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Curns AT, Rha B, Lively JY, Sahni LC, Englund JA, Weinberg GA, Halasa NB, Staat MA, Selvarangan R, Michaels M, Moline H, Zhou Y, Perez A, Rohlfs C, Hickey R, Lacombe K, McHenry R, Whitaker B, Schuster J, Pulido CG, Strelitz B, Quigley C, Dnp GW, Avadhanula V, Harrison CJ, Stewart LS, Schlaudecker E, Szilagyi PG, Klein EJ, Boom J, Williams JV, Langley G, Gerber SI, Hall AJ, McMorrow ML. Respiratory Syncytial Virus-Associated Hospitalizations Among Children <5 Years Old: 2016 to 2020. Pediatrics 2024; 153:e2023062574. [PMID: 38298053 DOI: 10.1542/peds.2023-062574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the leading cause of hospitalization in US infants. Accurate estimates of severe RSV disease inform policy decisions for RSV prevention. METHODS We conducted prospective surveillance for children <5 years old with acute respiratory illness from 2016 to 2020 at 7 pediatric hospitals. We interviewed parents, reviewed medical records, and tested midturbinate nasal ± throat swabs by reverse transcription polymerase chain reaction for RSV and other respiratory viruses. We describe characteristics of children hospitalized with RSV, risk factors for ICU admission, and estimate RSV-associated hospitalization rates. RESULTS Among 13 524 acute respiratory illness inpatients <5 years old, 4243 (31.4%) were RSV-positive; 2751 (64.8%) of RSV-positive children had no underlying condition or history of prematurity. The average annual RSV-associated hospitalization rate was 4.0 (95% confidence interval [CI]: 3.8-4.1) per 1000 children <5 years, was highest among children 0 to 2 months old (23.8 [95% CI: 22.5-25.2] per 1000) and decreased with increasing age. Higher RSV-associated hospitalization rates were found in premature versus term children (rate ratio = 1.95 [95% CI: 1.76-2.11]). Risk factors for ICU admission among RSV-positive inpatients included: age 0 to 2 and 3 to 5 months (adjusted odds ratio [aOR] = 1.97 [95% CI: 1.54-2.52] and aOR = 1.56 [95% CI: 1.18-2.06], respectively, compared with 24-59 months), prematurity (aOR = 1.32 [95% CI: 1.08-1.60]) and comorbid conditions (aOR = 1.35 [95% CI: 1.10-1.66]). CONCLUSIONS Younger infants and premature children experienced the highest rates of RSV-associated hospitalization and had increased risk of ICU admission. RSV prevention products are needed to reduce RSV-associated morbidity in young infants.
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Affiliation(s)
- Aaron T Curns
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joana Y Lively
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leila C Sahni
- Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Marian Michaels
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Heidi Moline
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yingtao Zhou
- Centers for Disease Control and Prevention, Atlanta, Georgia
- TDB Communications, Inc, Atlanta, Georgia
| | - Ariana Perez
- Centers for Disease Control and Prevention, Atlanta, Georgia
- GDIT, Atlanta, Georgia
| | - Chelsea Rohlfs
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert Hickey
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Rendie McHenry
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brett Whitaker
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Christina Quigley
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Vasanthi Avadhanula
- Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | | | - Elizabeth Schlaudecker
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Peter G Szilagyi
- UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California
| | | | - Julie Boom
- Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - John V Williams
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gayle Langley
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan I Gerber
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aron J Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Edens C, Clopper BR, DeVies J, Benitez A, McKeever ER, Johns D, Wolff B, Selvarangan R, Schuster JE, Weinberg GA, Szilagyi PG, Dawood FS, Radhakrishnan L, Quigley C, Sahni LC, Halasa N, Stewart LS, McMorrow ML, Whitaker B, Zerr DM, Avadhanula V, Williams JV, Michaels MG, Kite-Powell A, Englund JA, Staat MA, Hartnett K, Moline HL, Cohen AL, Diaz M. Notes from the Field: Reemergence of Mycoplasma pneumoniae Infections in Children and Adolescents After the COVID-19 Pandemic, United States, 2018-2024. MMWR Morb Mortal Wkly Rep 2024; 73:149-151. [PMID: 38386615 PMCID: PMC10899077 DOI: 10.15585/mmwr.mm7307a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
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3
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Quigley C, Storan ER. Discussing reproductive potential with transgender patients in dermatology clinics – a plea for more considerate terminology. J Eur Acad Dermatol Venereol 2022; 37:e686-e687. [PMID: 36461776 DOI: 10.1111/jdv.18798] [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] [Received: 10/06/2022] [Accepted: 11/29/2022] [Indexed: 12/04/2022]
Affiliation(s)
- C. Quigley
- Mater Misercordiae University Hospital Dublin
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Quigley C, Ellard R, Arreyedh HA, Droney T, Harney F, Townley D. Classical Music for Analgesia in Laser Panretinal Photocoagulation for Treatment of Diabetic Retinopathy. Ir Med J 2019; 112:941. [PMID: 31411394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- C Quigley
- Dept. of Ophthalmology, Galway University Hospital, Galway, Ireland
| | - R Ellard
- Dept. of Ophthalmology, Galway University Hospital, Galway, Ireland
| | - H A Arreyedh
- Dept. of Ophthalmology, Galway University Hospital, Galway, Ireland
| | - T Droney
- Dept. of Ophthalmology, Galway University Hospital, Galway, Ireland
| | - F Harney
- Dept. of Ophthalmology, Galway University Hospital, Galway, Ireland
| | - D Townley
- Dept. of Ophthalmology, Galway University Hospital, Galway, Ireland
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Bhaskaran N, Quigley C, Weinberg A, Huang A, Popkin D, Pandiyan P. Transforming growth factor-β1 sustains the survival of Foxp3(+) regulatory cells during late phase of oropharyngeal candidiasis infection. Mucosal Immunol 2016; 9:1015-26. [PMID: 26530137 PMCID: PMC4854793 DOI: 10.1038/mi.2015.115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/21/2015] [Indexed: 02/04/2023]
Abstract
As CD4(+)CD25(+)Foxp3(+) regulatory T cells (Tregs) play crucial immunomodulatory roles during infections, one key question is how these cells are controlled during antimicrobial immune responses. Mechanisms controlling their homeostasis are central to ensure efficient protection against pathogens, as well as to control infection-associated immunopathology. Here we studied how their viability is regulated in the context of mouse oropharyngeal candidiasis (OPC) infection, and found that these cells show increased protection from apoptosis during late phase of infection and reinfection. Tregs underwent reduced cell death because they are refractory to T cell receptor restimulation-induced cell death (RICD). We confirmed their resistance to RICD, using mouse and human Tregs in vitro, and by inducing α-CD3 antibody-mediated apoptosis in vivo. The enhanced viability is dependent on increased transforming growth factor-β1 (TGF-β1) signaling that results in upregulation of cFLIP (cellular FLICE (FADD-like IL-1β-converting enzyme)-inhibitory protein) in Tregs. Protection from cell death is abrogated in the absence of TGF-β1 signaling in Tregs during OPC infection. Taken together, our data unravel the previously unrecognized role of TGF-β1 in promoting Treg viability, coinciding with the pronounced immunomodulatory role of these cells during later phase of OPC infection, and possibly other mucosal infections.
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Affiliation(s)
- N Bhaskaran
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - C Quigley
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - A Weinberg
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - A Huang
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - D Popkin
- Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - P Pandiyan
- Department of Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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6
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Dai YC, Zhang XF, Xia M, Tan M, Quigley C, Lei W, Fang H, Zhong W, Lee B, Pang X, Nie J, Jiang X. Antigenic Relatedness of Norovirus GII.4 Variants Determined by Human Challenge Sera. PLoS One 2015; 10:e0124945. [PMID: 25915764 PMCID: PMC4411064 DOI: 10.1371/journal.pone.0124945] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/19/2015] [Indexed: 12/15/2022] Open
Abstract
The GII.4 noroviruses (NoVs) are a single genotype that is responsible for over 50% of NoV gastroenteritis epidemics worldwide. However, GII.4 NoVs have been found to undergo antigenic drifts, likely selected by host herd immunity, which raises an issue for vaccine strategies against NoVs. We previously characterized GII.4 NoV antigenic variations and found significant levels of antigenic relatedness among different GII.4 variants. Further characterization of the genetic and antigenic relatedness of recent GII.4 variants (2008b and 2010 cluster) was performed in this study. The amino acid sequences of the receptor binding interfaces were highly conserved among all GII.4 variants from the past two decades. Using serum samples from patients enrolled in a GII.4 virus challenge study, significant cross-reactivity between major GII.4 variants from 1998 to 2012 was observed using enzyme-linked immunosorbent assays and HBGA receptor blocking assays. The overall abilities of GII.4 NoVs to bind to the A/B/H HBGAs were maintained while their binding affinities to individual ABH antigens varied. These results highlight the importance of human HBGAs in NoV evolution and how conserved antigenic types impact vaccine development against GII.4 variants.
