1
|
Zironda A, Zhang C, Day C, McWilliams RR, Starlinger P, Warner SG, Smoot RL, Cleary SP, Kendrick ML, Truty MJ, Thiels CA. Early vs conventional onset pancreatic ductal adenocarcinoma: analysis of surgical and oncologic outcomes in patients undergoing curative intent resection. HPB (Oxford) 2024; 26:145-153. [PMID: 37752029 DOI: 10.1016/j.hpb.2023.09.010] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) impacts patients in their 60s, but its incidence in younger patients is increasing. We hypothesize that younger patients may have worse oncologic outcomes. METHODS Patients who underwent curative pancreatic resection for PDAC between January 2011 and December 2021 at a single institution were analyzed. Early-onset pancreatic cancer (EOPC) was defined as pancreatic cancer diagnosed in patients ≤50 years. Clinical and survival outcomes were compared between EOPC and Conventional Onset Pancreas Cancer (COPC). RESULTS A total of 1133 patients were identified, 65 (5.7%) were EOPC. Preoperative patient characteristics including sex, smoking status, alcohol habitus, diabetes mellitus, CA 19-9, and neoadjuvant therapy were similar between EOPC and COPC (p > 0.05). EOPC patients were more likely non-white (p = 0.03), had lower ASA scores (p = 0.02) and larger median tumor size (33 vs 28 mm, p = 0.04), but had similar pathological stages and rate of R0 resections (p > 0.05). Postoperative outcomes were similar (p > 0.05). There was no statistically significant difference in overall (HR 0.93, CI 0.64, 1.33; p = 0.68) or recurrence free (HR 1.05, CI 0.75, 1.48; p = 0.77) survival between the EOPC and COPC after adjusting for significant factors. CONCLUSION Patients with EOPC who underwent surgical resection had similar oncological outcomes compared to patients with COPC.
Collapse
Affiliation(s)
- Andrea Zironda
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Chi Zhang
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Courtney Day
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | | | - Patrick Starlinger
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Susanne G Warner
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Rory L Smoot
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Sean P Cleary
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Micheal L Kendrick
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Mark J Truty
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA
| | - Cornelius A Thiels
- Hepatobiliary and Pancreas Surgery Division, Mayo Clinic, Rochester MN, USA.
| |
Collapse
|
2
|
Zhang C, Gudmundsdottir H, Takahashi H, Day C, Glasgow A, Wasif N, Starlinger P, Warner S, Grotz T, Smoot R, Truty M, Cleary S, Kendrick M, Nagorney D, Navin P, Halfdanarson TR, Thiels C. Accuracy of DOTATATE PET imaging in the preoperative planning of small bowel neuroendocrine tumor resection. J Surg Oncol 2023; 128:1072-1079. [PMID: 37529970 DOI: 10.1002/jso.27413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND AND OBJECTIVES We assessed the accuracy of preoperative gallium-68 DOTA-Tyr3-octreotate (DOTATATE) positron emission tomography (PET) imaging in estimating multifocality and nodal metastases of small bowel neuroendocrine tumors (sbNETs). METHODS A multicenter analysis was performed on patients with sbNETs who underwent preoperative DOTATATE PET imaging and surgical resection, with manual palpation of the entire length of the small bowel, between January 2016 and August 2022. Preoperative imaging reports and blinded secondary imaging reviews were compared to the final postoperative pathology reports. Descriptive statistics were applied. RESULTS One-hundred and four patients met inclusion criteria. Pathology showed 53 (51%) patients had multifocal sbNETs and 96 (92%) had nodal metastases. The original preoperative DOTATATE PET imaging identified multifocal sbNET in 28 (27%) patients and lymph node (LN) metastases in 80 (77%) patients. Based on original radiology reports, sensitivity for multifocal sbNET identification was 45%, specificity was 92%, positive predictive value (PPV) was 86%, and negative predictive value (NPV) was 62%. For the identification of LN metastases, sensitivity was 82%, specificity was 88%, PPV was 99%, and NPV was 29%. CONCLUSIONS Although DOTATATE PET imaging is specific and relatively accurate, sensitivity and NPV are insufficient to guide surgical planning. Preoperative use should not replace open palpation to identify additional synchronous lesions or to omit regional lymphadenectomy.
Collapse
Affiliation(s)
- Chi Zhang
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Hallbera Gudmundsdottir
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Courtney Day
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Amy Glasgow
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Nabil Wasif
- Department of Surgery, Mayo Clinic, Phoenix, Arizona, USA
| | | | - Susanne Warner
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Travis Grotz
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Rory Smoot
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark Truty
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Sean Cleary
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - David Nagorney
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Patrick Navin
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Cornelius Thiels
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
3
|
Roxburgh A, Livingston M, Dietze P, Nielsen S, Cogger S, Bartlett M, Day C, Latimer J, Jauncey M, Clark N. The impact of COVID-19 public health measures on attendance and overdose at supervised injecting facilities in Australia. Public Health 2023; 224:90-97. [PMID: 37742585 DOI: 10.1016/j.puhe.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/23/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES The COVID-19 pandemic disrupted service provision of harm reduction and drug treatment services for people who inject drugs in many countries. The two supervised injecting facilities (SIFs) in Sydney and Melbourne were differentially impacted by the pandemic, requiring local procedural changes in each service. We aimed to examine the impact of pandemic responses (including restrictions on movement, known as 'lockdowns') on service use and key parameters such as client reports of drug injected and recorded overdose rates. STUDY DESIGN Time series analysis of weekly client visits and monthly overdoses occurring at each service. METHODS Administrative client data from the two SIFs (Sydney data from 1 January 2018 to 30 April 2022; Melbourne data from 1 July 2018 to 30 April 2022) were examined using interrupted time series analyses with lockdown dates in each state entered as interruption terms. We analysed weekly SIF visits overall and by drug type, and monthly rates of opioid overdose at each service. RESULTS Lockdowns resulted in decreased visits to both services. The number of weekly client visits decreased during the first national lockdown for both the Sydney (trend change = -57.9; 95% CI [-109.4, -6.4]) and Melbourne SIF (near sig trend change = -54.8 [-110.8, 1.05]). Trends in visit numbers increased after lockdowns were lifted in each city; however, visits in Sydney have not returned to the numbers recorded prior to the pandemic. Visits to the Melbourne SIF related to heroin use declined at each lockdown (trend 1 = -42.7 [-81.5, -3.9]; trend 2 = -56.1 [-94.6, -17.7]; trend 3 = -33.8 [-67.4, -0.2]); heroin visits to the Sydney SIF declined during the first lockdown and remained low (trend = -55.6 [-82.8, -28.3]). Methamphetamine visits to the Sydney SIF fluctuated, surpassing heroin visits at several timepoints. Rates of monthly opioid overdoses at both services declined immediately following the start of the first lockdown (Sydney = -16.6 [-26.1, -6.8]; Melbourne = -6.4 [-8.7, -4.1]), with increasing trends recorded at the end of the final lockdown in each jurisdiction (Sydney = 2.8 [0.6, 5.0]; Melbourne = 1.3 [0.72, 3.2]). CONCLUSIONS Public health restrictions related to the COVID-19 pandemic were associated with reduced client visits to, and overdoses in, Australian SIFs. Variations were noted in the drugs injected, likely reflecting changes in local drug markets. Shifts to other drugs during these periods were evident: methamphetamine in Sydney; co-injection of heroin and diphenhydramine in Melbourne.
