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Eeles E, Tran DD, Boyd J, Tronstad O, Teodorczuk A, Flaws D, Fraser JF, Dissanayaka N. A narrative review of the development and performance characteristics of electronic delirium-screening tools. Aust Crit Care 2023:S1036-7314(23)00195-9. [PMID: 38102026 DOI: 10.1016/j.aucc.2023.11.006] [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: 06/25/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Electronic delirium-screening tools are an emergent area of research. OBJECTIVE The objective of this study was to summarise the development and performance characteristics of electronic screening tools in delirium. METHODS Searches were conducted in Pubmed, Embase, and CINAHL Complete databases to identify electronic delirium-screening tools. RESULTS Five electronic delirium-screening tools were identified and reviewed. Two were designed for and tested within a medical setting, and three were applied to intensive care. Adaptive design features, such as skip function to reduce test burden, were variably integrated into instrument design. All tools were shown to have acceptable psychometric properties, but validation studies were largely incomplete. CONCLUSIONS Electronic delirium-screening tools are an exciting area of development and may offer hope for improved uptake of delirium screening.
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Affiliation(s)
- Eamonn Eeles
- Internal Medicine Services, The Prince Charles Hospital, Brisbane, Queensland, Australia; Northside Clinical School, School of Medicine, University of Queensland, Australia; Critical Care Research Group, School of Clinical Sciences, Queensland University of Technology, Department of Mental Health, Caboolture Hospital, University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia; UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Queensland, Australia.
| | - David Duc Tran
- Critical Care Research Group, School of Clinical Sciences, Queensland University of Technology, Department of Mental Health, Caboolture Hospital, University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
| | - Jemima Boyd
- Allied Health Department, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Oystein Tronstad
- Critical Care Research Group Level 3, Clinical Sciences, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Andrew Teodorczuk
- Critical Care Research Group, School of Clinical Sciences, Queensland University of Technology, Department of Mental Health, Caboolture Hospital, University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
| | - Dylan Flaws
- Critical Care Research Group, School of Clinical Sciences, Queensland University of Technology, Department of Mental Health, Caboolture Hospital, University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
| | - John F Fraser
- Critical Care Research Group Level 3, Clinical Sciences, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Nadeeka Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Queensland, Australia
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2
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van Bruggen R, Maksimovic K, You J, Tran DD, Lee HJ, Khan M, Kao CS, Kim JR, Cho W, Chen XXL, Park J. MATR3 F115C knock-in mice do not exhibit motor defects or neuropathological features of ALS. Biochem Biophys Res Commun 2021; 568:48-54. [PMID: 34182213 DOI: 10.1016/j.bbrc.2021.06.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/15/2021] [Indexed: 12/28/2022]
Abstract
The F115C mutation in the MATR3 gene has been linked to amyotrophic lateral sclerosis (ALS). To determine the pathogenicity of the F115C mutation and the mechanism by which this mutation causes ALS, we generated mice that harbor the F115C mutation in the endogenous murine Matr3 locus. Heterozygous or homozygous MATR3 F115C knock-in mice were viable and did not exhibit motor deficits up to 2 years of age. The mutant mice showed no significant differences in the number of Purkinje cells or motor neurons compared to wild-type littermates. Neuropathological examination revealed an absence of MATR3 and TDP-43 pathology in Purkinje cells and motor neurons in the mutant mice. Together, our results suggest that the F115C mutation in MATR3 may not confer pathogenicity.
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Affiliation(s)
- Rebekah van Bruggen
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Katarina Maksimovic
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Justin You
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - David Duc Tran
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Hyeok Jun Lee
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Mashiat Khan
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Ching Serena Kao
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Jihye Rachel Kim
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Wooin Cho
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Xiao Xiao Lily Chen
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Jeehye Park
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Canada.