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Affiliation(s)
- Ying-Chun Dai
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Xu-Fu Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Ming Xia
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Ming Tan
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Christina Quigley
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Wen Lei
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Hao Fang
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Weiming Zhong
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Bonita Lee
- Provincial Laboratory for Public Health (ProvLab), Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton,Alberta, Canada
| | - Xiaoli Pang
- Provincial Laboratory for Public Health (ProvLab), Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton,Alberta, Canada
| | - Jun Nie
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- * E-mail: (XJ); (JN)
| | - Xi Jiang
- Divisions of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
- * E-mail: (XJ); (JN)
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Abstract
Human noroviruses (HuNoVs) are the major cause of nonbacterial gastroenteritis epidemics. The culturable feline calicivirus and murine norovirus have been used extensively as surrogates to study HuNoV biology, as HuNoV does not grow in vitro. Additional efforts to identify new surrogates are needed, because neither of these common surrogates are truly intestinal pathogens. The newly described Tulane virus (TV) is a typical calicivirus, it is isolated from macaque stools, is cultivable in vitro, and recognizes human histo-blood group antigens. Therefore, TV is a promising surrogate for HuNoVs. In this study, we evaluated the resistance or stability of TV under various physical and environmental conditions by measuring a 50% reduction of tissue culture infective dose (TCID50) by using a TV cell culture system. Due to the nature of this virus, it is hard to produce a high-titer stock through tissue culture. In our study, the maximal reduction in virus titers was 5D (D = 1 log) in heat-denaturation and EtOH experiments, and 4D in UV, chlorine, and pH-stability experiments. Therefore in this study, we defined the inactivation of TV as reaching a TCID50/ml of 0 (a 4- to 5-D reduction in TCID50, depending on the detection limit). TV was inactivated after incubation at 63 °C for 5 min, incubation at 56 °C for 30 min (5D), exposure to 60 mJ/cm2 of UVC radiation (4D), or incubation at 300 ppm of free chlorine for 10 min (4D). TV was shown to be stable from pH 3.0 to 8.0, though an obvious reduction in virus titer was observed at pH 2.5 and 9.0, and was inactivated at pH 10.0 (4D). TV was resistant to a low concentration of EtOH (40% or lower) but was fully inactivated (5D) by 50 to 70% EtOH after a short exposure (20 s). In contrast, quantitative real-time PCR was unable to detect, or poorly detected, virus titer reductions between treated and untreated samples described in this study.
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Affiliation(s)
- Peng Tian
- U.S. Department of Agriculture, Agricultural Research Service, Western Regional Research Center, Produce Safety and Microbiology Research Unit, Albany, California 94710, USA.
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Borg ML, Modi A, Tostmann A, Gobin M, Cartwright J, Quigley C, Crook PD, Boxall N, Paul J, Cheasty T, Gill N, Hughes G, Simms I, Oliver I. Ongoing outbreak of Shigella flexneri serotype 3a in men who have sex with men in England and Wales, data from 2009–2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.13.20137-en] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Diagnoses of Shigella flexneri in the United Kingdom (UK) are usually travel-related. However, since 2009, there has been an overall increase in UK-acquired cases. The Health Protection Agency has been investigating a national outbreak of S. flexneri detected in 2011 and which is still ongoing. Cases occurred mostly in men who have sex with men and were of serotype 3a. The investigation aimed at obtaining epidemiological data to inform targeted outbreak management and control.
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Affiliation(s)
- M L Borg
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Health Protection Agency, South West Region, United Kingdom
| | - A Modi
- Health Protection Agency, North West Region, United Kingdom
| | - A Tostmann
- Health Protection Agency, South West Region, United Kingdom
| | - M Gobin
- Health Protection Agency, South West Region, United Kingdom
| | - J Cartwright
- Health Protection Agency, North West Region, United Kingdom
| | - C Quigley
- Health Protection Agency, North West Region, United Kingdom
| | - P D Crook
- Health Protection Agency, South East Region, United Kingdom
| | - N Boxall
- Health Protection Agency, South East Region, United Kingdom
| | - J Paul
- Health Protection Agency, South East Region, United Kingdom
| | - T Cheasty
- Gastro-Intestinal Infections Reference Unit, Health Protection Agency - Colindale, London, United Kingdom
| | - N Gill
- HIV & STI Department, Health Protection Agency - Colindale, London, United Kingdom
| | - G Hughes
- HIV & STI Department, Health Protection Agency - Colindale, London, United Kingdom
| | - I Simms
- HIV & STI Department, Health Protection Agency - Colindale, London, United Kingdom
| | - I Oliver
- University of Bristol, Bristol, United Kingdom
- Health Protection Agency, South West Region, United Kingdom
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Borg ML, Modi A, Tostmann A, Gobin M, Cartwright J, Quigley C, Crook P, Boxall N, Paul J, Cheasty T, Gill N, Hughes G, Simms I, Oliver I. Ongoing outbreak of Shigella flexneri serotype 3a in men who have sex with men in England and Wales, data from 2009-2011. Euro Surveill 2012; 17:20137. [PMID: 22490381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Diagnoses of Shigella flexneri in the United Kingdom (UK) are usually travel-related. However, since 2009, there has been an overall increase in UK-acquired cases. The Health Protection Agency has been investigating a national outbreak of S. flexneri detected in 2011 and which is still ongoing. Cases occurred mostly in men who have sex with men and were of serotype 3a. The investigation aimed at obtaining epidemiological data to inform targeted outbreak management and control.
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Affiliation(s)
- M L Borg
- Health Protection Agency, South West Region, United Kingdom.
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Cleary P, Browning L, Coia J, Cowden J, Fox A, Kearney J, Lane C, Mather H, Quigley C, Syed Q, Tubin-Delic D, on behalf of the outbreak control team C. A foodborne outbreak of Salmonella Bareilly in the United Kingdom, 2010. Euro Surveill 2010; 15. [DOI: 10.2807/ese.15.48.19732-en] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- P Cleary
- Health Protection Agency North West region (HPA NW), Liverpool, United Kingdom
| | - L Browning
- Health Protection Scotland (HPS), Glasgow, United Kingdom
| | - J Coia
- Scottish Salmonella, Shigella and Clostridium difficile Reference Laboratory, Glasgow, United Kingdom
| | - J Cowden
- Health Protection Scotland (HPS), Glasgow, United Kingdom
| | - A Fox
- Health Protection Agency Food Water and Environmental Microbiology Laboratory, Preston, United Kingdom
| | - J Kearney
- Health Protection Agency East of England region, Witham, Essex, United Kingdom
| | - C Lane
- Health Protection Agency Gastrointestinal, Emerging and Zoonotic Infections Department (GEZI) - Epidemiological Services, London, United Kingdom
| | - H Mather
- Scottish Salmonella, Shigella and Clostridium difficile Reference Laboratory, Glasgow, United Kingdom
| | - C Quigley
- Health Protection Agency North West region (HPA NW), Liverpool, United Kingdom
| | - Q Syed
- Health Protection Agency North West region (HPA NW), Liverpool, United Kingdom
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Vivancos R, Keenan A, Sopwith W, Quigley C, Mutton K, Nichols G, Harris J, Syed Q, Reid J. Management of an international outbreak of norovirus on board a cruise ship. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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McGuigan C, McCarthy A, Quigley C, Bannan L, Hawkins SA, Hutchinson M. Latitudinal variation in the prevalence of multiple sclerosis in Ireland, an effect of genetic diversity. J Neurol Neurosurg Psychiatry 2004; 75:572-6. [PMID: 15026499 PMCID: PMC1739004 DOI: 10.1136/jnnp.2003.012666] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Northern Ireland has a high and rising prevalence rate of multiple sclerosis (MS). The most recent survey in 1996 found a rate of 168.7/100 000. Recorded prevalence rates for the south of Ireland, including County Wexford, have been markedly lower and seemed to suggest the existence of a prevalence gradient within the island. OBJECTIVES To compare the prevalence of multiple sclerosis in Co. Wexford in the south east of Ireland and Co. Donegal in the north west, and to establish whether a variation in prevalence of MS exists within Ireland. METHODS Patients were referred from multiple sources. Review of clinical case records and/or patient examination confirmed the diagnosis. RESULTS In Co. Wexford, 126 patients were found to have clinically definite or probable multiple sclerosis with a prevalence rate of 120.7/100 000 (95% confidence intervals (CI) 100.6 to 143.8), which is similar to other areas of similar latitude within the British Isles. In Co. Donegal, 240 people had clinically definite or probable MS with a prevalence rate of 184.6/100 000 (95% CI 162.0 to 209.5). The difference in prevalence rates is statistically significant (Z = 3.94, p = <0.001). CONCLUSION There is a latitudinal variation in the prevalence rate of MS between the north and the south of Ireland. The increased prevalence of MS seen in Co. Wexford is likely to represent better case ascertainment and improved diagnostic accuracy rather than an actual increase in prevalence. The north/south variation in prevalence may represent a variation in the genetic predisposition to MS between the background populations of the two counties.
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Affiliation(s)
- C McGuigan
- St Vincent's University Hospital, Elm Park, Dublin 4, Republic of Ireland.
