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McCarroll K, Carroll T, Neville M, Fitzpatrick D, Lannon R. Delayed and significant hypercalcaemia due to teriparatide therapy: a case report and review. Osteoporos Int 2024:10.1007/s00198-024-07082-9. [PMID: 38613637 DOI: 10.1007/s00198-024-07082-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
INTRODUCTION Transient hypercalcaemia due to teriparatide occurs in up to 11% of patients though delayed hypercalcaemia (> 24 h post injection) is rare. We report the case of a female who developed significant delayed hypercalcaemia after teriparatide treatment for osteoporosis and review other cases in the literature to date. CASE REPORT A 72-year-old female on teriparatide for the treatment of osteoporosis was found to have hypercalcaemia (3.30 mmol/l) on routine testing approximately 3 months after starting therapy. Serum calcium pretreatment was normal at 2.39 mmol/l. She was admitted to the hospital for investigations which identified a serum 25-hydroxyvitamin D of 94 nmol/l, a low parathyroid hormone of 6.0 pg/ml, and normal test results for 1,25 dihydroxyvitamin D (115 pmol/l), parathyroid hormone-related peptide (< 1.4 pmol/ml), serum electrophoresis and angiotensin-converting enzyme (39 IU/l). CT abdomen, pelvis, and thorax revealed no evidence of malignancy and an isotope bone scan ruled out skeletal metastases. Serum calcium normalised (2.34 mmol/l) several days after stopping teriparatide and calcium supplements and administering intravenous fluid. On restarting teriparatide, delayed hypercalcaemia reoccurred and treatment was switched to denosumab. DISCUSSION Delayed moderate to severe hypercalcaemia (serum calcium > 3.0 mmol/l) due to teriparatide is rare but may lead to therapy withdrawal. The underlying predisposing risk factors remain unclear and highlight the importance of a routine serum calcium assessment on therapy.
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Affiliation(s)
- K McCarroll
- Bone Heath Unit, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
- School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - T Carroll
- Bone Heath Unit, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - M Neville
- Department of Biochemistry, St. James's Hospital, Dublin, Ireland
| | - D Fitzpatrick
- Bone Heath Unit, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R Lannon
- Bone Heath Unit, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Stacey MJ, Leckie T, Fitzpatrick D, Hodgson L, Barden A, Jenkins R, Galloway R, Weller C, Grivas GV, Pitsiladis Y, Richardson AJ, Woods DR. Neurobiomarker and body temperature responses to recreational marathon running. J Sci Med Sport 2023; 26:566-573. [PMID: 37777396 DOI: 10.1016/j.jsams.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To assess how biomarkers indicating central nervous system insult (neurobiomarkers) vary in peripheral blood with exertional-heat stress from prolonged endurance exercise. DESIGN Observational study of changes in neuron specific enolase (NSE), S100 calcium-binding protein B (S100β), Glial Fibrillary Acid Protein (GFAP) and Ubiquitin carboxyl-terminal hydrolase isozyme L1 (UCHL1) at Brighton Marathon 2022. METHODS In 38 marathoners with in-race core temperature (Tc) monitoring, exposure (High, Intermediate or Low) was classified by cumulative hyperthermia - calculated as area under curve of Time × Tc > 38 °C - and also by running duration (finishing time). Blood was sampled for neurobiomarkers, cortisol and fluid-regulatory stress surrogates, including copeptin and creatinine (at rested baseline; within 30 min of finishing; and at 24 h). RESULTS Finishing in 236 ± 40 min, runners showed stable GFAP and UCH-L1 across the marathon and next-day. Significant (P < 0.05) increases from baseline were shown post-marathon and at 24 h for S100β (8.52 [3.65, 22.95] vs 39.0 [26.48, 52.33] vs 80.3 [49.1, 99.7] ng·L-1) and post-marathon only for NSE (3.73 [3.30, 4.32] vs 4.85 [4.45, 5.80] μg·L-1, P < 0.0001). Whilst differential response to hyperthermia was observed for cortisol, copeptin and creatinine, neurobiomarker responses did not vary. Post-marathon, only NSE differed by exercise duration (High vs Low, 5.81 ± 1.77 vs. 4.69 ± 0.73 μg·L-1, adjusted P = 0.0358). CONCLUSIONS Successful marathon performance did not associate with evidence for substantial neuronal insult. To account for variation in neurobiomarkers with prolonged endurance exercise, factors additional to hyperthermia, such as exercise duration and intensity, should be further investigated.
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Affiliation(s)
- M J Stacey
- Academic Department of Military Medicine, Defence Medical Services, UK; Carnegie School of Sport, Leeds Beckett University, UK; Department of Surgery and Cancer, Imperial College London, UK.
| | - T Leckie
- School of Sport and Health Sciences, University of Brighton, UK
| | - D Fitzpatrick
- School of Sport and Health Sciences, University of Brighton, UK; Sport and Exercise Medicine Department, Charing Cross Hospital, UK
| | - L Hodgson
- Brighton & Sussex Medical School, Brighton, UK
| | - A Barden
- School of Medicine, Imperial College London, UK
| | - R Jenkins
- Foundation Programme, Defence Medical Services, UK
| | - R Galloway
- Brighton & Sussex Medical School, Brighton, UK
| | - C Weller
- Brighton & Sussex Medical School, Brighton, UK
| | - G V Grivas
- Division of Humanities and Political Sciences, Physical Education and Sports, Hellenic Naval Academy, Greece
| | - Y Pitsiladis
- School of Sport and Health Sciences, University of Brighton, UK; Human Telemetrics, UK
| | - A J Richardson
- School of Sport and Health Sciences, University of Brighton, UK
| | - D R Woods
- Academic Department of Military Medicine, Defence Medical Services, UK; Carnegie School of Sport, Leeds Beckett University, UK
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Fitzpatrick D, Seebah S, Lannon R, Mc Carroll K. Atypical femoral fracture after denosumab for the treatment of osteoporosis in bisphosphonate naïve patients: two further cases. Osteoporos Int 2023; 34:1807-1808. [PMID: 37526671 DOI: 10.1007/s00198-023-06869-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Affiliation(s)
- D Fitzpatrick
- Bone health Unit, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
| | - S Seebah
- Bone health Unit, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - R Lannon
- Bone health Unit, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - K Mc Carroll
- Bone health Unit, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Fitzpatrick D, Laird E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Tracey F, Molloy A, Cunningham C, McCarroll K. 72 SEASONAL VARIATION IN HYPERPARATHYROIDISM IN OLDER IRISH ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Vitamin D deficiency is common in Ireland, varies by season and can result in secondary hyperparathyroidism. High Parathyroid Hormone (PTH) levels due to low vitamin D status are associated with increased bone turnover and lower bone mineral density, especially at cortical sites such as the hip. Given the variation in vitamin D status by time of year, our study aimed to examine for seasonal differences in hyperparthyroidism in older adults.
