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Moloney PB, McHugh J, O'Byrne J, Llamas Y, Lynch T, McGovern E. Ictal aphasia in LGI1-related autosomal dominant epilepsy with auditory features. Pract Neurol 2022; 22:317-320. [PMID: 35354661 DOI: 10.1136/practneurol-2022-003366] [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] [Accepted: 03/13/2022] [Indexed: 11/03/2022]
Abstract
Autosomal dominant epilepsy with auditory features (OMIM 600512) is characterised by focal seizures with distinctive auditory auras and/or ictal aphasia. We describe a 17-year-old girl with recurrent attacks of ictal aphasia and rare nocturnal convulsions. She had a four-generation paternal family history of epilepsy. Her father and aunt perceived bells ringing at the onset of seizures. Sequence analysis of the leucine-rich glioma-inactivated 1 (LGI1) gene identified a novel heterozygous variant in the proband and her father. LGI1-related genetic epilepsy has a benign clinical course with a favourable response to anti-seizure medications. Auditory or vertiginous seizures may be mistaken for peripheral audio-vestibular symptoms, while complex auditory ictal symptoms may be misattributed to primary psychiatric disorders. Recognising this distinctive inherited syndrome should prompt targeted analysis of the LGI1 gene.
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Affiliation(s)
- Patrick B Moloney
- Department of Neurology, Mater Misericordiae University Hospital, Dublin, Ireland
- Dublin Neurological Institute at the Mater Hospital, Dublin, Ireland
| | - John McHugh
- Department of Neurophysiology, Children's Health Ireland at Our Lady's Children's Hospital and Tallaght University Hospital, Dublin, Ireland
| | - James O'Byrne
- National Centre for Inherited Metabolic Disorders, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Yudy Llamas
- Department of Neurology, Mater Misericordiae University Hospital, Dublin, Ireland
- Dublin Neurological Institute at the Mater Hospital, Dublin, Ireland
| | - Tim Lynch
- Department of Neurology, Mater Misericordiae University Hospital, Dublin, Ireland
- Dublin Neurological Institute at the Mater Hospital, Dublin, Ireland
| | - Eavan McGovern
- Dublin Neurological Institute at the Mater Hospital, Dublin, Ireland
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
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2
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McKenna MC, McGovern E, Farrell M, Killeen RP, McGuigan C, Connolly S. Neurogenic muscle hypertrophy following L5 motor radiculopathy. Pract Neurol 2022; 22:422-424. [DOI: 10.1136/pn-2022-003461] [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] [Accepted: 06/27/2022] [Indexed: 11/03/2022]
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3
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Dudley A, Sweeney K, Looby S, Farrell M, McGovern E. Teaching NeuroImage: Cerebral Amyloid Angiopathy Related Inflammation: An Interesting Evolution of Imaging Findings. Neurology 2022; 99:216-217. [PMID: 35654596 DOI: 10.1212/wnl.0000000000200833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/22/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Alex Dudley
- )Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Kieron Sweeney
- )National centre for Neurosurgery , Beaumont Hospital, Dublin 9, Ireland.,)Honorary senior clinical lecturer, Royal College of Surgeons in Ireland
| | - Seamus Looby
- )Department of Radiology, Beaumont Hospital, Dublin 9, Ireland
| | - Michael Farrell
- )Department of Neuropathology, Beaumont Hospital, Dublin 9, Ireland
| | - Eavan McGovern
- )Department of Neurology, Beaumont Hospital, Dublin 9, Ireland.,)Honorary senior clinical lecturer, Royal College of Surgeons in Ireland
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4
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McGovern E, Alsaied T, Szugye N, Pradhan S, Batlivala SP, Lubert A, Hirsch R. The Fontan Pathway: Change in Dimension and Catheter-Based Intervention over Time. Pediatr Cardiol 2021; 42:1740-1748. [PMID: 34136951 DOI: 10.1007/s00246-021-02658-2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
An unobstructed Fontan pathway is essential for optimal hemodynamics. We hypothesize that more extracardiac conduit (ECC) Fontan pathways develop obstruction compared to lateral tunnel (LT) Fontans and that the dilation typically observed in LTs results in similar mid-term clinical outcomes. A single-center, retrospective study was done including all Fontan cardiac catheterizations from 2006 to 2019. Angiography and medical records were reviewed to define Fontan pathway dimensions, interventions, and clinical outcomes. 232 patients underwent cardiac catheterization, where 60% were ECCs and 30% LTs. The minimum cross-sectional area (CSA) of ECCs was significantly smaller than LTs and LTs dilated over time. 13% of patients had Fontan pathway stenting at a median age of 16.2 years. The minimum CSA for patients who underwent intervention was significantly smaller than patients who did not. Lower weight at Fontan surgery was associated with intervention on the Fontan pathway, with a threshold weight of 15 kg for patients with an ECC. The median follow-up was 3.3 years. Patients who had Fontan pathway intervention were not more likely to experience the composite adverse clinical outcome. LTs were more likely than ECCs to have worse clinical outcome, when liver fibrosis was included. This is the first study to describe angiographic dimensions of the Fontan pathway in a large number of patients over time. ECCs tend to become stenotic. Lower weight at Fontan surgery is a potential risk for Fontan pathway intervention. LTs may experience worse clinical outcomes in follow-up. This information can help inform the optimal timing and method of post-Fontan surveillance.
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Affiliation(s)
- E McGovern
- Division of Pediatric Cardiology, Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
| | - T Alsaied
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - N Szugye
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S Pradhan
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S P Batlivala
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A Lubert
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Hirsch
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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5
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Meira B, Degos B, Corsetti E, Doulazmi M, Berthelot E, Virbel-Fleischman C, Dodet P, Méneret A, Mariani LL, Delorme C, Cormier-Dequaire F, Bendetowicz D, Villain N, Tarrano C, Mantisi L, Letrillart H, Louapre C, McGovern E, Worbe Y, Grabli D, Vidailhet M, Hainque E, Roze E. Long-term effect of apomorphine infusion in advanced Parkinson's disease: a real-life study. NPJ Parkinsons Dis 2021; 7:50. [PMID: 34117268 PMCID: PMC8196159 DOI: 10.1038/s41531-021-00194-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/09/2021] [Indexed: 02/06/2023]
Abstract
Long-term effects of continuous subcutaneous apomorphine infusion (CSAI) on health-related quality of life (HRQoL) and predictors of CSAI discontinuation are poorly known. Data from consecutive advanced Parkinson’s disease patients treated in routine care were retrospectively collected over 24 months after CSAI initiation, with a focus on the 39-item Parkinson’s disease questionnaire (PDQ-39). We determined predictors of CSAI discontinuation and HRQoL improvement using multiple regression analysis. Of the 110 subjects evaluated over a 2-year period, 35% discontinued CSAI. Of those who continued treatment, HRQoL remained stable with a sustained reduction in motor fluctuations. The observed effect on dyskinesias was mild and transient. Of note, patients with preexisting impulse control disorders showed an overall good tolerability. PDQ-39 was the only baseline predictor of HRQoL improvement after 2 years of treatment. The presence of dyskinesias, poorer psychological status, shorter disease duration, male sex, and worse OFF state were predictors of discontinuation. Best candidates for CSAI are patients with: (i) poor baseline HRQoL and (ii) marked motor fluctuations.
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Affiliation(s)
- Bruna Meira
- Neurology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Bertrand Degos
- Neurology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, Bobigny, France
| | - Elise Corsetti
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Mohamed Doulazmi
- Adaptation Biologique et Vieillissement, Institut de Biologie Paris Seine, Sorbonne University, CNRS, Paris, France
| | - Emeline Berthelot
- Neurology Department, Hôpital Zobda Quitman, Fort-de-France, French West Indies, France
| | - Clara Virbel-Fleischman
- Air Liquide SA, Explor Center (Healthcare), Fort-de-France, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Pauline Dodet
- Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France.,Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Paris, France
| | - Aurélie Méneret
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Louise-Laure Mariani
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Cécile Delorme
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Florence Cormier-Dequaire
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - David Bendetowicz
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Nicolas Villain
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France.,Sorbonne Université, GRC no 21, Alzheimer Precision Medicine, Paris, France
| | - Clément Tarrano
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Lise Mantisi
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Hélène Letrillart
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Céline Louapre
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Eavan McGovern
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Yulia Worbe
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Neurophysiology Department, Saint Antoine Hospital, AP-HP, Paris, France
| | - David Grabli
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Marie Vidailhet
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Elodie Hainque
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Emmanuel Roze
- Neurology Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France. .,Paris Brain Institute, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France.