Collapse
Affiliation(s)
- A Roxburgh
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
| | - M Livingston
- National Drug Research Institute, Curtin University, Perth, Australia
| | - P Dietze
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - S Nielsen
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - S Cogger
- North Richmond Community Health Medically Supervised Injecting Room, Melbourne Australia
| | - M Bartlett
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - C Day
- Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - J Latimer
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - M Jauncey
- Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - N Clark
- North Richmond Community Health Medically Supervised Injecting Room, Melbourne Australia; Addiction Medicine, Royal Melbourne Hospital, Melbourne, Australia
| |
Collapse
|
4
|
Day C, Van der Walt J, Crombie K, Hendrikse C, Peter J. Acute angioedema in Cape Town emergency centres and a suggested algorithm to simplify and improve management. S Afr Med J 2023; 113:51-57. [PMID: 37882115 DOI: 10.7196/samj.2023.v113i8.717] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Angioedema is the most common acute allergic presentation to emergency centres (EC), with hospitalisation rates increasing in high-income countries. Angioedema can complicate with life-threatening laryngeal obstruction. There are no local data; therefore, we aimed to characterise acute angioedema cases presenting to ECs and develop a simple management algorithm. OBJECTIVE To characterise the clinical presentation, management and outcomes of acute angioedema cases presenting to ECs. Based on these findings, we developed a management algorithm for acute angioedema to improve the care of acute angioedema in South Africa (SA). METHODS We conducted a retrospective folder review of all patients admitted to Groote Schuur Hospital (tertiary) and Mitchells Plain District Hospital (secondary) ECs from 1 June 2018 to 31 June 2020. Using ICD-10 coding, folders of adults ≥18 years with possible angioedema presenting to the ECs were screened. An allergist extracted demographics, medical history, management and outcome data for each angioedema event. RESULTS A total of 142 acute angioedema episodes were included, with a median (interquartile range) age of 42 (28 - 58) years, and 62% of patients were female. The majority (124/142, 87%) of acute angioedema EC presentations involved swelling above the shoulders, with airway involvement in 20 (14%) patients, with two patients requiring intubation. Nineteen (13%) patients required admission, with five (26%) admitted to high care/intensive care. Drug-induced angioedema was the most common cause, with 64/142 (45%) linked to a known offending drug, 42/64 (65.6%) being angiotensin-converting enzyme inhibitor (ACE-I). Critical information to guide angioedema management, including past personal/family allergy history, and duration of angioedema prior to EC visit, was not recorded in 64.7% and 37.8% of EC records, respectively. Unnecessary treatment with corticosteroids or antihistamines occurred in 19/53 (36%) and 16/53 (30%) cases with bradykinin-mediated angioedema ACE-I angioedema and hereditary angioedema). Overall, only 36/142 (25%) of angioedema patients were connected to allergy care. CONCLUSION Angioedema is the most common allergy presentation to two ECs in Cape Town, SA. Bradykinin-mediated angioedema secondary to ACE-I therapy is the single most common offender, and was not appropriately managed in more than a third of cases. Based on these findings, we have developed a management algorithm that easily stratifies patients into bradykinin or mast cell-mediated angioedema with a step-by-step management approach that is applicable to the SA context. Ongoing awareness and education on allergy emergencies are required to ensure accurate diagnosis of less common causes of angioedema (particularly bradykinin-mediated angioedema) and linkage to allergy specialist care.
Collapse
Affiliation(s)
- C Day
- Division of Allergology and Clinical Immunology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - J Van der Walt
- Division of Allergology and Clinical Immunology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - K Crombie
- Division of Emergency Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Hendrikse
- Division of Emergency Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Peter
- Division of Allergology and Clinical Immunology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| |
Collapse
|
5
|
Degnim AC, Siontis BL, Ahmed SK, Hoskin TL, Hieken TJ, Jakub JW, Baum CL, Day C, Schrup SE, Smith L, Carter JM, Sae Kho TM, Glazebrook KN, Vijayasekaran A, Okuno SH, Petersen IA. Trimodality Therapy Improves Disease Control in Radiation-Associated Angiosarcoma of the Breast. Clin Cancer Res 2023; 29:2885-2893. [PMID: 37223927 DOI: 10.1158/1078-0432.ccr-23-0443] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/07/2023] [Accepted: 05/16/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE To evaluate the impact of trimodality treatment versus monotherapy or dual therapy for radiation-associated angiosarcoma of the breast (RAASB) after prior breast cancer treatment. EXPERIMENTAL DESIGN With Institutional Review Board approval, we identified patients diagnosed with RAASB and abstracted data on disease presentation, treatment, and oncologic outcomes. Trimodality therapy included (i) taxane induction, (ii) concurrent taxane/radiation, and then (iii) surgical resection with wide margins. RESULTS A total of 38 patients (median age 69 years) met inclusion criteria. Sixteen received trimodality therapy and 22 monotherapy/dual therapy. Skin involvement and disease extent were similar in both groups. All trimodality patients required reconstructive procedures for wound closure/coverage, compared with 48% of monotherapy/dual therapy patients (P < 0.001). Twelve of 16 (75%) patients receiving trimodality therapy had a pathologic complete response (pCR). With median follow-up of 5.6 years, none had local recurrence, 1 patient (6%) had distant recurrence, and no patients died. Among 22 patients in the monotherapy/dual therapy group, 10 (45%) had local recurrence, 8 (36%) had distant recurrence, and 7 (32%) died of disease. Trimodality therapy demonstrated significantly better 5-year recurrence-free survival [RFS; 93.8% vs. 42.9%; P = 0.004; HR, 7.6 (95% confidence interval, CI: 1.3-44.2)]. Combining all patients with RAASB regardless of treatment, local recurrence was associated with subsequent distant recurrence (HR, 9.0; P = 0.002); distant recurrence developed in 3 of 28 (11%) patients without local recurrence compared with 6 of 10 (60%) with local recurrence. The trimodality group had more surgical complications that required reoperation or prolonged healing. CONCLUSIONS Trimodality therapy for RAASB was more toxic but is promising, with a high rate of pCR, durable local control, and improved RFS.
Collapse
Affiliation(s)
- Amy C Degnim
- Breast and Melanoma Surgical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Safia K Ahmed
- Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Tanya L Hoskin
- Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Tina J Hieken
- Breast and Melanoma Surgical Oncology, Mayo Clinic, Rochester, Minnesota
| | - James W Jakub
- Division of Surgical Oncology, Mayo Clinic, Jacksonville, Florida
| | | | - Courtney Day
- Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Sarah E Schrup
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Lauren Smith
- Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Jodi M Carter
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | | |
Collapse
|
6
|
Day C, Deetlefs M, O'Brien A, Smith J, Boyd M, Embling N, Patel S, Moody K, Ramabele T, Budge A, Tarwa T, Jim O, Maharaj T, Pandy S, Abrahams JM, Panieri A, Verhage S, Van der Merwe M, Geragotellis A, Amanjee W, Joseph C, Zhao Z, Moosa S, Bunting M, Pulani Y, Mukhari P, De Paiva M, Deyi G, Wonkam RP, Mancotywa N, Dunge A, Msimanga T, Singh A, Monnaruri O, Molale B, Butler TAG, Browde K, Muller C, Van der Walt J, Whitelaw R, Cronwright D, Sinha S, Binase U, Francis I, Boakye D, Dlamini S, Mendelson M, Peter J. Self-reported beta-lactam allergy in government and private hospitals in Cape Town, South Africa. S Afr Med J 2023; 113:69-74. [PMID: 36757070 DOI: 10.7196/samj.2023.v113i2.16760] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Up to a quarter of inpatients in high-income countries (HICs) self-report beta-lactam allergy (BLA), which if incorrect,increases the use of alternative antibiotics, worsening individual health outcomes and driving bacterial resistance. In HICs, up to 95% ofself-reported BLAs are incorrect. The epidemiology of BLA in low- and middle-income African countries is unknown. OBJECTIVES To describe the epidemiology and de-labelling outcomes of self-reported BLA in hospitalised South African (SA) patients. METHODS Point-prevalence surveys were conducted at seven hospitals (adult, paediatric, government and privately funded, district andtertiary level) in Cape Town, SA, between April 2019 and June 2021. Ward prescription records and in-person interviews were conductedto identify and risk-stratify BLA patients using the validated PEN-FAST tool. De-labelling was attempted at the tertiary allergy clinic atGroote Schuur Hospital. RESULTS A total of 1 486 hospital inpatients were surveyed (1 166 adults and 320 children). Only 48 patients (3.2%) self-reported a BLA,with a higher rate in private than in government-funded hospitals (6.3% v. 2.8%; p=0.014). Using the PEN-FAST tool, only 10.4% (n=5/48)of self-reported BLA patients were classified as high risk for true penicillin hypersensitivity. Antibiotics were prescribed to 70.8% (n=34/48)of self-reported BLA patients, with 64.7% (n=22/34) receiving a beta-lactam. Despite three attempts to contact patients for de-labelling atthe allergy clinic, only 3/36 underwent in vivo testing, with no positive results, and 1 patient proceeded to a negative oral challenge. CONCLUSION Unlike HICs, self-reported BLA is low among inpatients in SA. The majority of those who self-reported BLA were low risk fortype 1 hypersensitivity, but outpatient de-labelling efforts were largely unsuccessful.
