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Tremblay J, Haloui M, Attaoua R, Tahir R, Hishmih C, Harvey F, Marois-Blanchet FC, Long C, Simon P, Santucci L, Hizel C, Chalmers J, Marre M, Harrap S, Cífková R, Krajčoviechová A, Matthews DR, Williams B, Poulter N, Zoungas S, Colagiuri S, Mancia G, Grobbee DE, Rodgers A, Liu L, Agbessi M, Bruat V, Favé MJ, Harwood MP, Awadalla P, Woodward M, Hussin JG, Hamet P. Correction to: Polygenic risk scores predict diabetes complications and their response to intensive blood pressure and glucose control. Diabetologia 2021; 64:2355-2356. [PMID: 34448881 PMCID: PMC8587372 DOI: 10.1007/s00125-021-05544-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Johanne Tremblay
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada.
| | - Mounsif Haloui
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Redha Attaoua
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Ramzan Tahir
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Camil Hishmih
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - François Harvey
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | | | - Carole Long
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Paul Simon
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Lara Santucci
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Candan Hizel
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - John Chalmers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Michel Marre
- Clinique Ambroise Paré, Neuilly-sur-Seine, and Centre de Recherches des Cordeliers, Paris, France
| | - Stephen Harrap
- Department of Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Renata Cífková
- Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic
| | - Alena Krajčoviechová
- Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic
| | - David R Matthews
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London, London, UK
| | - Neil Poulter
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Giuseppe Mancia
- Istituto Auxologico Italiano, University of Milano, Bicocca, Italy
| | - Diederick E Grobbee
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anthony Rodgers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Liusheng Liu
- Beijing Hypertension League Institute, Beijing, China
| | | | - Vanessa Bruat
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | | | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Department of Molecular Genetics and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK.
| | - Julie G Hussin
- Montreal Heart Institute, Research Center, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Pavel Hamet
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada.
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Tremblay J, Haloui M, Attaoua R, Tahir R, Hishmih C, Harvey F, Marois-Blanchet FC, Long C, Simon P, Santucci L, Hizel C, Chalmers J, Marre M, Harrap S, Cífková R, Krajčoviechová A, Matthews DR, Williams B, Poulter N, Zoungas S, Colagiuri S, Mancia G, Grobbee DE, Rodgers A, Liu L, Agbessi M, Bruat V, Favé MJ, Harwood MP, Awadalla P, Woodward M, Hussin JG, Hamet P. Polygenic risk scores predict diabetes complications and their response to intensive blood pressure and glucose control. Diabetologia 2021; 64:2012-2025. [PMID: 34226943 PMCID: PMC8382653 DOI: 10.1007/s00125-021-05491-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/22/2021] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes increases the risk of cardiovascular and renal complications, but early risk prediction could lead to timely intervention and better outcomes. Genetic information can be used to enable early detection of risk. METHODS We developed a multi-polygenic risk score (multiPRS) that combines ten weighted PRSs (10 wPRS) composed of 598 SNPs associated with main risk factors and outcomes of type 2 diabetes, derived from summary statistics data of genome-wide association studies. The 10 wPRS, first principal component of ethnicity, sex, age at onset and diabetes duration were included into one logistic regression model to predict micro- and macrovascular outcomes in 4098 participants in the ADVANCE study and 17,604 individuals with type 2 diabetes in the UK Biobank study. RESULTS The model showed a similar predictive performance for cardiovascular and renal complications in different cohorts. It identified the top 30% of ADVANCE participants with a mean of 3.1-fold increased risk of major micro- and macrovascular events (p = 6.3 × 10-21 and p = 9.6 × 10-31, respectively) and a 4.4-fold (p = 6.8 × 10-33) higher risk of cardiovascular death. While in ADVANCE overall, combined intensive blood pressure and glucose control decreased cardiovascular death by 24%, the model identified a high-risk group in whom it decreased the mortality rate by 47%, and a low-risk group in whom it had no discernible effect. High-risk individuals had the greatest absolute risk reduction with a number needed to treat of 12 to prevent one cardiovascular death over 5 years. CONCLUSIONS/INTERPRETATION This novel multiPRS model stratified individuals with type 2 diabetes according to risk of complications and helped to target earlier those who would receive greater benefit from intensive therapy.