Methods
Study participants were from a large cross-sectional study of older Irish adults recruited from hospital outpatient services and GP practices. Exclusion criteria were: eGFR< 30ml/min and elevated serum calcium (>2.5 mmol/l) in order to avoid primary hyperparathyroidism or elevated serum PTH due to advanced renal impairment. Hyperparathyroidism was defined as a PTH level > 65 ng/ml. The relationship between hyperparathyroidism and season was examined in regression models adjusting for potential factors affecting PTH.
Results
There were 4324 participants, mean age 73.8 +/- 7.9 years, 65.4% were female. Hyperparathyroidism was more prevalent in Spring versus Autumn (17.4 vs 11.4 %, P = 0.0002). The increased prevalence remained after adjusting for age, gender, body mass index, timed up and go, dairy intake, eGFR, and smoking (OR 1.6, 1.2- 2.0, P=0.0003). This also corresponded to the seasonal variation in vitamin D status with deficiency (25(OH)D < 30 nmol/l) highest in Spring (23.3%) and lowest in Autumn (16.8%).
Conclusion
We found that hyperparathyroidism fluctuates with season in an inverse relationship with vitamin D. Overall, high PTH levels were 60% more likely in Spring versus Autumn. This emphasises the importance of maintaining adequate vitamin D status all year round. While we adjusted for dairy intake, we did not have accurate measures of total dietary calcium intake which could also vary seasonally and be a contributory factor.
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Affiliation(s)
- D Fitzpatrick
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - F Tracey
- Causeway Hospital, Northern Health and Social Care Trust , Coleraine, Northern Ireland, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - K McCarroll
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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6
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Fitzpatrick D, Laird E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Tracey F, Molloy A, Cunningham C, Carroll KM. 73 PREVALENCE OF SECONDARY HYPERPARATHYROIDISM BY VITAMIN D STATUS IN OLDER IRISH ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Secondary hyperparathyroidism commonly results from vitamin D deficiency and can lead to accelerated bone turnover and bone loss, especially at cortical sites like the hip. It can also attenuate the response to antiresorptive treatments used for osteoporosis. However, several factors may influence PTH response. We aimed to identify the prevalence of secondary hyperparathyroidism by categories of vitamin D status in older Irish adults attending a bone health clinic.
Methods
The study population consisted of older adults (aged over 60 years) attending a bone health clinic at a large hospital. Participants with a serum calcium >2.5 mmol/l and eGFR <30 ml/min were excluded to avoid cases of primary hyperparathyroidism or elevated serum PTH due to advanced renal disease. Hyperparathyroidism was defined as a serum PTH > 65 pg/ml. 25 hydroxyvitamin D (25(OH)D) was measured with liquid chromatography mass spectroscopy.
Results
There were 800 cases identified, mean age 72.9 +/- 7.9 years, and 85.3% were female. The prevalence of secondary hyperparathyroidism by 25(OH)D categories were 28.1% (<30nmol/l), 17.4% (30-49.9 nmol/l) and 8.0% (50-74 nmol/l). Older age (P < 0.03) and lower eGFR (P = 0.01) were associated with hyperparathyroidism independent of vitamin D status.
Conclusion
Nearly one-third of patients who were vitamin D deficient (<30 nmol/L) and one-sixth who were insufficient (30-49.9 nmol/l) had hyperparathyroidism, similar to the results of other studies. However, hyperparathyroidism was also observed in 8% of those with 25(OH)D levels between 50 -74 nmol/l, suggesting that higher levels i.e. ≥ 75 nmol/l may be preferable in older adults. Lower eGFR and older age were also independently associated with higher PTH, consistent with previous research. Higher dietary and supplemental calcium intake is also known to suppress PTH response, though we were not able to account for this in our study.
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Affiliation(s)
- D Fitzpatrick
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - F Tracey
- Causeway Hospital, Northern Health and Social Care Trust , Coleraine, Northern Ireland, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - KM Carroll
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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7
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Breslin L, Bradley E, Fitzpatrick D, Laird E, Hoey L, Hughes C, McNulty H, Strain JJ, Ward M, Tracey F, Molloy A, Cunningham C, McCarroll K. 261 HIGH FRACTURE RISK IN OLDER IRISH ADULT FALLERS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Fracture risk due to falls depends on several factors including bone density, quality and size, hip geometry (axis length), direction of fall (forward, backwards or sideways), body mass index (BMI), type of surface impacted, body site of impact and mechanism of fall (eg syncope). We aimed to identify the fracture risk per fall in frail older Irish adults.
Methods
Participants were from the hypertensive and cognitive cohort of the Trinity, Ulster, Dept Agriculture (TUDA) study of Irish adults (aged >60) recruited from hospital outpatient services and GP practises. Falls and falls resulting in fracture in the previous year were self-reported so those with an MMSE < 25 were excluded to avoid recall bias. We identified fallers, recurrent fallers and fractures due to falls in the previous year.
Results
892 fallers, mean age 76.3 ± 8.4 yrs, 65.2% female. 23.8% had 2 falls and 24.2% ≥3 falls. Mean timed up and go was 17.3 ± 9.5 seconds. Commonest fracture due to falls were hip (20.1%), upper limb (18.5%) and lower limb (17.9%) with one fracture of neck and skull. Fracture rate per fall was 7.1%: 1.7% for hip, 1.3% for lower and 1.2% for upper limb. Annual fracture rate per faller was 16.5%. The only predictors of fall with fracture versus no fracture were female sex (OR 2.4, 1.6-3.6, P<0.001) and lower body mass index (P=0.001).
Conclusion
We identified similar hip fracture rates (1.7%) due to falls as in other studies. However, one in six fallers had sustained a fracture in the previous year reflecting the high proportion of recurrent fallers. Lower BMI and female sex predicted fall with fracture as both are strongly correlated with risk of osteoporosis. Recent guidelines now factor in recurrent falls when estimating the probability of future osteoporotic fractures.