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3
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Zhao M, Kao CS, Arndt C, Tran DD, Cho WI, Maksimovic K, Chen XXL, Khan M, Zhu H, Qiao J, Peng K, Hong J, Xu J, Kim D, Kim JR, Lee J, van Bruggen R, Yoon WH, Park J. Knockdown of genes involved in axonal transport enhances the toxicity of human neuromuscular disease-linked MATR3 mutations in Drosophila. FEBS Lett 2020; 594:2800-2818. [PMID: 32515490 DOI: 10.1002/1873-3468.13858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022]
Abstract
Mutations in the nuclear matrix protein Matrin 3 (MATR3) have been identified in amyotrophic lateral sclerosis and myopathy. To investigate the mechanisms underlying MATR3 mutations in neuromuscular diseases and efficiently screen for modifiers of MATR3 toxicity, we generated transgenic MATR3 flies. Our findings indicate that expression of wild-type or mutant MATR3 in motor neurons reduces climbing ability and lifespan of flies, while their expression in indirect flight muscles (IFM) results in abnormal wing positioning and muscle degeneration. In both motor neurons and IFM, mutant MATR3 expression results in more severe phenotypes than wild-type MATR3, demonstrating that the disease-linked mutations confer pathogenicity. We conducted a targeted candidate screen for modifiers of the MATR3 abnormal wing phenotype and identified multiple enhancers involved in axonal transport. Knockdown of these genes enhanced protein levels and insolubility of mutant MATR3. These results suggest that accumulation of mutant MATR3 contributes to toxicity and implicate axonal transport dysfunction in disease pathogenesis.
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Affiliation(s)
- Melody Zhao
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Ching Serena Kao
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Claudia Arndt
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - David Duc Tran
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Woo In Cho
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Katarina Maksimovic
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Xiao Xiao Lily Chen
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Mashiat Khan
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Hongxian Zhu
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Julia Qiao
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Kailong Peng
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Jingyao Hong
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Jialu Xu
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Deanna Kim
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Jihye Rachel Kim
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Jooyun Lee
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Rebekah van Bruggen
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
| | - Wan Hee Yoon
- Aging & Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Jeehye Park
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Canada
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Lawson JS, Ngan CC, Glenn WK, Tran DD. Correction to: mouse mammary tumour virus (MMTV) and human breast cancer with neuroendocrine differentiation. Infect Agent Cancer 2017; 12:51. [PMID: 29034001 PMCID: PMC5629764 DOI: 10.1186/s13027-017-0161-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 11/10/2022] Open
Abstract
[This corrects the article DOI: 10.1186/s13027-017-0135-8.].
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Affiliation(s)
- J S Lawson
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - C C Ngan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - W K Glenn
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia
| | - D D Tran
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, Australia.,Douglass Hanly Moir Pathology, Sydney, Australia
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Lawson JS, Tran DD, Carpenter E, Ford CE, Rawlinson WD, Whitaker NJ, Delprado W. Presence of mouse mammary tumour-like virus gene sequences may be associated with morphology of specific human breast cancer. J Clin Pathol 2006; 59:1287-92. [PMID: 16698952 PMCID: PMC1860546 DOI: 10.1136/jcp.2005.035907] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mouse mammary tumour virus (MMTV) has a proven role in breast carcinogenesis in wild mice and genetically susceptible in-bred mice. MMTV-like env gene sequences, which indicate the presence of a replication-competent MMTV-like virus, have been identified in some human breast cancers, but rarely in normal breast tissues. However, no evidence for a causal role of an MMTV-like virus in human breast cancer has emerged, although there are precedents for associations between specific histological characteristics of human cancers and the presence of oncogenic viruses. AIM To investigate the possibility of an association between breast cancer and MMTV-like viruses. METHODS Histological characteristics of invasive ductal human breast cancer specimens were compared with archival MMTV-associated mammary tumours from C3H experimental mice. The presence of MMTV-like env DNA sequences in the human breast cancer specimens was determined by polymerase chain reaction and confirmed by Southern hybridisation. RESULTS MMTV-like env gene sequences were identified in 22 of 59 (37.3%) human breast cancer specimens. Seventeen of 43 (39.5%) invasive ductal carcinoma breast cancer specimens and 4 of 16 (25%) ductal carcinoma in situ specimens had some histological characteristics, which were similar to MMTV-associated mouse mammary tumours. However, these similarities were not associated with the presence or absence of MMTV-like gene sequences in the human breast tumour specimens. A significant (p = 0.05) correlation was found between the grade of the human breast cancer and similarity to the mouse mammary tumours. The lower the grade, the greater the similarity. CONCLUSION Some human breast cancer specimens, in which MMTV-like env DNA sequences have been identified, were shown to have histological characteristics (morphology) similar to MMTV-associated mouse mammary tumours. These observations are compatible with, but not conclusive of, an association between the presence of MMTV-like env DNA sequences and some human breast cancers.