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Affiliation(s)
- Johanne Tremblay
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada.
| | - Mounsif Haloui
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Redha Attaoua
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Ramzan Tahir
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Camil Hishmih
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - François Harvey
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | | | - Carole Long
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Paul Simon
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Lara Santucci
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - Candan Hizel
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada
| | - John Chalmers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Michel Marre
- Clinique Ambroise Paré, Neuilly-sur-Seine, and Centre de Recherches des Cordeliers, Paris, France
| | - Stephen Harrap
- Department of Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Renata Cífková
- Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic
| | - Alena Krajčoviechová
- Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic
| | - David R Matthews
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Bryan Williams
- University College London, Institute of Cardiovascular Science, London, UK
| | - Neil Poulter
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Giuseppe Mancia
- Istituto Auxologico Italiano, University of Milano, Bicocca, Italy
| | - Diederick E Grobbee
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anthony Rodgers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Liusheng Liu
- Beijing Hypertension League Institute, Beijing, China
| | | | - Vanessa Bruat
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | | | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Department of Molecular Genetics and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK.
| | - Julie G Hussin
- Montreal Heart Institute, Research Center, Montréal, Québec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Pavel Hamet
- Department of Medicine, University of Montréal, CRCHUM, Québec, Canada.
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Derbyshire S, Harvey F, Swann M. A survey of the contribution made by UK orchestras to the health and well-being sectors. Public Health 2021; 193:150-152. [PMID: 33848907 DOI: 10.1016/j.puhe.2021.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/21/2021] [Accepted: 01/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To provide a comprehensive picture of the contribution that orchestras currently make in the public health sector. STUDY DESIGN An online survey of member orchestras of the Association of British Orchestras. METHODS Data gathered covered geographical, financial and musical aspects, the type of healthcare settings in which the work takes place, orchestras' motivation for their involvement in the healthcare sector, the role health and well-being delivery plays in their business models, and finally, the impact of COVID-19 on orchestras' current and future plans. RESULTS Approximately half of UK orchestras are engaged significantly in the area of health and well-being in all four UK nations and a wide range of healthcare settings. There is a strong appetite to develop this work among those orchestras not yet involved. At the same time, the extent of this work is not formally recognised or paid for by the healthcare sector. CONCLUSIONS While there is considerable unevenness in the provision, it is clear that UK professional orchestras made a significant contribution to the health and well-being sectors in hospitals and other healthcare settings. There is scope for a greater contribution by orchestras to the healthcare sector, which will require more formal recognition of the value of this work.
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Affiliation(s)
| | - F Harvey
- Association of British Orchestras, UK.
| | - M Swann
- City of London Sinfonia, UK.
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Chapuy L, Bsat M, Rubio M, Harvey F, Motta V, Schwenter F, Wassef R, Richard C, Deslandres C, Nguyen BN, Soucy G, Hacohen N, Fritz J, Villani AC, Mehta H, Sarfati M. Transcriptomic Analysis and High-dimensional Phenotypic Mapping of Mononuclear Phagocytes in Mesenteric Lymph Nodes Reveal Differences Between Ulcerative Colitis and Crohn's Disease. J Crohns Colitis 2020; 14:393-405. [PMID: 31541232 PMCID: PMC7068244 DOI: 10.1093/ecco-jcc/jjz156] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Crohn's disease [CD] and ulcerative colitis [UC] are distinct forms of inflammatory bowel disease. Heterogeneity of HLA-DR+SIRPα + mononuclear phagocytes [MNPs], including macrophages [MΦ], monocyte-derived [Mono] cells, and dendritic cells [DCs], was reported in gut tissue but not yet investigated in mesenteric lymph nodes [MLNs] of IBD patients. We here compared the phenotype, function, and molecular profile of HLA-DR+SIRPα + MNPs in CD and UC MLNs. METHODS Cell distribution, morphology, immune function, and transcriptomic [bulk RNAseq] and high-dimensional protein expression profiles [CyTOF] of HLA-DR+SIRPα + MNPs were examined in MLNs of UC [n = 14], CD [n = 35], and non-IBD [n = 12] patients. RESULTS Elevated frequencies of CD14+CD64+CD163+ [Mono/MΦ-like] MNPs displaying monocyte/MΦ morphology and phagocytic function were a distinct feature of UC MLNs. In CD, the proportion of CD14-CD64-CD163- [DC-like] cells was augmented relative to Mono/MΦ-like cells; DC-like cells drove naïve T cell proliferation, Th1 polarisation, and Th17 TCM plasticity. Gene expression profile corroborated the nature of DC-like cells, best represented by BTLA, SERPINF, IGJ and, of Mono/MΦ-like cells, defined by CD163, MARCO, MAFB, CD300E, S100A9 expression. CyTOF analysis showed that CD123+ plasmacytoid cells predominated over conventional DCs in DC-like cells. Four CD163+ clusters were revealed in Mono/MΦ-like cells, two of which were enriched in MARCO-CD68dimHLA-DRdim monocyte-like cells and MARCOhiCD68hiHLA-DRhi Mɸ, whose proportion increased in UC relative to CD. CONCLUSIONS Defining the landscape of MNPs in MLNs provided evidence for expansion of CD163+ Mono/MΦ-like cells in UC only, highlighting a distinction between UC and CD, and thus the potential contribution of monocyte-like cells in driving colitis.