Collapse
Affiliation(s)
- C Day
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Deetlefs
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A O'Brien
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Smith
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Boyd
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - N Embling
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Patel
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - K Moody
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Ramabele
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Budge
- Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Tarwa
- Molecular Mycobacteriology Research Unit, Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - O Jim
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Maharaj
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Pandy
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J-M Abrahams
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Panieri
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Verhage
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Van der Merwe
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Geragotellis
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - W Amanjee
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Joseph
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Z Zhao
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Moosa
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Bunting
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Y Pulani
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - P Mukhari
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M De Paiva
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - G Deyi
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - R P Wonkam
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - N Mancotywa
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Dunge
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Msimanga
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Singh
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - O Monnaruri
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - B Molale
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T A G Butler
- Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - K Browde
- Division of Allergology and Clinical Immunology, Department of Paediatrics, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Muller
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - J Van der Walt
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - R Whitelaw
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - D Cronwright
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Sinha
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - U Binase
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - I Francis
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - D Boakye
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Dlamini
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Peter
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| |
Collapse
|
7
|
Schwenzer JC, Day C, Giegerich T, Santucci A. Operational Tritium Inventories in the EU-DEMO Fuel Cycle. Fusion Science and Technology 2022. [DOI: 10.1080/15361055.2022.2101834] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- J. C. Schwenzer
- Karlsruhe Institute of Technology (KIT), Institute for Technical Physics, Karlsruhe, Germany
| | - C. Day
- Karlsruhe Institute of Technology (KIT), Institute for Technical Physics, Karlsruhe, Germany
| | - T. Giegerich
- Karlsruhe Institute of Technology (KIT), Institute for Technical Physics, Karlsruhe, Germany
| | - A. Santucci
- ENEA, Fusion and Technology for Nuclear Safety and Security Department, Frascati, Italy
| |
Collapse
|
8
|
Abu Dayyeh BK, Bazerbachi F, Vargas EJ, Sharaiha RZ, Thompson CC, Thaemert BC, Teixeira AF, Chapman CG, Kumbhari V, Ujiki MB, Ahrens J, Day C, Galvao Neto M, Zundel N, Wilson EB. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet 2022; 400:441-451. [PMID: 35908555 DOI: 10.1016/s0140-6736(22)01280-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Endoscopic sleeve gastroplasty (ESG) is an endolumenal, organ-sparing therapy for obesity, with wide global adoption. We aimed to explore the efficacy and safety of ESG with lifestyle modifications compared with lifestyle modifications alone. METHODS We conducted a randomised clinical trial at nine US centres, enrolling individuals aged 21-65 years with class 1 or class 2 obesity and who agreed to comply with lifelong dietary restrictions. Participants were randomly assigned (1:1·5; with stratified permuted blocks) to ESG with lifestyle modifications (ESG group) or lifestyle modifications alone (control group), with potential retightening or crossover to ESG, respectively, at 52 weeks. Lifestyle modifications included a low-calorie diet and physical activity. Participants in the primary ESG group were followed up for 104 weeks. The primary endpoint at 52 weeks was the percentage of excess weight loss (EWL), with excess weight being that over the ideal weight for a BMI of 25 kg/m2. Secondary endpoints included change in metabolic comorbidities between the groups. We used multiple imputed intention-to-treat analyses with mixed-effects models. Our analyses were done on a per-protocol basis and a modified intention-to-treat basis. The safety population was defined as all participants who underwent ESG (both primary and crossover ESG) up to 52 weeks. FINDINGS Between Dec 20, 2017, and June 14, 2019, 209 participants were randomly assigned to ESG (n=85) or to control (n=124). At 52 weeks, the primary endpoint of mean percentage of EWL was 49·2% (SD 32·0) for the ESG group and 3·2% (18·6) for the control group (p<0·0001). Mean percentage of total bodyweight loss was 13·6% (8·0) for the ESG group and 0·8% (5·0) for the control group (p<0·0001), and 59 (77%) of 77 participants in the ESG group reached 25% or more of EWL at 52 weeks compared with 13 (12%) of 110 in the control group (p<0·0001). At 52 weeks, 41 (80%) of 51 participants in the ESG group had an improvement in one or more metabolic comorbidities, whereas six (12%) worsened, compared with the control group in which 28 (45%) of 62 participants had similar improvement, whereas 31 (50%) worsened. At 104 weeks, 41 (68%) of 60 participants in the ESG group maintained 25% or more of EWL. ESG-related serious adverse events occurred in three (2%) of 131 participants, without mortality or need for intensive care or surgery. INTERPRETATION ESG is a safe intervention that resulted in significant weight loss, maintained at 104 weeks, with important improvements in metabolic comorbidities. ESG should be considered as a synergistic weight loss intervention for patients with class 1 or class 2 obesity. This trial is registered with ClinicalTrials.gov, NCT03406975. FUNDING Apollo Endosurgery, Mayo Clinic.
Collapse
Affiliation(s)
- Barham K Abu Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
| | - Fateh Bazerbachi
- CentraCare, Interventional Endoscopy Program, St Cloud Hospital, St Cloud, MN, USA
| | - Eric J Vargas
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Reem Z Sharaiha
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA
| | - Christopher C Thompson
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham & Women's Hospital, Boston, MA, USA
| | | | - Andre F Teixeira
- Weight Loss and Bariatric Surgery Institute, Orlando Health, Orlando, FL, USA
| | - Christopher G Chapman
- Center for Endoscopic Research and Therapeutics, University of Chicago, Chicago, IL, USA
| | - Vivek Kumbhari
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Michael B Ujiki
- Department of Surgery, NorthShore University Health System, Chicago, IL, USA
| | | | - Courtney Day
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Manoel Galvao Neto
- Division of Gastrointestinal Endoscopy, ABC Medical School, São Paulo, Brazil
| | - Natan Zundel
- Department of Surgery, State University of New York, Buffalo, NY, USA
| | - Erik B Wilson
- Department of Surgery, The University of Texas Health Science Center, Houston, TX, USA
| |
Collapse
|
9
|
Cutrone R, Day C, Valentin-Torres A, Palmer M, Mays R, Busch S. Mesenchymal Stem/Stromal Cells: MULTIPOTENT ADULT PROGENITOR CELLS MODULATE MONOCYTE/MACROPHAGE PHENOTYPE, CYTOKINE SECRETION AND FUNCTION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00205-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
10
|
Spallino L, Angelucci M, Pasqualetti A, Battes K, Day C, Grohmann S, Majorana E, Ricci F, Cimino R. Cryogenic vacuum considerations for future gravitational wave detectors. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.104.062001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
11
|
Siviero F, Caruso L, Mura M, Maccallini E, Manini P, Sartori E, Siragusa M, Hanke S, Day C, Sonato P. Robustness of ZAO based NEG pump solutions for fusion applications. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
12
|
Osagiede O, Habermann E, Day C, Gabriel E, Merchea A, Lemini R, Jabbal IS, Colibaseanu DT. Factors associated with worse outcomes for colorectal neuroendocrine tumors in radical versus local resections. J Gastrointest Oncol 2020; 11:836-846. [PMID: 33209480 DOI: 10.21037/jgo-20-193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Colorectal neuroendocrine tumors (NETs) are the most common NETs of the gastrointestinal tract. Due to the rarity, colorectal NETs are understudied and are not clearly understood. Our study sought to identify the factors associated with worse outcomes for colorectal NETs following resection. Methods We identified patients diagnosed with colorectal NETs [2004-2014] who underwent resection from the National Cancer Data Base. Non-NETs were excluded. Overall survival (OS) was evaluated using the Kaplan Meier method. Cox proportional hazards and logistic regression models were used to assess factors associated with radical versus local resection, OS and LOS. Results A total of 7,967 colon and 11,929 rectal NETs were analyzed. The majority of colon (93.4%) and rectal (89.1%) NETs underwent radical and local resection respectively. The 5-year OS was 69% and 92% for colon and rectal NETs respectively. Older age (OR 1.45, CI 1.37-1.53) and clinical stage 4 (OR 9.91, CI 4.56-21.52) were associated with higher odds for colonic radical resection. Lowest median income quartile (OR 1.41, CI 1.21-1.64) and African Americans (OR 1.26, CI 1.07-1.49) experienced higher mortality for colon and rectal NETs respectively. Conclusions Racial minority and low-income patients experience worse outcomes for colorectal NETs following resection.