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6
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Behary J, Raposo AE, Amorim NML, Zheng H, Gong L, McGovern E, Chen J, Liu K, Beretov J, Theocharous C, Jackson MT, Seet-Lee J, McCaughan GW, El-Omar EM, Zekry A. Defining the temporal evolution of gut dysbiosis and inflammatory responses leading to hepatocellular carcinoma in Mdr2 -/- mouse model. BMC Microbiol 2021; 21:113. [PMID: 33858327 PMCID: PMC8048083 DOI: 10.1186/s12866-021-02171-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/31/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Emerging evidence implicates the gut microbiome in liver inflammation and hepatocellular carcinoma (HCC) development. We aimed to characterize the temporal evolution of gut dysbiosis, in relation to the phenotype of systemic and hepatic inflammatory responses leading to HCC development. In the present study, Mdr2 -/- mice were used as a model of inflammation-based HCC. Gut microbiome composition and function, in addition to serum LPS, serum cytokines/chemokines and intrahepatic inflammatory genes were measured throughout the course of liver injury until HCC development. RESULTS Early stages of liver injury, inflammation and cirrhosis, were characterized by dysbiosis. Microbiome functional pathways pertaining to gut barrier dysfunction were enriched during the initial phase of liver inflammation and cirrhosis, whilst those supporting lipopolysaccharide (LPS) biosynthesis increased as cirrhosis and HCC ensued. In parallel, serum LPS progressively increased during the course of liver injury, corresponding to a shift towards a systemic Th1/Th17 proinflammatory phenotype. Alongside, the intrahepatic inflammatory gene profile transitioned from a proinflammatory phenotype in the initial phases of liver injury to an immunosuppressed one in HCC. In established HCC, a switch in microbiome function from carbohydrate to amino acid metabolism occurred. CONCLUSION In Mdr2 -/- mice, dysbiosis precedes HCC development, with temporal evolution of microbiome function to support gut barrier dysfunction, LPS biosynthesis, and redirection of energy source utilization. A corresponding shift in systemic and intrahepatic inflammatory responses occurred supporting HCC development. These findings support the notion that gut based therapeutic interventions could be beneficial early in the course of liver disease to halt HCC development.
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Affiliation(s)
- J Behary
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia
| | - A E Raposo
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - N M L Amorim
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - H Zheng
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - L Gong
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - E McGovern
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - J Chen
- Liver Injury and Cancer, Centenary Institute, University of Sydney, Sydney, Australia
| | - K Liu
- Liver Injury and Cancer, Centenary Institute, University of Sydney, Sydney, Australia
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - J Beretov
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Department of Anatomical Pathology, St George Hospital, Sydney, Australia
| | - C Theocharous
- Department of Anatomical Pathology, St George Hospital, Sydney, Australia
| | - M T Jackson
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - J Seet-Lee
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
| | - G W McCaughan
- Liver Injury and Cancer, Centenary Institute, University of Sydney, Sydney, Australia
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, Australia
| | - E M El-Omar
- St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia
- Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia
| | - A Zekry
- St George and Sutherland Clinical School, UNSW, Sydney, Australia.
- Microbiome Research Centre, St George and Sutherland Clinical School, UNSW, Sydney, Australia.
- Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia.
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7
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McGovern E, Louapre C, Cassereau J, Flamand-Roze C, Corsetti E, Jegatheesan P, Bendetowicz D, Giron C, Dunoyer M, Villain N, Renaud MC, Sauleau P, Michel L, Vérin M, Worbe Y, Falissard B, Roze E. NeuroQ: A neurophobia screening tool assesses how roleplay challenges neurophobia. J Neurol Sci 2021; 421:117320. [PMID: 33518377 DOI: 10.1016/j.jns.2021.117320] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/07/2020] [Revised: 12/20/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Neurophobia is a chronic disease of medical students and junior doctors. Early detection is needed to facilitate prevention and management as this fear can negatively impact patient care. METHODS We conducted a two-part mono-centric study at the faculty of Medicine, Sorbonne University, in Paris. Part one: a cross-sectional study to validate a newly constructed neurophobia scale, NeuroQ. Part two: a prospective longitudinal study to assess the impact of The Move on student neurophobia using NeuroQ. A population-based sample of second-year medical students of the 2019 and 2020 class of the Faculty of Medicine of Sorbonne University were invited to participate. RESULTS NeuroQ incorporates the main themes of the neurophobia definition and demonstrates uni-dimensionality. Three hundred and ninety-five medical students participated in the study (mean age was 20.0 years, SD: 2.1 years) assessing the effect of The Move teaching on neurophobia. Two hundred and eighty-eight (72.9%) students were female. After the Move teaching the mean NeuroQ score was significantly lower compared to the baseline NeuroQ score (mean [SD] variation, -1.1 [2.6], p < 0.001). There was a 22.3% relative reduction in the number of neurophobic students after The Move teaching. CONCLUSION Our results highlight the utility of NeuroQ in assessing (i) baseline neurophobia and (ii) the impact of pre-clinical educational interventions on neurophobia. Furthermore, we have shown the importance of pre-clinical educational interventions, such as The Move, in tackling neurophobia.
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Affiliation(s)
- Eavan McGovern
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France; INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France.
| | - Céline Louapre
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France; INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France
| | - Julien Cassereau
- Université d'Angers, Faculté de Médecine, Angers, France; Hôpital Universitaire d'Angers, Angers, France
| | | | - Elise Corsetti
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France
| | | | - David Bendetowicz
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France; INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France
| | - Camille Giron
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France
| | - Margaux Dunoyer
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France
| | - Nicolas Villain
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France; INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France
| | | | - Paul Sauleau
- Hôpital Universitaire de Rennes, Département de Neurologie, Rennes, France; Institut des Neurosciences Cliniques de Rennes, équipe EA4712, Rennes, France
| | - Laure Michel
- Hôpital Universitaire de Rennes, Département de Neurologie, Rennes, France; Université Rennes 1, Rennes, France
| | - Marc Vérin
- Hôpital Universitaire de Rennes, Département de Neurologie, Rennes, France; Institut des Neurosciences Cliniques de Rennes, équipe EA4712, Rennes, France; Université Rennes 1, Rennes, France
| | - Yulia Worbe
- Sorbonne Université, France; INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France; AP-HP, Hôpital Saint Antoine, Service de Neurophysiologie, Paris, France
| | - Bruno Falissard
- Centre de Recherche en Epidémiologie et Santé des Populations, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Département de Santé Publique, Villejuif, France
| | - Emmanuel Roze
- AP-HP, Hôpital Pitié-Salpêtrière, Département de Neurologie, Paris, France; Sorbonne Université, France; INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France
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8
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Adanyeguh IM, Lou X, McGovern E, Luton MP, Barbier M, Yazbeck E, Valabregue R, Deelchand D, Henry PG, Mochel F. Multiparametric in vivo analyses of the brain and spine identify structural and metabolic biomarkers in men with adrenomyeloneuropathy. Neuroimage Clin 2021; 29:102566. [PMID: 33516063 PMCID: PMC7847955 DOI: 10.1016/j.nicl.2021.102566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/31/2020] [Accepted: 01/11/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Progressive myelopathy causes severe handicap in men with adrenomyeloneuropathy (AMN), an X-linked disorder due to ABCD1 pathogenic variants. At present, treatments are symptomatic but disease-modifying therapies are under evaluation. Given the small effect size of clinical scales in AMN, biomarkers with higher effect size are needed. Here we used high-resolution magnetic resonance techniques to identify non-invasive in vivo biomarkers of the brain and spine with high effect sizes. METHODS We performed a multiparametric imaging and spectroscopy study in 23 male patients with AMN (age: 44 ± 11) and 23 male controls (age: 43 ± 11) of similar age and body-mass index. We combined (i) macrostructural analyses of the spine, using cross-sectional area (CSA) and magnetization transfer ratio (MTR), (ii) microstructural analyses of the spine and the brain, using diffusion tensor and the newly developed fixel-based analysis, and (iii) advanced metabolic analyses of the spine using metabolite cycling coupled to a semi-LASER sequences. RESULTS Macrostructural alterations (decrease in CSA and MTR) were observed in patients at all spinal cord levels studied (C1-T2 for CSA and C1-C5 for MTR) (p < 0.001). Microstructural alterations were observed in the spine and brain on diffusion tensor and fixel-based metrics though the latter showed higher effect sizes. Metabolic alterations were observed in patients as a decreased total N-acetylaspartate/myo-inositol ratio (p < 0.001). Overall, MTR showed the highest effect size. CONCLUSION This cross-sectional study supports the use of multiparametric techniques that elucidate the structural, microstructural and metabolic alterations in AMN. These outcome measures should be tested longitudinally and in clinical trials.
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Affiliation(s)
- Isaac M Adanyeguh
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Xiaofang Lou
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Eavan McGovern
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Marie-Pierre Luton
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Magali Barbier
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Elise Yazbeck
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Romain Valabregue
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Center for NeuroImaging Research (CENIR), Institut du Cerveau et de la Moelle épinière, 75013 Paris, France
| | - Dinesh Deelchand
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, United States
| | - Pierre-Gilles Henry
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, United States
| | - Fanny Mochel
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; AP-HP, Pitié-Salpêtrière University Hospital, Department of Genetics, Paris, France; University Pierre and Marie Curie, Neurometabolic Research Group, Paris, France.