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MESH Headings
- Animals
- Breast Neoplasms/pathology
- Breast Neoplasms/virology
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/virology
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/virology
- DNA, Viral/analysis
- Female
- Humans
- Mammary Neoplasms, Animal/pathology
- Mammary Neoplasms, Animal/virology
- Mammary Tumor Virus, Mouse/genetics
- Mammary Tumor Virus, Mouse/isolation & purification
- Mice
- Mice, Inbred C3H
- Polymerase Chain Reaction/methods
- Retroviridae Infections/complications
- Tumor Virus Infections/complications
- Viral Envelope Proteins/analysis
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Affiliation(s)
- J S Lawson
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
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6
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Lawson JS, Field AS, Tran DD, Houssami N. Hormone replacement therapy use dramatically increases breast oestrogen receptor expression in obese postmenopausal women. Breast Cancer Res 2001; 3:342-5. [PMID: 11597325 PMCID: PMC57804 DOI: 10.1186/bcr318] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2001] [Revised: 03/30/2001] [Accepted: 05/17/2001] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND It is known that use of hormone replacement therapy (HRT) by postmenopausal women increases the risk of breast cancer. METHOD In this study, oestrogen receptor (ER)-alpha expression is examined using standard immunoperoxidase technique. RESULTS Normal breast samples of 11 Australian postmenopausal women have been included in the ER-alpha study; the result showed a strong correlation (r(2) = 0.80) between ER-alpha expression in normal breast epithelial cells and body mass index (BMI) in normal women who currently use HRT. CONCLUSION This finding confirms that the possibility of increased risk of breast cancer associated with increased ER-alpha expression in normal breast epithelial cells, in turn associated with high BMI and the use of HRT.
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Affiliation(s)
- J S Lawson
- School of Health Services Management, University of New South Wales, Sydney, New South Wales, Australia.
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7
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Ma TY, Hoa NT, Tran DD, Bui V, Pedram A, Mills S, Merryfield M. Cytochalasin B modulation of Caco-2 tight junction barrier: role of myosin light chain kinase. Am J Physiol Gastrointest Liver Physiol 2000; 279:G875-85. [PMID: 11052983 DOI: 10.1152/ajpgi.2000.279.5.g875] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The intracellular mechanisms that mediate cytochalasin-induced increase in intestinal epithelial tight junction (TJ) permeability are unclear. In this study, we examined the involvement of myosin light chain kinase (MLCK) in this process, using the filter-grown Caco-2 intestinal epithelial monolayers. Cytochalasin B (Cyto B) (5 microg/ml) produced an increase in Caco-2 MLCK activity, which correlated with the increase in Caco-2 TJ permeability. The inhibition of Cyto B-induced MLCK activation prevented the increase in Caco-2 TJ permeability. Additionally, myosin-Mg(2+)-ATPase inhibitor and metabolic inhibitors (which inhibit MLCK induced actin-myosin contraction) also prevented the Cyto B-induced increase in Caco-2 TJ permeability. Cyto B caused a late-phase (15-30 min) aggregation of actin fragments into large actin clumps, which was also inhibited by MLCK inhibitors. Cyto B produced a morphological disturbance of the ZO-1 TJ proteins, visually correlating with the functional increase in Caco-2 TJ permeability. The MLCK and myosin-Mg(2+)-ATPase inhibitors prevented both the functional increase in TJ permeability and disruption of ZO-1 proteins. These findings suggested that Cyto B-induced increase in Caco-2 TJ permeability is regulated by MLCK activation.
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Affiliation(s)
- T Y Ma
- Division of Gastroenterology, Department of Medicine, Department of Veterans Affairs Medical Center, California State University, Long Beach 90822, California.