Collapse
Affiliation(s)
- Osayande Osagiede
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, NY, USA
| | - Elizabeth Habermann
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
| | - Courtney Day
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | |
Collapse
|
13
|
Ruan GJ, Smith CJ, Day C, Harmsen WS, Zblewski DL, Alkhateeb H, Begna K, Al-Kali A, Litzow MR, Hogan W, Gangat N, Patnaik MS, Pardanani A, Tefferi A, Go RS, Shah MV. A population-based study of chronic eosinophilic leukemia-not otherwise specified in the United States. Am J Hematol 2020; 95:E257-E260. [PMID: 32533865 DOI: 10.1002/ajh.25906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Gordon J Ruan
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Caleb J Smith
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Courtney Day
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - William S Harmsen
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Kebede Begna
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - William Hogan
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Naseema Gangat
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Ayalew Tefferi
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mithun V Shah
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
14
|
Cismondi F, Spagnuolo G, Boccaccini L, Chiovaro P, Ciattaglia S, Cristescu I, Day C, Del Nevo A, Di Maio P, Federici G, Hernandez F, Moreno C, Moscato I, Pereslavtsev P, Rapisarda D, Santucci A, Utili M. Progress of the conceptual design of the European DEMO breeding blanket, tritium extraction and coolant purification systems. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111640] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Ruan GJ, Smith CJ, Day C, Harmsen WS, Zblewski DL, Alkhateeb H, Begna K, Al-Kali A, Litzow MR, Hogan W, Szuber N, Gangat N, Patnaik MS, Pardanani A, Elliott MA, Tefferi A, Go RS, Shah MV. A population-based study of chronic neutrophilic leukemia in the United States. Blood Cancer J 2020; 10:68. [PMID: 32541648 PMCID: PMC7296009 DOI: 10.1038/s41408-020-0334-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Gordon J Ruan
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Caleb J Smith
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Courtney Day
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - William S Harmsen
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | | | - Kebede Begna
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - William Hogan
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Mithun V Shah
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
16
|
Du Plooy N, Day C, Manning K, Abdullah F, James K, Grace L, Vorajee N, April C, Peter J, Raubenheimer PJ. Prevalence and outcome of delirium among acute general medical inpatients in Cape Town, South Africa. S Afr Med J 2020; 110:519-524. [PMID: 32880565 DOI: 10.7196/samj.2020.v110i6.14363] [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] [Received: 05/29/2020] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Delirium is a common, serious, underdiagnosed condition in medical and surgical inpatients with acute conditions. It is associated with increased risk of mortality and morbidity. Data of geriatric cohorts are largely limited to developed countries. OBJECTIVES To describe prevalence, risk factors and outcomes of delirium among general medical patients admitted to two hospitals in Cape Town, South Africa. METHODS This was a prospective cohort study of patients with acute conditions admitted to a general medical inpatient service in secondary- and tertiary-level public hospitals in the Metro West area of Cape Town. Patients ≥18 years of age were recruited daily from all acute medical admissions. Patients were excluded if they were aphasic or their Glasgow coma scale was <8/15. Delirium was diagnosed using the validated confusion assessment method (CAM) tool and performed by trained neuropsychologists. Demographic data were collected by a clinical team and short- and long-term mortality data were obtained using linkage analysis of hospitalised patients and routinely collected provincial death certification records. RESULTS The median age of inpatients was 51 (interquartile range 36 - 65) years, 29% were HIV-infected and the overall prevalence of delirium was 12.3%. Multivariate predictors of delirium included the presence of an indwelling urinary catheter (odds ratio (OR) 4.47; confidence interval (CI) 2.43 - 8.23), admission with a central nervous system disease (OR 4.34; CI 2.79 - 7.90), pre-existing cognitive impairment (OR 3.02; CI 1.22 - 7.43) and immobility (OR 1.88; CI 1.01 - 3.51). HIV infection was not associated with increased risk of delirium. Delirium was associated with an increased risk of inhospital (delirium v. no delirium: 29% v. 12%; p<0.01) and 12-month (30% v. 20%; p<0.01) mortality, as well as increased length of hospital stay (7 days v. 5 days; p<0.01). CONCLUSIONS In this cohort of medical inpatients (relatively young and with a high HIV prevalence) 1 of 8 (12.3%) patients was delirious. Delirium was associated with adverse outcomes. Delirium risk factors in this young cohort were similar to those in geriatric cohorts in developed countries, and neither HIV nor opportunistic infections increased risk.
Collapse
Affiliation(s)
- N Du Plooy
- Division of General Medicine, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Neugebauer C, Hörstensmeyer Y, Day C. Technology Development for Isotope Rebalancing and Protium Removal in the EU-DEMO Fuel Cycle. Fusion Science and Technology 2020. [DOI: 10.1080/15361055.2019.1704139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Cyra Neugebauer
- Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Y. Hörstensmeyer
- Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - C. Day
- Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| |
Collapse
|
18
|
Vu TND, Melik RE, Nehring S, Bergquist W, Hoskin T, Day C, Jakub JW. Venous thromboembolism chemoprophylaxis in mastectomy patients: A 5-year follow-up study. J Surg Oncol 2020; 121:193-199. [PMID: 31758708 DOI: 10.1002/jso.25771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/05/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) chemoprophylaxis in breast surgery remains controversial. In 2012, we instituted a practice change of routine chemoprophylaxis for patients with invasive cancer undergoing mastectomy. Herein, we report the effects of this on rates of VTE and hematoma. METHODS Our 30-day rates of VTE and hematoma requiring reoperation among patients with mastectomy since the practice change were retrospectively collected from National Surgical Quality Improvement Program (NSQIP). The subsequent 5-year data (2012-2017) was compared with historic NSQIP data (2006-2010). We utilized information from our 30-day follow-up databank to assess patients not sampled by NSQIP. RESULTS After the practice change, the heparin prophylaxis rate rose from 19.5% to 95.6% (P < .001) and the VTE rate fell from 0.8% to 0% (P = .30). There was no significant change in reoperative hematoma rate (P = .39). The majority of the current NSQIP patient population (93.1%) had a Caprini score of 5 or greater. Among 663 patients obtained from 30-day postoperative follow-up, there were 2 VTE (0.3%) and 7 (1.1%) reoperations for hematoma. CONCLUSIONS The practice change resulted in an increase of VTE chemoprophylaxis without significant change in hematoma incidence. Although not statistically significant, VTE incidence decreased. This supports the use of standardized VTE chemoprophylaxis in this population and warrants further study.
Collapse
Affiliation(s)
- T N Diem Vu
- Department of Surgery, Mayo Clinic College of Education and Research, Rochester, Minnesota
| | - Razan El Melik
- Department of Pharmacy, Mayo Clinic, Rochester, Minnesota
| | - Sharon Nehring
- Department of Nursing, Mayo Clinic College of Education and Research, Rochester, Minnesota
| | | | - Tanya Hoskin
- Department of Biostatistics, Mayo Clinic College of Education and Research, Rochester, Minnesota
| | - Courtney Day
- Department of Biostatistics, Mayo Clinic College of Education and Research, Rochester, Minnesota
| | - James W Jakub
- Department of Surgery, Mayo Clinic College of Education and Research, Rochester, Minnesota
| |
Collapse
|
19
|
Giegerich T, Battes K, Schwenzer J, Day C. Development of a viable route for lithium-6 supply of DEMO and future fusion power plants. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.111339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
20
|
Siragusa M, Sonato P, Visentin M, Mura M, Siviero F, Viale L, Maccallini E, Day C, Hanke S, Sartori E. Conceptual design of scalable vacuum pump to validate sintered getter technology for future NBI application. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2018.11.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
21
|
Siviero F, Caruso L, Porcelli T, Mura M, Maccallini E, Manini P, Sartori E, Siragusa M, Day C, Sonato P. Characterization of ZAO® sintered getter material for use in fusion applications. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
22
|
D'Oria M, Sen I, Day C, Bower TC, Weiss S, Oderich GS, Goodney PP, DeMartino RR. IP071. Readmission Patterns Following Diagnosis of Aortic Dissection, Intramural Hematoma and Penetrating Aortic Ulcer in a Population-Based Cohort From 1995 to 2015. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.04.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
23
|
Rose L, Cresta E, Day C, Dakpoe F, O’Flynn J, Segaran E. Audit of enteral nutrition provision during citrate anticoagulation of continuous renal replacement therapy in the intensive care units. Clin Nutr ESPEN 2018. [DOI: 10.1016/j.clnesp.2018.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
24
|
Federici G, Bachmann C, Barucca L, Biel W, Boccaccini L, Brown R, Bustreo C, Ciattaglia S, Cismondi F, Coleman M, Corato V, Day C, Diegele E, Fischer U, Franke T, Gliss C, Ibarra A, Kembleton R, Loving A, Maviglia F, Meszaros B, Pintsuk G, Taylor N, Tran M, Vorpahl C, Wenninger R, You J. DEMO design activity in Europe: Progress and updates. Fusion Engineering and Design 2018. [DOI: 10.1016/j.fusengdes.2018.04.001] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
25
|
Sartorius B, Sartorius K, Taylor M, Aagaard-Hansen J, Dukhi N, Day C, Ndlovu N, Slotow R, Hofman K. Rapidly increasing body mass index among children, adolescents and young adults in a transitioning population, South Africa, 2008-15. Int J Epidemiol 2018; 47:2099. [PMID: 30376046 PMCID: PMC6280934 DOI: 10.1093/ije/dyy248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|
26
|
Day C, Middleton D, Loibl S. Application of CDK4/6 inhibitors in practice: Effect of online education on clinician competence and confidence. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Day C, Søpstad S, Ma H, Jiang C, Nathan A, Elliott SR, Karet Frankl FE, Hutter T. Impedance-based sensor for potassium ions. Anal Chim Acta 2018; 1034:39-45. [PMID: 30193638 DOI: 10.1016/j.aca.2018.06.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/07/2018] [Accepted: 06/15/2018] [Indexed: 11/17/2022]
Abstract
A conductometric sensor for potassium ions in solution is presented. Interdigitated, planar gold electrodes were coated with a potassium-selective polymer membrane composed of a poly(vinyl chloride) matrix with about 65 wt% of plasticiser and 2-5 wt% of a potassium-selective ionophore. The impedance of the membrane was measured, using the electrodes as a transducer, and related to the concentration of potassium in a sample solution in contact with the membrane. Sensitivity was optimised by varying the sensor components, and selectivity for potassium over sodium was also shown. The resulting devices are compact, miniature, robust sensors which, by means of impedance measurements, eliminate the need for a reference electrode. The sensor was tested for potassium concentration changes of 2 mM across the clinically relevant range of 2.7-18.7 mM.
