indexed: 06/15/2023]
Abstract
This study aims to adapt the Soil and Watershed Assessment Tool (SWAT), a ubiquitously used watershed model, for ground-water dominated surface waterbodies by accounting for recharge from the aquifers. Using measured flow to a headwater slope wetland in Alabama's coastal plain region as a case study, we present challenges and relatively simple approaches in using the SWAT model to predict flows from the draining watershed and relatively simple approaches to model groundwater upwelling. SWAT-simulated flow at the study watershed was limited by precipitation, and consequently, simulated flows were several times smaller in magnitude than observed flows. Thus, our first approach involved a separate stormflow and baseflow calibration which included the use of a regression relationship between observed and simulated baseflow (E NASH = 0.67). Our next approach involved adapting SWAT to simulate upwelling groundwater discharge instead of deep aquifer losses by constraining the range of deep losses, β deep parameter, to negative values (E NASH = 0.75). Finally, we also investigated the use of artificial neural networks (ANN) in conjunction with SWAT to further improve calibration performance. This approach used SWAT-calibrated flow, evapotranspiration, and precipitation as inputs to ANN (E NASH = 0.88). The methods investigated in this study can be used to navigate similar flow calibration challenges in other groundwater dominant watersheds which can be very useful tool for managers and modelers alike.
Collapse
Affiliation(s)
- R. Ramesh
- School of Forestry and Wildlife Sciences, Auburn University, 602 Duncan Drive, Auburn, AL 36849, USA
| | - L. Kalin
- School of Forestry and Wildlife Sciences, Auburn University, 602 Duncan Drive, Auburn, AL 36849, USA
| | - M. Hantush
- Center for Environmental Solutions and Emergency Response, U.S. Environmental Protection Agency, 26 West Martin Luther King Dr., Cincinnati, OH 45268, USA
| | | | - C. Anderson
- School of Forestry and Wildlife Sciences, Auburn University, 602 Duncan Drive, Auburn, AL 36849, USA
| |
Collapse
|
36
|
McMahon W, Ftouni S, Collet J, Diep C, Rajaratnam S, Maruff P, Drummond S, Anderson C. Task-dependent effects of the wake maintenance zone on cognition and alertness, with and without sleep loss. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.698] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
37
|
Linz D, Loffler K, Sanders P, Catcheside P, Anderson C, Redline S, McEvoy D, Baumert M. P4404Prognostic value of novel nocturnal oxygen saturation metrics in patients with obstructive sleep apnoea and high cardiovascular event risk. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0809] [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: 11/14/2022] Open
Abstract
Abstract
Aim
To determine prognostic value of novel oximetry-derived metrics in patients with obstructive sleep apnoea (OSA) and high cardiovascular (CV) event risk.
Methods and results
Ancillary study of the Sleep Apnoea CV Endpoints (SAVE) randomised controlled trial, which investigated the effects of CPAP treatment on secondary CV event outcomes in 2687 participants with moderate-severe OSA and established CV disease. Associations between baseline characteristics, standard sleep and pulse oximetry-derived metrics, and CV outcomes were determined in Cox proportional hazards regression models stratified for treatment allocation. Metrics evaluated included: oxygen desaturation index, time below 90% oxygen saturation (SpO2), average SpO2across recordings (mean SpO2), across episodic desaturation events (desaturation SpO2), and baseline interpolated through episodic desaturation events (baseline SpO2); duration and desaturation/resaturation time ratio of episodic desaturation events; and mean and standard deviation of pulse rate. No SpO2 metric was associated with the composite outcome. Mean and baseline SpO2 were negatively associated with heart failure (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.69–0.95; P=0.009 and 0.78, 0.67–0.90; P=0.001, respectively) and myocardial infarction risk (0.86, 0.77–0.95; P=0.003 and 0.81, 0.73–0.90; P<0.001, respectively) and marginally positively associated with stroke risk (1.09, 1.00–1.20; P=0.065 and 1.13, 1.02–1.26; P=0.020, respectively). Desaturation duration and desaturation/resaturation time ratio, with established risk factors, predicted heart failure (area under the receiver-operating-characteristic curve 0.86, 95% CI 0.79–0.93).