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Abstract
To assess the role of striatal glutamatergic synapses in mediating sensorimotor orientation behavior, glutamate receptor antagonists were infused into the left striatum of awake rats and behavioral orientation to contralateral and ipsilateral stimuli were quantified. The AMPA-kainate antagonist, DNQX, and the NMDA antagonist, CPP, both induced a large asymmetry in responding, such that the rats oriented much less to stimuli presented contralateral to the antagonist infusions. Furthermore, intrastriatal glutamate antagonist infusions increased the occurrence of incorrect responses, or turning away from a contralaterally-presented stimulus. In a separate experiment, intrastriatal DNQX was shown to block kainic acid (KA)-induced Fos expression in the striatum, but not in adjacent cerebral cortex, suggesting that the diffusion of this drug is restricted to the striatum.
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Affiliation(s)
- J J Schuller
- Department of Psychobiology, University of California, Irvine, CA 92697-4550, USA
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Burdette JH, Minoshima S, Vander Borght T, Tran DD, Kuhl DE. Alzheimer disease: improved visual interpretation of PET images by using three-dimensional stereotaxic surface projections. Radiology 1996; 198:837-43. [PMID: 8628880 DOI: 10.1148/radiology.198.3.8628880] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE To compare the diagnostic usefulness of three-dimensional (3D) stereotaxic surface projection (SSP) with that of standard transaxial display in brain positron emission tomography (PET) in Alzheimer disease (AD). MATERIALS AND METHODS Standard transaxial section display and 3D-SSP PET image sets obtained after administration of 2-deoxy-2-[fluorine-18]fluoro-D-glucose in 39 patients with probable AD (aged 53-82 years; 15 men, 24 women) and 40 subjects without AD (aged 21-78 years; 14 men, 26 women) were randomly interpreted. Receiver operating characteristic (ROC) analysis was performed. RESULTS Diagnostic performance was superior with 3D SSP (Az[section]=0.94,Az[3D SSP]=0.99[Az=area under the ROC curve];P=.043). With 3D SSP, diagnosis of AD was equally good in beginners and experts. The sensitivity and specificity in questionable or mild dementia were 94% and 99% with 3D SSP and 79% and 88% with standard transaxial display. CONCLUSION Accuracy of detecting AD was improved in PET with 3D SSP.
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Affiliation(s)
- J H Burdette
- Department of Radiology, University of Michigan Medical Center, University Hospital, Ann Arbor 48109-0028, USA
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Abstract
BACKGROUND Nitric oxide is an important mediator in inflammatory and autoimmune-mediated tissue destruction and may be of pathophysiologic importance in inflammatory bowel disease. We studied whether serum levels of nitrate, the stable end-product of nitric oxide, are increased in active Crohn's disease or ulcerative colitis, in comparison with quiescent disease and healthy controls. The setting was the gastroenterology unit of the Free University Hospital, Amsterdam. METHODS In 146 patients--75 with ulcerative colitis and 71 with Crohn's disease--and 33 controls serum nitrate was measured by the Griess reaction after enzymatic conversion of nitrate to nitrite with nitrate reductase. RESULTS Median serum nitrate concentrations did not differ statistically significantly between ulcerative colitis (median, 34.2 mumol/l; range, 15.6-229.4 mumol/l), Crohn's disease (median 32.3 mumol; range 13.2-143.2 mumol/l), and healthy controls (median, 28.7 mumol/l; range, 13.0-108.4 mumol/l). However, when active ulcerative colitis patients (median, 44 mumol/l; range, 29.1-229.4 mumol/l were compared with inactive ulcerative colitis patients (median, 31.2 mumol/l; range, 15.6-59.7 mumol/l), a significant difference in nitrate concentration was found (p < 0.0001). A significant positive correlation was found between serum nitrate levels in ulcerative colitis and erythrocyte sedimentation rate (ESR) (r = 0.30, p - 0.01), leucocyte count (r = 0.27, p = 0.02), and thrombocyte count (r = 0.24, p = 0.04). Comparing active Crohn's disease patients (median, 37.5 mumol/l; range, 13.2-143.2 mumol/l) with inactive Crohn's disease patients (median, 31.3 mumol/l; range, 14.5-92.3 mumol/l) also showed a significant difference in serum nitrate concentration (p < 0.009). Serum nitrate levels correlated with the ESR (r = 0.26, p = 0.028) and serum albumin (r = 0.38, p = 0.004) as well. CONCLUSION Nitric oxide production is increased in both active ulcerative colitis and Crohn's disease and may be implicated in the pathogenesis of inflammatory bowel disease.