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McGovern E, Pringsheim T, Medina A, Cosentino C, Shalash A, Sardar Z, Fung VSC, Kurian MA, Roze E. Transitional Care for Young People with Neurological Disorders: A Scoping Review with A Focus on Patients with Movement Disorders. Mov Disord 2020; 36:1316-1324. [PMID: 33200525 DOI: 10.1002/mds.28381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/10/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood-onset movement disorders represent a heterogenous group of conditions. Given the complexity of these disorders, the transition of care from pediatric to adult medicine is an important consideration. We performed a scoping review of the literature on transitional care in chronic neurological disease, exploring key transitional issues and proposed transitional care models. Our aim was to describe the current knowledge and gaps about the transition process of young adults with chronic neurological disorders, paying special attention to childhood onset movement disorders. A total of 64 articles were included in the qualitative synthesis; 56 articles reported on transitional care issues, and 8 articles reported on transitional care models. Only 2 articles included patients with movement disorders. The following 4 main transitional issues were identified following synthesis of the available literature: (1) inadequate preparation for the transition process, (2) inappropriate and inconsistent transition practices, (3) inadequate adult services, and (4) heightened emotional response surrounding transition. Of the reported transitional care models, multidisciplinary ambulatory care was the most common approach. In studies evaluating patient-related outcomes, positive health, educational, and vocational outcomes were found. The available literature provides insights on issues that can arise during transition that should be addressed to improve patient and caregiver comfort and satisfaction with care. Further research is needed to evaluate how transitional care programs affect outcomes and their cost effectiveness. More studies are required to determine the needs and outcomes specific to patients with childhood onset movement disorders. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Eavan McGovern
- Dublin Neurological Institute, Mater University Hospital, Dublin, Ireland
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Alex Medina
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Zomer Sardar
- Department of Neurology, Mayo Hospital, Lahore, Pakistan
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital & Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Emmanuel Roze
- Department of Neurology, Salpêtrière Hospital, Sorbonne University and Assistance Publique - Hôpitaux de Paris, Paris, France
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Williams L, Butler JS, Thirkettle M, Stafford T, Quinlivan B, McGovern E, O'Riordan S, Redgrave P, Reilly R, Hutchinson M. Slowed Luminance Reaction Times in Cervical Dystonia: Disordered Superior Colliculus Processing. Mov Disord 2020; 35:877-880. [DOI: 10.1002/mds.27975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 11/25/2019] [Indexed: 01/23/2023] Open
Affiliation(s)
- Laura Williams
- Department of NeurologySt. Vincent's University Hospital Dublin Ireland
- School of Medicine and Medical Science, University College Dublin Dublin Ireland
| | - John S. Butler
- Trinity Centre for Bioengineering, Trinity College Dublin Dublin Ireland
- School of Mathematical Sciences, Technological University Dublin Dublin 2 Dublin Ireland
| | - Martin Thirkettle
- Department of Psychology, Sociology & PoliticsSheffield Hallam University Sheffield United Kingdom
| | - Tom Stafford
- Department of PsychologyUniversity of Sheffield Sheffield United Kingdom
| | - Brendan Quinlivan
- Trinity Centre for Bioengineering, Trinity College Dublin Dublin Ireland
| | - Eavan McGovern
- Department of NeurologySt. Vincent's University Hospital Dublin Ireland
- School of Medicine and Medical Science, University College Dublin Dublin Ireland
| | - Sean O'Riordan
- Department of NeurologySt. Vincent's University Hospital Dublin Ireland
- School of Medicine and Medical Science, University College Dublin Dublin Ireland
| | - Peter Redgrave
- Department of PsychologyUniversity of Sheffield Sheffield United Kingdom
| | - Richard Reilly
- Trinity Centre for Bioengineering, Trinity College Dublin Dublin Ireland
| | - Michael Hutchinson
- Department of NeurologySt. Vincent's University Hospital Dublin Ireland
- School of Medicine and Medical Science, University College Dublin Dublin Ireland
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11
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Van Iseghem V, McGovern E, Apartis E, Keren B, Vidailhet M, Roze E, Degos B. Subcortical Myoclonus and Associated Dystonia in 22q11.2 Deletion Syndrome. Tremor Other Hyperkinet Mov (N Y) 2020; 10:tre-10-729. [PMID: 32002279 PMCID: PMC6982424 DOI: 10.7916/tohm.v0.729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/05/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Vincent Van Iseghem
- Department of Neurology, Ghent University Hospital, Ghent, BE.,Department of Neurology, AZ Groeninge, Kortrijk, BE
| | - Eavan McGovern
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, FR
| | - Emmanuelle Apartis
- Neurophysiology Unit, Saint-Antoine Hospital, AP-HP, Paris, FR.,Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, Sorbonne University, Paris, FR
| | - Boris Keren
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Paris, FR
| | - Marie Vidailhet
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, FR.,Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, Sorbonne University, Paris, FR
| | - Emmanuel Roze
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, FR.,Inserm U 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, Sorbonne University, Paris, FR
| | - Bertrand Degos
- Neurology Unit, Avicenne University Hospital, Hôpitaux Universitaires de Paris-Seine Saint Denis, Bobigny, FR.,Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, MemoLife Labex, Paris, FR
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12
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Narasimham S, Sundarajan V, McGovern E, Quinlivan B, Killian O, O'Riordan S, Hutchinson M, Reilly RB. Characterizing Brain Network Topology in Cervical Dystonia Patients and Unaffected Relatives via Graph Theory. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:1694-1697. [PMID: 31946223 DOI: 10.1109/embc.2019.8856624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cervical Dystonia (CD) is a neurological movement disorder characterized by intermittent muscle contractions in the head and neck. The pathophysiology and neural networks underpinning this condition are incompletely understood. There is increasing evidence that isolated focal dystonias are due to network-wide functional alterations. An abnormal temporal discrimination threshold (TDT) is believed to be a mediational endophenotype due to its prevalence in unaffected first-degree relatives as well as patients. However the neural correlates linking abnormal TDT and CD remain poorly understood. Probing changes in large-scale network topology via graph theory with resting state fMRI data from relatives and patients may provide further insight into the pathophysiology of CD. In this study, resting state fMRI data were acquired and analyzed from 16 CD patients with abnormal TDT, 32 unaffected first degree relatives (16 with normal TDT and 16 with abnormal TDT) and 16 healthy controls. Graph theory metrics demonstrating network topology were extracted. The results indicate large-scale functional reorganization of networks in relatives (with abnormal TDT) along with a manifestation of topological aberrations similar to patients.
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Affiliation(s)
- Aurélie Méneret
- Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Inserm U 1127, CNRS UMR 7225, Sorbonne University, UPMC Univ Paris 06 UMR S 1127, Paris, France (A.M., E.M., E.R.)
| | | | - Eavan McGovern
- Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Inserm U 1127, CNRS UMR 7225, Sorbonne University, UPMC Univ Paris 06 UMR S 1127, Paris, France (A.M., E.M., E.R.)
| | - Emmanuel Roze
- Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Inserm U 1127, CNRS UMR 7225, Sorbonne University, UPMC Univ Paris 06 UMR S 1127, Paris, France (A.M., E.M., E.R.)
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14
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Méneret A, Roze E, Maranci JB, Dodet P, Doummar D, Riant F, Tranchant C, Fraix V, Anheim M, Ekmen A, McGovern E, Vidailhet M, Arnulf I, Leu-Semenescu S. Sleep in ADCY5-Related Dyskinesia: Prolonged Awakenings Caused by Abnormal Movements. J Clin Sleep Med 2019; 15:1021-1029. [PMID: 31383240 DOI: 10.5664/jcsm.7886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/25/2019] [Accepted: 03/18/2019] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES ADCY5 mutations cause early-onset hyperkinetic movement disorders comprising diurnal and nocturnal paroxysmal dyskinesia, and patient-reported sleep fragmentation. We aimed to characterize all movements occurring during sleep and in the transition from sleep to awakening, to ascertain if there is a primary sleep disorder, or if the sleep disturbance is rather a consequence of the dyskinesia. METHODS Using video polysomnography, we evaluated the nocturnal motor events and abnormal movements in 7 patients with ADCY5-related dyskinesia and compared their sleep measures with those of 14 age- and sex-matched healthy controls. RESULTS We observed an increased occurrence of abnormal movements during wake periods compared to sleep in patients with ADCY5-related dyskinesia. While asleep, abnormal movements occurred more frequently during stage N2 and REM sleep, in contrast with stage N3 sleep. Abnormal movements were also more frequent during morning awakenings compared to wake periods before falling asleep. The pattern of the nocturnal abnormal movements mirrored those observed during waking hours. Compared to controls, patients with ADCY5-related dyskinesia had lower sleep efficiencies due to prolonged awakenings secondary to the abnormal movements, but no other differences in sleep measures. Notably, sleep onset latency was short and devoid of violent abnormal movements. CONCLUSIONS In this series of patients with ADCY5-related dyskinesia, nocturnal paroxysmal dyskinesia were not associated with drowsiness or delayed sleep onset, but emerged during nighttime awakenings with subsequent delayed sleep, whereas sleep architecture was normal.
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Affiliation(s)
- Aurélie Méneret
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France.,Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Emmanuel Roze
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France.,Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Jean-Baptiste Maranci
- Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Pauline Dodet
- Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Diane Doummar
- Department of Pediatric Neurology, Hôpital Armand-Trousseau, Paris, France
| | - Florence Riant
- Groupe hospitalier Lariboisière-Fernand Widal, Laboratoire de Génétique, Paris, France.,Université Paris, Paris, France
| | - Christine Tranchant
- Department of Neurology, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg, France.,Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, France.,Strasbourg Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Valérie Fraix
- Service de Neurologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble Institut des Neurosciences, Université Grenoble Alpes, Grenoble, France
| | - Mathieu Anheim
- Department of Neurology, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg, France.,Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, France.,Strasbourg Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Asya Ekmen
- Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Eavan McGovern
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Vidailhet
- Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France.,Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Isabelle Arnulf
- Faculty of Medicine of Sorbonne University, Institut du Cerveau et de la Moelle épinière, Paris, France.,Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorders (Department "R3S"), Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
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Lannuzel A, Fergé JL, Lobjois Q, Signate A, Rozé B, Tressières B, Madec Y, Poullain P, Herrmann C, Najioullah F, McGovern E, Savidan AC, Valentino R, Breurec S, Césaire R, Hirsch E, Lledo PM, Thiery G, Cabié A, Lazarini F, Roze E. Long-term outcome in neuroZika. Neurology 2019; 92:e2406-e2420. [DOI: 10.1212/wnl.0000000000007536] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/22/2019] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo characterize the full spectrum, relative frequency, and prognosis of the neurologic manifestations in Zika virus (ZIKV) postnatal infection.MethodsWe conducted an observational study in consecutive ZIKV-infected patients presenting with neurologic manifestations during the French West Indies 2016 outbreak.ResultsEighty-seven patients, including 6 children, were enrolled. Ninety-five percent of all cases required hospitalization. Guillain-Barré syndrome was the most frequent manifestation (46.0%) followed by encephalitis or encephalomyelitis (20.7%), isolated single or multiple cranial nerve palsies (9.2%), other peripheral manifestations (6.9%), and stroke (1.1%). Fourteen patients (16.1%), including one child, developed a mixed disorder involving both the central and peripheral nervous system. Mechanical ventilation was required in 21 cases, all of whom had ZIKV RNA in at least one biological fluid. Two adult patients died due to neuroZika. Clinical follow-up (median 14 months; interquartile range, 13–17 months) was available for 76 patients. Residual disability (modified Rankin Scale score ≥2) was identified in 19 (25.0%) patients; in 6 cases (7.9%), disability was severe (modified Rankin Scale score ≥4). Among patients with ZIKV RNA detected in one biological fluid, the risk of residual disability or death was higher (odds ratio 9.19; confidence interval 1.12–75.22; p = 0.039).ConclusionsNeuroZika spectrum represents a heterogeneous group of clinical neurologic manifestations. During an outbreak, clinicians should consider neuroZika in patients presenting with cranial nerve palsies and a mixed neurologic disorder. Long-term sequelae are frequent in NeuroZika. ZIKV reverse-transcription PCR status at admission can inform prognosis and should therefore be taken into consideration in the management of hospitalized patients.