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Affiliation(s)
- L Breslin
- Mercer's Institute for Successful Ageing, St. James Hospital , Dublin, Ireland
| | - E Bradley
- Mercer's Institute for Successful Ageing, St. James Hospital , Dublin, Ireland
| | - D Fitzpatrick
- Mercer's Institute for Successful Ageing, St. James Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - F Tracey
- Northern Health and Social Care Trust Causeway Hospital, , Coleraine, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Trinity College Dublin Mercer's Institute for Successful Ageing, St. James's Hospital, Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - K McCarroll
- Trinity College Dublin Mercer's Institute for Successful Ageing, St. James's Hospital, Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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8
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Rangaswamy G, McNulty M, Browne D, Sharma P, Walkins F, Burke M, Houlihan O, Skourou C, Dunne M, Fitzpatrick D, El Beltagi N, Faul C. PO-1142 Clinical outcomes following Stereotactic Radiosurgery for Brain Metastases from Ovarian Carcinoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03106-1] [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: 11/16/2022]
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9
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McNulty M, Waldron O, Ather M, Rangaswamy G, Houlihan O, Dunne M, Curran B, Ryan S, Skourou C, El Beltagi N, Fitzpatrick D, O'Sullivan S, Faul C. PO-1141 Stereotactic ablative body radiation therapy for spinal metastases; A single institution study. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03105-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Burke M, Rangaswamy G, Dunne M, Armstrong J, Faul C, Fitzpatrick D. PO-1430 A Retrospective study of outcomes with stereotactic radiosurgery for melanoma brain metastasis. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Farmer-Diaz K, Matthew-Bernard M, Ramos-Nino M, Fitzpatrick D, Cheetham S. Comparison of virus concentration methods for the reverse-transcriptase quantitative PCR (RT-qPCR)-based detection of bacteriophage Φ6, an enveloped virus surrogate for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, from untreated wastewater at St. George’s University (SGU), Grenada. Am J Clin Pathol 2021. [PMCID: PMC8574520 DOI: 10.1093/ajcp/aqab191.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction/Objective With the ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the consequent opening of borders, it is of paramount importance to monitor communities for the presence of potential COVID-19 clusters. Wastewater-based epidemiology (WBE) is an effective way to monitor community spread of pathogens and has been implemented in many countries to identify potential outbreaks. Most standardized methodologies used in WBE for the detection of viruses have been validated for non-enveloped viruses; therefore, there is a need for the creation of a standardized method for the detection of enveloped viruses, such as SARS-CoV-2. Methods/Case Report Wastewater seeded with a Pseudomonas syringae bacteriophage (Φ6) was used to test the efficiency of five wastewater virus concentration methods. Two methods were based on AlCl3 flocculation with different pH adjustments. The other methods utilized membrane filtration followed by beef elution: one added a pretreatment with HCl; another added a pretreatment with MgCl2; and finally, an untreated control. A known amount of Bacteriophage Φ6 was used for all methods, and detection was quantified by reverse-transcription quantitative polymerase chain reaction. Results (if a Case Study enter NA) The Cq values for each method, ranging from 24.38–38.6, were compared. The highest recovery of Φ6 was obtained with the AlCl3 flocculation method with an adjusted pH of 6, followed in descending order by MgCl2-pretreated sample with beef elution; HCl-pretreated sample with beef elution, the untreated sample, and AlCl3 flocculation method with an adjusted pH of 3.5. Conclusion The results suggest that AlCl3 flocculation with an adjusted pH of 6 may be a quick and cost-effective methodology for the detection of enveloped viruses in WBE. This can facilitate the implementation of WBE at SGU, Grenada, as a useful tool to conduct active surveillance and track outbreaks of enveloped viral diseases, such as SARS-CoV-2.
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Affiliation(s)
- K Farmer-Diaz
- Department of Microbiology, School of Medicine, St. George’s University, Grenada, St. George, GRENADA
| | - M Matthew-Bernard
- Department of Microbiology, School of Medicine, St. George’s University, Grenada, St. George, GRENADA
| | - M Ramos-Nino
- Department of Microbiology, School of Medicine, St. George’s University, Grenada, St. George, GRENADA
| | - D Fitzpatrick
- Department of Pathobiology, School of Veterinary Medicine, St. George’s University, St. George, GRENADA
| | - S Cheetham
- Department of Pathobiology, School of Veterinary Medicine, St. George’s University, St. George, GRENADA
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12
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Rangaswamy G, Houlihan O, Nicholson J, O’Driscoll H, Dunne M, Skourou C, Faul C, Fitzpatrick D. PO-1062 Stereotactic Radiosurgery for Brain Metastases from Renal Cell Carcinoma: A retrospective study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07513-7] [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: 10/20/2022]
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13
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Houlihan O, Rangaswamy G, Dunne M, Fennell L, Skourou C, Faul C, Fitzpatrick D. PO-1044 Stereotactic radiosurgery for meningioma: a single institution retrospective analysis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07495-8] [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: 11/28/2022]
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14
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Thirion P, Dunne M, Parker I, Small C, Shannon A, Clayton-Lea A, Parker M, Collins C, Coffey J, Elbeltagi N, Fitzpatrick D, McArdle O, Stevenson M, Alvarez-Iglesias A, Moriarty M, Salib O, Gillham C, Armstrong J. CTRIAL-IE (ICORG) 07-11: Phase II Trial Evaluating Radiobiological Based Reirradiation Strategy for Patients with Malignant Spinal Cord Compression. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2133] [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]
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15
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Glynn A, Rangaswamy G, O'Shea J, Dunne M, Faul C, Fitzpatrick D. PO-0871: Outcomes in Pineal Parenchymal tumours of intermediate differentiation: A single institution study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00888-4] [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]
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16
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Cummins D, Skourou C, O'Sullivan S, Davenport P, Fitzpatrick D, Faul C, Javadpour M, Dunne M. EP-1908 A Guide For Predicting Normal Tissue Dose in Stereotactic Radiosurgery. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32328-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Higgins MJ, Burke O, Nugent K, Skourou C, Dunne M, Javadpour M, Fitzpatrick D, Faul C. P05.03 Stereotactic Radiosurgery to Surgical Cavity Post Resection of Brain Metastases: Local Recurrence and Overall Survival Rates. A Single Centre Experience. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M J Higgins
- St Lukes Radiation Oncology Network, Dublin, Irel
| | - O Burke
- St Lukes Radiation Oncology Network, Dublin, Irel
| | - K Nugent
- St Lukes Radiation Oncology Network, Dublin, Irel
| | - C Skourou
- St Lukes Radiation Oncology Network, Dublin, Irel
| | - M Dunne
- St Lukes Radiation Oncology Network, Dublin, Irel
| | | | | | - C Faul
- St Lukes Radiation Oncology Network, Dublin, Irel
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18
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Glynn A, Rangaswamy G, O’Shea J, Dunne M, Grogan R, McNally S, Fitzpatrick D, Faul C. EP-1184: Elderly patients with Glioblastoma Multiforme treated with radiotherapy: a single institution study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31494-4] [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: 10/14/2022]
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19
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Higgins M, Burke O, Nugent K, Dunne M, Skourou C, Fitzpatrick D, Faul C. EP-1193: SRS to cavity post resection of intracranial metastases. A single centre experience 2013-2016. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Fitzpatrick D, Ibrahim ES, Kennelly S, Sherlock M, O'Neill D. Structuring Diabetes Mellitus Care in Long-Term Nursing Home Residents. Ir Med J 2018; 111:711. [PMID: 30376229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Nursing home residents with diabetes have more complex care needs with higher levels of comorbidity, disability and cognitive impairment. We compared current practice in the 44 long-term residents in Peamount hospital with the standards recommended in the Diabetes UK "Good Clinical Practice Guidelines for Care Home Residents with Diabetes". Of 44 residents, 11 were diabetic. Residents did not have specific diabetes care plans. There were some elements of good practice with a low incidence of hypoglycaemia and in-house access to dietetics and chiropody. However, diabetes care was delivered on an ad-hoc basis without individualised care plans, documented glycaemic targets, or scheduled monitoring for complications and no formal screening for diabetes on admission. National and local policy to guide management of diabetes mellitus should be developed. There should be individualised diabetes care plans, clear policies for hypoglycaemia, hyperglycaemia and long-term diabetes complications, screening on admission and increased uptake of the national retinal screening and foot care programmes.