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Affiliation(s)
- M Oudkerk Pool
- Dept. of Gastroenterology, Free University Hospital, Amsterdam, The Netherlands
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11
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de Fijter CW, Popp-Snijders C, Oe LP, Tran DD, van der Meulen J, Donker AJ. Does additional treatment with fish oil mitigate the side effects of recombinant human erythropoietin in dialysis patients? Haematologica 1995; 80:332-4. [PMID: 7590502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Since fish oil has been reported to reduce platelet aggregability, to reduce blood viscosity by increasing red blood cell deformability and to lower blood pressure, we studied the effect of dietary supplementation with fish oil on the occurrence of adverse effects in patients receiving recombinant human erythropoietin (rHuEPO). In a prospective, randomized, double blind cross-over design we studied the effect of daily ingestion of 3 g fish oil versus 3 g corn oil (placebo) for 5 months, with a wash-out period of 3 months in between. Thirty-two dialysis patients newly treated with rHuEPO participated. rHuEP0 was given using a low and slow dose regimen (25 U/kg twice weekly s.c.). Target Hct was 35%. Blood pressure, red blood cell deformability, plasma viscosity, fatty acid composition of plasma phospholipids, and fibrinogen levels were measured at 0, 5, 8 and 13 months. In both groups a stable target Hct (35%) was reached within 3 months. Blood pressure was not significantly different between the groups at any time point. In 4 patients (2 on fish oil and 2 on placebo) antihypertensives had to be increased to regulate blood pressure adequately, whereas shunt occlusion occurred in one patient on placebo. Despite a significant increase in the omega-3 fatty acid content of plasma phospholipids during ingestion of fish oil, no significant changes in red blood cell deformability were observed. Since hypertension and shunt occlusion occurred at rates comparable to those reported in the literature, long-term ingestion of fish oil does not appear to mitigate the side effects of low and slow dose rHuEPO.
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Affiliation(s)
- C W de Fijter
- Department of Internal Medicine, Free University Hospital, Amsterdam, The Netherlands
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12
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Tran DD. Clinical staging system for acute pancreatitis. Am J Med 1995; 98:213; author reply 214-5. [PMID: 7847439 DOI: 10.1016/s0002-9343(99)80407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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13
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Tran DD, Visser JJ. Possible protective effect of chronic renal failure against sepsis and endotoxin-induced organ failure and mortality in acute renal failure. Nephron Clin Pract 1995; 69:172-3. [PMID: 7723903 DOI: 10.1159/000188437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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15
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Tran DD. Translocation of enteric bacteria in humans. Br J Surg 1994; 81:470-1. [PMID: 8173935 DOI: 10.1002/bjs.1800810352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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16
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Harris KG, Tran DD, Sickels WJ, Cornell SH, Yuh WT. Diagnosing intracranial vasculitis: the roles of MR and angiography. AJNR Am J Neuroradiol 1994; 15:317-30. [PMID: 8192080 PMCID: PMC8334625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To describe our experience with MR and angiography in diagnosing intracranial vasculitis and to test the hypothesis that MR can be used to screen for patients unlikely to have vasculitis. METHODS Ninety-two patients who had angiography with "exclude vasculitis" as the indication or who had angiography and a clinical diagnosis of vasculitis were identified. Angiograms of all 92 patients and the MRs of the 70 patients who had both studies were reviewed. RESULTS Eleven patients had intracranial vasculitis. Angiography showed characteristic changes in 8. MR, performed in 9 of 11 vasculitis cases, was significantly abnormal in all 9. Among 70 patients who had both studies, 19 had MR that was completely normal or showed only incidental findings. None of these 19 was diagnosed with vasculitis. The diagnostic yield of angiography performed to exclude vasculitis was only 6%. CONCLUSIONS Evaluation for intracranial vasculitis should include MR. A negative MR excludes intracranial vasculitis more definitively than does a negative angiogram and makes the likelihood of finding vasculitis with angiography negligible.