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16
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McGovern E, Kenny D, Kelly A, Waters S. 75 Late-Breaking: Investigation into the relationship Methanobrevibacter millerae YE315. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.875] [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: 11/13/2022] Open
Affiliation(s)
| | | | - A Kelly
- University College Dublin,Dublin, Ireland
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17
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Roze E, Worbe Y, Louapre C, Méneret A, Delorme C, McGovern E, Ruiz M, Capron J, Le Bouc R, Epelbaum S, Alamowitch S, Duguet A, Renaud MC, Palombi O, Pringsheim TM, Flamand-Roze C, Steichen O. Miming neurological syndromes improves medical student's long-term retention and delayed recall of neurology. J Neurol Sci 2018; 391:143-148. [DOI: 10.1016/j.jns.2018.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/25/2018] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
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O'Connor L, McGovern E, O'Meara M, Dean J, Ward M, O'Connor M. Extensive hepatitis A outbreak in an urban childcare facility in Ireland, associated with considerable adult morbidity. Epidemiol Infect 2018; 146:705-711. [PMID: 29582721 PMCID: PMC9134359 DOI: 10.1017/s0950268818000638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/26/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 11/07/2022] Open
Abstract
Hepatitis A infection results in a spectrum of illness from asymptomatic disease to severe fulminant hepatitis. Since 2000, <50 cases have been reported annually in Ireland. We report on an outbreak of hepatitis A associated with a childcare facility(CCF) in 2015 in Ireland. Between January and July 2015, 12 outbreak-associated symptomatic hepatitis A cases were identified, including one delayed, retrospective diagnosis. Seven (58%) cases were adults, eight (67%) were male, six of the adults required hospitalisation. All 12 cases were confirmed on serology and the four cases that were genotyped were identical on phylogenetic analysis. Potential environmental exposures and hygiene practices at the CCF were investigated. Outbreak control measures included the provision of: hepatitis A information, infection prevention advice, hepatitis A vaccination to 554 CCF contacts, and voluntary closure of the CCF for deep-cleaning and staff education. From a healthcare perspective1, outbreak control costs were in excess of €45 000. This outbreak illustrates the considerable adult morbidity that can occur in hepatitis A outbreaks, highlights the challenges in controlling a large CCF-associated outbreak and the importance of early recognition by clinicians of hepatitis A.
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Affiliation(s)
- L. O'Connor
- Department of Public Health, HSE East, Dr Steevens’ Hospital, Steevens’ Lane, Dublin 8, Ireland
| | - E. McGovern
- Department of Public Health, HSE East, Dr Steevens’ Hospital, Steevens’ Lane, Dublin 8, Ireland
| | - M. O'Meara
- Department of Public Health, HSE East, Dr Steevens’ Hospital, Steevens’ Lane, Dublin 8, Ireland
| | - J. Dean
- National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - M. Ward
- Department of Public Health, HSE East, Dr Steevens’ Hospital, Steevens’ Lane, Dublin 8, Ireland
| | - M. O'Connor
- Department of Public Health, HSE East, Dr Steevens’ Hospital, Steevens’ Lane, Dublin 8, Ireland
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McGovern E, Killian O, Narasimham S, Quinlivan B, Beiser I, Williams L, Beck R, O’Riordan S, Reilly R, Hutchinson M. PO089 Disrupted superior collicular activity may reveal cervical dystonia disease pathomechanisms. J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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McGovern E, Hutchinson M, Lynch T, Webb D. PO090 Familial early-onset dystonia and myoclonus due to a novel gnal mutation (dyt25). J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McGovern E, Voss C, Duncombe S, Hosking M, Harris K. PULMONARY ARTERY WALL THICKNESS IN CHILDREN WITH FONTAN PHYSIOLOGY – AN OPTICAL COHERENCE TOMOGRAPHY CASE CONTROL STUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.030] [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] Open
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McGovern E, Butler J, Beiser I, Williams L, Quinlivan B, Riordan SO, Reilly R, Hutchinson M. COMPARING STIMULUS-PRESENTATION METHODS IN TEMPORAL DISCRIMINTATION TESTING. J Neurol Neurosurg Psychiatry 2016. [DOI: 10.1136/jnnp-2016-315106.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Williams L, McGovern E, Kimmich O, Molloy A, Beiser I, Butler JS, Molloy F, Logan P, Healy DG, Lynch T, Walsh R, Cassidy L, Moriarty P, Moore H, McSwiney T, Walsh C, O'Riordan S, Hutchinson M. Epidemiological, clinical and genetic aspects of adult onset isolated focal dystonia in Ireland. Eur J Neurol 2016; 24:73-81. [DOI: 10.1111/ene.13133] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/09/2016] [Indexed: 02/06/2023]
Affiliation(s)
- L. Williams
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - E. McGovern
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - O. Kimmich
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - A. Molloy
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - I. Beiser
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - J. S. Butler
- Trinity Centre for Bioengineering; Dublin and School of Mathematical Sciences; Dublin Institute of Technology; Dublin Ireland
| | | | - P. Logan
- Beaumont Hospital; Dublin Ireland
| | | | - T. Lynch
- Mater Misericordiae University Hospital; Dublin Ireland
| | - R. Walsh
- Adelaide and Meath Hospital; Dublin Ireland
| | - L. Cassidy
- Royal Victoria Eye and Ear Hospital; Dublin Ireland
| | - P. Moriarty
- Royal Victoria Eye and Ear Hospital; Dublin Ireland
| | - H. Moore
- Cork University Hospital; Cork Ireland
| | | | - C. Walsh
- Departments of Statistics; Trinity College Dublin; University of Limerick; Limerick Ireland
| | - S. O'Riordan
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
| | - M. Hutchinson
- Department of Neurology; St Vincent's University Hospital; Dublin Ireland
- School of Medicine and Medical Sciences; University College Dublin; Dublin Ireland
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Quinlivan B, Butler JS, Beiser I, Williams L, McGovern E, O'Riordan S, Hutchinson M, Reilly RB. Application of virtual reality head mounted display for investigation of movement: a novel effect of orientation of attention. J Neural Eng 2016; 13:056006. [PMID: 27518212 DOI: 10.1088/1741-2560/13/5/056006] [Citation(s) in RCA: 8] [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: 11/11/2022]
Abstract
OBJECTIVE To date human kinematics research has relied on video processing, motion capture and magnetic search coil data acquisition techniques. However, the use of head mounted display virtual reality systems, as a novel research tool, could facilitate novel studies into human movement and movement disorders. These systems have the unique ability of presenting immersive 3D stimulus while also allowing participants to make ecologically valid movement-based responses. APPROACH We employed one such system (Oculus Rift DK2) in this study to present visual stimulus and acquire head-turn data from a cohort of 40 healthy adults. Participants were asked to complete head movements towards eccentrically located visual targets following valid and invalid cues. Such tasks are commonly employed for investigating the effects orientation of attention and are known as Posner cueing paradigms. Electrooculography was also recorded for a subset of 18 participants. MAIN RESULTS A delay was observed in onset of head movement and saccade onset during invalid trials, both at the group and single participant level. We found that participants initiated head turns 57.4 ms earlier during valid trials. A strong relationship between saccade onset and head movement onset was also observed during valid trials. SIGNIFICANCE This work represents the first time that the Posner cueing effect has been observed in onset of head movement in humans. The results presented here highlight the role of head-mounted display systems as a novel and practical research tool for investigations of normal and abnormal movement patterns.