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Affiliation(s)
| | | | - S Kennelly
- Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin
| | - M Sherlock
- Department of Endocrinology and Diabetes, Tallaght Hospital, Dublin
| | - D O'Neill
- Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin
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21
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Richardson AJ, Leckie T, Watkins ER, Fitzpatrick D, Galloway R, Grimaldi R, Baker P. Post marathon cardiac troponin T is associated with relative exercise intensity. J Sci Med Sport 2018; 21:880-884. [PMID: 29588114 DOI: 10.1016/j.jsams.2018.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 11/07/2017] [Revised: 01/15/2018] [Accepted: 02/17/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVES This study aimed to investigate whether measures of cardiopulmonary fitness and relative exercise intensity were associated with high sensitivity cardiac troponin T (cTnT) rise after a road marathon. METHODS Fifty-two marathon runners (age 39±11 years, body mass 76.2±12.9kg, height 1.74±0.09m) attended the laboratory between 2 and 3 weeks prior to attempting the Brighton Marathon, UK. Running economy at 10kmh-1 (RE10) and race pace (RERP), ventilatory threshold (VT) and VO2max tests were completed. CTnT was measured within 48h prior to the marathon and within 10min of completing the marathon, using a high sensitivity assay. Heart rates (HR) were recorded throughout the marathon. RESULTS Runners demonstrated a significant increase in cTnT over the marathon (pre-race 5.60±3.27ngL-1, post-race 74.52±30.39ngL-1, p<0.001). Markers of endurance performance such as running economy (10kmh-1 223±18mlkg-1km-1; race pace 225±22mlkg-1km-1), VT (38.5±6.4mlkg-1min-1) and V˙O2max (50.9±7.7mlkg-1min-1) were not associated with post-race cTnT. Runners exercise intensity correlated with post-race cTnT (mean HR %VT 104±5%, r=0.50; peak HR %VT 118±8%, r=0.68; peak HR %V˙O2max 96±6, r=0.60, p<0.05) and was different between the low, medium and high cTnT groups (p<0.05). CONCLUSIONS CTnT increases above reference limits during a marathon. Magnitude of cTnT rise is related to exercise intensity relative to ventilatory threshold and V˙O2max, but not individuals' absolute cardiopulmonary fitness, training state or running history.
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Affiliation(s)
- A J Richardson
- Centre of Sport and Exercise Medicine (SESAME), University of Brighton, Welkin Laboratories, UK; Brighton Marathon Research Group, UK.
| | - T Leckie
- Anaesthetics Department, Eastbourne DGH, East Sussex Healthcare Trust, UK; Brighton Marathon Research Group, UK
| | - E R Watkins
- Centre of Sport and Exercise Medicine (SESAME), University of Brighton, Welkin Laboratories, UK
| | | | - R Galloway
- Royal Sussex County Hospital, Brighton and Sussex Hospital NHS Trust, UK; Brighton Marathon Research Group, UK
| | - R Grimaldi
- Royal Sussex County Hospital, Brighton and Sussex Hospital NHS Trust, UK; Brighton Marathon Research Group, UK
| | - P Baker
- Centre of Sport and Exercise Medicine (SESAME), University of Brighton, Welkin Laboratories, UK; Brighton Marathon Research Group, UK
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22
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Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, Allemani C, Bouzbid S, Hamdi-Chérif M, Zaidi Z, Bah E, Swaminathan R, Nortje S, El Mistiri M, Bayo S, Malle B, Manraj S, Sewpaul-Sungkur R, Fabowale A, Ogunbiyi O, Bradshaw D, Somdyala N, Stefan D, Abdel-Rahman M, Jaidane L, Mokni M, Kumcher I, Moreno F, González M, Laura E, Espinola S, Calabrano G, Carballo Quintero B, Fita R, Garcilazo D, Giacciani P, Diumenjo M, Laspada W, Green M, Lanza M, Ibañez S, Lima C, Lobo de Oliveira E, Daniel C, Scandiuzzi C, De Souza P, Melo C, Del Pino K, Laporte C, Curado M, de Oliveira J, Veneziano C, Veneziano D, Latorre M, Tanaka L, Azevedo e Silva G, Galaz J, Moya J, Herrmann D, Vargas S, Herrera V, Uribe C, Bravo L, Arias-Ortiz N, Jurado D, Yépez M, Galán Y, Torres P, Martínez-Reyes F, Pérez-Meza M, Jaramillo L, Quinto R, Cueva P, Yépez J, Torres-Cintrón C, Tortolero-Luna G, Alonso R, Barrios E, Nikiforuk C, Shack L, Coldman A, Woods R, Noonan G, Turner D, Kumar E, Zhang B, McCrate F, Ryan S, Hannah H, Dewar R, MacIntyre M, Lalany A, Ruta M, Marrett L, Nishri D, McClure C, Vriends K, Bertrand C, Louchini R, Robb K, Stuart-Panko H, Demers S, Wright S, George J, Shen X, Brockhouse J, O'Brien D, Ward K, Almon L, Bates J, Rycroft R, Mueller L, Phillips C, Brown H, Cromartie B, Schwartz A, Vigneau F, MacKinnon J, Wohler B, Bayakly A, Clarke C, Glaser S, West D, Green M, Hernandez B, Johnson C, Jozwik D, Charlton M, Lynch C, Huang B, Tucker T, Deapen D, Liu L, Hsieh M, Wu X, Stern K, Gershman S, Knowlton R, Alverson J, Copeland G, Rogers D, Lemons D, Williamson L, Hood M, Hosain G, Rees J, Pawlish K, Stroup A, Key C, Wiggins C, Kahn A, Schymura M, Leung G, Rao C, Giljahn L, Warther B, Pate A, Patil M, Schubert S, Rubertone J, Slack S, Fulton J, Rousseau D, Janes T, Schwartz S, Bolick S, Hurley D, Richards J, Whiteside M, Nogueira L, Herget K, Sweeney C, Martin J, Wang S, Harrelson D, Keitheri Cheteri M, Farley S, Hudson A, Borchers R, Stephenson L, Espinoza J, Weir H, Edwards B, Wang N, Yang L, Chen J, Song G, Gu X, Zhang P, Ge H, Zhao D, Zhang J, Zhu F, Tang J, Shen Y, Wang J, Li Q, Yang X, Dong J, Li W, Cheng L, Chen J, Huang Q, Huang S, Guo G, Wei K, Chen W, Zeng H, Demetriou A, Pavlou P, Mang W, Ngan K, Swaminathan R, Kataki A, Krishnatreya M, Jayalekshmi P, Sebastian P, Sapkota S, Verma Y, Nandakumar A, Suzanna E, Keinan-Boker L, Silverman B, Ito H, Nakagawa H, Hattori M, Kaizaki Y, Sugiyama H, Utada M, Katayama K, Narimatsu H, Kanemura S, Koike T, Miyashiro I, Yoshii M, Oki I, Shibata A, Matsuda T, Nimri O, Ab Manan A, Bhoo-Pathy N, Tuvshingerel S, Chimedsuren O, Al Khater A, El Mistiri M, Al-Eid H, Jung K, Won Y, Chiang C, Lai M, Suwanrungruang