Conclusions
Higher mean and baseline SpO2 were associated with reduced risk of heart failure and myocardial infarction, and small increases in stroke rate. Desaturation shape may have predictive utility for future CV events.
Clinical trial registration: clinicaltrials (NCT00738179).
Collapse
Affiliation(s)
- D Linz
- University of Adelaide, Adelaide, Australia
| | - K Loffler
- Flinders Medical Centre and Flinders University, Adelaide Institute for Sleep Health (AISH), Adelaide, Australia
| | - P Sanders
- University of Adelaide, Adelaide, Australia
| | - P Catcheside
- Flinders Medical Centre and Flinders University, Adelaide Institute for Sleep Health (AISH), Adelaide, Australia
| | - C Anderson
- The George Institute for Global Health, Sydney, Australia
| | - S Redline
- Harvard Medical School, Boston, United States of America
| | - D McEvoy
- Flinders Medical Centre and Flinders University, Adelaide Institute for Sleep Health (AISH), Adelaide, Australia
| | - M Baumert
- University of Adelaide, Adelaide, Australia
| |
Collapse
|
38
|
Nyiranshuti L, Abadjian C, Herneisey M, Liu L, Bellavia M, Janjic J, Anderson C. PET-MR amenable theranostic perfluorocarbon nanoemulsion for targeting inflammation. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30294-x] [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]
|
39
|
Chalmers J, Wang X, Moullaali T, Minhas J, Anderson C, Robinson T. ASSOCIATIONS OF EARLY BLOOD PRESSURE CONTROL AND OUTCOME IN THROMBOLYSIS-ELIGIBLE ACUTE ISCHAEMIC STROKE IN THE ENHANCED CONTROL OF HYPERTENSION AND THROMBOLYSIS STROKE STUDY. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000570324.46857.06] [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]
|
40
|
Koulidis K, Veremis Y, Heneghan N, Anderson C. Diagnostic accuracy of upper limb neurodynamic tests for the assessment of peripheral neuropathic pain: a systematic review. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.301] [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: 10/27/2022]
|
41
|
Anderson C, Robinson EJ, Krooupa AM, Henderson C. Changes in newspaper coverage of mental illness from 2008 to 2016 in England. Epidemiol Psychiatr Sci 2018; 29:e9. [PMID: 30511612 PMCID: PMC8061298 DOI: 10.1017/s2045796018000720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/30/2018] [Accepted: 11/04/2018] [Indexed: 11/08/2022] Open
Abstract
AIMS Since 2008 England's anti-stigma programme Time to Change has lobbied media outlets about stigmatising coverage and worked with them to promote accurate and non-stigmatising coverage. While this may have an impact on coverage and hence attitudes, it is also possible that coverage can change in response to improving attitudes, through the creation of a market demand for less stigmatising coverage. This study evaluates English newspaper coverage of mental health topics between 2008 and 2016. METHOD Articles covering mental health in 27 newspapers were retrieved using keyword searches on two randomly chosen days each month in 2008-2016, excluding 2012 and 2015 due to restricted resources. Content analysis used a structured coding framework. Univariate logistic regression models were used to estimate the odds of each hypothesised element occurring in 2016 compared with 2008 and Wald tests to assess the overall statistical significance of the year variable as the predictor. RESULTS The sample retrieved almost doubled between 2008 (n = 882) and 2016 (n = 1738). We found a significant increase in the proportion of anti-stigmatising articles (odds ratio (OR) 2.26 (95% confidence interval (CI) 1.86-2.74)) and a significant decrease in stigmatising articles (OR 0.62 (95% CI 0.51-0.75)). Reports on all diagnoses except for schizophrenia were more often anti-stigmatising than stigmatising. CONCLUSIONS This is the first clear evidence of improvement in coverage since the start of Time to Change. However, coverage of schizophrenia may be less affected by this positive shift than that of other diagnoses. The increase in the level of coverage identified in 2016 requires further investigation, as it may also influence public conceptualisation of what constitutes mental illness, attitudes to mental illness in general and/or specific diagnoses. While most anti-stigma programmes are not diagnosis specific, we suggest their evaluation would benefit from a diagnosis specific approach to allow fuller interpretation of their effects. This could include media analysis driven by hypotheses based on diagnoses to ascertain whether variations by diagnosis over time occur both in the nature and in the proportion of coverage.