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Abstract
BACKGROUND Patients with cancer, and increasingly chronic non-cancer pain frequently require strong opioids for pain relief. Morphine is the first-line strong opioid of choice for these patients. While most achieve adequate analgesia with morphine, a significant minority either suffer intolerable side-effects, inadequate pain relief, or both. For these patients switching to an alternative opioid is becoming established clinical practice. However, the evidence for the effectiveness of opioid switching does not appear to be established. OBJECTIVES The aim of this review was to investigate the usefulness of opioid switching for patients with pain. SEARCH STRATEGY Randomised trials that assessed opioid rotation, switching, or substitution in adults or children with acute or chronic pain were sought through electronic databases and by handsearching relevant journals. Date of the most recent search: January 2003. SELECTION CRITERIA The search strategy retrieved no randomised controlled trials, and therefore no studies were available to enable a quantitative synthesis that would assess the effectiveness of the strategy of opioid switching. DATA COLLECTION AND ANALYSIS Given the lack of RCTs, the review examined all case reports, uncontrolled, and retrospective studies in an attempt to determine the current level of evidence. MAIN RESULTS Fifty-two reports were identified, comprising 23 case reports, 15 retrospective studies/audits and 14 prospective uncontrolled studies. The majority of the reports used morphine as first-line opioid and the most frequently used second-line opioid was methadone. All reports, apart from one, concluded that opioid switching is a useful clinical manoeuvre for improving pain control and/or reducing opioid-related side-effects. REVIEWERS' CONCLUSIONS For patients with inadequate pain relief and intolerable opioid-related toxicity/adverse effects, a switch to an alternative opioid may be the only option for symptomatic relief. However, the evidence to support the practice of opioid switching is largely anecdotal or based on observational and uncontrolled studies. Randomised trials, including 'N of 1' studies, where a patient acts as their own control, are needed: firstly, to establish the true effectiveness of this clinical practice; secondly, to determine which opioid should be used first-line or second-line; and thirdly, to standardise conversion ratios when switching from one opioid to another.
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Affiliation(s)
- C Quigley
- Medical Oncology, Hammersmith Hospitals Trust, Du Cane Road, London, UK, W12 0NN.
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Quigley C, Easter C, Burrowes P, Witherspoon J. Biotechnology-based odour control: design criteria and performance data. Water Sci Technol 2004; 50:319-326. [PMID: 15484776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
As neighbouring areas continue to encroach upon wastewater treatment plants, there is an increasing need for odour control to mitigate potential negative offsite odorous impacts. One technology that is gaining widespread acceptance is biotechnology, which utilises the inherent ability of certain microorganisms to biodegrade offensive odorous compounds. Two main advantages of this form of treatment over other odour control technologies include the absence of hazardous chemicals and relatively low operation and maintenance requirements. The purpose of this paper is to provide information related to odour control design criteria used in sizing/selecting biotechnology-based odour control technologies, and to provide odour removal performance data obtained from several different biotechnology-based odour control systems. CH2M HILL has collected biotechnology-based odour control performance data over the last several years in order to track the continued performance of various biofilters and biotowers over time. Specifically, odour removal performance data have been collected from soil-, organic- and inorganic-media biofilters and inert inorganic media biotowers. Results indicate that biotechnology-based odour control is a viable and consistent technology capable of achieving high removal performance for odour and hydrogen sulphide. It is anticipated that the information presented in this paper will be of interest to anyone involved with odour control technology evaluation/selection or design review.
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Affiliation(s)
- C Quigley
- CH2M HILL INC, 8911 Capital of Texas Highway, Suite 1110, Austin, TX 78759-1154, USA.
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Witherspoon J, Allen E, Quigley C. Modelling to assist in wastewater collection system odour and corrosion potential evaluations. Water Sci Technol 2004; 50:177-183. [PMID: 15484759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Odour emissions and corrosion concerns can be a constant focus for many wastewater treatment and collection system owners, usually from the first day that their collection systems begin operation. Many sewer systems are reaching the end of their useful life, or have experienced either odour or corrosion issues. This paper shows a link between odour generation and corrosion potential, and how modelling can be used to assist in odour/corrosion assessments of existing wastewater collection systems. A model has been developed that is capable of predicting liquid-phase sulphide generation and subsequent release to overlying sewer headspace as hydrogen sulphide (H2S), where it can be the source of either odour or corrosion problems. This paper presents an overview of the model, and uses a case study involving both odour and corrosion issues to demonstrate the utility in modelling. The model was used to identify potential locations within the system where odour/corrosion may be problematic, as well as assisting in the evaluation of potential odour control alternatives.
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Affiliation(s)
- J Witherspoon
- CH2M HILL INC, 777 108th Avenue NE, Bellevue, WA 98004-5118, USA.
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Abstract
BACKGROUND While morphine is the gold standard for the management of severe cancer pain, some patients either do not achieve adequate analgesia, or suffer intolerable morphine-related toxicity. For these patients alternatives such as hydromorphone are recommended. However, there appear to be gaps in our understanding of the efficacy and potency of hydromorphone. OBJECTIVES This review explores and assesses the evidence for the efficacy of hydromorphone in the management of pain. SEARCH STRATEGY Randomised trials which included hydromorphone were sought using electronic databases and by handsearching relevant journals. Date of the most recent search: February 2000. SELECTION CRITERIA RCTs which involved the administration of hydromorphone, for both acute and chronic pain conditions, in adults and children, were included. DATA COLLECTION AND ANALYSIS A data extraction form was designed for the purpose of the review. The validity of each trial for inclusion was assessed using criteria described in the Cochrane Handbook. A grade was allocated to each study on the basis of allocation concealment. A checklist was used to assess blinding. MAIN RESULTS Forty three studies (2725 subjects) were included in the review. Approximately half of these studies received a low quality score. In addition, the heterogeneity of the studies precluded combination of data and results. A meta-analysis was therefore not possible. Of the 43 included studies, 11 (645 subjects) involved chronic pain conditions (all cancer) and 32 (2080 subjects) acute pain. Three studies were placebo-controlled. Of the remainder, hydromorphone was compared with other opioids (morphine, fentanyl, sufentanyl, meperidine, oxycodone, diamorphine), bupivicaine and with itself, using different formulations. The routes of administration included intravenous, oral, spinal, intramuscular and subcutaneous. Overall, hydromorphone appears to be a potent analgesic. The limited number of studies available suggest that there is little difference between morphine and hydromorphone in terms of analgesic efficacy, adverse effect profile and patient preference. However, as most studies involved small numbers of patients, it is difficult to determine real differences between both drugs. In the context of both acute and chronic pain, the issue of equi-analgesic ratios between morphine and hydromorphone was not resolved. REVIEWER'S CONCLUSIONS The studies included in this review were varied in terms of quality and methodology. However, the majority demonstrated that hydromorphone is a potent analgesic, that the clinical effects of hydromorphone appear to be dose-related, and that the adverse effect profile of hydromorphone is similar to that of other mu opioid receptor agonists.
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Affiliation(s)
- C Quigley
- Medical Oncology, Hammersmith Hospitals Trust, Du Cane Road, London, UK, W12 0NN.
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Quigley C. Dual-edged sword: dealing with the media before, during, and after a weapon of mass destruction event. Mil Med 2001; 166:56-8. [PMID: 11778437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- C Quigley
- Office of the Assistant Secretary of Defense for Public Affairs, 1400 Defense Pentagon, Washington, DC 20301-1400, USA.
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Granter SR, Weilbaecher KN, Quigley C, Fletcher CD, Fisher DE. Microphthalmia transcription factor: not a sensitive or specific marker for the diagnosis of desmoplastic melanoma and spindle cell (non-desmoplastic) melanoma. Am J Dermatopathol 2001; 23:185-9. [PMID: 11391097 DOI: 10.1097/00000372-200106000-00004] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Microphthalmia transcription factor (Mitf), a melanocytic nuclear protein critical for the embryonic development and postnatal viability of melanocytes, is a master lineage regulator and modulates extracellular signals. Recently, Mitf expression was shown to be both a sensitive and specific marker of epithelioid melanoma. Because loss of specific melanocytic markers in melanomas with spindle cell morphology is more common compared with those tumors with epithelioid morphology, we investigated the sensitivity of D5, an anti-Mitf antibody, for diagnosis in this diagnostically problematic subset of melanomas. Twenty of 21 (95%) spindle cell and desmoplastic melanomas examined were reactive for S-100 protein. Only 4 of 21 (19%) spindle cell and desmoplastic melanomas were reactive for HMB-45. Six of 21 tumors (29%) were reactive for D5, including one case that was non-reactive for S-100 and HMB-45. Melan-A reactivity was seen in 2 of 13 cases (15%) studied. Eight of 24 (33%) non-melanocytic spindle cell tumors were reactive for D5, including 4 of 6 dermatofibromas, 1 of 6 schwannomas, 1 of 2 leiomyomas, and 2 of 6 leiomyosarcomas. Although D5 was shown in a previous study to be a highly sensitive and specific marker for epithelioid melanomas, the results of this study show it is not a sensitive or specific marker of spindle cell and desmoplastic melanomas. Nevertheless, we believe that diffuse positive staining for D5 when taken in clinical, histologic and immunohistochemical context may be diagnostically useful in selected cases of melanoma.