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Molloy A, Williams L, Kimmich O, Butler JS, Beiser I, McGovern E, O'Riordan S, Reilly RB, Walsh C, Hutchinson M. Sun exposure is an environmental factor for the development of blepharospasm. J Neurol Neurosurg Psychiatry 2016; 87:420-4. [PMID: 25904812 DOI: 10.1136/jnnp-2014-310266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 12/29/2014] [Accepted: 04/01/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Adult-onset isolated focal dystonia may present with various phenotypes including blepharospasm and cervical dystonia. Although inherited in an autosomal dominant manner with a markedly reduced penetrance, environmental factors are considered important in disease penetrance and expression. We observed a marked variation by latitude in the reports of the frequency of patients with blepharospasm relative to those with cervical dystonia; we hypothesised that sun exposure is an environmental risk factor for the development of blepharospasm in genetically susceptible individuals. METHODS From published clinic cohorts and epidemiological reports, the ratio of the number of cases of blepharospasm to cervical dystonia (phenotype case ratio) at each study site was analysed with regard to latitude and measures of annual insolation. Meta-regression analyses of the phenotype case ratio to these environmental factors were performed. RESULTS The phenotype case ratio in 15 eligible study sites over 41° of latitude demonstrated a statistically significant inverse association with latitude (p=0.0004, R(2)=53.5%). There were significant positive associations between the phenotype case ratio and quarter-one (January-March) insolation (p=0.0005, R(2)=53%) and average annual insolation (p=0.003, R(2)=40%). CONCLUSION The increase in the blepharospasm: cervical dystonia case ratio with decreasing latitude and increasing insolation suggests that sunlight exposure is an environmental risk factor for the development of blepharospasm (rather than cervical dystonia) in individuals genetically susceptible to adult-onset dystonia.
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Affiliation(s)
- Anna Molloy
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Laura Williams
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Okka Kimmich
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - John S Butler
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
| | - Ines Beiser
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Eavan McGovern
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Sean O'Riordan
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland
| | - Cathal Walsh
- Department of Statistics, Trinity College Dublin, Dublin, Ireland Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Michael Hutchinson
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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Quinlivan B, Butler JS, Ridwan AR, Beiser I, Williams L, McGovern E, O'Riordan S, Hutchinson M, Reilly RB. Exploring the unknown: electrophysiological and behavioural measures of visuospatial learning. Eur J Neurosci 2016; 43:1128-36. [PMID: 26840918 DOI: 10.1111/ejn.13195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 11/30/2022]
Abstract
Visuospatial memory describes our ability to temporarily store and manipulate visual and spatial information and is employed for a wide variety of complex cognitive tasks. Here, a visuospatial learning task requiring fine motor control is employed to investigate visuospatial learning in a group of typically developing adults. Electrophysiological and behavioural data are collected during a target location task under two experimental conditions: Target Learning and Target Cued. Movement times (MTs) are employed as a behavioural metric of performance, while dynamic P3b amplitudes and power in the alpha band (approximately 10 Hz) are explored as electrophysiological metrics during visuospatial learning. Results demonstrate that task performance, as measured by MT, is highly correlated with P3b amplitude and alpha power at a consecutive trial level (trials 1-30). The current set of results, in conjunction with the existing literature, suggests that changes in P3b amplitude and alpha power could correspond to different aspects of the learning process. Here it is hypothesized that changes in P3b correspond to a diminishing inter-stimulus interval and reduced stimulus relevance, while the corresponding changes in alpha power represent an automation of response as habituation occurs in participants. The novel analysis presented in the current study demonstrates how gradual electrophysiological changes can be tracked during the visuospatial learning process under the current paradigm.
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Affiliation(s)
- Brendan Quinlivan
- Trinity Centre for Bioengineering, Trinity College Dublin, 152-160 Pearse St, Dublin 2, Ireland.,School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - John S Butler
- Trinity Centre for Bioengineering, Trinity College Dublin, 152-160 Pearse St, Dublin 2, Ireland.,School of Mathematical Sciences, Dublin Institute of Technology, Kevin St, Dublin, Ireland
| | - Abdur Raquib Ridwan
- Trinity Centre for Bioengineering, Trinity College Dublin, 152-160 Pearse St, Dublin 2, Ireland.,School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - Ines Beiser
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Ireland
| | - Laura Williams
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Ireland
| | - Eavan McGovern
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Ireland
| | - Sean O'Riordan
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Ireland
| | - Michael Hutchinson
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, Trinity College Dublin, 152-160 Pearse St, Dublin 2, Ireland.,School of Engineering, Trinity College Dublin, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
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Butler JS, Beiser IM, Williams L, McGovern E, Molloy F, Lynch T, Healy DG, Moore H, Walsh R, Reilly RB, O'Riordan S, Walsh C, Hutchinson M. Age-Related Sexual Dimorphism in Temporal Discrimination and in Adult-Onset Dystonia Suggests GABAergic Mechanisms. Front Neurol 2015; 6:258. [PMID: 26696957 PMCID: PMC4677337 DOI: 10.3389/fneur.2015.00258] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/23/2015] [Indexed: 12/04/2022] Open
Abstract
Background Adult-onset isolated focal dystonia (AOIFD) presenting in early adult life is more frequent in men, whereas in middle age it is female predominant. Temporal discrimination, an endophenotype of adult-onset idiopathic isolated focal dystonia, shows evidence of sexual dimorphism in healthy participants. Objectives We assessed the distinctive features of age-related sexual dimorphism of (i) sex ratios in dystonia phenotypes and (ii) sexual dimorphism in temporal discrimination in unaffected relatives of cervical dystonia patients. Methods We performed (i) a meta-regression analysis of the proportion of men in published cohorts of phenotypes of adult-onset dystonia in relation to their mean age of onset and (ii) an analysis of temporal discrimination thresholds in 220 unaffected first-degree relatives (125 women) of cervical dystonia patients. Results In 53 studies of dystonia phenotypes, the proportion of men showed a highly significant negative association with mean age of onset (p < 0.0001, pseudo-R2 = 59.6%), with increasing female predominance from 40 years of age. Age of onset and phenotype together explained 92.8% of the variance in proportion of men. Temporal discrimination in relatives under the age of 35 years is faster in women than men but the age-related rate of deterioration in women is twice that of men; after 45 years of age, men have faster temporal discrimination than women. Conclusion Temporal discrimination in unaffected relatives of cervical dystonia patients and sex ratios in adult-onset dystonia phenotypes show similar patterns of age-related sexual dimorphism. Such age-related sexual dimorphism in temporal discrimination and adult-onset focal dystonia may reflect common underlying mechanisms. Cerebral GABA levels have been reported to show similar age-related sexual dimorphism in healthy participants and may be the mechanism underlying the observed age-related sexual dimorphism in temporal discrimination and the sex ratios in AOIFD.
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Affiliation(s)
- John S Butler
- Trinity Centre for Bioengineering, School of Engineering, Trinity College Dublin , Dublin , Ireland
| | - Ines M Beiser
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Sciences, University College Dublin , Dublin , Ireland
| | - Laura Williams
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Sciences, University College Dublin , Dublin , Ireland
| | - Eavan McGovern
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Sciences, University College Dublin , Dublin , Ireland
| | | | - Tim Lynch
- Dublin Neurological Institute, Mater Misericordiae University Hospital , Dublin , Ireland
| | | | | | | | - Richard B Reilly
- Trinity Centre for Bioengineering, School of Engineering, Trinity College Dublin , Dublin , Ireland ; School of Medicine, Trinity College Dublin , Dublin , Ireland
| | - Seán O'Riordan
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Sciences, University College Dublin , Dublin , Ireland
| | - Cathal Walsh
- Department of Statistics, Trinity College Dublin , Dublin , Ireland ; Department of Mathematics and Statistics, University of Limerick , Limerick , Ireland
| | - Michael Hutchinson
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Sciences, University College Dublin , Dublin , Ireland
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Wilson JG, Minchin D, McHugh B, McGovern E, Tanner CJ, Giltrap M. Declines in TBT contamination in Irish coastal waters 1987-2011, using the dogwhelk (Nucella lapillus) as a biological indicator. Mar Pollut Bull 2015; 100:289-296. [PMID: 26443386 DOI: 10.1016/j.marpolbul.2015.08.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 08/19/2015] [Accepted: 08/23/2015] [Indexed: 06/05/2023]
Abstract
Using the vas deferens sequence index (VDSI) and relative penis size index (RPSI) in dogwhelks (Nucella lapillus), imposex levels were assessed at 63 sites within 11 sea inlets during 2010/2011 and compared these with levels gathered since 1987. Sterile females (VDS>5.0) were found at 14 of the 63 sites and 47 sites (75%) met the EcoQO (VDSI<2.0). The absence of imposex in 'control' areas on the west coast is due to the lack of vessel paint applications or net dips with TBT being used as an active anti-fouling ingredient. A significant decline was observed following 2005 when comparing VDSI levels which is consistent with the decline of TBT usage. Current levels are consistent with an overall improvement towards achieving Good Environmental Status according to the requirements under the Marine Strategy Framework Directive.
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Affiliation(s)
- J G Wilson
- Zoology Department, Trinity College Dublin, Dublin 2, Ireland
| | - D Minchin
- MOI, Marina Village, Ballina, Killaloe, Co. Clare, Ireland; Marine Science and Technology Center, Klaipeda University, 84 Manto, Klaipeda, Lithuania
| | - B McHugh
- Marine Institute, Rinville, Oranmore, Co. Galway, Ireland
| | - E McGovern
- Marine Institute, Rinville, Oranmore, Co. Galway, Ireland
| | - C J Tanner
- School of Natural Sciences, University of Nebraska, Lincoln, USA
| | - M Giltrap
- Zoology Department, Trinity College Dublin, Dublin 2, Ireland.