K, Wiangnon S, Daoprasert K, Pongnikorn D, Geater S, Sriplung H, Eser S, Yakut C, Hackl M, Mühlböck H, Oberaigner W, Zborovskaya A, Aleinikova O, Henau K, Van Eycken L, Dimitrova N, Valerianova Z, Šekerija M, Zvolský M, Engholm G, Storm H, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier A, Faivre J, Guizard A, Bouvier V, Launoy G, Arveux P, Maynadié M, Mounier M, Fournier E, Woronoff A, Daoulas M, Clavel J, Le Guyader-Peyrou S, Monnereau A, Trétarre B, Colonna M, Cowppli-Bony A, Molinié F, Bara S, Degré D, Ganry O, Lapôtre-Ledoux B, Grosclaude P, Estève J, Bray F, Piñeros M, Sassi F, Stabenow R, Eberle A, Erb C, Nennecke A, Kieschke J, Sirri E, Kajueter H, Emrich K, Zeissig S, Holleczek B, Eisemann N, Katalinic A, Brenner H, Asquez R, Kumar V, Ólafsdóttir E, Tryggvadóttir L, Comber H, Walsh P, Sundseth H, Devigili E, Mazzoleni G, Giacomin A, Bella F, Castaing M, Sutera A, Gola G, Ferretti S, Serraino D, Zucchetto A, Lillini R, Vercelli M, Busco S, Pannozzo F, Vitarelli S, Ricci P, Pascucci C, Autelitano M, Cirilli C, Federico M, Fusco M, Vitale M, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Maule M, Sacerdote C, Tumino R, Di Felice E, Vicentini M, Falcini F, Cremone L, Budroni M, Cesaraccio R, Contrino M, Tisano F, Fanetti A, Maspero S, Candela G, Scuderi T, Gentilini M, Piffer S, Rosso S, Sacchetto L, Caldarella A, La Rosa F, Stracci F, Contiero P, Tagliabue G, Dei Tos A, Zorzi M, Zanetti R, Baili P, Berrino F, Gatta G, Sant M, Capocaccia R, De Angelis R, Liepina E, Maurina A, Smailyte G, Agius D, Calleja N, Siesling S, Visser O, Larønningen S, Møller B, Dyzmann-Sroka A, Trojanowski M, Góźdż S, Mężyk R, Grądalska-Lampart M, Radziszewska A, Didkowska J, Wojciechowska U, Błaszczyk J, Kępska K, Bielska-Lasota M, Kwiatkowska K, Forjaz G, Rego R, Bastos J, Silva M, Antunes L, Bento M, Mayer-da-Silva A, Miranda A, Coza D, Todescu A, Valkov M, Adamcik J, Safaei Diba C, Primic-Žakelj M, Žagar T, Stare J, Almar E, Mateos A, Quirós J, Bidaurrazaga J, Larrañaga N, Díaz García J, Marcos A, Marcos-Gragera R, Vilardell Gil M, Molina E, Sánchez M, Franch Sureda P, Ramos Montserrat M, Chirlaque M, Navarro C, Ardanaz E, Moreno-Iribas C, Fernández-Delgado R, Peris-Bonet R, Galceran J, Khan S, Lambe M, Camey B, Bouchardy C, Usel M, Ess S, Herrmann C, Bulliard J, Maspoli-Conconi M, Frick H, Kuehni C, Schindler M, Bordoni A, Spitale A, Chiolero A, Konzelmann I, Dehler S, Matthes K, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Bannon F, Black R, Brewster D, Huws D, White C, Finan P, Allemani C, Bonaventure A, Carreira H, Coleman M, Di Carlo V, Harewood R, Liu K, Matz M, Montel L, Nikšić M, Rachet B, Sanz N, Spika D, Stephens R, Peake M, Chalker E, Newman L, Baker D, Soeberg M, Aitken J, Scott C, Stokes B, Venn A, Farrugia H, Giles G, Threlfall T, Currow D, You H, Hendrix J, Lewis C. Erratum to “The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)” [Gynecol. Oncol. 144 (2017) 405–413]. Gynecol Oncol 2017; 147:726. [DOI: 10.1016/j.ygyno.2017.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cagney DN, Thirion PG, Dunne MT, Fleming C, Fitzpatrick D, O'Shea CM, Finn MA, O'Sullivan S, Booth C, Collins CD, Buckney SJ, Shannon A, Armstrong JG. A Phase II Toxicity End Point Trial (ICORG 99-09) of Accelerated Dose-escalated Hypofractionated Radiation in Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2017; 30:30-38. [PMID: 29097074 DOI: 10.1016/j.clon.2017.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 09/18/2017] [Accepted: 09/21/2017] [Indexed: 12/25/2022]
Abstract
AIMS The objective of this phase II clinical trial was to prospectively evaluate the safety and efficacy of accelerated hypofractionated three-dimensional conformal radiation therapy (3DCRT) in localised non-resectable/non-operable non-small cell lung cancer (NSCLC). MATERIALS AND METHODS Sixty patients with stage I-III NSCLC were enrolled in a prospective single-arm All Ireland Co-operative Oncology Research Group (ICORG 99-09) toxicity end point phase II trial. The protocol allocated patients between three radiation schedule dose levels (60, 66 or 72 Gy, in 20, 22 and 24 fractions, respectively, 3 Gy daily, five fractions per week) according to combined lung V25Gy (V25Gy ≤ 30%) with built-in early stopping toxicity rules. The primary end point was toxicity with evaluation of dose-limiting toxicity. The secondary objectives included radiological tumour response rate at 3 months after the completion of radiation therapy and the thoracic progression-free survival time. RESULTS Sixty patients were recruited from August 1999 to June 2009. Forty-nine patients were included in the primary per-protocol analysis. Eleven patients were not evaluable. In the first 30 evaluable patient cohort, severe oesophageal toxicity was reported in two patients (2/49; 4% experiencing grade 5 oesophageal late toxicity, related to the 97% oesophageal length). The trial was temporarily closed and was then reopened to validate an oesophageal dose volume constraint (DVC) of limiting the length of oesophagus fully encompassed by the 97% isodose to less than 1 cm (applied to 21 patients). The trial prospectively showed the safety of the oesophageal DVC, with no oesophageal toxicity above grade 3 thereafter. Thirty-nine per cent of patients had disease progression at 3-4 months after radiotherapy, 22% had stable disease, 20% had a complete response and 14% had a partial response. The median overall survival was 13.6 months (95% confidence interval 10.5-16.7) and overall survival at 1 and 3 years was 57% and 29%, respectively. CONCLUSION A strategy using accelerated hypofractionated 3DCRT is feasible and reasonably safe for patients with inoperable NSCLC. It is safe to deliver for centrally located tumours if DVCs are applied to the oesophagus, which is the primary dose-limiting toxicity. Further studies are required to assess the efficacy of hypofractionated regimens for centrally located tumours using an oesophageal DVC and monitoring for oesophageal toxicity.