Collapse
Affiliation(s)
- C Day
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, United Kingdom.
| | - S Søpstad
- Institute for Microsystems, University College of Southeast Norway, N-3184, Borre, Norway; Zimmer & Peacock AS, N-3183, Horten, Norway.
| | - H Ma
- Electrical Engineering Division, Engineering Department, University of Cambridge, 9 JJ Thomson Avenue, Cambridge, CB3 0FA, United Kingdom.
| | - C Jiang
- Electrical Engineering Division, Engineering Department, University of Cambridge, 9 JJ Thomson Avenue, Cambridge, CB3 0FA, United Kingdom.
| | - A Nathan
- Electrical Engineering Division, Engineering Department, University of Cambridge, 9 JJ Thomson Avenue, Cambridge, CB3 0FA, United Kingdom.
| | - S R Elliott
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, United Kingdom.
| | - F E Karet Frankl
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, CB2 0XY, United Kingdom.
| | - T Hutter
- Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, United Kingdom.
| |
Collapse
|
28
|
Fisher G, Guerra W, Day C, Montagut C. Optimizing the use of EGFR antibodies across the continuum of care in mCRC: Effect of online education on clinician knowledge, competence and confidence. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Fisher G, Guerra W, Day C, Ducreux M. Treatment based on tumor sidedness in mCRC: Effect of online education on clinician knowledge, competence and confidence. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Sartorius B, Sartorius K, Taylor M, Aagaard-Hansen J, Dukhi N, Day C, Ndlovu N, Slotow R, Hofman K. Rapidly increasing body mass index among children, adolescents and young adults in a transitioning population, South Africa, 2008-15. Int J Epidemiol 2018; 47:942-952. [PMID: 29253189 PMCID: PMC6005035 DOI: 10.1093/ije/dyx263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/21/2017] [Accepted: 12/04/2017] [Indexed: 11/18/2022] Open
Abstract
Background There is a global epidemic of overweight and obesity; however, this rate of increase is even greater in some low- and middle-income countries (LMIC). South Africa (SA) is undergoing rapid socioeconomic and demographic changes that have triggered a rapid nutrition transition. The paper focuses on the recent rate of change of body mass index (BMI) among children, adolescents and young adults, further stratified by key sociodemographic factors. Methods We analysed mean BMI of 28 247 individuals (including children) from 7301 households by age and year, from anthropometric data from four national cross-sectional (repeated panel) surveys using non-linear fitted curves and associated 95% confidence intervals. Results From 2008 to 2015, there was rapid rise in mean BMI in the 6-25 age band, with the highest risk (3-4+ BMI unit increase) among children aged 8-10 years. The increase was largely among females in urban areas and of middle-high socioeconomic standing. Prominent gains were also observed in certain rural areas, with extensive geographical heterogeneity across the country. Conclusions We have demonstrated a major deviation from the current understanding of patterns of BMI increase, with a rate of increase substantially greater in the developing world context compared with the global pattern. This population-wide effect will have major consequences for national development as the epidemic of related non-communicable disease unfolds, and will overtax the national health care budget. Our refined understanding highlights that risks are further compounded for certain groups/places, and emphasizes that urgent geographical and population-targeted interventions are necessary. These interventions could include a sugar tax, clearer food labelling, revised school feeding programmes and mandatory bans on unhealthy food marketing to children.The scenario unfolding in South Africa will likely be followed in other LMICs.
Collapse
Affiliation(s)
- B Sartorius
- Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - K Sartorius
- Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
- Faculty of Commerce, University of the Witwatersrand, Johannesburg, South Africa
| | - M Taylor
- Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - J Aagaard-Hansen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark, and MRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - N Dukhi
- Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - C Day
- Health Systems Trust, Westville, South Africa
| | - N Ndlovu
- Health Systems Trust, Westville, South Africa
| | - R Slotow
- School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Genetics, Evolution and Environment, University College London, London, UK
| | - K Hofman
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
31
|
Rauck C, Perez-Guijarro E, Day C, Merlino G. 105 Assessing CEACAM1 blockade as a therapeutic strategy using a CRISPR-Cas9-based mouse melanoma model. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.109] [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: 10/17/2022]
|
32
|
Fisher G, Middleton D, Day C, Harbeck N. Application of CDK4/6 inhibitors in advanced breast cancer: Effect of online education on clinician knowledge, competence and confidence. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30531-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
33
|
Fisher G, Middleton D, Day C, Andre F. Predictive biomarkers for CDK4/6 inhibitors: Effect of online education on clinician knowledge. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30534-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
34
|
Fisher G, Middleton D, Day C, Di Leo A. Management of HR-positive, HER2-negative advanced breast cancer with CDK4/6 inhibitors: Effect of online education on clinician knowledge, competence and confidence. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30533-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
35
|
Abstract
Introduction: Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. Method: A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. Results: Our cohort consisted of 74 patients. On initiation of home haemodialysis, 62 individuals were using an arteriovenous fistula as vascular access, while the remaining were on a tunnelled dialysis catheter. Of the 12 patients who started on a tunnelled dialysis catheter, 5 were subsequently converted to either an arteriovenous fistula ( n = 4) or an arteriovenous graft ( n = 1). During the period of home haemodialysis use, four arteriovenous fistula failed or thrombosed with patients continuing on home haemodialysis using an arteriovenous graft ( n = 3) or a tunnelled dialysis catheter ( n = 1). To maintain uninterrupted home haemodialysis, interventional rates were 0.32 per arteriovenous fistula/arteriovenous graft access-year and 0.4 per tunnelled dialysis catheter access-year. Hospital admission rates for patients on home haemodialysis were 0.33 per patient-year. Conclusion: Our study has shown that home haemodialysis can be safely and independently performed at home within a closely managed home haemodialysis programme. The authors also advocate the use of arteriovenous fistulas for this cohort of patients due to both low complication and intervention rates.
Collapse
Affiliation(s)
| | - C Day
- Department of Renal Medicine, University Hospital Birmingham, Birmingham, UK
| | - N Inston
- Department of Renal Surgery, University Hospital Birmingham, Birmingham, UK
| |
Collapse
|
36
|
Gao E, SoRelle J, Jiao R, Veazey J, Day C, Day P, Pagels P, Gimpel N. 159 Effects of Cross-sex Hormone Therapy on Laboratory Values in Female-to-male Transgender Patients. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
37
|
|
38
|
Murphy B, Day C, Hoskin TL, Habermann EB, Boughey JC. Neoadjuvant Chemotherapy Is Increasing in Breast Cancer in Early Stage Disease and Across all Biologic Subtypes. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Arnett A, Day C, Harmsen W, Merrell K. Definitive chemotherapy and radiation in the treatment of stage IV anal cancer: Analysis of the National Cancer Database. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
40
|
Barrows M, Killick R, Day C, Saunders R, Baiker K, Ressel L, Denk D. Neuroaxonal Dystrophy in a Flock of Pied Imperial Pigeons (Ducula bicolor). J Comp Pathol 2017; 156:451-457. [PMID: 28391972 DOI: 10.1016/j.jcpa.2017.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/27/2017] [Indexed: 12/13/2022]
Abstract
Five juvenile pied imperial pigeons (Ducula bicolor) presented with neurological signs including torticollis, ataxia and poor flying ability. All were humanely destroyed and submitted for post-mortem examination. Microscopically, the most significant findings were in the brain and spinal cord. Spheroid formation was evident within the medulla, pons, diencephalon, cortical grey and subcortical white matter, spinal cord white and grey matter and the granular and molecular cell layers of the cerebellum. There was no evidence of associated inflammation. Immunohistochemistry revealed positive labelling within the spheroids for S100 axons and phosphorylated neurofilaments including SMI31, neurofilament cocktail and microtubule-associated protein 2. Transmission electron microscopy confirmed the light microscopical findings of frequent axonal spheroids. These results are consistent with neuroaxonal dystrophy, which has not been described previously in pigeons. This highlights the importance of considering neuroaxonal dystrophy in juvenile birds with neurological signs. A genetic basis is suspected in this group.
