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Stock NM, Costa B, Bannister W, Ashby C, Matthews N, Hebden L, Melles L, Hilton-Webb Z, Smith S, Kane K, Carter L, Kearney A, Piggott K, Russell C, Wilkinson-Bell K. "When I was Younger, My Story Belonged to Everyone Else": Co-production of Resources for Adults Living with Craniosynostosis. Cleft Palate Craniofac J 2024:10556656241236580. [PMID: 38500357 DOI: 10.1177/10556656241236580] [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: 03/20/2024] Open
Abstract
OBJECTIVE Despite growing recognition that congenital craniofacial conditions have lifelong implications, psychological support for adults is currently lacking. The aim of this project was to produce a series of short films about living with craniosynostosis in adulthood, alongside a psychoeducational booklet. DESIGN The resources were developed using multiple focus groups and meetings attended by researchers, patient representatives, a leading charitable organisation, an award-winning film production company, clinicians, and other experts in the field. RESULTS An online mixed-methods survey was developed based on prior work to request feedback on the acceptability and utility of the resources from the craniosynostosis community. While data collection to evaluate the resources is ongoing, preliminary results (n = 36) highlight an acceptability rating of 100%. CONCLUSIONS The resources developed represent a step forward in addressing the unmet information and support needs of adults with craniosynostosis and highlight the benefits of co-production in research.
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Affiliation(s)
- Nicola M Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Bruna Costa
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | | | | | | | | | | | | | | | | | | | - Anna Kearney
- Alder Hey Craniofacial Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Katie Piggott
- Alder Hey Craniofacial Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Charlotte Russell
- Centre for Appearance Research, University of the West of England, Bristol, UK
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2
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Jones JR, Barber A, Le Bihan YV, Weinhold N, Ashby C, Walker BA, Wardell CP, Wang H, Kaiser MF, Jackson GH, Davies FE, Chopra R, Morgan GJ, Pawlyn C. Mutations in CRBN and other cereblon pathway genes are infrequently associated with acquired resistance to immunomodulatory drugs. Leukemia 2021; 35:3017-3020. [PMID: 34373585 PMCID: PMC8478640 DOI: 10.1038/s41375-021-01373-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023]
Affiliation(s)
- J R Jones
- The Institute of Cancer Research, London, UK.
- Brighton and Sussex Medical School, Brighton, UK.
- Kings College Hospital NHS Foundation Trust, London, UK.
| | - A Barber
- The Institute of Cancer Research, London, UK
| | | | - N Weinhold
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - C Ashby
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Arkansas, USA
| | - B A Walker
- Indiana University School of Medicine, Indiana, USA
| | - C P Wardell
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Arkansas, USA
| | - H Wang
- The Institute of Cancer Research, London, UK
| | - M F Kaiser
- The Institute of Cancer Research, London, UK
- The Royal Marsden Hospital, London, UK
| | - G H Jackson
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - F E Davies
- Perlmutter Cancer Center, NYU Langone Health, New York, USA
| | - R Chopra
- The Institute of Cancer Research, London, UK
- Apple Tree Partners, London, UK
| | - G J Morgan
- Perlmutter Cancer Center, NYU Langone Health, New York, USA
| | - C Pawlyn
- The Institute of Cancer Research, London, UK.
- The Royal Marsden Hospital, London, UK.
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Luque-Martin R, Angell DC, Kalxdorf M, Bernard S, Thompson W, Eberl HC, Ashby C, Freudenberg J, Sharp C, Van den Bossche J, de Jonge WJ, Rioja I, Prinjha RK, Neele AE, de Winther MPJ, Mander PK. IFN-γ Drives Human Monocyte Differentiation into Highly Proinflammatory Macrophages That Resemble a Phenotype Relevant to Psoriasis. J Immunol 2021; 207:555-568. [PMID: 34233910 DOI: 10.4049/jimmunol.2001310] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/09/2021] [Indexed: 02/07/2023]
Abstract
As key cells of the immune system, macrophages coordinate the activation and regulation of the immune response. Macrophages present a complex phenotype that can vary from homeostatic, proinflammatory, and profibrotic to anti-inflammatory phenotypes. The factors that drive the differentiation from monocyte to macrophage largely define the resultant phenotype, as has been shown by the differences found in M-CSF- and GM-CSF-derived macrophages. We explored alternative inflammatory mediators that could be used for in vitro differentiation of human monocytes into macrophages. IFN-γ is a potent inflammatory mediator produced by lymphocytes in disease and infections. We used IFN-γ to differentiate human monocytes into macrophages and characterized the cells at a functional and proteomic level. IFN-γ alone was sufficient to generate macrophages (IFN-γ Mϕ) that were phagocytic and responsive to polarization. We demonstrate that IFN-γ Mϕ are potent activators of T lymphocytes that produce IL-17 and IFN-γ. We identified potential markers (GBP-1, IP-10, IL-12p70, and IL-23) of IFN-γ Mϕ and demonstrate that these markers are enriched in the skin of patients with inflamed psoriasis. Collectively, we show that IFN-γ can drive human monocyte to macrophage differentiation, leading to bona fide macrophages with inflammatory characteristics.