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Affiliation(s)
- Laurence Chapuy
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal [CRCHUM], Montréal, QC, Canada
| | - Marwa Bsat
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal [CRCHUM], Montréal, QC, Canada
| | - Manuel Rubio
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal [CRCHUM], Montréal, QC, Canada
| | - François Harvey
- Department of Biomedical Informatics, Centre de Recherche du Centre Hospitalier de l’Université de Montréal [CRCHUM], Montréal, QC, Canada
| | - Vinicius Motta
- McGill Goodman Research Center, McGill University, Montréal, QC, Canada
| | - Frank Schwenter
- Digestive Surgery Department, Centre Hospitalier de l’Université de Montréal [CHUM], Montréal, QC, Canada
| | - Ramses Wassef
- Digestive Surgery Department, Centre Hospitalier de l’Université de Montréal [CHUM], Montréal, QC, Canada
| | - Carole Richard
- Digestive Surgery Department, Centre Hospitalier de l’Université de Montréal [CHUM], Montréal, QC, Canada
| | - Colette Deslandres
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, CHU Sainte-Justine, Université de Montreal, QC, Canada
| | - Bich N Nguyen
- Pathology Department, Centre Hospitalier de l’Université de Montréal [CHUM], Montréal, QC, Canada
| | - Geneviève Soucy
- Pathology Department, Centre Hospitalier de l’Université de Montréal [CHUM], Montréal, QC, Canada
| | - Nir Hacohen
- Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Jorge Fritz
- Department of Microbiology and Immunology, McGill University, Montréal, Qc, Canada
| | - Alexandra-Chloé Villani
- Broad Institute of MIT and Harvard, Cambridge, MA USA
- Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Heena Mehta
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal [CRCHUM], Montréal, QC, Canada
| | - Marika Sarfati
- Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal [CRCHUM], Montréal, QC, Canada
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Vormoor B, Wilkinson S, Harvey F, Plummer R, Curtin N. 349 Ewing's Sarcoma Cells Can Be Sensitized to Temozolomide and to a Lesser Extent to Radiotherapy by Co-treatment with a PARP-inhibitor (AG014699). Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72147-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carson E, Cramp D, Flowerday A, Harrar H, Harvey F, Leicester H, Roudsari A. REALITY in Home Telecare: A Systemic Approach to Evaluation. Conf Proc IEEE Eng Med Biol Soc 2007; 2005:3927-30. [PMID: 17281090 DOI: 10.1109/iembs.2005.1615320] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This paper describes the REALITY telecare system, designed to enable a range of commonly occurring chronic diseases to be managed in the home setting. This uses hand-held computers linked to the internet for collecting and transmitting clinical and quality of life data and providing remote clinical advice. Key to the success of such telecare is a proper scheme of evaluation. An overall framework for such evaluation is proposed. Within this schema formative evaluation results are presented, focusing particularly on technical issues being addressed, patient recruitment and retention, and data collection. User acceptability is then considered as a first ingredient of summative evaluation.