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Affiliation(s)
- K G Harris
- Department of Radiology, University of Iowa College of Medicine, Iowa City 52242-1077
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17
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Tran DD. Interleukin-6 in the early assessment of acute pancreatitis. Gut 1993; 34:1467. [PMID: 8244123 PMCID: PMC1374566 DOI: 10.1136/gut.34.10.1467-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Abstract
We studied the prevalence of multiple organ system failure (MOSF), the relations between age, pre-existing chronic conditions, local complications, systemic infection, organ system failure, and mortality in patients with acute pancreatitis. During the study period, 267 consecutive patients were admitted to a tertiary hospital with acute pancreatitis. Multivariate analyses were used to identify factors predictive of MOSF occurrence and mortality. Using a previously developed MOSF scoring system at our center, MOSF (> or = 2 organ systems) was found to occur in 63 (24%) of the patients. Cardiovascular, pulmonary, renal, and hepatic failure predominated. Advanced age (> 55 yr) and chronic disease were related to local complications and systemic infection (both, P < .001). Local complications and systemic infection occurred in 68% and 75% of patients, respectively. In multiple logistic regression, advanced age, chronic disease, local complications, and systemic infection independently contributed to the development of MOSF. Overall mortality was 19%. MOSF accounted for 96% of deaths; mortality increased from 1% to 79% in patients without and with MOSF, respectively. In multiple logistic regression, advanced age, chronic disease, local complications, failure of the cardiovascular, renal, hepatic, gastrointestinal, and neurological systems independently contributed to mortality prediction. Advanced age and prior chronic disease may reflect diminished physiological reserve and predispose to local complications, systemic infection, and MOSF. Although local complications and systemic infection are important predisposing factors for MOSF, a host-dependent response to unknown specific or nonspecific factors may have a role in the pathogenesis of the syndrome in 25% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D D Tran
- Department of Surgery, Free University Hospital, Amsterdam, The Netherlands
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Tran DD. Gut permeability and disease severity in acute pancreatitis. Gastroenterology 1993; 105:956-7. [PMID: 8359669 DOI: 10.1016/0016-5085(93)90932-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Tran DD. Prognostic factors in sterile pancreatic necrosis. Gastroenterology 1993; 105:307-8. [PMID: 8514056 DOI: 10.1016/0016-5085(93)90054-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Tran DD, Cuesta MA, van Leeuwen PA, Nauta JJ, Wesdorp RI. Risk factors for multiple organ system failure and death in critically injured patients. Surgery 1993; 114:21-30. [PMID: 8102816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND This study was undertaken to evaluate the relative importance of factors related to the extent of multiple organ system failure (MOSF) and outcome in critical trauma. METHODS We performed a retrospective case series analysis of 206 consecutive patients with trauma admitted to a surgical intensive care unit during a 5-year period. Multivariate methods were used to select independent factors related to the MOSF score and subsequent death. RESULTS Multiple linear regression selected advancing age, prior chronic conditions, malnutrition, injury severity score (ISS), coma on admission, use of H2-receptor antagonists or antacids, number of blood transfusions, and intraabdominal infection as independent factors related to the MOSF score. Multiple logistic regression selected advancing age, chronic disease, ISS, and MOSF score as major predictors of death. CONCLUSIONS Advancing age, prior chronic disease, malnutrition, coma on admission, and use of H2-receptor antagonists or antacids may impair host defenses of the gastrointestinal tract and predispose to invasive infection, thereby aggravating the severity of existing MOSF. These findings, together with the predominance of Enterobacteriaceae in patients with infection, suggest that bacterial translocation may be important in the late MOSF septic state. Although infection, particularly intraabdominal infection, is a major risk factor for MOSF, a nonspecific host response to critical trauma, as expressed by the ISS and transfusion requirement, and intestinal endotoxin may contribute to the development of the syndrome.