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Williams LJ, Butler JS, Molloy A, McGovern E, Beiser I, Kimmich O, Quinlivan B, O'Riordan S, Hutchinson M, Reilly RB. Young Women do it Better: Sexual Dimorphism in Temporal Discrimination. Front Neurol 2015. [PMID: 26217303 PMCID: PMC4497309 DOI: 10.3389/fneur.2015.00160] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The temporal discrimination threshold (TDT) is the shortest time interval at which two sensory stimuli presented sequentially are detected as asynchronous by the observer. TDTs are known to increase with age. Having previously observed shorter thresholds in young women than in men, in this work we sought to systematically examine the effect of sex and age on temporal discrimination. The aims of this study were to examine, in a large group of men and women aged 20–65 years, the distribution of TDTs with an analysis of the individual participant’s responses, assessing the “point of subjective equality” and the “just noticeable difference” (JND). These respectively assess sensitivity and accuracy of an individual’s response. In 175 participants (88 women) aged 20–65 years, temporal discrimination was faster in women than in men under the age of 40 years by a mean of approximately 13 ms. However, age-related decline in temporal discrimination was three times faster in women so that, in the age group of 40–65 years, the female superiority was reversed. The point of subjective equality showed a similar advantage in younger women and more marked age-related decline in women than men, as the TDT. JND values declined equally in both sexes, showing no sexual dimorphism. This observed sexual dimorphism in temporal discrimination is important for both (a) future clinical research assessing disordered mid-brain covert attention in basal-ganglia disorders, and (b) understanding the biology of this sexual dimorphism which may be genetic or hormonal.
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Affiliation(s)
- Laura Jane Williams
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - John S Butler
- Trinity Centre for Bioengineering, Trinity College Dublin , Dublin , Ireland ; School of Engineering, Trinity College Dublin , Dublin , Ireland
| | - Anna Molloy
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - Eavan McGovern
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - Ines Beiser
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - Okka Kimmich
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - Brendan Quinlivan
- Trinity Centre for Bioengineering, Trinity College Dublin , Dublin , Ireland ; School of Engineering, Trinity College Dublin , Dublin , Ireland
| | - Sean O'Riordan
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - Michael Hutchinson
- Department of Neurology, St. Vincent's University Hospital , Dublin , Ireland ; School of Medicine and Medical Science, University College Dublin , Dublin , Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, Trinity College Dublin , Dublin , Ireland ; School of Engineering, Trinity College Dublin , Dublin , Ireland ; School of Medicine, Trinity College Dublin , Dublin , Ireland
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McGovern E, Moylett E, McMahon CJ. Myocardial ischaemia following cocaine and adrenaline exposure in a child during an ophthalmological procedure. Ir Med J 2015; 108:89-90. [PMID: 25876303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report a 23-month old girl who presented with bilateral epiphora who underwent bilateral lacrimal probing and syringing, during which a cocaine adrenaline solution was used. Two hours after the procedure she developed acute pulmonary oedema secondary to myocardial ischaemia. The patient was treated with intravenous glyceryltrinitrate and milrinone infusions; cardiac enzymes and left ventricular function normalised over the subsequent 72 hours. Topical administration of cocaine and adrenaline solution may have dangerous systemic cardiac effects and should always be used judiciously.
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White P, McHugh B, Poole R, McGovern E, White J, Behan P, Foley B, Covaci A. Application of congener based multi-matrix profiling techniques to identify potential PCDD/F sources in environmental samples from the Burrishoole Catchment in the West of Ireland. Environ Pollut 2014; 184:449-456. [PMID: 24121420 DOI: 10.1016/j.envpol.2013.09.026] [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] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/16/2013] [Accepted: 09/18/2013] [Indexed: 06/02/2023]
Abstract
Homologue and congener profiles of PCDD/Fs in eels, passive sampler and sediment extracts from the Burrishoole, a rural upland catchment on the western Irish seaboard were compared with potential PCDD sources. ΣPCDD/F levels in eels ranged from 2.9 to 25.9 pg g(-1) wet weight, which are elevated compared to other Irish locations. The OCDD congener dominated the pattern of ΣPCDD/Fs in all matrices from Burrishoole. Passive samplers were successfully deployed to identify for the first time the presence in the water column of PCDD/Fs and dimethoxylated octachlorodiphenyl ether (diMeOoctaCDE), impurities found in pentachlorophenol (PCP) production. Principal component analysis (PCA) identified similarities between PCDD/F profiles in technical PCP mixtures and environmental samples from the Burrishoole region. Results strongly suggest residual PCDD contamination associated with historic local use of a dioxin contaminated product in the catchment area, with pentachlorophenol a strong candidate.
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Affiliation(s)
- P White
- Marine Institute, Rinville, Oranmore, Galway and Newport, Mayo, Ireland; School of Chemical and Pharmaceutical Sciences, Dublin Institute of Technology, Kevin St., Dublin 8, Ireland.
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Ryan C, McHugh B, Boyle B, McGovern E, Bérubé M, Lopez-Suárez P, Elfes CT, Boyd DT, Ylitalo GM, Van Blaricom GR, Clapham PJ, Robbins J, Palsbøll PJ, O’Connor I, Berrow SD. Levels of persistent organic pollutants in eastern North Atlantic humpback whales. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Giltrap M, Ronan J, Hardenberg S, Parkes G, McHugh B, McGovern E, Wilson JG. Assessment of biomarkers in Mytilus edulis to determine good environmental status for implementation of MSFD in Ireland. Mar Pollut Bull 2013; 71:240-249. [PMID: 23664067 DOI: 10.1016/j.marpolbul.2013.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/07/2013] [Accepted: 02/09/2013] [Indexed: 06/02/2023]
Abstract
Candidate OSPAR/ICES recommended biomarkers at the level of the individual in Mytilus edulis for determination of good environmental status for MSFD were evaluated against contaminant levels at sites around Ireland. The sites chosen ranged from moderate to low pollution levels, but the actual ranking of the sites varied according to the contaminant levels present. At the most contaminated site, Cork, 4 out of 16 contaminants exceeded the EAC, while at Shannon, no EACs were exceeded. The SOS assay suggested that Cork was the healthiest site with a LT50 of 17.6 days, while SOS for Shannon was 15.6 days. Likewise, condition factors varied among sites and did not always correspond to contaminant-based status. There may be uncertainty in assigning status around the not good:good boundary. This raises potential difficulties not only in the biomarker/contaminant load relationship but also in the reliability of the biomarkers themselves and hence barriers meeting compliance levels.
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Affiliation(s)
- M Giltrap
- Zoology Department, Trinity College Dublin, Dublin 2, Ireland.
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Robinson D, McGovern E, Doorley E, Hayden C, O'Shea D. The Nursing Homes Support Scheme Act in Ireland – older persons’ views. Eur Geriatr Med 2011. [DOI: 10.1016/j.eurger.2011.04.006] [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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Forlee MV, Haider SN, Colgan MP, McGovern E, Moore DJ, Madhavan P. Hybrid repair of thoracic aortic arch aneurysm. Ir J Med Sci 2010; 181:431-3. [DOI: 10.1007/s11845-010-0647-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2009] [Accepted: 11/16/2010] [Indexed: 12/01/2022]
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McGovern E, McDonnell TJ. Herbal medicine--sets the heart racing! Ir Med J 2010; 103:219. [PMID: 20845605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The potential for pharmaceuticals to produce side effects and drug interactions is well known to medical practitioners and the lay public alike. However, the potential for alternative medicines to produce such effects is less widely known. We describe a potentially dangerous interaction between a herbal medicine and concomitant selective serotonin re-uptake inhibitor (SSRI) ingestion.
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Al-Alao B, McGovern E, O'Byrne K, Young V. Lymph nodes dissection, implication on prognosis in surgical non-small cell lung cancer. Lung Cancer 2010. [DOI: 10.1016/s0169-5002(10)70115-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: 11/16/2022]
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Al-Alao B, McGovern E, Young V, O'Byrne K. The prognostic significance of intra-tumoural vascular invasion in surgically resected non-small cell lung cancer. Lung Cancer 2010. [DOI: 10.1016/s0169-5002(10)70116-1] [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: 11/25/2022]
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Al-Sarraf N, Thalib L, Hughes A, Tolan M, Young V, McGovern E. Lack of Correlation between Smoking Status and Early Postoperative Outcome following Valve Surgery. Thorac Cardiovasc Surg 2008; 56:449-55. [DOI: 10.1055/s-2008-1038693] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McGovern E, Fleming P, O'Marcaigh A. The dental management of five paediatric patients with a history of acute intermittent porphyria. Eur Arch Paediatr Dent 2008; 8:215-8. [PMID: 18076854 DOI: 10.1007/bf03262600] [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: 11/28/2022]
Abstract
BACKGROUND Acute Intermittent Porphyria (AIP) is a rare autosomal dominant metabolic disorder resulting from partial deficiency of porphobobilinogen deaminase, the third enzyme of the haem synthetic pathway. Patients with AIP may be vulnerable to acute neurovisceral attacks if exposed to certain drugs, including some drugs used in dental practice. CASE REPORTS This article outlines the dental management of 5 children with a diagnosis of latent AIP or a family history of AIP. The local analgesic agent used in all cases was bupivacaine or levobupivacaine. Nitrous oxide and oxygen inhalation sedation was used in 2 cases and general anaesthesia, using propofol, isoflurane with nitrous oxide and oxygen, was used in another case. The dental treatment undertaken included restorations, endodontics and extractions. CONCLUSION Dental treatment using bupivacaine or levobupivacaine as local analgesic agents was successfully and safely provided for 5 children with a diagnosis of latent AIP or a family history of AIP.