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Affiliation(s)
- E Carson
- Centre for Health Informatics, City Univ., London
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Dick JM, Leakey RRB, McBeath C, Harvey F, Smith RI, Woods C. Influence of nutrient application rate on growth and rooting potential of the West African hardwood Triplochiton scleroxylon. Tree Physiol 2004; 24:35-44. [PMID: 14652212 DOI: 10.1093/treephys/24.1.35] [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] [Indexed: 05/24/2023]
Abstract
Effects of stock plant nutrition on growth and subsequent rooting of leafy stem cuttings of the commercially important west African tree Triplochiton scleroxylon K. Schum. were investigated to identify the primary morphological variables influencing adventitious root formation. Potted plants were watered as required with one of four balanced nutrient solutions (0, 15, 63 or 125 mg N l(-1)). Increasing the nutrient supply to stock plants increased growth rate and rate of adventitious root production of subsequently harvested cuttings, but an optimum nutrient regime was not identified. Rooting percentage increased from 27% in cuttings harvested from stock plants receiving a low nutrient supply to 64% for cuttings harvested from stock plants receiving eight times the amount of nutrients extractable from plants under typical field conditions in West Africa. The ability of a cutting to retain its leaf during propagation and the length of the cutting were the primary measured characteristics associated with rooting and accounted for 43% of the variance fitted in the model. The length of the new shoot, total leaf area and within-shoot position (node position) were also significantly associated with rooting. After these characteristics were fitted to the model, the genetic origin (clone) was not statistically significant. We conclude that genetic variation in rooting potential is mediated through variations in morphological and physiological traits, rather than through genetic variation in cell differentiation or related aspects of root initiation.
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Affiliation(s)
- J McP Dick
- Centre for Ecology and Hydrology, Bush Estate, Penicuik, EH26 0QB, Scotland, UK.
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Wilkinson S, Fellowes D, Goodman M, Low J, Harvey F. 1236 District nurses perceptions of a home based nursing service for dying patients: a national survey of reasons for referral and non-referral. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)91262-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Patzakis MJ, Bains RS, Lee J, Shepherd L, Singer G, Ressler R, Harvey F, Holtom P. Prospective, randomized, double-blind study comparing single-agent antibiotic therapy, ciprofloxacin, to combination antibiotic therapy in open fracture wounds. J Orthop Trauma 2000; 14:529-33. [PMID: 11149497 DOI: 10.1097/00005131-200011000-00002] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.5] [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: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the efficacy of a single agent, ciprofloxacin, with that of combination antibiotic therapy consisting of cefamandole and gentamicin in all types of open fracture wounds. STUDY DESIGN A prospective double-blind randomized clinical trial. SETTING A Level 1 trauma center. PATIENTS One hundred ninety-five consecutive patients with 203 open fractures were enrolled over a twenty-month period. Twenty-nine fractures from low-velocity gunshot wounds were excluded, and three other patients were excluded because of protocol violations. Our final number of patients were 163, with 171 open fractures. MAIN OUTCOME MEASUREMENT The infection rates for Type I and Type II open fractures for both antibiotic groups were calculated. The infection rate of Type III open fractures for both antibiotic groups was also calculated. Chi-square analysis with Yates correction was used to assess statistical significance of two treatment groups. RESULTS The infection rate for Types I and II open fractures in the ciprofloxacin group was 5.8 percent and 6 percent for the cefamandole/gentamicin group (p = 1.000). The infection rate for Type III open fractures for the ciprofloxacin group was 31 percent (8 of 26) versus 7.7 percent (2 of 26) for the cefamandole/gentamicin group (p = 0.079). There were no statistically significant differences in infection rate between the group treated with ciprofloxacin and that treated with cefamandole/gentamicin for Types I and II open fracture wounds. However, there appeared to be a high failure rate for the ciprofloxacin Type III open fracture group, with patients being 5.33 times more likely to become infected than those in the combination therapy group. Although this difference was not statistically significant, possibly because of the small sample size, there was a definite trend toward statistical significance. CONCLUSION Single-agent antibiotic therapy with ciprofloxacin is effective in treatment of Type I and Type II open fracture wounds. However, on the basis of our results, we cannot recommend ciprofloxacin alone for Type III wounds. Possibly one can use fluoroquinolones in combination therapy, specifically as an alternate to an aminoglycoside.