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Affiliation(s)
- Rosario Luque-Martin
- Department of Medical Biochemistry, Experimental Vascular Biology, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Davina C Angell
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | | | - Sharon Bernard
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | - William Thompson
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | | | - Charlotte Ashby
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | | | - Catriona Sharp
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | - Jan Van den Bossche
- Department of Molecular Cell Biology and Immunology, Amsterdam Cardiovascular Sciences, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; and
| | - Wouter J de Jonge
- Tytgat Institute for Liver and Intestinal Research, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Inmaculada Rioja
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | - Rab K Prinjha
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom
| | - Annette E Neele
- Department of Medical Biochemistry, Experimental Vascular Biology, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Menno P J de Winther
- Department of Medical Biochemistry, Experimental Vascular Biology, Amsterdam Cardiovascular Sciences, Amsterdam Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Palwinder K Mander
- Immuno-Epigenetics, Adaptive Immunity Research Unit, GSK Medicines Research Centre, Stevenage, United Kingdom;
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4
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Rasche L, Alapat D, Kumar M, Gershner G, McDonald J, Wardell CP, Samant R, Van Hemert R, Epstein J, Williams AF, Thanendrarajan S, Schinke C, Bauer M, Ashby C, Tytarenko RG, van Rhee F, Walker BA, Zangari M, Barlogie B, Davies FE, Morgan GJ, Weinhold N. Combination of flow cytometry and functional imaging for monitoring of residual disease in myeloma. Leukemia 2018; 33:1713-1722. [PMID: 30573775 PMCID: PMC6586541 DOI: 10.1038/s41375-018-0329-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/24/2018] [Accepted: 10/10/2018] [Indexed: 02/08/2023]
Abstract
The iliac crest is the sampling site for minimal residual disease (MRD) monitoring in multiple myeloma (MM). However, the disease distribution is often heterogeneous, and imaging can be used to complement MRD detection at a single site. We have investigated patients in complete remission (CR) during first-line or salvage therapy for whom MRD flow cytometry and the two imaging modalities positron emission tomography (PET) and diffusion-weighted magnetic resonance imaging (DW-MRI) were performed at the onset of CR. Residual focal lesions (FLs), detectable in 24% of first-line patients, were associated with short progression-free survival (PFS), with DW-MRI detecting disease in more patients. In some patients, FLs were only PET positive, indicating that the two approaches are complementary. Combining MRD and imaging improved prediction of outcome, with double-negative and double-positive features defining groups with excellent and dismal PFS, respectively. FLs were a rare event (12%) in first-line MRD-negative CR patients. In contrast, patients achieving an MRD-negative CR during salvage therapy frequently had FLs (50%). Multi-region sequencing and imaging in an MRD-negative patient showed persistence of spatially separated clones. In conclusion, we show that DW-MRI is a promising tool for monitoring residual disease that complements PET and should be combined with MRD.
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Affiliation(s)
- L Rasche
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Department of Internal Medicine 2, University Hospital of Würzburg, Würzburg, Germany
| | - D Alapat
- Pathology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Kumar
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - G Gershner
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J McDonald
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C P Wardell
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Samant
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R Van Hemert
- Radiology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Epstein
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A F Williams
- Pathology Department, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Thanendrarajan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Schinke
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Bauer
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Ashby
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - R G Tytarenko
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - F van Rhee
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B A Walker
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Zangari
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B Barlogie
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - F E Davies
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - G J Morgan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - N Weinhold
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
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5
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Chavan SS, He J, Tytarenko R, Deshpande S, Patel P, Bailey M, Stein CK, Stephens O, Weinhold N, Petty N, Steward D, Rasche L, Bauer M, Ashby C, Peterson E, Ali S, Ross J, Miller VA, Stephens P, Thanendrarajan S, Schinke C, Zangari M, van Rhee F, Barlogie B, Mughal TI, Davies FE, Morgan GJ, Walker BA. Bi-allelic inactivation is more prevalent at relapse in multiple myeloma, identifying RB1 as an independent prognostic marker. Blood Cancer J 2017; 7:e535. [PMID: 28234347 PMCID: PMC5386330 DOI: 10.1038/bcj.2017.12] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 01/13/2017] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study is to identify prognostic markers and treatment targets using a clinically certified sequencing panel in multiple myeloma. We performed targeted sequencing of 578 individuals with plasma cell neoplasms using the FoundationOne Heme panel and identified clinically relevant abnormalities and novel prognostic markers. Mutational burden was associated with maf and proliferation gene expression groups, and a high-mutational burden was associated with a poor prognosis. We identified homozygous deletions that were present in multiple myeloma within key genes, including CDKN2C, RB1, TRAF3, BIRC3 and TP53, and that bi-allelic inactivation was significantly enriched at relapse. Alterations in CDKN2C, TP53, RB1 and the t(4;14) were associated with poor prognosis. Alterations in RB1 were predominantly homozygous deletions and were associated with relapse and a poor prognosis which was independent of other genetic markers, including t(4;14), after multivariate analysis. Bi-allelic inactivation of key tumor suppressor genes in myeloma was enriched at relapse, especially in RB1, CDKN2C and TP53 where they have prognostic significance.