Collapse
Affiliation(s)
- C. Anderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E. J. Robinson
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A.-M. Krooupa
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - C. Henderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
42
|
Song SV, Anderson C, Good RT, Leslie S, Wu Y, Oakeshott JG, Robin C. Population differentiation between Australian and Chinese Helicoverpa armigera occurs in distinct blocks on the Z-chromosome. Bull Entomol Res 2018; 108:817-830. [PMID: 29397798 DOI: 10.1017/s0007485318000081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Over the last 40 years, many types of population genetic markers have been used to assess the population structure of the pest moth species Helicoverpa armigera. While this species is highly vagile, there is evidence of inter-continental population structure. Here, we examine Z-chromosome molecular markers within and between Chinese and Australian populations. Using 1352 polymorphic sites from 40 Z-linked loci, we compared two Chinese populations of moths separated by 700 km and found virtually no population structure (n = 41 and n = 54, with <1% of variation discriminating between populations). The levels of nucleotide diversity within these populations were consistent with previous estimates from introns in Z-linked genes of Australian samples (π = 0.028 vs. 0.03). Furthermore, all loci surveyed in these Chinese populations showed a skew toward rare variants, with ten loci having a significant Tajima's D statistic, suggesting that this species could have undergone a population expansion. Eight of the 40 loci had been examined in a previous study of Australian moths, of which six revealed very little inter-continental population structure. However, the two markers associated with the Cyp303a1 locus that has previously been proposed to be a target of a selective sweep, exhibited allele structuring between countries. Using a separate dataset of 19 Australian and four Chinese moths, we scanned the molecular variation distributed across the entire Z-chromosome and found distinct blocks of differentiation that include the region containing Cyp303a1. We recommend some of these loci join those associated with insecticide resistance to form a set of genes best suited to analyzing population structure in this global pest.
Collapse
Affiliation(s)
- S V Song
- School of Biosciences, University of Melbourne,Victoria,Australia
| | - C Anderson
- MRC Human Genetics Unit,MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital,Edinburgh,UK
| | - R T Good
- School of Biosciences, University of Melbourne,Victoria,Australia
| | - S Leslie
- School of Biosciences, University of Melbourne,Victoria,Australia
| | - Y Wu
- College of Plant Protection, Nanjing Agricultural University,Nanjing,China
| | - J G Oakeshott
- Land and Water Flagship,Commonwealth Scientific and Industrial Research Organisation,Australian Capital Territory,Australia
| | - C Robin
- School of Biosciences, University of Melbourne,Victoria,Australia
| |
Collapse
|
43
|
Sage A, Stewart G, Rowbotham D, Enfield K, Marshall E, Martinez V, Anderson C, Lam W. MA24.07 A Novel cis-Acting lncRNA Controls HMGA1 Expression in Lung Adenocarcinoma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.525] [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]
|
44
|
Alipour P, Azizi Z, Anderson C, Holbrook R, Sadri S, Sadri H, Khaykin Y. HEALTHCARE RELATED COSTS ASSOCIATED WITH RADIOFREQUENCY VERSUS CRYOBALLOON CATHETER ABLATION: FIRE AND ICE TRIAL CANADIAN HEALTH ECONOMIC STUDY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.282] [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] Open
|
45
|
Baines N, Anderson C, Tobin P. A Coordinated Approach to Lung Cancer Screening in Canada. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.13600] [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: 11/20/2022] Open
Abstract