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Affiliation(s)
- S R Granter
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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Ghebrehewet S, Quigley C. Health professionals' attitudes to MMR vaccine. Format of "green book" should be changed. BMJ 2001; 322:1120. [PMID: 11360902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
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Granter SR, Weilbaecher KN, Quigley C, Fletcher CD, Fisher DE. Clear cell sarcoma shows immunoreactivity for microphthalmia transcription factor: further evidence for melanocytic differentiation. Mod Pathol 2001; 14:6-9. [PMID: 11211309 DOI: 10.1038/modpathol.3880249] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [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: 11/08/2022]
Abstract
Microphthalmia transcription factor, a melanocytic nuclear protein critical for the embryonic development and postnatal viability of melanocytes, is a master regulator in modulating extracellular signals. Recently, microphthalmia transcription factor expression was shown to be both a sensitive and specific marker of epithelioid melanoma. We investigated the sensitivity of D5, an anti-microphthalmia transcription factor antibody, for diagnosis of clear cell sarcoma (also known as malignant melanoma of soft parts). Immunoreactivity in a nuclear pattern for D5 was present in 8 of 12 (75%) tumors. D5 staining was strong in three tumors, moderate in two, and weak in three. S-100 protein expression was seen in all 12 cases that had clear cell sarcoma examined. HMB-45 staining was seen in 11 of 12 (92%) tumors. Focal Melan-A positivity was seen in 3 of 7 (43%) tumors. Although D5 was shown in a previous study to be a highly sensitive and specific marker for epithelioid melanomas, the results of this study expand the spectrum of tumors showing immunoreactivity for D5. D5 immunoreactivity in clear cell sarcoma provides further evidence for melanocytic differentiation in this unusual tumor.
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Affiliation(s)
- S R Granter
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
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Abstract
To understand the origins and function of the human germ cell lineage and to identify germ cell-specific markers we have isolated a human ortholog of the Drosophila gene vasa. The gene was mapped to human chromosome 5q (near the centromere) by radiation hybrid mapping. We show by Northern analysis of fetal and adult tissues that expression of the human VASA gene is restricted to the ovary and testis and is undetectable in somatic tissues. We generated polyclonal antibodies that bind to the VASA protein in formalin-fixed, paraffin-embedded tissue and characterized VASA protein expression in human germ cells at various stages of development. The VASA protein is cytoplasmic and expressed in migratory primordial germ cells in the region of the gonadal ridge. VASA protein is present in fetal and adult gonadal germ cells in both males and females and is most abundant in spermatocytes and mature oocytes. The gene we have isolated is thus a highly specific marker of germ cells and should be useful for studies of human germ cell determination and function.
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Affiliation(s)
- D H Castrillon
- Women's and Perinatal Pathology Division, Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
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Sin J, Quigley C, Davies M. Survey of raw egg use by home caterers. Commun Dis Public Health 2000; 3:90-4. [PMID: 10902249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Outbreaks of egg related salmonella infection continue to occur despite over ten years of national guidance on this subject. Fifty-four out of 70 registered home caterers in Cheshire responded to a telephone questionnaire, which revealed that a sixth prepared raw egg dishes containing shell eggs, none used pasteurised egg, and advice about storage of eggs and handwashing was not always followed. A postal questionnaire sent to 13 wholesalers and major supermarket chains showed that pasteurised egg was available in large packs from wholesalers but not from supermarkets. It is time to consider new approaches to reinforce advice about pasteurised egg use for raw egg dishes, storage, and measures to prevent cross contamination. These findings have implications for the training of home caterers and the general public.
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Affiliation(s)
- J Sin
- Cheshire and Wirral Communicable Disease Unit, Chester Public Health Laboratory.
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Hunter PR, Quigley C. Investigation of an outbreak of cryptosporidiosis associated with treated surface water finds limits to the value of case control studies. Commun Dis Public Health 1998; 1:234-8. [PMID: 9854880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Fifty-two cases of cryptosporidiosis satisfied the case definition employed in investigation of an outbreak in Spring 1996 among residents of the Wirral peninsula supplied by a single water treatment plant using river water. The attack rate among those whose water was supplied solely from the plant was 1.42 per 10,000, compared with 0.42/10,000 among those having some but less than 50% supplied from it. Single oocysts were detected in treated water from this plant on four occasions during the investigation. A case control study did not demonstrate a significant association between illness and water consumption and no obvious failure in water treatment procedures occurred during the relevant period. Nevertheless, according to PHLS criteria, this outbreak was strongly associated with water, as the descriptive epidemiology was consistent and oocysts were detected, albeit in small numbers, in treated water. This paper discusses the value of detection of oocysts and case control studies in investigating waterborne outbreaks of cryptosporidiosis. Populations that normally drink surface water, particularly river water, are thought to be exposed repeatedly to cryptosporidium oocysts and so develop some protective immunity. Case control studies are therefore likely to have less power in the investigation of outbreaks in localities where the population normally drink treated surface water. Although oocysts are often isolated from treated surface waters without being associated with obvious disease in the population, their detection should still be considered in assessing the strength of association of waterborne outbreaks.
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Affiliation(s)
- P R Hunter
- Public Health Laboratory, Countess of Chester Health Park, Chester
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24
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Abstract
OBJECTIVE To evaluate the efficacy of a self-collected vaginal introital specimen, obtained by women using only an instruction booklet as a guide, for the detection of Chlamydia trachomatis using polymerase chain reaction (PCR). METHODS Comparison analysis in an Urban hospital clinic, using a convenience sample of 101 women undergoing screening or treatment for C trachomatis infection. Subjects were given an illustrated instruction booklet and were asked to collect a single specimen from the vaginal introitus using the Amplicor collection kit. Cervical and introital specimens then were obtained by clinicians. The presence of C trachomatis in patient-collected versus clinician-collected samples was determined by PCR. Discordant specimens were retested by PCR, using primer pairs to the C trachomatis major outer membrane protein gene, and were screened for the presence of PCR assay inhibitors. RESULTS Ninety-nine subjects completed the self-collection. Sixty-two percent were adolescents and 17% spoke English as their second language. Forty-three percent had never used tampons, and 36% had never looked at their own genitals. Twenty-eight cervical specimens (28%), 32 clinician-collected introital specimens (32%), and 33 self-collected introital specimens (33%) were positive for C trachomatis infection. All clinician-collected introital specimens that were positive for C trachomatis and all cervical specimens that were positive for C trachomatis were positive on self-test. Compared with clinician-collected introital specimens, self-collected specimens had a sensitivity of 100% and a specificity of 98.5%. Compared with cervical specimens, self-collected specimens had a sensitivity of 100% and a specificity of 93.4%. After discrepant analysis, self-test had a sensitivity of 100% and a specificity of 94.6% for detection of C trachomatis cervical infection. CONCLUSION Self-collection of introital samples is both sensitive and specific in screening for C trachomatis.
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Affiliation(s)
- M Polaneczky
- Department of Obstetrics and Gynecology, Cornell University Medical College, New York, New York, USA.
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Quigley C. Investigation of tuberculosis in an adolescent. The Outbreak Control Team. Commun Dis Rep CDR Rev 1997; 7:R113-6. [PMID: 9256532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In February 1996, sputum smear positive tuberculosis was diagnosed in an adolescent white girl born in the United Kingdom. The investigation was complex because the index case had attended two schools and had a large extended family. The extent of transmission was consistent with "adult" pulmonary disease; eight previously unvaccinated contacts showed evidence of infection: one had proven tuberculosis, four had pulmonary radiological changes and positive Heaf test results, and three had positive Heaf test results. Seven of the eight were family/ household contacts, the eighth was a school contact. Current guidelines for the management of tuberculosis in schools were followed in this investigation and it was concluded that they remain appropriate. The source of infection for the index case was not definitely established. It may have been an adult who presented with active tuberculosis in 1994. The index case had erythema nodosum with a normal chest radiograph in 1993.
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Affiliation(s)
- C Quigley
- Cheshire and Wirral Communicable Disease Unit, Chester Public Health Laboratory
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26
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Quigley C. Nifedipine for hiccups. J Pain Symptom Manage 1997; 13:313. [PMID: 9204645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Mulloy E, Donaghy D, Quigley C, McNicholas WT. A one-year prospective audit of an asthma education programme in an out-patient setting. Ir Med J 1996; 89:226-8. [PMID: 8996955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A prospective randomised trial was performed to evaluate the effectiveness of an asthma education programme administered by an asthma nurse specialist in an out-patient setting. Sixty asthmatic patients (mean age 28.5 years) were enrolled, 30 to a usual care control group and 30 to an education group. The education group underwent an individual education programme lasting at least one hour. The following variables were measured at baseline, one month after the education programme and at one year follow-up: asthma knowledge by MCQ (36 point questionnaire), inhaler technique (7 point scale), peak expiratory flow rate (PEFR) and symptomatology by visual analogue score (0 to 10 score). The education group's inhaler technique and MCQ score both improved significantly at one month, from 5.4 (0.3) (mean [SEM]) to 6.5 (0.3), p < 0.001, and from 7.5 (2.4) to 22 (1.8), p < 0.0001 respectively. Both of these improvements were significantly greater than in the control group, and both were maintained at one year follow-up. The symptom score improved over one year in the education group, from 5.4 (0.6) to 7.6 (0.5), p < 0.05, and was unchanged in the control group. There was no change in the PEFR in either group. This study shows clear objective benefits to an out-patient asthma education programme conducted by an asthma nurse specialist.