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Affiliation(s)
- E McGovern
- Dental Dept., Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
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Al-Sarraf N, Mahmood S, Baird A, Gately K, Norvig-Reiff J, Hinrichsen J, Teh B, McGovern E, De Meyts P, O'Byrne K, Gray S. 60 Insulin receptor substrate 5 (IRS-5). Its regulation and altered expression in cancer. Lung Cancer 2007. [DOI: 10.1016/s0169-5002(07)70386-0] [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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Al-Sarraf N, Baird A, Pidgeon G, McGovern E, O'Byrne K, Gray S. 61 The VEGF signalling pathway and the chromatin environment in lung cancer. Lung Cancer 2007. [DOI: 10.1016/s0169-5002(07)70387-2] [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: 10/23/2022]
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McGovern E, Al-Mudaffer M, McMahon C, Brosnahan D, Fleming P, Reardon W. Oculo-facio-cardio-dental syndrome in a mother and daughter. Int J Oral Maxillofac Surg 2006; 35:1060-2. [PMID: 16829040 DOI: 10.1016/j.ijom.2006.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Revised: 03/02/2006] [Accepted: 05/04/2006] [Indexed: 10/24/2022]
Abstract
Oculo-facio-cardio-dental (OFCD) syndrome is a rare X-linked dominant syndrome characterized by canine teeth with extremely large roots (radiculomegaly), congenital cataract, dysmorphic facial features and congenital heart disease. A case of mother-daughter vertical transmission of OFCD is reported. Dental findings were important in confirming the diagnosis in the mother.
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Affiliation(s)
- E McGovern
- Dental Department, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland.
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Coate LE, Gately K, Barr MP, Meaney J, O’Connell F, Nicholson S, McGovern E, Young V, O’Byrne K. Phase II pilot study of neoadjuvant cetuximab in combination with cisplatin and gemcitabine in patients with resectable IB-IIIA non small cell lung cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17107] [Citation(s) in RCA: 4] [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: 11/20/2022] Open
Abstract
17107 Background: Adjuvant and neoadjuvant chemotherapy play a role in optimising long term outcome of patients with resectable non small cell lung cancer (NSCLC). The epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase which is overexpressed NSCLC. Cetuximab is a monoclonal antibody which attaches to the extracellular domain of the EGFR preventing ligand binding. Preclinical data and phase II evidence in advanced NSCLC suggest cetuximab potentiates the effect of conventional cytotoxic agents. Methods: Patients with histologically confirmed resectable stage IB-IIIA NSCLC and adequate end-organ function, giving informed written consent are eligible. Three weekly cycles of cisplatin 80 mg/m2 D1, gemcitabine 1250 mg/m2 D1,D8 and cetuximab loading dose of 400 mg/m2 on first infusion, thereafter weekly 250 mg/m2 are used. The primary endpoint is response rate (radiological and pathological). Secondary endpoints are safety and tolerability of the combination, resection rate following therapy, overall survival and relapse free survival. In addition, molecular prognostic and predictive biomarkers of response are being assessed. Sequential samples of tissue, plasma, serum and white blood cells are being collected before, during and after therapy on all patients. Results: 16 patients have been recruited to date. (10 men, 6 women). Median age 66 (range 29–76). 3 patients stage I, 4 patients, stage II, 9 patients stage III. 11 have completed treatment. Response (RECIST guidelines); PR - 6 patients, SD - 4 patients, PD - 1 patient. The most common toxicity was skin rash (100%). Grade 3/4 toxicities were neutropenia (73%), thrombocytopenia (45%). There were 2 grade 3 and 2 grade 4 cardiovascular toxicities in patients with significant co-morbid cardiovascular histories. Conclusion: The response rate is consistent with that established for neoadjuvant chemotherapy. Ongoing biomarker studies may identify those patients most likely to benefit from induction treatment. No significant financial relationships to disclose.
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Affiliation(s)
| | - K. Gately
- St. James’ Hospital, Dublin, Ireland
| | | | - J. Meaney
- St. James’ Hospital, Dublin, Ireland
| | | | | | | | - V. Young
- St. James’ Hospital, Dublin, Ireland
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Cosgrave J, Foley JB, Kelly R, McGovern E, Bennett K, Young V, Tolan M, Crean P, Kelleher D, Walsh MJ. Perioperative serum inflammatory response and the development of atrial fibrillation after coronary artery bypass surgery. Heart 2005; 91:1475-6. [PMID: 16230451 PMCID: PMC1769158 DOI: 10.1136/hrt.2004.054262] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/04/2022] Open
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Flavin R, Finn S, McErlean A, Smyth P, Meaney J, O'Connell F, Kellett J, McGovern E, Gaffney E. Cannonball metastases with favourable prognosis. Ir J Med Sci 2005; 174:61-4. [PMID: 15868893 DOI: 10.1007/bf03168522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 10/20/2022]
Abstract
BACKGROUND Secondary 'cannonball' metastases to the lung are frequent and usually associated with disseminated malignancy and poor prognosis. AIM To report the case of a patient with metastatic pulmonary endometrial stromal sarcoma who had a previous hysterectomy for benign uterine fibroids and no past history of malignancy. RESULT A 70-year-old female presented with cannonball metastases in her lung. Four years previously she had a hysterectomy for 'fibroids'. Review of the original histology revealed endometrial stromal sarcoma, similar to the lung metastasis. She currently has a good prognosis. CONCLUSION A patient with 'cannonball' metastases can have a favourable prognosis. A female patient with a previous hysterectomy for uterine fibroids, should be considered to have metastatic sarcoma until proven otherwise.
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Affiliation(s)
- R Flavin
- Department of Histopathology, St. James's Hospital and Trinity College Medical School, Dublin
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Larney V, Lyons F, McGovern E, Fagan C, O'Malley CMN. Angiotensin-converting enzyme inhibitor induced angioedema: a new trigger? Ir Med J 2005; 98:115-6. [PMID: 15938557] [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: 05/02/2023]
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de Feyter PJ, Serruys PW, Unger F, Beyar R, de Valk V, Milo S, Simon R, Regensburger D, Crean PA, McGovern E, van den Heuvel P, van Cauwelaert C, Penn I, Tyers GFO, Lindeboom W. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina. Circulation 2002; 105:2367-72. [PMID: 12021222 DOI: 10.1161/01.cir.0000016643.34907.17] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or bypass surgery (381), and 450 patients with unstable angina were randomly assigned to coronary stenting (226) or bypass surgery (224). All patients had multivessel disease considered to be equally treatable by either technique. Freedom from major adverse events, including death, myocardial infarction, and cerebrovascular events, at 1 year was not different in unstable patients (91.2% versus 88.9%) and stable patients (90.4% versus 92.6%) treated, respectively, with coronary stenting or bypass surgery. Freedom from repeat revascularization at 1 year was similar in unstable and stable angina treated with stenting (79.2% versus 78.9%) or bypass surgery (96.3% versus 96%) but was significantly higher in both unstable and stable patients treated with stenting (16.8% versus 16.9%) compared with bypass surgery (3.6% versus 3.5%). Neither the difference in costs between stented or bypassed stable or unstable angina ($2594 versus $3627) nor the cost-effectiveness was significantly different at 1 year. CONCLUSIONS There was no difference in rates of death, myocardial infarction, and cerebrovascular event at 1 year in patients with unstable angina and multivessel disease treated with either stented angioplasty or bypass surgery compared with patients with stable angina. The rate of repeat revascularization of both unstable and stable angina was significantly higher in patients with stents.
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Affiliation(s)
- P J de Feyter
- University Hospital Rotterdam, Dijkzigt, Thoraxcenter, Rotterdam, the Netherlands.
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Geller J, Janson P, McGovern E, Valdini A. Loneliness as a predictor of hospital emergency department use. J Fam Pract 1999; 48:801-804. [PMID: 12224678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Recent studies indicate that loneliness is a significant risk factor for many ailments from colds to heart disease. If lonely patients are at greater risk for illness, then we might expect that they would use the emergency department (ED) more often and incur greater medical costs than those who are not lonely. Our goal was to determine the prevalence of loneliness in patients in an ED and to evaluate it as a predictor of ED use, hospital admission, and chronic illness. METHODS We evaluated a convenience sample of 164 ED patients with the University of California-Los Angeles Loneliness Scale, Version 3 and a survey of patient characteristics. Using medical record review and patient self-report, we determined total ED visits, the presence of chronic illness, and discharge diagnoses during a 1-year retrospective period. We evaluated data with least mean square regression and a 2-tailed t test. RESULTS We found a statistically significant correlation between loneliness score and total hospital ED visits (P <.001). The mean loneliness score (39) was equal to that of normal populations. Patients scoring higher than the mean used the ED 60% more per year than patients who scored lower (P = .008). There was no association between a patient's loneliness score and baseline chronic illness or severity of current illness (P = .56). Spanish-speaking patients had higher loneliness scores than English-speaking patients (P = .001). CONCLUSION Loneliness is a predictor of hospital ED use independent of chronic illness and is potentially very expensive to society. We recommend further studies be done to examine if allocating resources for preventing, diagnosing, and treating loneliness would be cost effective.
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Affiliation(s)
- J Geller
- Lawrence Family Practice Residency, MA 01841, USA.