Background and context: Lung cancer screening with low-dose computed tomography is recommended by the Canadian Task Force on Preventive Health Care for individuals at high risk. While no organized lung cancer screening programs currently exist, several Canadian jurisdictions have begun to plan for program implementation with pilot programs, studies, or business cases. Aim: The Canadian Partnership Against Cancer (the Partnership) has supported lung cancer screening activities by initiating a series of projects to promote lung health in Canada. Strategy/Tactics: The Partnership responded to emerging evidence on lung cancer screening with the establishment of the Pan-Canadian Lung Cancer Screening Network (PLCSN) in 2012. The PLCSN brings together key stakeholders from across Canada to promote pan-Canadian collaboration and serves as a national platform for knowledge exchange. Program/Policy process: One of the first priorities of the PLCSN was the development of a consensus statement-based Lung Cancer Screening Framework for Canada in 2014. The Framework outlines key considerations for lung cancer screening programs, including screening eligibility, radiologic testing, pathology quality and reporting, diagnostic treatment and follow-up, and the inclusion of smoking cessation interventions. As the development of the Framework drew to completion, the second priority of the PLCSN was the development of national quality indicators for lung cancer screening. An initial set of ten national-level lung cancer screening quality indicators was developed for national reporting. Most recently, the PLCSN developed a list of five quality-related lung cancer screening questions that should be explored in advance of the widespread implementation of lung cancer screening programs. These considerations included eligibility, enrollment, smoking cessation, nodule management and the effect of lung cancer screening programs on projected lung cancer mortality. Other Partnership initiatives to promote lung health include health economic modeling for lung cancer screening and collecting data on evidence-based smoking cessation programs. Outcomes: These initiatives have aligned pan-Canadian lung cancer screening efforts to facilitate knowledge sharing and resource efficiency, standardization of data collection and reporting, and acceleration of lung cancer screening in Canada. As of January 2018, four provinces have completed business cases, one province has implemented a pilot study, and three trials are ongoing across the country. Partnership initiatives and resources were used by several jurisdictions to inform the development of lung health activities. What was learned: By initiating these activities in advance of organized lung cancer screening programs, the Partnership has contributed to the evidence base on best practices in lung cancer screening that will be necessary for successful program implementation.
Collapse
|
46
|
Kosari S, Walker EJ, Anderson C, Peterson GM, Naunton M, Castillo Martinez E, Garg S, Thomas J. Power outages and refrigerated medicines: The need for better guidelines, awareness and planning. J Clin Pharm Ther 2018; 43:737-739. [PMID: 29900564 DOI: 10.1111/jcpt.12716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Vaccines and other pharmaceuticals are essential medical supplies that require continuous storage at specific temperatures to maintain viability. Power outages can lead to a break in the cold chain, resulting in the degradation of essential medicines. COMMENT After a power outage, the stability of vaccines and other medicines can be difficult to ascertain. Many public health guidelines therefore recommend discarding potentially compromised pharmaceuticals unless the cold chain can be guaranteed-a costly endeavour. There are government guidelines aimed at minimizing exposure to high temperatures in the event of a power outage; however, the usefulness of these guidelines is uncertain. WHAT IS NEW AND CONCLUSION The actual cost of vaccine and pharmaceutical loss due to a break in the cold chain is poorly studied and requires further research. Additional recommendations regarding the stability of specific medicines would also be a valuable resource.