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Affiliation(s)
- E Mulloy
- Department of Respiratory Medicine & Asthma Education Centre, St. Vincent's Hospital, Elm Park, Dublin 4, Ireland
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Quigley C. Postgraduate research training. Palliat Med 1996; 10:346. [PMID: 8931076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Sadler DW, Quigley C. Unsuspected self-poisoning with flecainide and alcohol. J Forensic Sci 1995; 40:903-5. [PMID: 7595337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The death of a 23-year-old man by suicidal flecainide and alcohol poisoning is reported. Flecainide was identified by ultraviolet (UV) spectrophotometry and gas chromatography-mass spectrometry (GC-MS). Flecainide levels, quantitated by high performance liquid chromatography (HPLC) with UV detection were: femoral blood 7.3 mg/L, urine 117 mg/L, stomach contents 19 mg and liver 302 mg/kg. Ethanol levels in femoral blood, urine and vitreous humor were 107, 136 and 113 mg%, respectively. The importance of carefully considering all the available pathological and toxicological data, together with the past medical history and circumstances surrounding the death in poisoning cases is emphasized.
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Affiliation(s)
- D W Sadler
- Department of Forensic Medicine, Dundee Royal Infirmary, Scotland
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Crawshaw SC, Gill ON, Heptonstall J, Rowland MG, West RJ, Hill JM, Davies AB, Dunbar EM, Buttery RB, Quigley C. Outcome of an exercise to notify patients treated by an obstetrician/gynaecologist infected with HIV-1. Commun Dis Rep CDR Rev 1994; 4:R125-8. [PMID: 7787920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Experience with hepatitis B suggests that the risk of HIV transmission from a health care worker infected with HIV to a patient will be greatest during major surgical procedures. The number of patients worldwide who are known to have undergone such procedures, been notified, and subsequently tested is still too small to be confident that the risk of HIV transmission in these circumstances is negligible. We describe a patient notification exercise, undertaken in the United Kingdom in 1991. Attempts were made to contact 1217 patients, in three health districts (A, B, and C), who had undergone surgical procedures performed by an obstetrician/gynaecologist who was infected with HIV. The exercise aimed to offer the patients reassurance, counselling and--if they wished--HIV testing. One thousand one hundred and forty-two patients (94%) were contacted, and all 520 who elected to be tested were negative for anti-HIV. The proportion of identified patients tested was 63% in district A, 35% in district B, and 61% in district C. Surgical procedures were classified retrospectively according to the likely risk (none, possible, or high) of exposure to the doctor's blood and, therefore, risk of HIV transmission. One hundred and ninety-five of those tested had undergone a procedure that carried a high risk of exposure; 179 had undergone a procedure thought to carry no risk. Patients in districts A and C who had undergone a procedure that carried a high risk of exposure were more likely to be tested than those who had not; 206 patients overall had undergone procedures that carried a high risk of exposure but were not subsequently tested.(ABSTRACT TRUNCATED AT 250 WORDS)
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Carson KD, Grimes SB, McGinley JM, Thornton MT, Mulhall J, Bourke AM, McCrory C, Marsh B, Hone R, Phelan D, White M, Fabry J, Hughes D, Carson K, Donnelly M, Shanahan E, Fitzpatrick GJ, Bourke M, Warde D, Buggy D, Hughes N, Taylor A, Dowd N, Markham T, Blunnie W, Nicholson G, O’Leary E, Cunningham AJ, Dwyer R, McMechan S, Cullen C, Dempsey G, Wright G, MacKenzie G, Anderson J, Adgey J, Walsh M, O’Callaghan P, Graham I, O’Hare JA, Geoghegan M, Iman N, Shah P, Chander R, Lavin F, Daly K, Johnston PW, Imam Z, Adgey AAJ, Rusk RA, Richardson SG, Hale A, Kinsella BM, FitzGerald GA, King G, Crean P, Gearty G, Cawley T, Docherty JR, Geraghty J, Osborne H, Upton J, D’Arcy G, Stinson J, Cooke T, Colgan MP, Hall M, Tyrrell J, Gaffney K, Grouden M, Moore DJ, Shanik G, Feely J, Delanty N, Reilly M, Lawson JA, Fitzgerald DJ, Reilly MP, McAdam BF, Bergin C, Walshe MJ, Herity NA, Allen JD, Silke B, Singh HP, O’Neill S, Hargrove M, Coleman E, Shorten E, Aherne T, Kelly BE, Hill DH, McIlrath E, Morrow BC, Lavery GG, Blackwood B, Fee JPH, Kevin L, Doran M, Tansey D, Boylan I, McShane AJ, O’Reilly G, Tuohy B, Grainger P, Larkin T, Mahady J, Malone J, Condon C, Donoghue T, O’Leary J, Lyons JF, Tay YK, Tham SN, Khoo Tan HS, Gibson G, O’Grady A, Leader M, Walshe J, Carmody M, Donohoe J, Murphy GM, O’Connor W, Barnes L, Watson R, Darby C, O’Moore R, Mulcahy F, O’Toole E, O’Briain DS, Young MM, Buckley D, Healy E, Rogers S, Ni Scannlain N, McKenna MJ, McBrinn Y, Murray B, Freaney R, Barrett E, Razza Q, Abuaisha F, Powell D, Murray TM, Powell AM, O’Mongain E, O’Neill J, Kernan RP, O’Connor P, Clarke D, Fearon U, Cunningham SK, McKenna TJ, Hayes F, Heffernan A, Sheahan K, Harper R, Johnston GD, Atkinson AB, Sheridan B, Bell PM, Heaney AP, Loughrey G, McCance DR, Hadden DR, Kennedy AL, McNamara P, O’Shaughnessy C, Loughrey HC, Reid I, Teahan S, Caldwell M, Walsh TN, McSweeney J, Hennessy TP, Caldwell MTP, Byrne PJ, Hennessy TPJ, El-Magbri AA, Stevens FM, O’Sullivan R, McCarthy CF, Laundon J, Heneghan MA, Kearns M, Goulding J, Egan EL, McMahon BP, Hegarty F, Malone JF, Merriman R, MacMathuna P, Crowe J, Lennon J, White P, Clarke E, Prabhakar MC, Ryan E, Graham D, Yeoh PL, Kelly P, McKeogh D, O’Keane C, Kitching A, Mulligan E, Gorey TF, Mahmud N, O’Connell M, Goggins M, Keeling PWN, Weir DG, Kelleher D, McDonald GSA, Maguire D, O’Sullivan G, Harvey B, Cherukuri A, McGrath JP, Timon C, Lawlor P, O’Shea J, Buckley M, English L, Walsh T, O’Morain C, Lavelle SM, Kanagaratnam B, Harding B, Murphy B, Kavanagh J, Kerr D, Lavelle E, O’Gorman T, Liston S, Fitzpatrick C, Fitzpatrick P, Turner M, Murphy AW, Cafferty D, Dowling J, Bury G, Kaf Al-Ghazal S, Zimmermann E, O’Donoghue J, McCann J, Sheehan C, Boissel L, Lynch M, Cryan B, Fanning S, O’Meara D, Fennell J, Byrne PM, Lyons D, Mulcahy R, Pooransingh A, Walsh JB, Coakley D, O’Neill D, Ryall N, Connolly P, Namushi R, Lawler M, Locasciulli A, Bacigalupo A, Humphries P, McCann SR, Pamphilon D, Reidy M, Madden M, Finch T, Borton M, Barnes CA, Lawlor SE, Gardiner N, Egan LJ, Orren A, Doherty J, Curran C, O’Hanlon D, Kent P, Kerin M, Maher D, Given HF, Lynch S, McManus R, O’Farrelly C, Madrigal L, Feighery C, O’Donoghue D, Whelan CA, Rea IM, Stewart M, Campbell P, Alexander HD, Crockard AD, Morris TCM, Maguire H, Davidson F, Kaminski GZ, Butler K, Hillary IB, Parfrey NA, Crowley B, McCreary C, Keane C, O’Reilly M, Goh J, Kennedy M, Fitzgerald M, Scott T, Murphy S, Hildebrand J, Holliman R, Smith C, Kengasu K, Riain UN, Cormican M, Flynn J, Glennon M, Smith T, Whyte D, Keane CT, Barry T, Noone D, Maher M, Dawson M, Gilmartin JJ, Gannon F, Eljamel MS, Allcut D, Pidgeon CN, Phillips J, Rawluk D, Young S, Toland J, Deveney AM, Waddington JL, O’Brien DP, Hickey A, Maguire E, Phillips JP, Al-Ansari N, Cunney R, Smyth E, Sharif S, Eljamel M, Pidgeon C, Maguire EA, Burke ET, Staunton H, O’Riordan JI, Hutchinson M, Norton M, McGeeney B, O’Connor M, Redmond JMT, Feely S, Boyle G, McAuliffe F, Foley M, Kelehan P, Murphy J, Greene RA, Higgins J, Darling M, Byrne P, Kondaveeti U, Gordon AC, Hennelly B, Woods T, Harrison RF, Geary M, Sutherst JR, Turner MJ, DeLancey JOL, Donnelly VS, O’Connell PR, O’Herlihy C, Barry-Kinsella C, Sharma SC, Drury L, Lewis S, Stratton J, Ni Scanaill S, Stuart B, Hickey K, Coulter-Smith S, Moloney A, Robson MS, Murphy M, Keane D, Stronge J, Boylan P, Gonsalves R, Blankson S, McGuinness E, Sheppard B, Bonnar J, MacDonagh-White CM, Kelleher CC, Newell J, White O, Young Y, Hallahan C, Carroll K, Tipton K, McDermott EW, Reynolds JV, Nolan N, McCann A, Rafferty R, Sweeney P, Carney D, O’Higgins NJ, Duffy MJ, Grimes H, Gallagher S, O’Hanlon DM, Strattan J, Lenehan P, Robson M, Cusack YA, O’Riordain D, Mercer PM, Smyth PPA, Gallagher HJ, Moule B, Cooke TG, McArdle CS, Burke C, Vance A, Saidtéar C, Early A, Eustace P, Maguire L, Cullinane ABP, Prosser ES, Coca-Prados M, Harvey BJ, Saidléar C, Orwa S, Fitzsimons RB, Bradley O, Hogan M, Zimmerman