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Willison HJ, Lastovica AJ, Prendergast MM, Moran AP, Walsh C, Flitcroft I, Eustace P, McMahon C, Smith J, Smith OP, Lakshmandass G, Taylor MRH, Holland CV, Cox D, Good B, Kearns GM, Gaffney P, Shark K, Frauenshuh M, Ortmann W, Messner R, King R, Rich S, Behrens T, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Walsh KM, Thorburn D, Mills P, Morris AJ, Good T, Cameron S, McCruden EAB, Bennett MW, O’Connell J, Brady C, Roche D, Collins JK, Shanahan F, O’Sullivant GC, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, McGonagle D, Gibbon W, O’Connor P, Emery P, Murphy M, Watson R, Casey E, Naidu E, Murphy M, Watson R, Barnes L, McCann S, Murphy M, Watson R, Barnes L, Sweeney E, Barrett EJ, Graham H, Cunningham RT, Johnston CF, Curry WJ, Buchanan KD, Courtney CH, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Kilbane MT, Smith DF, Murray MJ, Shering SG, McDermott EWM, O’Higgins NJ, Smyth PPA, McEneny J, Trimble ER, Young IS, Sharpe P, Mercer C, McMaster D, Young IS, Evans AE, Young IS, Cundick J, Hasselwander O, McMaster D, McGeough J, Savage D, Maxwell AP, Evans AE, Kee F, Larkin CJ, Watson RGP, Johnston C, Ardill JES, Buchanan KD, McNamara DA, Walsh TN, Bouchier-Hayes DJ, Madden C, Timon C, Gardiner N, Lawler M, O’Riordan J, Duggan C, McCann SR, Gowing H, Braakman E, Lawler M, Byrne C, Martens ACM, Hagenbeek A, McCann SR, Kinsella N, Cusack S, Lawler M, Baker H, White B, Smith OP, Lawler M, Gardiner N, Molloy K, Gowing H, Wogan A, McCann SR, McElwaine S, Lawler M, Hollywood D, McCann SR, Mcmahon C, Merry C, Ryan M, Smith O, Mulcahy FM, Murphy C, Briones J, Gardiner N, McCann SR, Lawler M, White B, Lawler M, Cusack S, Kinsella N, Smith OP, Lavin P, McCaffrey M, Gillen P, White B, Smith OP, Thompson L, Lalloz M, Layton M, Barnes L, Corish C, Kennedy NP, Flood P, Mulligan S, McNamara E, Kennedy NP, Flood P, Mathias PM, Ball E, Duiculescu D, Calistru P, O’Gorman N, Kennedy NP, Abuzakouk M, Feighery C, Brannigan M, Pender S, Keeling F, Varghese J, Lee M, Colreavy M, Gaffney R, Hone S, Herzig M, Walsh M, Dolan C, Wogan A, Lawler M, McCann SR, Hollywood D, Donovan D, Harmey J, Bouchier-Hayes DJ, Haverty A, Wang JH, Harmey JH, Redmond HP, Bouchier-Hayes DJ, McGreal G, Shering SG, Moriarty MJ, Shortt A, Kilbane MT, Smith DF, McDermott EWM, O’Higgins NJ, Smyth PPA, McNamara DA, Harmey J, Wang JH, Donovan D, Walsh TN, Bouchier-Hayes DJ, Kay E, Pidgeon G, Harmey J, McNamara DA, Bouchier-Hayes DJ, Dunne P, Lambkin H, Russell JM, O’Neill AJ, Dunne BM, O’Donovan M, Lawler M, Gaffney EF, Gillan JE, Cotter TG, Horan J, Jones D, Biswas SK, Mulkerrin EC, Brady H, O’Donnell J, Neary J, Healy E, Watson A, Keogh B, Ryan M, Cassidy C, Ward S, Stokes E, Keoghan F, Barrett A, O’Connell P, Ryall N, O’Connell PA, Jenkinson A, O’Brien T, O’Connell PG, Harrison R, Barrett T, Bailey DMD, Butler A, Barton DE, Byrne C, McElwaine S, McCann SR, Lawler M, Cusack S, Lawler M, White B, Smith OP, Daly G, Gill M, Heron S, Hawi Z, Fitzgerald M, Hawi Z, Mynett-Johnson L, Shiels D, Kendler K, McKeon P, Gill M, Straub R, Walsh D, Ryan F, Barton DE, McCabe D, Murphy R, Segurado R, Mulcahy T, Larson B, Comerford C, O’Connell R, O’Mahony E, Gill M, Donnelly J, Minahan F, O’Neill D, Farrell Z, O’Neill D, Jones D, Horan J, Glynn C, Biswas SK, Mulkerrin E, Brady H, Lennox SE, Murphy A, Rea IM, McNulty H, McMeel C, O’Neill D, McEvoy H, Freaney R, McKenna MJ, Crowe M, Keating D, Colreavy M, Hone S, Norman G, Widda S, Viani L, Galvin, Nolan CM, Hardiman O, Hardiman O, Brett F, Droogan O, Gallagher P, Harmey M, King M, Murphy J, Perryrnan R, Sukumaran S, Walsh J, Farrell MA, Hughes G, Cunningham C, Walsh JB, Coakley D, O’Neill D, Hurson M, Flood P, McMonagle P, Hardiman O, Ryan F, O’Sullivan S, Merry C, Dodd P, Redmond J, Mulcahy FM, Browne R, Keating S, O’Connor J, Cassidy BP, Smyth R, Sheppard NP, Cullivan R, Crown J, Walsh N, Denihan A, Bruce I, Radic A, Coakley D, Lawlor BA, Bridges PK, O’Doherty M, Farrington A, O’Doherty M, Farragher B, Fahy S, Kelly R, Carey T, Owens J, Gallagher O, Sloan D, McDonough C, Casey P, Horgan A, Elneihum A, O’Neill C, McMonagle T, Quinn J, Meagher D, Murphy P, Kinsella A, Mullaney J, Waddington JL, Rooney S, Rooney S, Bamford L, Sloan D, O’Connor JJ, Franklin R, O’Brien K, Fitzpatrick G, Laffey JG, Boylan JF, Laffey J, Coleman M, Boylan J, Laffey JG, McShane AJ, Boylan JF, Loughrey JPR, Gardiner J, McGinley J, Leonard I, Carey M, Neligan P, O’Rourke J, Cunningham A, Fennessy F, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes DJ, Kellett J, Laffey J, Murphy D, Regan J, O’Keeffe D, Mahmud A, Hemeryck L, Feely J, Mahmud A, Hemeryck L, Hall M, Feely J, Menown IBA, Mathew TP, Nesbitt GS, Syme M, Young IS, Adgey AAJ, Menown IBA, Turtle F, Allen J, Anderson J, Adgey AAJ, O’Hanlon R, Codd MB, Walkin S, McCann HA, Sugrue DD, Rasheed AM, Chen G, Kelly C, Bouchier-Hayes DJ, Leahy A, Rasheed AM, Kay E, Jina S, Bouchier-Hayes DJ, Leahy A, McDowell I, Rasheed AM, Wang JH, Wo Q, Kelly C, Bouchier-Hayes DJ, Leahy A, Shuhaibar MN, McGovern E, Turtle F, Menown IBA, Manoharan G, Kirkpatrick R, Campbell NPS, Walkin S, Codd MB, O’Hanlon R, McCarthy C, McCann HA, Sugrue DD, Wen Y, Killalea S, Hall M, Hemeryck L, Feely J, Fahy CJ, Griffith A, McGinley J, McCabe D, Fraser A, Casey E, Ryan T, Murphy R, Browne M, Fenton J, Hughes J, Timon CI, Fenton J, Curran A, Smyth D, Viani L, Walsh M, Hughes JP, Fenton J, Lee P, Kelly A, Timon CI, Hughes JP, Fenton J, Shine N, Blayney A, McShane DP, Timon CI, Hussey J, Howlett M, Langton A, McEvoy A, Slevin J, Fitzpatrick C, Turner MJ, Enright F, Goggin N, Costigan C, Duff D, Osizlok P, Wood F, Watson R, Fitzsimons RB, Flanagan N, Enright F, Barnes L, Watson R, Molloy E, Griffin E, Deasy PF, Sheridan M, White MJ, Moore R, Gray A, Hill J, Glasgow JFT, Middleton B, Slattery D, Donoghue V, McMahon A, Murphy J, Slattery D, McCarthy A, Oslislok P, Duff D, Colreavy M, Keogh I, Hone S, Walsh M, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, Russell KJ, Henry M, Fitzgerald MX, O’Connor CM, Kavanagh PV, McNamara SM, Feely J, Barry M, O’Brien JE, McCormick P, Molony C, Doyle RM, Walsh JB, Coakley D, Codd MB, O’Connell PR, Dowey LC, McGlynn H, Thurnham DI, Elborn SJ, Flynn L, Carton J, Byrne B, O’Farrelly C, Kelehan P, O’Herlihy C, O’Hara AM, Moran AP, Orren A, Fernie BA, Merry C, Clarke S, Courtney G, de Gascun C, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Byrne M, Moylett E, Murphy H, Butler K, Nourse C, Thaker H, Barry C, Russell J, Sheehan G, Boyle B, Hone R, Conboy B, Butler C, Moris D, Cormican M, Flynn J, McCormack O, Corbally N, Murray A, Kirrane S, O’Keane C, Hone R, Lynch SM, Cryan B, Whyte D, Morris D, Butler C, Cormican M, Flynn J, Corbett-Feeney G, Murray A, Corbally N, Hone R, Mackle T, Colreavy M, Perkins J, Saidlear C, Young A, Eustace P, Wrigley M, Clifford J, Waddington JL, Tighe O, Croke DT, Drago J, Sibley DR, Feely J, Kelly A, Carvalho M, Hennessy M, Kelly M, Feely J, Hughes C, Hanlon M, Feely J, Sabra K, Keane T, Egan D, Ryan M, Maerry C, Ryan M, Barry M, Mulcahy FM, Maerry C, Ryan M, Barry M, Mulcahy FM, Sharma SC, Williams D, Kelly A, Carvalho M, Feely J, Williams D, Kelly A, Carvalho M, Feely J, Codd MB, Mahon NG, McCann HA, Sugrue DD, Sayers GM, Johnson Z, McNamara SM, Kavanagh PV, Feely J. National scientific medical meeting 1997 abstracts. Ir J Med Sci 1998. [DOI: 10.1007/bf02937234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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