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Affiliation(s)
- S S Chavan
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J He
- Foundation Medicine Inc., Cambridge, MA, USA
| | - R Tytarenko
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Deshpande
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - P Patel
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Bailey
- Foundation Medicine Inc., Cambridge, MA, USA
| | - C K Stein
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - O Stephens
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - N Weinhold
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - N Petty
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - D Steward
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - L Rasche
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Bauer
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Ashby
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - E Peterson
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - S Ali
- Foundation Medicine Inc., Cambridge, MA, USA
| | - J Ross
- Foundation Medicine Inc., Cambridge, MA, USA.,Albany Medical College, Albany, NY, USA
| | - V A Miller
- Foundation Medicine Inc., Cambridge, MA, USA
| | - P Stephens
- Foundation Medicine Inc., Cambridge, MA, USA
| | - S Thanendrarajan
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Schinke
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Zangari
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - F van Rhee
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B Barlogie
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - T I Mughal
- Foundation Medicine Inc., Cambridge, MA, USA.,Tufts University Medical Center, Boston, MA, USA
| | - F E Davies
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - G J Morgan
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - B A Walker
- The Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Furber MJW, Anton-Solanas A, Koppe E, Ashby C, Roberts MG, Roberts JD. An Acute Increase of Dietary Protein Intake Elicits Positive Cellular Metabolic Adaptations in Healthy Males. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487463.66856.2a] [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: 11/21/2022]
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7
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Calvo D, Vázquez MJ, Ashby C, Domínguez JM. Kinetic considerations on the development of binding assays in single-addition mode: application to the search for α2δ1 modulators. J Biomol Screen 2012; 17:1041-9. [PMID: 22772056 DOI: 10.1177/1087057112452318] [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] [Indexed: 11/16/2022]
Abstract
The development of assays in single-addition mode is of great interest for screening purposes given the multiple advantages of minimizing the number of intervention steps. Binding assays seem to be more prone to this attractive format because no functional biological activity is taking place but instead a biophysical process, whose dynamics seem easier to control without introducing significant alterations, is happening. Therefore, single-addition assays based on the displacement of prebound labeled ligands can be conceived, but careful kinetic considerations must still be taken to maximize the sensitivity of the assay and to avoid jeopardizing the identification of compounds with slow-binding kinetics. This article shows the development of a single-addition, displacement-based binding assay intended to identify modulators that act by binding to the gabapentin site of the ion channel regulatory protein α2δ1. After studying the kinetics of gabapentin binding and the influence they might have on the assay sensitivity, the best conditions were identified, and the sensitivity was compared with that of the more classical two-additions competition-based assay. Although the present study focuses on α2δ1 and its interaction with gabapentin, the rationale and the methodology followed are of broad purpose and can be applied to virtually every binding assay.
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Affiliation(s)
- David Calvo
- Biological Reagents and Assay Development Department, GlaxoSmithKline, Madrid, Spain
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8
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McElver J, Tzafrir I, Aux G, Rogers R, Ashby C, Smith K, Thomas C, Schetter A, Zhou Q, Cushman MA, Tossberg J, Nickle T, Levin JZ, Law M, Meinke D, Patton D. Insertional mutagenesis of genes required for seed development in Arabidopsis thaliana. Genetics 2001; 159:1751-63. [PMID: 11779812 PMCID: PMC1461914 DOI: 10.1093/genetics/159.4.1751] [Citation(s) in RCA: 238] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this project was to identify large numbers of Arabidopsis genes with essential functions during seed development. More than 120,000 T-DNA insertion lines were generated following Agrobacterium-mediated transformation. Transgenic plants were screened for defective seeds and putative mutants were subjected to detailed analysis in subsequent generations. Plasmid rescue and TAIL-PCR were used to recover plant sequences flanking insertion sites in tagged mutants. More than 4200 mutants with a wide range of seed phenotypes were identified. Over 1700 of these mutants were analyzed in detail. The 350 tagged embryo-defective (emb) mutants identified to date represent a significant advance toward saturation mutagenesis of EMB genes in Arabidopsis. Plant sequences adjacent to T-DNA borders in mutants with confirmed insertion sites were used to map genome locations and establish tentative identities for 167 EMB genes with diverse biological functions. The frequency of duplicate mutant alleles recovered is consistent with a relatively small number of essential (EMB) genes with nonredundant functions during seed development. Other functions critical to seed development in Arabidopsis may be protected from deleterious mutations by extensive genome duplications.