L, Wang J, Kuliszewski M, Liu J, Post M, Premkumar, Conran MJ, Nolan G, Duff D, Oslizlok P, Denham B, O’Connell PA, Birthistle K, Hitchcock R, Carrington D, Calvert S, Holmes K, Smith DF, Hetherton AM, Mott MG, Oakhill A, Foreman N, Foot A, Dixon J, Walsh S, Mortimer G, O’Sullivan C, Kilgallen CM, Sweeney EC, Brayden DJ, Kelly JG, McCormack PME, Hayes C, Johnson Z, Dack P, Hosseini J, O’Connell T, Hemeryck L, Condren L, McCormack P, McAdam B, Lawson J, Keimowitz R, O’Leary A, Pilkington R, Adebayo GI, Gaffney P, McGettigan P, McManus J, O’Shea B, Wen Y, Killalea S, Golden J, Swanwick G, Clare AW, Mulvany F, Byrne M, O’Callaghan E, Byrne H, Cannon N, Kinsella T, Cassidy B, Shepard N, Horgan R, Larkin C, Cotter D, Coffey VP, Sham PC, Murray LH, Lane A, Kinsella A, Murphy P, Colgan K, Sloan D, Gilligan P, McEnri J, Ennis JT, Stack J, Corcoran E, Walsh D, Thornton L, Temperley I, Lawlor E, Tobin A, Hillary I, Nelson HG, Martin M, Ryan FM, Christie MA, Murray D, Keane E, Holmes E, Hollyer J, Strangeways J, Foster P, Stanwell-Smith R, Griffin E, Conlon T, Hayes E, Clarke T, Fogarty J, Moloney AC, Killeen P, Farrell S, Clancy L, Hynes M, Conlon C, Foley-Nolan C, Shelley E, Collins C, McNamara E, Hayes B, Creamer E, LaFoy M, Costigan P, Al fnAnsari N, Cunney RJ, Smyth EG, Johnson H, McQuoid G, Gilmer B, Browne G, Keogh JAB, Jefferson A, Smith M, Hennessy S, Burke CM, Sreenan S, Power CK, Pathmakanthan S, Poulter LW, Chan A, Sheehan M, Maguire M, O’Connor CM, FitzGerald MX, Southey A, Costello CM, McQuaid K, Urbach V, Thomas S, Horwitz ER, Mulherin D, FitzGerald O, Bresnihan B, Kirk G, Veale DJ, Belch JJF, Mofidi A, Mofidi R, Quigley C, McLaren M, Veale D, D’Arrigo C, Couto JC, Woof J, Greer M, Cree I, Belch J, Hone S, Fenton J, Hamilton S, McShane D. National Scientific Medical Meeting 1994 Abstracts. Ir J Med Sci 1994. [DOI: 10.1007/bf02943102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Detailed toxicological studies were undertaken on two suicides by amitriptyline overdose, one with salicylate also. In the first case, 10 initial blood samples taken 21 h after body discovery and an estimated 28 1/2 h after overdose had drug concentration (mg/L) ranges of 2.5-12 for amitriptyline (AM), 0.7-3.1 for nortriptyline (NOR), and 81-244 for salicylate (SAL). Ten blood samples taken 42 h later showed corresponding ranges of 1-39 AM, 0.6-7.0 NOR, and 86-310 SAL. Sample haemoglobin concentrations (range, 8.7-23.5 g/dl) did not correlate with drug concentrations. Postmortem increase in pulmonary vein AM concentration occurred more rapidly than in the pulmonary artery, likely reflecting relative ease of diffusion across the vessel walls from lung (AM, 60 mg/kg). In nine tissue samples, drug concentrations (mg/kg) were highest in the liver: AM, 301; and SAL, 670. Considerable drug residue was present in gastric contents, duodenal contents, and seven sequential small bowel contents. In both cases, sanguineous putrefactive pleural fluid showed higher AM concentrations on the left than on the right (2.0 vs 1.4 and 23 vs 16), likely reflecting diffusion from gastric drug residue. The detailed case data illustrate the intensity and complexity of postmortem drug diffusion from reservoirs in solid organs, such as the lungs, and unabsorbed gastric residue, into the blood and putrefactive fluids.
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Affiliation(s)
- D J Pounder
- Department of Forensic Medicine, University of Dundee, Scotland
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Richardson JA, Quigley C. An outbreak of measles in Trafford. Commun Dis Rep CDR Rev 1994; 4:R73-5. [PMID: 7519516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In the autumn of 1993 an outbreak of measles occurred in Trafford, Greater Manchester, associated with two junior schools. Thirty-four cases were reported. Twenty-five of the 32 cases whose ages were known were aged between 7 and 11 years. The mean age was 8.6 years, and the median and modal age was 10. Two of the cases had received measles vaccine. Eighteen of the 19 cases who provided samples were confirmed as measles by laboratory tests. The incident showed that extensive resources are needed to investigate such outbreaks and implement control measures, and identified problems with the local child health computer system. The outbreak did, however, provide an opportunity to immunise children within the district who had not previously received measles vaccine. It is important for unprotected siblings of affected children to be vaccinated to prevent the secondary spread of infection, and all cases of measles should be notified promptly so that outbreaks can be identified.
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Affiliation(s)
- J A Richardson
- Department of Public Health Medicine, Trafford Health Authority
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Chan KH, Singh HP, Aherne T, Carabine U, Gilliland H, Johnston JR, Lowry KG, McGuigan J, Cosgrove J, Veerasingham D, McCarthy J, Hurley J, Wood AE, Gilliland R, McGuigan JA, McManus KG, Wilkinson P, Johnston LC, MacMahon J, Wilson D, Austin C, Anikin V, McManus K, McGuigan J, McManus K, Anikin V, Gibbons JRP, McGuigan J, Sharkey R, Long M, Maree A, O’Neill S, Maguire CP, Hayes JP, Masterson J, Fitzgerald MX, Hayes M, Maguire CP, Hayes JP, Masterson J, Fitzgerald MX, Quigley C, Mofidi A, Mofidi R, Fitzgerald MX, O’Neill M, Watson JBG, O’Halloran ET, Shortt C, Taylor M, Holland C, O’Lorcain P, Taylor M, Holland C, O’Lorcain P, Pathmakanthan S, Sreenan S, Power CK, Poulter LW, Burke CM, Reilly D, Pathmakanthan S, Sreenan S, Doyle S, Burke CM, Sreenan S, Power C, Pathmakanthan S, Goggin A, Burke CM, Poulter LW, Sreenan S, Doyle S, Pathmakanthan S, Poulter LW, Burke CM, Sreenan S, Debenham P, Pathmakanthan S, Burke CM, Poulter LW, Southey A, O’Connor CM, Fitzgerald MX, Bourke WJ, McDonnell TJ, Buck JB, Magee TRA, Lowry RC, Graham ANJ, Owens WA, Kelly SB, McGuigan JA, Costelloe RW, Ryan J, Collins J, Guerin D, Rooney D, Long E, O’Donnell M, O’Neill S, Cotter TP, Bredin CP, Buick JB, Lowry RC, MacMahon JJ, Finlay G, Concannon D, McDonnell TJ, Reid PT, Alderdice J, Carson J, Sinnamon DG, Murphy S, Scott T, Keane CT, Walsh JB, Coakley D, McKeown D, Kelly P, Clancy L, Kiely JL, Cryan B, Bredin CP, Killeen P, Farrell S, Kelly P, Clancy L, Kiely JL, O’Riordan DM, Sheehan S, Curtain J, Hogan J, Bredin CP, Malone A, Ahmed S, Watson JBG, Murphy M, Fennell W, Ahmed S, Watson JBG, Aherne T, Keohane C, O’Neill M, Gleeson CM, McGuigan J, Ritchie AJ, Russell SEH, Molloy E, Keane M, Coakley R, Costello R, Condron C, Watson RGW, O’Neill S, Kelly C, Redmond H, Watson W, Burke P, Bouchier-Hayes D, Donnelly SC, Haslett C, Dransfield I, Robertson CE, Carter DC, Ross JA, Grant IS, Tedder TF, Doyle S, Sreenan S, Pathmakanthan S, Burke CM, Heaney LG, Cross LJM, Stanford CF, Ennis M, Sreenan S, Pathmakanthan S, Power C, Goggin A, Poulter LW, Burke CM, Murphy S, Scott T, Keane CT, Walsh JB, Coakley D, O’Riordan DM, Gergely L, Deng N, Rose RM, Hennessy T, Hickey L, Thornton L, Collum C, Durity M, Power J, Johnson H, Lee B, Doherty E, Kelly E, McDonnell T, McKeown D, Kelly P, Clancy L, Wilkinson P, Varghese G, Anikin V, Gibbons J, McManus K, McGuigan J, Reid PT, Gower NH, Rudd RM. Irish thoracic society. Ir J Med Sci 1994. [DOI: 10.1007/bf02967229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Quigley C. Control of communicable disease. Compulsory removal powers inappropriate. BMJ 1993; 307:59. [PMID: 8343681 PMCID: PMC1678464 DOI: 10.1136/bmj.307.6895.59-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
A study was made in the north-west of England during 1989 in order to ascertain the incidence of serious Haemophilus influenzae infection, its short-term morbidity and certain characteristics of treatment. The incidence of culture-proven infection was 28 per 100,000 children under 5 years of age. Case fatality was 3%, one of the deaths being in a 6-year-old child. Some of the information obtained will help to assess the cost-effectiveness of the new vaccine to be administered to children in the U.K. The mean length of stay in hospital for all cases was 10 days. Of a total of 87 patients, 20 (23%) were admitted to an intensive therapy unit while five were transferred from a district general hospital to a regional paediatric unit. The estimated average cost per episode of acute care was 2700 pounds. Antibiotic regimens varied considerably.