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Affiliation(s)
- D D Tran
- Department of Surgery, Free University Hospital, Amsterdam, The Netherlands
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Tran DD. Source of infection in nosocomial pneumonia. Lancet 1993; 341:1357-8. [PMID: 8098497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Tran DD, Cuesta MA. Evaluation of severity in patients with acute pancreatitis. Am J Gastroenterol 1992; 87:604-8. [PMID: 1595648] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We compared the multiple organ system failure (MOSF) score, the Acute Physiologic and Chronic Health Evaluation (APACHE) II, and Ranson and Imrie scores for their predictive value in evaluating severity of acute pancreatitis. Of the 259 patients, 73 (28%) had severe disease. Fifty-two (20%) patients had organ system failure (OSF) on admission, and 59% of patients with severe disease had OSF. Shortly after admission, only MOSF and APACHE II scores were available, and in patients with severe disease, these predictions were correct in 64% and 60%, respectively. Forty-eight hours later, the MOSF score was the most sensitive, and correctly predicted outcome in 67% of patients, compared with about 60% for other scores. Of four scoring systems, only MOSF and APACHE II scores allowed repetitive assessment to monitor the course of the disease. MOSF score is organ-specific and may be better than APACHE II in reflecting disease activity. Our results suggest that the MOSF score is valuable in early identification and close monitoring of high risk patients and in deciding on therapy in these patients.
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Affiliation(s)
- D D Tran
- Department of Surgery, Free University Hospital, Amsterdam, The Netherlands
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Groeneveld AB, Tran DD, van der Meulen J, Nauta JJ, Thijs LG. Acute renal failure in the medical intensive care unit: predisposing, complicating factors and outcome. Nephron Clin Pract 1991; 59:602-10. [PMID: 1766500 DOI: 10.1159/000186651] [Citation(s) in RCA: 176] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The factors predisposing to and complicating acute renal failure (ARF) in the medical intensive care unit (ICU), and their relative influence on outcome during ARF are unclear. We retrospectively evaluated the relative importance of age, prior chronic disease (including chronic renal failure), sepsis and organ system failure, for development and outcome of ARF in the medical ICU. Of 487 consecutively admitted patients, 78 (16%) had ARF, in 63% treated with renal replacement therapy. Mortality was 63%. Independently from each other, advancing age, prior chronic disease, and cardiovascular and pulmonary failure directly related to the development of ARF, while neurological failure related inversely. Sepsis only contributed to ARF prediction from these variables if cardiopulmonary failure was excluded. Advancing age, cardiovascular failure before and after onset of ARF, pulmonary failure before ARF and use of renal replacement therapy were the major independent factors directly related to ARF mortality, while prior chronic renal failure related inversely and sepsis did not contribute. Hence, the outcome of ARF in a medical ICU is largely dependent on factors predisposing to ARF, even though the severity and complications of ARF may partly contribute. Our results may help in deciding on the prevention and therapy of ARF in a medical ICU.
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Affiliation(s)
- A B Groeneveld
- Medical Intensive Care Unit, Free University Hospital, Amsterdam, The Netherlands
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Tran DD, Groeneveld AB, van der Meulen J, Nauta JJ, Strack van Schijndel RJ, Thijs LG. Age, chronic disease, sepsis, organ system failure, and mortality in a medical intensive care unit. Crit Care Med 1990; 18:474-9. [PMID: 2328591 DOI: 10.1097/00003246-199005000-00002] [Citation(s) in RCA: 270] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We retrospectively studied relations between age, pre-existing chronic disease, sepsis, organ system failure, and mortality in 487 patients from a medical ICU. Single organ system failure (SOSF) occurred in 136 (28%) and multiple (greater than or equal to 2) organ system failure (MOSF) in 187 (38%) patients. Cardiovascular and pulmonary failure predominated. Overall mortality was 27%. SOSF mortality was 16% and for MOSF 58%. Eighty-three percent of nonsurvivors had MOSF. Hence, MOSF is common and a major cause of death in critically ill medical patients. Advancing age and prior chronic disease may diminish physiologic reserve and predispose to sepsis and MOSF. Although sepsis is a major risk factor for MOSF, a nonspecific host response to critical illness may contribute to the syndrome in 35% of patients. Advancing age, chronic disease, and the number of failing organs, particularly failure of cardiovascular, pulmonary, renal, and neurologic systems, are major determinants of overall mortality, but sepsis is not an independent contributor.
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Affiliation(s)
- D D Tran
- Department of Internal Medicine, Free University Hospital, Amsterdam, The Netherlands
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Tran DD. Experience with therapeutic abortion by D&C suction type under acupuncture analgesia. Am J Chin Med (Gard City N Y) 1974; 2:79-83. [PMID: 4812067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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