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Affiliation(s)
- J McElver
- Syngenta, Research Triangle Park, North Carolina 27709, USA
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Abstract
The aim of our study was to evaluate the success rate, complications, and long term outcomes following day-case percutaneous endoscopic gastrostomy (PEG). This retrospective study was carried out in a 650-bed District General hospital in Northamptonshire, UK. Thirty-six patients, aged 28-90 years, were included in the study, 21 males (58%) and 15 females (42%). Indications for PEG insertion included head and neck cancer, dysphagia as a result of primary disease, and AIDS-related malnutrition. Data were collected from the medical and dietetic records. The PEG procedure was successful in 33 patients (92%). In 32 cases (97%) the patient was discharged home. Twenty five of the patients (76%) suffered no complications whilst seven (21%) suffered complications within a month of the procedure. No patient required further surgical intervention. Five patients (15%) died of their primary disease within a month of the procedure. Patients had had their PEG tubes in situ for up to 2.5 years at the end of data collection. We conclude that PEG can be performed as a day-case procedure in stable patients with no increase in complication rate, morbidity, or mortality.
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Affiliation(s)
- A Mandal
- Kettering General Hospital NHS Trust, Kettering, Northamptonshire NN16 8UZ, UK
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10
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Ashby C. Maxwell Cranna Andrew Walters Forbes Geoffrey Frederick James Goddard Daniel John Goldstein Ginette Lesley Harrison Michael Leibson John David Lewis Patrick Joseph O'Rourke Kathleen Mary Spencer Andrew Watt John Leslie David Williams. West J Med 2000. [DOI: 10.1136/bmj.320.7229.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
TOPIC How nurses can meet the priority needs of the acute care clients during inpatient psychiatric hospitalizations that average five days. PURPOSE To assist acute care nursing staff in reorganizing their caregiving to maximize therapeutic gains of clients in a minimum period of time SOURCE Personal experience. CONCLUSION Success in the short-term unit depends not only on the ability of nurses to stabilize clients in crisis, but also on their ability to provide linkage with aftercare services so the therapeutic process can be continued.
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Volkow ND, Ding YS, Fowler JS, Wang GJ, Logan J, Gatley JS, Dewey S, Ashby C, Liebermann J, Hitzemann R. Is methylphenidate like cocaine? Studies on their pharmacokinetics and distribution in the human brain. Arch Gen Psychiatry 1995; 52:456-63. [PMID: 7771915 DOI: 10.1001/archpsyc.1995.03950180042006] [Citation(s) in RCA: 371] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The purposes of this study were to investigate the pharmacokinetics of methylphenidate hydrochloride (Ritalin) in the human brain, to compare them with those of cocaine, and to evaluate whether cocaine and methylphenidate compete for the same binding sites. METHODS We used positron emission tomography to measure the temporal and spatial distribution of carbon 11 (11C)-labeled methylphenidate. These results were compared with those obtained previously for [11C]cocaine. Eight healthy male subjects, 20 to 51 years of age, were scanned with [11C]methylphenidate. Three were tested twice to assess test-retest variability, four were tested at baseline and after administration of methylphenidate, and one was tested with [11C]methylphenidate and [11C]cocaine. Two baboons were scanned to evaluate whether there was competition between cocaine and methylphenidate for the same binding sites in the brain. RESULTS The uptake of [11C]methylphenidate in the brain was high (mean +/- SD, 7.5% +/- 1.5%), and the maximal concentration occurred in striatum. Pretreatment with methylphenidate decreased binding only in striatum (40%). Although the regional distribution of [11C]methylphenidate, was identical to that of [11C]cocaine and they competed with each other for the same binding sites, these two drugs differed markedly in their pharmacokinetics. Clearance of [11C]methylphenidate from striatum (90 minutes) was significantly slower than that of [11C]cocaine (20 minutes). For both drugs, their fast uptake in striatum paralleled the experience of the "high." For methylphenidate, the high decreased very rapidly despite significant binding of the drug in the brain. In contrast, for cocaine, the decline in the high paralleled its fast rate of clearance from the brain. CONCLUSION We speculate that because the experience of the high is associated with the fast uptake of cocaine and methylphenidate in the brain, the slow clearance of methylphenidate from the brain may serve as a limiting factor in promoting its frequent self-administration.
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Affiliation(s)
- N D Volkow
- Medical Department, State University of New York, Stony Brook, USA
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