Collapse
Affiliation(s)
- M Barrows
- Bristol Zoological Society, Clifton, Bristol, UK.
| | - R Killick
- Bristol Zoological Society, Clifton, Bristol, UK
| | - C Day
- Bristol Zoological Society, Clifton, Bristol, UK
| | - R Saunders
- Bristol Zoological Society, Clifton, Bristol, UK
| | - K Baiker
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Sutton Bonington, UK
| | - L Ressel
- Department of Veterinary Pathology, Infection and Public Health, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK
| | - D Denk
- International Zoo Veterinary Group Pathology, Station House, Parkwood Street, Keighley, UK
| |
Collapse
|
41
|
Parker W, Habermann E, Day C, Zaid H, Frank I, Thompson RH, Tollefson M, Boorjian S, Pagliaro L, Karnes RJ. MP34-14 THE EFFECT OF ADJUVANT CHEMOTHERAPY FOR PATIENTS WITH ADVERSE PATHOLOGY AFTER NEOADJUVANT CHEMOTHERAPY FOR MUSCLE-INVASIVE BLADDER CANCER. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
42
|
Karavana V, Smith I, Kanellis G, Sigala I, Kinsella T, Zakynthinos S, Liu L, Chen J, Zhang X, Liu A, Guo F, Liu S, Yang Y, Qiu H, Grimaldi DG, Kaya E, Acicbe O, Kayaalp I, Asar S, Dogan M, Eren G, Hergunsel O, Pavelescu D, Grintescu I, Mirea L, Guanziroli M, Gotti M, Marino A, Cressoni M, Vergani G, Chiurazzi C, Chiumello D, Gattinoni L, Guanziroli M, Gotti M, Vergani G, Cressoni M, Chiurazzi C, Marino A, Spano S, Chiumello D, Gattinoni L, Guanziroli M, Gotti M, Vergani G, Marino A, Cressoni M, Chiurazzi C, Chiumello D, Gattinoni L, Massaro F, Moustakas A, Johansson S, Larsson A, Perchiazzi G, Zhang XW, Guo FM, Chen JX, Xue M, Yang Y, Qiu HB, Chen JX, Liu L, Yang L, Zhang XW, Guo FM, Yang Y, Qiu HB, Fister M, Knafelj R, Suzer MA, Kavlak ME, Atalan HK, Gucyetmez B, Cakar N, Weller D, Grootendorst AF, Dijkstra A, Kuijper TM, Cleffken BI, Regli A, De Keulenaer B, Van Heerden P, Hadfield D, Hopkins PA, Penhaligon B, Reid F, Hart N, Rafferty GF, Grasselli G, Mauri T, Lazzeri M, Carlesso E, Cambiaghi B, Eronia N, Maffezzini E, Bronco A, Abbruzzese C, Rossi N, Foti G, Bellani G, Pesenti A, Bassi GL, Panigada M, Ranzani O, Kolobow T, Zanella A, Cressoni M, Berra L, Parrini V, Kandil H, Salati G, Livigni S, Livigni S, Amatu A, Girardis M, Barbagallo M, Moise G, Mercurio G, Costa A, Vezzani A, Lindau S, Babel J, Cavana M, Torres A, Panigada M, Bassi GL, Ranzani OT, Kolobow T, Zanella A, Cressoni M, Berra L, Parrini V, Kandil H, Salati G, Livigni S, Amatu A, Girardis M, Barbagallo M, Moise G, Mercurio G, Costa A, Vezzani A, Lindau S, Babel J, Cavana M, Torres A, Umbrello M, Taverna M, Formenti P, Mistraletti G, Vetrone F, Marino A, Vergani G, Baisi A, Chiumello D, Garnero AG, Novotni DN, Arnal JA, Urner M, Fan E, Dres M, Vorona S, Brochard L, Ferguson ND, Goligher EC, Leung C, Joynt G, Wong W, Lee A, Gomersall C, Poels S, Casaer M, Schetz M, Van den Berghe G, Meyfroidt G, Holzgraefe B, Von Kobyletzki LB, Larsson A, Cianchi G, Becherucci F, Batacchi S, Cozzolino M, Franchi F, Di Valvasone S, Ferraro MC, Peris A, Phiphitthanaban H, Wacharasint P, Wongsrichanalai V, Lertamornpong A, Pengpinij O, Wattanathum A, Oer-areemitr N, Boddi M, Cianchi G, Cappellini E, Ciapetti M, Batacchi S, Di Lascio G, Bonizzoli M, Cozzolino M, Peris A, Lazzeri C, Cianchi G, Bonizzoli M, Di Lascio G, Cozzolino M, Peris A, Katsin ML, Hurava MY, Dzyadzko AM, Hermann A, Schellongowski P, Bojic A, Riss K, Robak O, Lamm W, Sperr W, Staudinger T, Buoninsegni LT, Bonizzoli M, Cozzolino M, Parodo J, Ottaviano A, Cecci L, Corsi E, Ricca V, Peris A, de Garibay APR, Ende-Schneider B, Schreiber C, Kreymann B, Turani F, Resta M, Niro D, Castaldi P, Boscolo G, Gonsales G, Martini S, Belli A, Zamidei L, Falco M, Lamas T, Mendes J, Galazzi A, Mauri T, Benco B, Binda F, Masciopinto L, Lazzeri M, Carlesso E, Lissoni A, Grasselli G, Adamini I, Pesenti A, Thamjamrassri T, Watcharotayangul J, Numthavaj P, Kongsareepong S, Higuera J, Cabestrero D, Rey L, Narváez G, Blandino A, Aroca M, Saéz S, De Pablo R, Mohamed A, Sklar M, Munshi L, Mauri T, Lazzeri M, Alban L, Turrini C, Panigada M, Taccone P, Carlesso E, Marenghi C, Spadaro S, Grasselli G, Volta C, Pesenti A, Higuera J, Alonso DC, Blandino A, Narváez G, González LR, Aroca M, Saéz S, De Pablo R, Franci A, Stocchi G, Cappuccini G, Socci F, Cozzolino M, Guetti C, Rastrelli P, Peris A, Nestorowicz A, Glapinski J, Fijalkowska-Nestorowicz A, Wosko J, Fijalkowska-Nestorowicz A, Glapinski J, Wosko J, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Ollieuz S, Reychler G, Bonus T, Duprez F, Cuvelier G, Mashayekhi S, Ollieuz S, Reychler G, Kuchyn I, Bielka K, Sergienko A, Jones H, Day C, Park SC, Yeom SR, Myatra SN, Gupta S, Rajnala V, Divatia J, Silva JV, Olvera OA, Schulte RC, Bermudez MC, Zorrilla LP, Ferretis HL, García KT, Balciuniene N, Ramsaite J, Kriukelyte O, Krikscionaitiene A, Tamosuitis T, Terragni P, Brazzi L, Falco D, Pistidda L, Magni G, Bartoletti L, Mascia L, Filippini C, Ranieri V, Kyriakoudi A, Rovina N, Koltsida O, Konstantellou E, Kardara M, Kostakou E, Gavriilidis G, Vasileiadis I, Koulouris N, Koutsoukou A, Van Snippenburg W, Kröner A, Flim M, Buise M, Hemler R, Spronk P, Regli A, Noffsinger B, De Keulenaer B, Singh B, Hockings L, Van Heerden P, Spina C, Bronco A, Magni F, Di Giambattista C, Vargiolu A, Bellani G, Foti G, Citerio G, Scaramuzzo G, Spadaro S, Waldmann AD, Böhm SH, Ragazzi R, Volta CA, Heines SJ, Strauch U, Van de Poll MC, Roekaerts PM, Bergmans DC, Sosio S, Gatti S, Maffezzini E, Punzi V, Asta A, Foti G, Bellani G, Glapinski J, Mroczka J, Nestorowicz A, Fijalkowska-Nestorowicz A, Yaroshetskiy AI, Rezepov NA, Mandel IA, Gelfand BR, Ozen E, Karakoc E, Ayyildiz A, Kara S, Ekemen S, Yelken BB, Saasouh W, Freeman J, Turan A, Hajjej Z, Sellami W, Bousselmi M, Samoud W, Gharsallah H, Labbene I, Ferjani M, Vetrugno L, Barbariol F, Forfori F, Regeni I, Della Rocca G, Jansen D, Jonkman A, Doorduin J, Roesthuis L, Van der Hoeven J, Heunks L, Marocco SA, Bottiroli M, Pinciroli R, Galanti V, Calini A, Gagliardone M, Bellani G, Fumagalli R, Gatti S, Abbruzzese C, Ippolito D, Sala VL, Meroni V, Bronco A, Foti G, Bellani G, Elbanna M, Nassar Y, Abdelmohsen A, Yahia M, Mongodi S, Mojoli F, Via G, Tavazzi G, Fava F, Pozzi M, Iotti GA, Bouhemad B, Ruiz-Ferron F, Simón JS, Gordillo-Resina M, Chica-Saez V, Garcia MR, Vela-Colmenero R, Redondo-Orts M, Gontijo-Coutinho C, Ozahata T, Nocera P, Franci D, Santos T, Carvalho-Filho M, Fochi O, Gatti S, Nacoti M, Signori D, Bronco A, Bonacina D, Bellani G, Bonanomi E, Mongodi S, Bonvecchio E, Stella A, Roldi E, Orlando A, Luperto M, Bouhemad B, Iotti GA, Mojoli F, Trunfio D, Licitra G, Martinelli R, Vannini D, Giuliano G, Vetrugno L, Forfori F, Näslund E, Lindberg LG, Lund I, Larsson A, Frithiof R, Nichols A, Freeman J, Pentakota S, Kodali B, Pranskunas A, Kiudulaite I, Simkiene J, Damanskyte D, Pranskuniene Z, Arstikyte J, Vaitkaitis D, Pilvinis V, Brazaitis M, Pool R, Haugaa H, Botero A, Escobar D, Maberry D, Tønnessen T, Zuckerbraun B, Pinsky