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Affiliation(s)
- C Quigley
- Manchester Public Health Laboratory, University Hospital of South Manchester, Withington, U.K
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Walsh PN, Conliffe C, Abdulkadir AS, Kelehan P, Conroy R, Foley M, Lenehan P, Murphy JF, Stronge J, Cantwell B, Wright C, Millward M, Carpenter M, Lennard T, Wilson R, Home C, Corbett AR, O’Sullivan G, Collins JK, Doran M, McDermott EWM, Mercer P, Smyth P, O’Higgins NJ, Duffy MJ, Reilly D, McDermott E, Faul C, Fennelly JJ, O’Higgins N, Lowry S, Russell H, Atkinson R, Hickey I, O’Brien F, O’Mahony A, O’Donoghue M, Pomeroy M, Prosser ES, Barker F, Casey M, Carroll K, Davis M, Duffy G, O’Kennedy R, Smyth PPA, O’Carroll D, Hetherton AM, Coveney E, McAlister V, Murray MJ, Brayden DJ, O’Hora A, Street J, O’Leary J, Pollock AM, Crowley M, Healy I, Murphy J, Landers R, Burke L, O’Brien D, Annis P, Hogan J, Kealy W, Lewis FA, Doyle CT, Callaghan M, Whelan A, Feighery C, Bresnihan B, Kelleher D, Reams G, Murphy A, Hall N, Casey EB, Mulherin D, Doherty E, Yanni G, Wallace E, Jackson J, Bennett M, Tighe O, Mulcahy H, O’Donoghue D, Croke DT, Cahill RJ, Beattie S, Hamilton H, O’Morain C, Corridan B, Collins RA, O’Morain CA, Fitzgerald E, Gilvarry JM, Leader M, Fielding JF, Johnson BT, Lewis SA, Love AHG, Johnston BT, Collins JSA, McFarland RJ, Johnston PW, Collins BJ, Kilgallen CM, Murphy GM, Markey GM, McCormack JA, Curry RC, Morris TCM, Alexander HD, Edgar S, Treacy M, O’Connell MA, Weir DG, Sheehan J, O’Loughlin G, Traynor O, Walsh N, Xia HX, Daw MA, Keane CT, Dupont C, Gibson G, McGinnity E, Walshe J, Carmody M, Donohoe J, McGrath P, O’Moore R, Kieran E, Rogers S, McKenna KE, Walsh M, Bingham EA, Hughes AE, Nevin NC, Todd DJ, Stanford CF, Callender ME, Burrows D, Paige DG, Allen GE, O’Brien DP, Gough DB, Phelan C, Given HF, Kamal SZ, Kehoe S, Coldicott S, Luesley D, Ward K, MacDonnell HF, Mullins S, Gordon I, Norris LA, Devitt M, Bonnar J, Sharma SC, Sheppard BL, Fitzsimons R, Kingston S, Garvey M, Hoey HMCV, Glasgow JFT, Moore R, Robinson PH, Murphy E, Murphy JFA, Wood AE, Sweeney P, Neligan M, MacLeod D, Cunnane G, Kelly P, Corcoran P, Clancy L, Drury RM, Drury MI, Powell D, Firth RGR, Jones T, Ferris BF, O’Flynn W, O’Donnell J, Kingston SM, Cunningham F, Hinds GME, McCluskey DR, Howell F, O’Mahony M, Devlin J, O’Reilly O, Buttanshaw C, Jennings S, Keane ER, Foley-Nolan C, Ryan FM, Taylor M, Lyons RA, O’Kelly F, Mason J, Carroll D, Doherty K, Flynn M, O’Dwyer R, Gilmartin JJ, McCarthy CF, Armstrong C, Mannion D, Feely T, Fitzpatrick G, Cooney CM, Aleong JC, Rooney R, Lyons J, Phelan DM, Joshi GP, McCarroll SM, Blunnie WP, O’Brien TM, Moriarty DC, Brangan J, Kelly CP, Kenny P, Gallagher H, McGovern E, Luke D, Lowe D, Rice T, Phelan D, Lyons JB, Lyons FM, McCoy DM, McGinley J, Hurley J, McDonagh P, Crowley JJ, Donnelly SM, Tobin M, Fitzgerald O, Maurer BJ, Quigley PJ, King G, Duly EB, Trinick TR, Boyle D, Wisdom GB, Geoghegan F, Collins PB, Goss C, Younger K, Mathias P, Graham I, MacGowan SW, Sidhu P, McEneaney DJ, Cochrane DJ, Adgey AAJ, Anderson JM, Moriarty J, Fahy C, Lavender A, Lynch L, McGovern C, Nugent AM, Neely D, Young I, McDowell I, O’Kane M, Nicholls DP, McEneaney D, Nichols DP, Campbell NPS, Campbell GC, Halliday MI, O’Donnell AF, Lonergan M, Ahearne T, O’Neill J, Keaveny TV, Ramsbottom D, Boucher-Hayes D, Sheahan R, Garadaha MT, Kidney D, Freyne P, Gearty G, Crean P, Singh HP, Hargrove M, Subareddy K, Hurley JP, O’Rourke W, O’Connor C, FitzGerald MX, McDonnell TJ, Chan R, Stinson J, Hemeryck L, Feely J, Chopra MP, Sivner A, Sadiq SM, Abernathy E, Plant L, Bredin CP, Hickey P, Slevin G, McCrory K, Long M, Conlon P, Walker F, Fitzgerald P, O’Neill SJ, O’Connor CM, Quigley C, Donnelly S, Southey A, Healy E, Mulcahy F, Lyons DJ, Keating J, O’Mahony C, Roy D, Shattock AG, Hillary IB, Waiz A, Hossain R, Chakraborthy B, Clancy LP, O’Reilly L, Byrne C, Costello E, O’Shaughnessy E, Cryan B, Farrell J, Walshe JJ, Mellotte GJ, Ho CA, Morgan SH, Bending MR, Bonner J. Inaugural national scientific medical meeting. Ir J Med Sci 1993. [PMCID: PMC7101915 DOI: 10.1007/bf02942100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Quigley C. Preventive Medicine: A Report of a Working Party of the Royal College of Physicians. Br J Soc Med 1993. [DOI: 10.1136/jech.47.1.78-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quigley C, Garvey P. Promoting sexual health. BMJ 1992; 305:363-4. [PMID: 1392896 PMCID: PMC1882999 DOI: 10.1136/bmj.305.6849.363-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
Seven of nine people developed gastro-intestinal symptoms between 18 and 27 h after eating a trifle with a topping containing raw eggs. Salmonella enteritidis Phage Type (PT) 4 was isolated both from the faeces of affected persons and from eggs remaining in the same box as those used to prepare the topping. The findings show that eggs being produced and sold in the U.K. still contain S. enteritidis PT4 and that this is continuing to cause human infection.
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Affiliation(s)
- C Harrison
- Department of Public Health Medicine, Trafford Health Authority, Urmston, Manchester, U.K
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Cruickshank R, Quigley C. Gastroenteritis and poached salmon. CDR (Lond Engl Rev) 1991; 1:R124. [PMID: 1669750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Smolen S, Quigley C. The action approach. Integrating a community's needs into the corporate planning process. Health Prog 1991; 72:73-5, 80. [PMID: 10111807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
With the city of Detroit in turmoil, Mercy Hospitals and Health Services of Detroit (MHHSD) is trying to assimilate the community's unmet needs into the corporate planning process. Through the Community Assessment of Human Needs process, MHHSD identified the needs of the poor in three of Michigan's most impoverished areas. On the basis of these findings, MHHSD collaborated with the Poverty and Social Reform Institute to form the East Side Initiative, a community planning effort to address the community's unmet needs. An advisory group was established to oversee the East Side Initiative's planning process. The East Side Initiative participants met as one group and in smaller groups to focus on specific needs in the areas of healthcare, crime prevention, substance abuse, education, housing, economic development, and family (social) supports. The proposed action plans of each small group have received approval. In the second phase of the East Side Initiative participants will attempt to obtain the necessary resources to implement the groups' proposed actions.