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Affiliation(s)
- D N Cagney
- St Luke's Radiation Oncology Network, Dublin, Ireland.
| | - P G Thirion
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - M T Dunne
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - C Fleming
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - D Fitzpatrick
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - C M O'Shea
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - M A Finn
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - S O'Sullivan
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - C Booth
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - C D Collins
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - S J Buckney
- St Luke's Radiation Oncology Network, Dublin, Ireland
| | - A Shannon
- Cancer Trials Ireland (formerly ICORG), Dublin, Ireland
| | - J G Armstrong
- St Luke's Radiation Oncology Network, Dublin, Ireland; Cancer Trials Ireland (formerly ICORG), Dublin, Ireland
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Minicozzi P, Innos K, Sánchez MJ, Trama A, Walsh PM, Marcos-Gragera R, Dimitrova N, Botta L, Visser O, Rossi S, Tavilla A, Sant M, Hackl M, Zielonke N, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Dušek L, Zvolský M, Mägi M, Aareleid T, Malila N, Seppä K, Bouvier A, Faivre J, Bossard N, Uhry Z, Colonna M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Katalinic A, Clough-Gorr K, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Ferretti S, Barchielli A, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Capocaccia R, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Maso LD, De Angelis R, Caldora M, Carrani E, Francisci S, Knijn A, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Natali M, Filiberti R, Marani E, Autelitano M, Spagnoli G, Cirilli C, Fusco M, Vitale M, Traina A, Staiti R, Vitale F, Cusimano R, Michiara M, Tumino R, Falcini F, Caiazzo A, Maspero S, Fanetti A, Zanetti R, Rosso S, Rugge M, Tognazzo S, Pildava S, Smailyte G, Johannesen T, Rachtan J, Góźdź S, Mężyk R, Błaszczyk J, Kępska K, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Antunes L, Miranda A, Mayer-da-Silva A, Safaei Diba C, Primic-Zakelj M, Almar E, Mateos A, Lopez de Munain A, Larrañaga N, Torrella-Ramos A, Díaz García J, Jimenez-Chillaron R, Marcos-Gragera R, Vilardell L, Moreno-Iribas C, Ardanaz E, Lambe M, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Damhuis R, Otter R, Coleman M, Allemani C, Rachet B, Rashbass J, Broggio J, Verne J, Gavin A, Fitzpatrick D, Huws D, White C. Quality analysis of population-based information on cancer stage at diagnosis across Europe, with presentation of stage-specific cancer survival estimates: A EUROCARE-5 study. Eur J Cancer 2017; 84:335-353. [DOI: 10.1016/j.ejca.2017.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/04/2017] [Accepted: 07/11/2017] [Indexed: 11/28/2022]
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Fitzpatrick D, O'Neill D. Older Motorcyclists in Ireland. Ir Med J 2017; 110:585. [PMID: 28952675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Older motorcyclists are under-recognised as vulnerable road users. Using Irish data from the Central Statistics Office, the Road Safety Authority and the Healthcare Pricing Office, we explored the trend of ageing riders and factors in older motorcyclist collisions and injuries. In 2005, 17 motorcyclists aged 55 and over were injured compared to 31 in 2012. Motorcyclists aged between 30-49 years and 50 years and over have longer lengths of stay compared to riders <30. The percentage of motorcycles with an engine capacity of 750cc or more increased from 39.6% in 2007 to 46.7% in 2015. Older motorcyclists are less likely to be fatally injured in single vehicle collisions. Older motorcyclists are generally safer than younger riders but the proportion of older motorcyclist injury is rising. Irish road safety strategies and trauma services need to incorporate these findings into planning and development of preventive and treatment approaches.
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Affiliation(s)
| | - D O'Neill
- Department of Orthopaedics, Kerry General Hospital, Tralee Co Kerry, Ireland
- National Programme Office for Traffic Medicine, Royal College of Physicians of Ireland, Dublin, Ireland
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Billfalk Kelly A, Dunne M, Faul C, McArdle O, Fraser I, Coffey J, Boychak A, O'Neill B, Fitzpatrick D. EP-1404: Survival time following palliative whole brain radiotherapy to treat brain metastases. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wilson P, Mort A, Roberts A, Fitzpatrick D, Williams C, Mellish C, Schneider A, Reiter E. MIME: pre-hospital technology for managing information in medical emergencies. Rural Remote Health 2016. [DOI: 10.22605/rrh4089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Marcos-Gragera R, Mallone S, Kiemeney LA, Vilardell L, Malats N, Allory Y, Sant M, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Zvolský M, Dušek L, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Velten M, Troussard X, Bouvier V, Launoy G, Guizard A, Faivre J, M. Bouvier A, Arveux P, Maynadié M, Woronoff A, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Bossard N, Belot A, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Meyer M, Stabenow R, Luttmann S, Eberle A, Brenner H, Nennecke A, Engel J, Schubert-Fritschle G, Kieschke J, Heidrich J, Holleczek B, Katalinic A, Jónasson J, Tryggvadóttir L, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mazzei A, Ferretti S, Crocetti E, Manneschi G, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Zucchetto A, De Angelis R, Caldora M, Capocaccia R, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Bonelli L, Vercelli M, Gennaro V, Ricci P, Autelitano M, Randi G, Ponz De Leon M, Marchesi C, Cirilli C, Fusco M, Vitale M, Usala M, Traina A, Zarcone M, Vitale F, Cusimano R, Michiara M, Tumino R, Giorgi Rossi P, Vicentini M, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Zanetti R, Rosso S, Candela P, Scuderi T, Stracci F, Rocca A, Tagliabue G, Contiero P, Dei Tos A, Tognazzo S, Pildava S, Smailyte G, Calleja N, Micallef R, Johannesen T, Rachtan J, Gózdz S, Mezyk R, Blaszczyk J, Kepska K, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Antunes L, Miranda A, Mayer-da-Silva A, Nicula F, Coza D, Safaei Diba C, Primic-Zakelj M, Almar E, Mateos A, Errezola M, Larrañaga N, Torrella-Ramos A, Díaz García J, Marcos-Navarro A, Marcos-Gragera R, Vilardell L, Sanchez M, Molina E, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Galceran J, Carulla M, Lambe M, Khan S, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Ess S, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Aben K, Coleman M, Allemani C, Rachet B, Verne J, Easey N, Lawrence G, Moran T, Rashbass J, Roche M, Wilkinson J, Gavin A, Fitzpatrick D, Brewster D, Huws D, White C, Otter R. Urinary tract cancer survival in Europe 1999–2007: Results of the population-based study EUROCARE-5. Eur J Cancer 2015; 51:2217-2230. [DOI: 10.1016/j.ejca.2015.07.028] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 07/02/2015] [Accepted: 07/20/2015] [Indexed: 12/22/2022]