Collapse
Affiliation(s)
- S Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - E J Walker
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - C Anderson
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - G M Peterson
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
| | - M Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - E Castillo Martinez
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - S Garg
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - J Thomas
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| |
Collapse
|
47
|
Schuld M, Perez J, Anderson C, Bhatia R, Ehlers M, Leger K, Lentz H, Marsh S, Haralson B, Puls A, Sheikh S, Smith A, Spellecy M, Sweeney M, Ya A, Antony E. ABCD: The Language of Replication Protein A (RPA). FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.lb210] [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: 11/11/2022]
Affiliation(s)
| | | | | | - R. Bhatia
- Ronald Reagan High SchoolMilwaukeeWI
| | - M. Ehlers
- Ronald Reagan High SchoolMilwaukeeWI
| | - K. Leger
- Ronald Reagan High SchoolMilwaukeeWI
| | - H. Lentz
- Ronald Reagan High SchoolMilwaukeeWI
| | - S. Marsh
- Ronald Reagan High SchoolMilwaukeeWI
| | | | - A. Puls
- Ronald Reagan High SchoolMilwaukeeWI
| | - S. Sheikh
- Ronald Reagan High SchoolMilwaukeeWI
| | - A. Smith
- Ronald Reagan High SchoolMilwaukeeWI
| | | | | | - A. Ya
- Ronald Reagan High SchoolMilwaukeeWI
| | | |
Collapse
|
48
|
Abstract
Patients with acute liver failure accumulate toxic substances in the circulation which may impair recovery of hepatic function. The aim of this study was to test an in vitro assay to detect inhibitory substances in the serum of patients with acute liver failure. Human liver-derived HepG2 cells were incubated for 24h in 96 well plates (30,000 cells/well) with sera (10%) from 24 patients with acute liver failure due to paracetamol overdose or NANB hepatitis and 11 normal controls. DNA synthesis was determined from the incorporation of 3H-thymidine and cell viability by the metabolism of the tetrazolium dye MTS. HepG2 cells exposed to acute liver failure sera incorporated significantly less 3H-thymidine (median 30% of control, range 0.2–169%) than normal sera (100%, 76–133%, p=0.002). Cell viability was also reduced (75%, 33–112% vs 100%, 96–105%, p<0.00l). There was no correlation between these values and patient outcome or levels of plasma TNF-α or serum interferon-γ. The assay detected inhibitory substances in sera of patients with acute liver failure and could be used to monitor the use of liver support systems.
Collapse
Affiliation(s)
- C. Anderson
- Institute of Liver Studies Guy's, King's and St Thomas’ School of Medicine and Dentistry, London - UK
| | - M. I. Thabrew
- Institute of Liver Studies Guy's, King's and St Thomas’ School of Medicine and Dentistry, London - UK
| | - R. D. Hughes
- Institute of Liver Studies Guy's, King's and St Thomas’ School of Medicine and Dentistry, London - UK
| |
Collapse
|
49
|
Hawkins Bressler L, Mersereau J, Anderson C, Rodriguez J, Hodgson M, Weinberg C, Sandler D, Nichols H. Fertility-related experiences after breast cancer diagnosis in the niehs sister study and two sister study survivor survey. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.02.036] [Citation(s) in RCA: 1] [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: 11/24/2022]
|
50
|
Toh LS, Lai PSM, Othman S, Shah A, Dang CPL, Low BY, Wong KT, Anderson C. Exploring the current and future role of the pharmacists in osteoporosis screening and management in Malaysia. Int J Clin Pharm 2018; 40:450-457. [PMID: 29380234 DOI: 10.1007/s11096-018-0597-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
Abstract
Background Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area. Objective To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management. Setting A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia. Method Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists. Results All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role. Conclusion Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
Collapse
Affiliation(s)
- L S Toh
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building Churchill Avenue, Tasmania, 7005, Australia. .,School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
| | - P S M Lai
- University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - S Othman
- University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - A Shah
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building Churchill Avenue, Tasmania, 7005, Australia
| | - C P L Dang
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building Churchill Avenue, Tasmania, 7005, Australia
| | - B Y Low
- School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - K T Wong
- School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - C Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK
| |
Collapse
|