M, Gomez H, Lyons H, Trimmings A, Domizi R, Scorcella C, Damiani E, Pierantozzi S, Tondi S, Monaldi V, Carletti A, Zuccari S, Adrario E, Pelaia P, Donati A, Kazune S, Grabovskis A, Volceka K, Rubins U, Bol M, Suverein M, Delnoij T, Driessen R, Heines S, Delhaas T, Vd Poll M, Sels J, Jozwiak M, Chambaz M, Sentenac P, Richard C, Monnet X, Teboul JL, Bitar Z, Maadarani O, Al Hamdan R, Huber W, Malbrain M, Chew M, Mallat J, Tagami T, Hundeshagen S, Wolf S, Huber W, Mair S, Schmid R, Aron J, Adlam M, Dua G, Mu L, Chen L, Yoon J, Clermont G, Dubrawski A, Duhailib Z, Al Assas K, Shafquat A, Salahuddin N, Donaghy J, Morgan P, Valeanu L, Stefan M, Provenchere S, Longrois D, Shaw A, Mythen MG, Shook D, Hayashida D, Zhang X, Munson SH, Sawyer A, Mariyaselvam M, Blunt M, Young P, Nakwan N, Khwannimit B, Checharoen P, Berger D, Moller P, Bloechlinger S, Bloch A, Jakob S, Takala J, Van den Brule JM, Stolk R, Vinke E, Van Loon LM, Pickkers P, Van der Hoeven JG, Kox M, Hoedemaekers CW, Werner-Moller P, Jakob S, Takala J, Berger D, Bertini P, Guarracino F, Colosimo D, Gonnella S, Brizzi G, Mancino G, Baldassarri R, Pinsky MR, Bertini P, Gonnella S, Brizzi G, Mancino G, Amitrano D, Guarracino F, Goslar T, Stajer D, Radsel P, De Vos R, Dijk NBV, Stringari G, Cogo G, Devigili A, Graziadei MC, Bresadola E, Lubli P, Amella S, Marani F, Polati E, Gottin L, Colinas L, Hernández G, Vicho R, Serna M, Canabal A, Cuena R, Jozwiak M, Gimenez J, Teboul JL, Mercado P, Depret F, Richard C, Monnet X, Hajjej Z, Sellami W, Sassi K, Gharsallah H, Labbene I, Ferjani M, Herner A, Schmid R, Huber W, Abded N, Nassar Y, Elghonemi M, Monir A, Nikhilesh J, Apurv T, Uber AU, Grossestreuer A, Moskowitz A, Patel P, Holmberg MJ, Donnino MW, Graham CA, Hung K, Lo R, Leung LY, Lee KH, Yeung CY, Chan SY, Trembach N, Zabolotskikh I, Caldas J, Panerai R, Camara L, Ferreira G, Almeida J, de Oliveira GQ, Jardim J, Bor-Seng-Shu E, Lima M, Nogueira R, Jatene F, Zeferino S, Galas F, Robinson T, Hajjar LA, Caldas J, Panerai R, Ferreira G, Camara L, Zeferino S, Jardim J, Bor-Seng-Shu E, Oliveira M, Norgueira R, Groehs R, Ferreira-Santos L, Galas F, Oliveira G, Almeida J, Robinson T, Jatene F, Hajjar L, Ferreira G, Ribeiro J, Galas F, Gaiotto F, Lisboa L, Fukushima J, Rizk S, Almeida J, Jatene F, Osawa E, Franco R, Kalil R, Hajjar L, Chlabicz M, Sobkowicz B, Kaminski K, Kazimierczyk R, Musial W, Tycińska A, Siranovic M, Gopcevic A, Gavranovic ZG, Horvat AH, Krolo H, Rode B, Videc L, Trifi A, Abdellatif S, Ismail KB, Bouattour A, Daly F, Nasri R, Lakhal SB, Beurton A, Teboul JL, Girotto V, Galarza L, Richard C, Monnet X, Beurton A, Teboul JL, Girotto V, Galarza L, Richard C, Monnet X, Girotto V, Teboul JL, Beurton A, Galarza L, Guedj T, Monnet X, Galarza L, Mercado P, Teboul JL, Girotto V, Beurton A, Richard C, Monnet X, Iliæ MK, Sakic L, NN V, Stojcic L, Jozwiak M, Depret F, Teboul JL, Alphonsine J, Lai C, Richard C, Monnet X, Tapanwong N, Chuntupama P, Wacharasint P, Huber W, Hoellthaler J, Lahmer T, Schmid R, Latham H, Bengtson CD, Satterwhite L, Stites M, Simpson SQ, Latham H, Bengtson CD, Satterwhite L, Stites M, Simpson SQ, Skladzien T, Cicio M, Garlicki J, Serednicki W, Wordliczek J, Vargas P, Salazar A, Mercado P, Espinoza M, Graf J, Kongpolprom N, Sanguanwong N, Jonnada S, Gerrard C, Jones N, Morley T, Thorburn PT, Trimmings A, Musaeva T, Zabolotskikh I, Salazar A, Vargas P, Mercado P, Espinoza M, Graf J, Horst S, Lipcsey M, Kawati R, Pikwer A, Rasmusson J, Castegren M, Shilova A, Yafarova A, Gilyarov M, Shilova A, Yafarova A, Gilyarov M, Stojiljkovic DLL, Ulici A, Reidt S, Lam T, Jancik J, Ragab D, Taema K, Farouk W, Saad M, Liu X, Holmberg MJ, Uber A, Montissol S, Donnino M, Andersen LW, Perlikos F, Lagiou M, Papalois A, Kroupis C, Toumpoulis I, Osawa E, Carter D, Sardo S, Almeida J, Galas F, Rizk S, Franco R, Hajjar L, Landoni G, Kongsayreepong S, Sungsiri R, Wongsripunetit P, Marchio P, Guerra-Ojeda S, Gimeno-Raga M, Mauricio MD, Valles SL, Aldasoro C, Jorda A, Aldasoro M, Vila JM, Borg UB, Neitenbach AM, García M, González PG, Romero MG, Orduña PS, Cano AG, Rhodes A, Grounds RM, Cecconi M, Lee C, Hatib F, Jian Z, Rinehart J, De Los Santos J, Canales C, Cannesson M, García MIM, Hatib F, Jian Z, Scheeren T, Jian Z, Hatib F, Pinsky M, Chantziara V, Vassi A, Michaloudis G, Sanidas E, Golemati S, Bateman RM, Mokhtar A, Omar W, Aziz KA, El Azizy H, Nielsen DLL, Holler JG, Lassen A, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Capoletto C, Almeida J, Ferreira G, Fukushima J, Nakamura R, Risk S, Osawa E, Park C, Oliveira G, Galas F, Franco R, Hajjar L, Dias F, D’Arrigo N, Fortuna F, Redaelli S, Zerman L, Becker L, Serrano T, Cotes L, Ramos F, Fadel L, Coelho F, Mendes C, Real J, Pedron B, Kuroki M, Costa E, Azevedo L. 37th International Symposium on Intensive Care and Emergency Medicine (part 1 of 3). Crit Care 2017. [PMCID: PMC5374603 DOI: 10.1186/s13054-017-1628-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
43
|
Osman W, Shabli S, Khan S, Watson N, Day C, Giridharan S, Pittius D, Haris M. 14: Superior vena cava obstruction (SVCO) syndrome caused by a ball like endovascular metastatic small cell lung cancer mass: A case report. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30064-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
44
|
Federici G, Bachmann C, Biel W, Boccaccini L, Cismondi F, Ciattaglia S, Coleman M, Day C, Diegele E, Franke T, Grattarola M, Hurzlmeier H, Ibarra A, Loving A, Maviglia F, Meszaros B, Morlock C, Rieth M, Shannon M, Taylor N, Tran M, You J, Wenninger R, Zani L. Overview of the design approach and prioritization of R&D activities towards an EU DEMO. Fusion Engineering and Design 2016. [DOI: 10.1016/j.fusengdes.2015.11.050] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
45
|
Munteanu M, Tiniakos D, Anstee Q, Charlotte F, Marchesini G, Bugianesi E, Trauner M, Romero Gomez M, Oliveira C, Day C, Dufour J, Bellentani S, Ngo Y, Traussnig S, Perazzo H, Deckmyn O, Bedossa P, Ratziu V, Poynard T. Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference. Aliment Pharmacol Ther 2016; 44:877-89. [PMID: 27549244 PMCID: PMC5113673 DOI: 10.1111/apt.13770] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/19/2016] [Accepted: 07/27/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Blood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis. AIMS To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading. METHODS We pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing. RESULTS A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864-0.892) for FibroTest and fibrosis stages, 0.846 (0.830-0.862) for ActiTest and activity grades, and 0.822 (0.804-0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820-0.852; P = 0.0001), FIB4 (0.845; 0.829-0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850-0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05). CONCLUSIONS In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.