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Cesario C, Shayman C, Abdullah A, Fitzpatrick D, Corkery M. Are physical therapist students adequately prepared for primary contact practice? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fitzpatrick D, Bassin J, Iversen M. Development and implementation of a global academic exchange to promote cultural awareness among physical therapy students: a longitudinal examination. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.609] [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: 11/27/2022]
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Fitzpatrick D, Duncan E. INVESTIGATING PATIENTS EXPERIENCES OF HYPOGLYCAEMIC EMERGENCIES. Arch Emerg Med 2015. [DOI: 10.1136/emermed-2015-204880.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fitzpatrick D, Thomas A, Patel N. Interprofessional South African global experience: impact on facilitation and assessment of cultural competence and core value development, 3 year study. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McClements J, Fitzpatrick D, Campbell WJ, Gavin A. Changes in management and outcome of patients with rectal cancer in Northern Ireland: 1996-2006. Colorectal Dis 2014; 16:O58-65. [PMID: 24447714 DOI: 10.1111/codi.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 09/02/2013] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to document developments in rectal cancer services in a UK population and evaluate changes in outcome over a 10-year period. METHOD Patients diagnosed with primary rectal carcinoma in 1996, 2001 and 2006 were identified by the Northern Ireland Cancer Registry. Data were retrospectively collected on presentation, investigation, treatment and staging. Differences over the period were analysed using the chi-squared test; Kaplan-Meier and Cox regression tests were used for survival analysis. RESULTS After exclusions there were 636 patients, including 187 presenting in 1996, 203 in 2001 and 246 in 2006. The use of preoperative MRI of the rectum, endorectal ultrasound and abdominal CT increased during the study period. For patients treated by surgery, total mesorectal excision (TME) increased from 19% in 1996 to 64% in 2006 (P < 0.001). The use of radiotherapy (27% in 1996, 47% in 2006) and chemotherapy (21% in 1996, 32% in 2006) increased. The overall 5-year survival improved significantly between 1996 and 2006 from 34% in 1996 to 45% in 2006 (P = 0.02). Among patients having surgery, 5-year survival increased from 43% in 1996 to 63% in 2006 (P < 0.001). Multivariate analysis showed that the improvement in survival was associated with TME and chemotherapy, while radiotherapy was not. CONCLUSION Survival of patients with rectal cancer in Northern Ireland has improved significantly over the last decade, probably due to the increased use of TME and chemotherapy.
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Affiliation(s)
- J McClements
- General Surgery Department, South-Eastern Trust, Ulster Hospital Dundonald, Belfast, UK
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Fitzpatrick D, Evans-Hurson R, Fu Y, Burke T, Krüse J, Vos B, McSweeney SG, Casaubieilh P, Keating JJ. Rapid profiling of enteric coated drug delivery spheres via Broadband Acoustic Resonance Dissolution Spectroscopy (BARDS). Analyst 2014; 139:1000-6. [DOI: 10.1039/c3an01809a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
There is an increased trend towards the use of drug and enteric coated sugar spheres for controlled oral delivery of active pharmaceutical ingredients (API).
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Affiliation(s)
- D. Fitzpatrick
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | - R. Evans-Hurson
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | - Y. Fu
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | - T. Burke
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | | | - B. Vos
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | - S. G. McSweeney
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | - P. Casaubieilh
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
| | - J. J. Keating
- Department of Chemistry
- Analytical and Biological Chemistry Research Facility (ABCRF)
- University College Cork
- Ireland
- School of Pharmacy
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Fitzpatrick D, McPartland A, Mcgowan B, Silke C, Whelan B. AB0211 Sarcopenia in patients with inflammatory arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fitzpatrick D, Mcgowan B, McPartland A, Silke C, Whelan B. AB0212 A study to determine the relationship between fatigue, physical activity and sitting time in patients with inflammatory arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kelly C, McVey G, Westhelle Murphy M, Fitzpatrick D. PO-0757: The use of Failure Mode Effect Analysis (FMEA) to enhance quality in a busy radiotherapy setting. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33063-2] [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: 11/29/2022]
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Rock K, McArdle O, Forde P, Dunne M, Fitzpatrick D, O'Neill B, Faul C. A clinical review of treatment outcomes in glioblastoma multiforme--the validation in a non-trial population of the results of a randomised Phase III clinical trial: has a more radical approach improved survival? Br J Radiol 2012; 85:e729-33. [PMID: 22215883 DOI: 10.1259/bjr/83796755] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Glioblastoma multiforme (GBM) accounts for up to 60% of all malignant primary brain tumours in adults, occurring in 2-3 cases per 100,000 in Europe and North America. In 2005, a Phase III clinical trial demonstrated a significant improvement in survival over 2, and subsequently 5, years with the addition of concurrent and adjuvant temozolomide (TMZ) to radical radiotherapy (RT). The aim of this study was to investigate if the demonstrated improved survival in the literature translated to clinical practice. METHODS This was a retrospective study including all patients with histologically proven GBM diagnosed from 1999 to 2008 and treated with adjuvant RT at our institution. A total of 273 patients were identified. Statistical analysis was carried out using SPSS® v.18 (SPSS, Chicago, IL). RESULTS The median survival for the whole group (n=273) over the 10-year period was 7.6 months (95% confidence interval 6.7-8.4 months). Overall, the cumulative probability of survival at 1 and 2 years was 31.5% and 9.4%, respectively. In total, 146 patients received radical RT. 103 patients were treated with radical RT and TMZ and 43 patients received radical RT alone. The median survival for patients receiving radical RT with TMZ was 13.4 months (95% CI 10.9-15.8 months) vs 8.8 months for radical RT alone (95% CI 6.9-10.7 months, p=0.006). 2-year survival figures were 21.2% vs 4.7%, respectively. On multivariate analysis, independent predictors of survival included Karnofsky Performance Status, RT dose, TMZ and extent of surgery. The strongest predictors of poorer outcome based on the hazard ratio were palliative RT, followed by not receiving TMZ chemotherapy, then KPS <90 and a biopsy only surgical approach. CONCLUSION This paper demonstrates improved survival outcomes consistent with those published in the literature for the addition of concurrent and adjuvant TMZ to radical RT for the treatment of GBM. Although 63% of patients seen in the clinic were suitable for a combined modality approach, the prognosis for the lower Radiation Therapy Oncology Group classes still remains poor.
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Affiliation(s)
- K Rock
- St. Luke's Radiation Oncology Network, Dublin, Ireland.