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Affiliation(s)
- S Smolen
- Samaritan Health Center, Detroit, MI
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Mitchell E, O'Mahony M, Watson JM, Lynch D, Joseph C, Quigley C, Aston R, Constable GN, Farrand RJ, Maxwell S. Two outbreaks of Legionnaires' disease in Bolton Health District. Epidemiol Infect 1990; 104:159-70. [PMID: 2323354 PMCID: PMC2271757 DOI: 10.1017/s095026880005932x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [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: 12/31/2022] Open
Abstract
In 1988, there were two outbreaks of legionellosis in Bolton Health District. Altogether 37 cases of Legionnaires' disease and 23 cases of non-pneumonic legionellosis were identified. Twenty-five patients with Legionnaires' disease were associated with an engineering plant, 4 with Bolton town centre, and 8 with both the plant and town centre. Twenty-two people with non-pneumonic legionellosis were linked with the engineering plant and one with the plant and the town centre. A case-control study carried out among 37 employees with legionellosis and 109 control subjects at the plant showed that infection was associated with one of the 15 cooling towers on the site. Legionella pneumophila indistinguishable by serological and genetic typing methods was isolated from this cooling tower and from sputum samples from two patients. In the town centre, no one tower was linked with infection and L. pneumophila was not cultured from any of the nine towers identified. Control measures were implemented and to date there have been no further cases of legionellosis associated with Bolton Health District.
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Affiliation(s)
- E Mitchell
- Public Health Laboratory Service, Communicable Disease Surveillance Centre, London
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Werther GA, Warne GL, Ennis G, Gold H, Silink M, Cowell CT, Quigley C, Howard N, Antony G, Byrne GC. Luteinizing hormone-releasing hormone analogue (Buserelin) treatment for central precocious puberty: a multi-centre trial. J Paediatr Child Health 1990; 26:4-8. [PMID: 2109996 DOI: 10.1111/j.1440-1754.1990.tb02369.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A multi-centre open trial of Buserelin, a luteinizing hormone-releasing hormone (LHRH) analogue, was conducted in 13 children with central precocious puberty. Eleven children (eight girls and three boys), aged 3.4-10.2 years at commencement, completed the required 12 month period of treatment. Initially all patients received the drug by intranasal spray in a dose of 1200 micrograms/day, but by the end of the 12 month period two were having daily subcutaneous injections and three were receiving an increased dose intranasally. The first month of treatment was associated in one boy with increased aggression and masturbation, and in the girls with an increase in the prevalence of vaginal bleeding. Thereafter, however, both behavioural abnormalities and menstruation were suppressed. Median bone age increased significantly during the study, but without any significant change in the ratio of height age to bone age. The median predicted adult height for the group therefore did not alter significantly over the twelve months of the study. Buserelin treatment caused a reduction in the peak luteinizing hormone and follicle-stimulating hormone (FSH) responses to LHRH, mostly to prepubertal levels, and also suppressed basal FSH. In the first weeks of treatment, the girls' serum oestradiol levels rose significantly and then fell to prepubertal or early pubertal levels. A similar pattern was seen for serum testosterone levels. Serum somatomedin-C levels, however, showed little fluctuation over the course of the study. Buserelin treatment was safe and well accepted, and offers the promise of improved linear growth potential in precocious puberty.
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Affiliation(s)
- G A Werther
- Royal Children's Hospital, Melbourne, Victoria, Australia
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Quigley C, Cowell C, Jimenez M, Burger H, Kirk J, Bergin M, Stevens M, Simpson J, Silink M. Normal or early development of puberty despite gonadal damage in children treated for acute lymphoblastic leukemia. N Engl J Med 1989; 321:143-51. [PMID: 2501681 DOI: 10.1056/nejm198907203210303] [Citation(s) in RCA: 132] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To determine the timing of pubertal development and the frequency of gonadal dysfunction in children who survive acute lymphoblastic leukemia, we assessed pubertal status and the plasma levels of sex steroids, gonadotropin, and inhibin in 45 children (20 girls and 25 boys) who had received combination chemotherapy along with 24 Gy of irradiation to the cranium (modified LSA2L2 protocol). We also reexamined testicular biopsy specimens, obtained at the time of the cessation of chemotherapy, for the presence of germ cells. Germ-cell damage, indicated by marked elevations in the plasma level of follicle-stimulating hormone (P less than 0.001 for the comparison with normal children), was evident in both sexes and was confirmed in the boys by the absence of germ cells in the testicular biopsy specimens and by the small size of the testes for pubic-hair stage. Only 44 percent of the pubertal girls had measurable plasma inhibin levels, as compared with more than 93 percent of normal pubertal girls. Although plasma sex-steroid levels were normal, the secretion of luteinizing hormone in response to stimulation with gonadotropin-releasing hormone was elevated in the pubertal children (P less than 0.01 for the comparison with normal controls)--a finding that suggests compensation for decreased gonadal function. Despite clear evidence of gonadal damage, girls had early menarche at a mean age (+/- SD) of 11.95 +/- 0.91 years, as compared with the Australian standard of 12.98 +/- 1.11 years (P less than 0.01). Thus, in girls, puberty was early despite primary gonadal damage. Thirteen of 23 boys reached puberty at a mean age of 12.36 +/- 0.73 years. We conclude that treatment for acute lymphoblastic leukemia may lead to primary gonadal damage in both sexes, regardless of the age at treatment, but that the secondary characteristics of puberty develop at a normal age or, in girls, relatively early.
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Affiliation(s)
- C Quigley
- Institute of Endocrinology, Royal Alexandra Hospital for Children, Camperdown, Australia
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48
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Abstract
1. The game of squash has recently been associated with a high incidence of ventricular arrhythmias and sudden death. To investigate this further, plasma catecholamines and potassium (K+) were monitored during a game of squash in six normal volunteers. 2. No cardiac arrhythmias were seen in this study despite the subjects reaching maximum heart rates of 181 +/- 5 beats/min (mean +/- SEM). 3. During exercise, plasma K+ rose from 3.82 +/- 0.16 to 4.29 +/- 0.2 mmol/l, but after 90 s rest this fell to 3.68 +/- 0.28 mmol/l and after 180 s to 3.44 +/- 0.17 mmol/l. This rapid K+ shift could not be accounted for by generalized changes in venous acid-base status or by changes in venous plasma catecholamines. Although pretreatment with a beta 2-antagonist caused the overall plasma K+ levels to be higher, it had no significant effect on the fall in plasma K+ after exercise. 4. Such rapid K+ shifts after exercise might contribute to arrhythmogenesis in susceptible individuals. The precise mechanism of the fall in K+ after exercise remains undetermined, but it seems not to involve catecholamines stimulating beta 2-adrenoceptors and is more likely to be due to increased skeletal muscle blood flow and/or intracellular acidosis.
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Affiliation(s)
- A D Struthers
- Department of Clinical Pharmacology, Royal Postgraduate Medical School, London
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Abstract
Fifteen patients presented during a four-year period with a pseudothrombophlebitis syndrome, subsequently confirmed arthrographically as being due to popliteal cyst rupture. Initially the majority of patients (73%) were erroneously diagnosed as having calf vein thrombosis, and were anticoagulated for periods of three to ten days. Clinical differentiation from venous thrombosis was usually impossible. Contrast arthrography was the definitive diagnostic investigation, revealing popliteal cysts in all patients, and an active synovial leak into the calf in 13 cases (87%). The mean delay in performing arthrography was 5.3 days, the procedure usually being performed after normal contrast venography. Doppler and isotope venography yielded misleading or equivocal results (42%) delaying diagnosis, and prolonging periods of potentially dangerous anticoagulation. We suggest that the marked overlap in the emergency presentation of popliteal cyst rupture and calf vein thrombosis mandates the aggressive use of arthrography combined with venography in all patients presenting with a painful swollen leg.
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Affiliation(s)
- H R Brady
- Department of Medicine, St Vincent's Hospital, Elm Park, Dublin, Ireland
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Struthers AD, Davies DL, Harland D, Price JS, Brown RA, Quigley C, Brown MJ. Adrenaline causes potassium influx in skeletal muscle and potassium efflux in cardiac muscle in rats: the role of Na/K ATPase. Life Sci 1987; 40:101-8. [PMID: 3025540 DOI: 10.1016/0024-3205(87)90258-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Previous in vitro evidence suggests that adrenaline causes K influx in skeletal muscle by stimulating a ouabain sensitive Na/K ATPase membrane pump. However in rabbits, adrenaline induced hypokalaemia was not significantly altered by pretreatment with digoxin (50 micrograms/kg). Rats were infused with adrenaline or saline after being given a tracer dose of 42KCl. Adrenaline caused a highly significant uptake of 42K in skeletal muscle and a decrease in 42K uptake in ventricle. Rats were also studied after receiving a high dose of digoxin (1.4 mg/kg) which by itself produced a significant increase in plasma K, a decrease in plasma Na and a decreased uptake of 42K in ventricle and lung. These results suggest that adequate widespread Na/K ATPase inhibition had been achieved by this dose of digoxin but despite this, adrenaline still caused hypokalaemia and also still caused significant 42K tissue uptake by skeletal muscle. These results suggest that adrenaline causes K influx by skeletal muscle and K efflux by cardiac tissue. Furthermore, the former mechanism was not inhibited by pretreatment with digoxin.
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