Collapse
Affiliation(s)
| | - D. Tiniakos
- Liver Research GroupInstitute of Cellular MedicineNewcastle UniversityNewcastle‐upon‐TyneUK,Laboratory of Histology & EmbryologyMedical SchoolNational & Kapodistrian University of AthensGreece
| | - Q. Anstee
- Liver Research GroupInstitute of Cellular MedicineNewcastle UniversityNewcastle‐upon‐TyneUK
| | - F. Charlotte
- Groupe Hospitalier Pitié Salpêtrière APHPSorbonne UniversitésUPMC Univ Paris 06INSERM, UMR_S 938 & Institute of Cardiometabolism and Nutrition (ICAN)ParisFrance
| | | | | | - M. Trauner
- Medizinischen Universitaet WienViennaAustria
| | | | - C. Oliveira
- Department of Gastroenterology (LIM‐07)University of São Paulo School of MedicineSão PauloBrazil
| | - C. Day
- Liver Research GroupInstitute of Cellular MedicineNewcastle UniversityNewcastle‐upon‐TyneUK
| | | | - S. Bellentani
- GastroenterologiaAzienda USL di Modena Reggio EmiliaModenaItaly
| | | | | | | | | | - P. Bedossa
- Assistance Publique‐Hôpitaux de Parishôpital BeaujonUniversity Paris‐DiderotParisFrance
| | - V. Ratziu
- Groupe Hospitalier Pitié Salpêtrière APHPSorbonne UniversitésUPMC Univ Paris 06INSERM, UMR_S 938 & Institute of Cardiometabolism and Nutrition (ICAN)ParisFrance
| | - T. Poynard
- Groupe Hospitalier Pitié Salpêtrière APHPSorbonne UniversitésUPMC Univ Paris 06INSERM, UMR_S 938 & Institute of Cardiometabolism and Nutrition (ICAN)ParisFrance
| | | |
Collapse
|
46
|
Barigye R, Davis S, Hunt R, Hunt N, Walsh S, Elliott N, Burnup C, Aumann S, Day C, Dyrting K, Weir R, Melville LF. Viral neurotropism, peripheral neuropathy and other morphological abnormalities in bovine ephemeral fever virus-infected downer cattle. Aust Vet J 2016; 94:362-70. [PMID: 27671080 DOI: 10.1111/avj.12482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 08/10/2015] [Accepted: 09/07/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study assessed the neurotropism of bovine ephemeral fever (BEF) virus (BEFV) and described histomorphological abnormalities of the brain, spinal cord and peripheral nerves that may causally contribute to paresis or paralysis in BEF. METHODS Four paralysed and six asymptomatic but virus-infected cattle were monitored, and blood and serum samples screened by qRT-PCR, virus isolation and neutralisation tests. Fresh brain, spinal cord, peripheral nerve and other tissues were qRT-PCR-tested for viral RNA, while formalin-fixed specimens were processed routinely and immunohistochemically evaluated for histomorphological abnormalities and viral antigen distribution, respectively. RESULTS The neurotropism of BEFV was immunohistochemically confirmed in the brain and peripheral nerves and peripheral neuropathy was demonstrated in three paralysed but not the six aneurological but virus-infected animals. Wallerian degeneration (WD) was present in the ventral funicular white matter of the lumbar spinal cord of a paralysed steer and in cervical and thoracic spinal cord segments of three paralysed animals. Although no spinal cord lesions were seen in the steer euthanased within 7 days of illness, peripheral neuropathy was present and more severe in nerves of the brachial plexuses than in the gluteal or fibular nerves. The only steer with WD in the lumbar spinal cord also showed intrahistiocytic cell viral antigen that was spatially distributed within areas of moderate brain stem encephalitis. CONCLUSION The data confirmed neurotropism of BEFV in cattle and documented histomorphological abnormalities in peripheral nerves and brain which, together with spinal cord lesions, may contribute to chronic paralysis in BEFV-infected downer cattle.
Collapse
Affiliation(s)
- R Barigye
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia. ,
| | - S Davis
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - R Hunt
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - N Hunt
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - S Walsh
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - N Elliott
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - C Burnup
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - S Aumann
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - C Day
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - K Dyrting
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - R Weir
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| | - L F Melville
- Berrimah Veterinary Laboratories, Department of Primary Industry & Fisheries, GPO Box 3000, Darwin, Northern Territory 0801, Australia
| |
Collapse
|
47
|
|
48
|
Abstract
BACKGROUND Peer-led interventions are increasingly common in community health settings. Although peer-led approaches have proven benefits for service users, relatively little is known about the process and outcomes of participation for peer leaders. This study investigated experiences of parents who had participated as 'peer facilitators' in Empowering Parents, Empowering Communities (EPEC), a peer-led programme designed to improve access to evidence-based parenting support in socially disadvantaged communities. METHOD A qualitative cross-sectional design was used. Semi-structured interviews were conducted with 14 peer facilitators and scrutinized using thematic analysis. RESULTS Peer facilitators developed their knowledge and skills through personal experience of receiving parenting support, participation in formal training and supervised practice, access to an intervention manual, and peer modelling. Peer facilitators described positive changes in their own families, confidence and social status. Transformative personal gains reinforced peer facilitators' role commitment and contributed to a cohesive 'family' identity among EPEC staff and service users. Peer facilitators' enthusiasm, openness and mutual identification with families were seen as critical to EPEC's effectiveness and sustainability. Peer facilitators also found the training emotionally and intellectually demanding. There were particular difficulties around logistical issues (e.g. finding convenient supervision times), managing psychosocial complexity and child safeguarding. CONCLUSIONS The successful delivery and sustained implementation of peer-led interventions requires careful attention to the personal qualities and support of peer leaders. Based on the findings of this study, support should include training, access to intervention manuals, regular and responsive supervision, and logistical/administrative assistance. Further research is required to elaborate and extend these findings to other peer-led programmes.
Collapse
Affiliation(s)
- S Thomson
- Lambeth Child and Adolescent Mental Health Services (CAMHS), South London & Maudsley NHS Foundation Trust, London, UK
| | | | | |
Collapse
|
49
|
Ireland AJ, Soro V, Sprague SV, Harradine NWT, Day C, Al-Anezi S, Jenkinson HF, Sherriff M, Dymock D, Sandy JR. The effects of different orthodontic appliances upon microbial communities. Orthod Craniofac Res 2013; 17:115-23. [PMID: 24345204 DOI: 10.1111/ocr.12037] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Orthodontic appliances can promote accumulation of dental plaque, with associated enamel decalcification or gingival inflammation. The aim of this study was to examine longer-term microbiological changes during orthodontic treatment with fixed appliances. MATERIALS AND METHODS Twenty-four orthodontic patients aged 11-14 years undergoing fixed appliance therapy were recruited into the study. Each was randomized for cross-mouth assignment of molar bands and bonded molar tubes to contralateral quadrants of the mouth. All patients received self-ligating brackets, but again using randomization, one upper lateral incisor bracket (left or right) also received an elastomeric ligature. Plaque samples from the molars and upper lateral incisors were obtained at intervals during treatment and up to 1 year after appliance removal. Denaturing gradient gel electrophoresis and 16S rDNA microarray were used to compare plaque microbial fingerprints. RESULTS Plaque populations changed within 3 months of commencing treatment at all sites. The greatest differences in plaque composition were seen with self-ligating brackets with an elastomeric ligature. Post-treatment plaque associated with both types of molar attachment contained increased levels of periodontal pathogens Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum, while Campylobacter rectus, Parvimonas micra, and Actinomyces odontolyticus were also elevated with bonds. CONCLUSIONS The results suggest that orthodontic treatment may cause sustained changes in plaque microbiotas and that molar bond-associated plaque may have raised disease potential.
Collapse
Affiliation(s)
- A J Ireland
- School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Chaar B, Wang H, Day C, Winstock A, Hanrahan J, Fois R. Factors Influencing Pharmacy Services in Opioid Substitution Treatment. Res Social Adm Pharm 2012. [DOI: 10.1016/j.sapharm.2012.08.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|