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Viner A, Mclean S, Fitzpatrick D, Flapan A. A6 Left bundle branch block: simplified Sgarbossa criteria applied to prehospital ECGs. Arch Emerg Med 2011. [DOI: 10.1136/emermed-2011-200645.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Duncan E, Fitzpatrick D. A1 Developing a prioritised vehicle equipment check-sheet (VECS): a modified Delphi Study. Arch Emerg Med 2011. [DOI: 10.1136/emermed-2011-200644.1] [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: 11/04/2022]
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Duncan E, Fitzpatrick D. A4 Developing a prioritised vehicle equipment check-sheet (VECS): a modified Delphi Study. Arch Emerg Med 2011. [DOI: 10.1136/emermed-2011-200645.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Skliarenko J, Craig T, Fitzpatrick D, Bayley A, Brierley J, Cummings B, Dinniwell R, Wong R, Kim J. Evaluation of Set-up Reproducibility with and without Customized Vacuum Immobilization Device in Rectal Cancer Patients Treated with Preoperative Pelvic Radiation Therapy. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1680] [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]
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Waddell-Smith K, Parsonage W, Arstall M, Coverdale S, Prasad C, Cross D, Collins N, Juergens C, Prasan A, Rankin J, Fitzpatrick D, Van Gaal B, Mattchoss S, Horsfall M, Chew D, Vaile J. Under-treatment of Women with Acute Coronary Syndrome Appears to be Related to Unrecognised Risk. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.111] [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]
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Bottlang M, Walleser S, Noll M, Honold S, Madey SM, Fitzpatrick D, Long WB. Biomechanical rationale and evaluation of an implant system for rib fracture fixation. Eur J Trauma Emerg Surg 2010; 36:417-26. [PMID: 21841953 PMCID: PMC3150823 DOI: 10.1007/s00068-010-0047-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 08/23/2010] [Indexed: 11/29/2022]
Abstract
Background Biomechanical research directed at developing customized implant solutions for rib fracture fixation is essential to reduce the complexity and to increase the reliability of rib osteosynthesis. Without a simple and reliable implant solution, surgical stabilization of rib fractures will remain underutilized despite proven benefits for select indications. This article summarizes the research, development, and testing of a specialized and comprehensive implant solution for rib fracture fixation. Methods An implant system for rib fracture fixation was developed in three phases: first, research on rib biomechanics was conducted to better define the form and function of ribs. Second, research results were implemented to derive an implant system comprising anatomical plates and intramedullary rib splints. Third, the functionality of anatomic plates and rib splints was evaluated in a series of biomechanical tests. Results Geometric analysis of the rib surface yielded a set of anatomical rib plates that traced the rib surface over a distance of 13–15 cm without the need for plate contouring. Structurally, the flexible design of anatomic plates did not increase the native stiffness of ribs while restoring 77% of the native rib strength. Intramedullary rib splints with a rectangular cross-section provided 48% stronger fracture fixation than traditional intramedullary fixation with Kirschner wires. Conclusion The anatomic plate set can simplify rib fracture fixation by minimizing the need for plate contouring. Intramedullary fixation with rib splints provides a less-invasive fixation alternative for posterior rib fracture, where access for plating is limited. The combination of anatomic plates and intramedullary splints provides a comprehensive system to manage the wide range of fractures encountered in flail chest injuries.
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Affiliation(s)
- M. Bottlang
- Biomechanics Laboratory, Legacy Clinical Research and Technology Center, 1225 NE 2nd Avenue, Portland, OR 97215 USA
| | - S. Walleser
- Biomechanics Laboratory, Legacy Clinical Research and Technology Center, 1225 NE 2nd Avenue, Portland, OR 97215 USA
| | - M. Noll
- Biomechanics Laboratory, Legacy Clinical Research and Technology Center, 1225 NE 2nd Avenue, Portland, OR 97215 USA
| | - S. Honold
- Biomechanics Laboratory, Legacy Clinical Research and Technology Center, 1225 NE 2nd Avenue, Portland, OR 97215 USA
| | - S. M. Madey
- Biomechanics Laboratory, Legacy Clinical Research and Technology Center, 1225 NE 2nd Avenue, Portland, OR 97215 USA
| | - D. Fitzpatrick
- Slocum Center for Orthopedics and Sports Medicine, Eugene, OR USA
| | - W. B. Long
- Biomechanics Laboratory, Legacy Clinical Research and Technology Center, 1225 NE 2nd Avenue, Portland, OR 97215 USA
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Wu W, Tiesinga P, Tucker T, Heiner J, Fitzpatrick D. The dynamics of V1 population response to instantaneous changes in direction of stimulus motion. J Vis 2010. [DOI: 10.1167/8.6.814] [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: 11/24/2022] Open
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Wu W, Tiesinga PH, Tucker TR, Mitroff SR, Fitzpatrick D. Distortions in perceived direction of motion predicted by population response dynamics in primary visual cortex. J Vis 2010. [DOI: 10.1167/8.17.33] [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: 11/24/2022] Open
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MacEvoy SP, Tucker TR, Fitzpatrick D. Characterizing V1 population responses to superimposed gratings. J Vis 2010. [DOI: 10.1167/5.8.429] [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: 11/24/2022] Open
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Xu X, Bosking W, Sary G, Jones M, Royal D, Stefansic J, Shima D, Fitzpatrick D, Casagrande V. The functional organization of orientation maps in owl monkey V1 and V2 revealed by optical imaging of intrinsic signals. J Vis 2010. [DOI: 10.1167/2.7.99] [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: 11/24/2022] Open
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Geary C, Jones E, Fitzpatrick D, Kelly CP, Birkinshaw C. In-vitro evaluation of a polyurethane compliant-layer glenoid for use in shoulder arthroplasty. Proc Inst Mech Eng H 2009; 224:551-63. [DOI: 10.1243/09544119jeim626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A polyurethane glenoid component has been designed and manufactured as part of a total shoulder arthroplasty (TSA) system based on compliant-layer (CL) technology. Compared with conventional TSA designs, this biomimetic approach offers reduced friction and wear and potentially improved longevity. In-vitro evaluation of the glenoid system has included loosening and stability tests, and wear measurement using a specially constructed wear simulator. The results obtained support the hypothesis that a CL glenoid design may provide improved resistance to dynamic loosening and rim erosion, and demonstrate superior wear performance over a standard ultra-high molecular weight polyethylene design. This study not only confirms the feasibility of a CL glenoid component but also highlights the potential to increase implant longevity, thereby allowing earlier surgical intervention before poor glenoid bone stock and soft tissue compromise the outcome of TSA.
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Affiliation(s)
- C Geary
- Department of Materials Science and Technology, University of Limerick, Limerick, Ireland
| | - E Jones
- Stryker Osteonics, Raheen, Limerick, Ireland
| | - D Fitzpatrick
- School of Electrical, Electronic and Mechanical Engineering, University College Dublin, Ireland
| | - C P Kelly
- Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - C Birkinshaw
- Department of Materials Science and Technology, University of Limerick, Limerick, Ireland
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