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Affiliation(s)
- M J Patzakis
- Department of Orthopaedic Surgery, University of Southern California School of Medicine, Los Angeles 90033, USA
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Abstract
Urine pregnancy tests performed at a large urban university student health center were examined for specific gravity to determine whether a low urine specific gravity, compared with a serum specimen, could alter the result of a urine pregnancy test. At the same time, a serum pregnancy test was performed on those samples with negative results and a specific gravity of less than 1.015. During the study period, 410 urine specimens were evaluated. Eighty of the women with a specific gravity under 1.015 had negative urine pregnancy tests with a concomitant serum specimen. The authors concluded that current sensitive immunoassay tests for human chorionic gonadotropin (HCG) are highly sensitive and that low specific gravity does not appear to alter this sensitivity.
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Affiliation(s)
- L Neinstein
- University of Southern California School of Medicine, USA
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Schreier DZ, Weaver FA, Frankhouse J, Papanicolaou G, Shore E, Yellin AE, Harvey F. A prospective study of carbon dioxide-digital subtraction vs standard contrast arteriography in the evaluation of the renal arteries. Arch Surg 1996; 131:503-7; discussion 507-8. [PMID: 8624196 DOI: 10.1001/archsurg.1996.01430170049008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To compare carbon dioxide-digital subtraction arteriographic (CO2-DSA) images of renal artery anatomy with standard iodinated contrast arteriographic (ICA) images. DESIGN One hundred patients with vascular disease who required abdominal aortography were evaluated by both CO2-DSA and ICA modalities. Two blinded readers interpreted arteriograms for the degree of renal artery stenosis, and a third reader was employed to resolve differences in reader interpretations. SETTING University medical center. MAIN OUTCOME MEASURES The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were calculated for the ability of CO2-DSA to demonstrate a 60% or greater stenosis of the main renal artery; kappa values for CO2-DSA and ICA were calculated to assess intraobserver variability. RESULTS Of the 200 main renal arteries imaged, 17 (9 by means of CO2-DSA), 8 means of ICA) were eliminated because of inadequate visualization of the renal artery. In identifying a renal artery stenosis of 60% or greater, CO2-DSA had a sensitivity of 0.83, specificity of 0.99, positive predictive value of 0.94, and negative predictive value of 0.98. The overall accuracy was 0.97. The kappa was 0.75 for CO2-DSA and 0.70 for ICA, hence, the variation in the interpretations of CO2-DSA and ICA were comparable. CONCLUSION Images by means of CO2-DSA accurately reflect pathologic changes in renal arteries and are thus useful in the diagnosis of clinically occult occlusive renal artery disease in patients at risk of contrast medium-related nephrotoxicity.
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Affiliation(s)
- D Z Schreier
- Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA
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Weaver FA, Modrall JG, Baek S, Harvey F, Siegal A, Rosental J, Yellin AE. Syme amputation: results in patients with severe forefoot ischemia. Cardiovasc Surg 1996; 4:81-6. [PMID: 8634853 DOI: 10.1016/0967-2109(96)83790-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Since 1980, 35 patients (age range 40-77 years) with severe forefoot ischemia have undergone a unilateral Syme amputation. Thirty-one patients (89%) were diabetic. The indication for amputation was either extensive forefoot gangrene or ulceration too advanced for a digital or transmetatarsal amputation. Twenty-two amputations (63%) were immediately preceded by either percutaneous transluminal angioplasty (four) or a bypass procedure to the popliteal artery (five) or an infrapopliteal artery (13). Primary healing occurred in 19 (86%) of 22 amputations immediately preceded by revascularization and in 10 (77%) of 13 limbs undergoing amputation alone. Twenty-eight (97%) of the 29 patients with successful primary healing were successfully rehabilitated. Rehabilitation rendered 13 patients fully ambulatory, 15 ambulatory with intermittent use of a walker or cane and one unable to walk. At follow-up of four months to 13 years (mean 42 months), the cumulative ambulatory rate at 1, 3, and 5 years was 92, 80 and 80%, respectively. Syme amputation allows a return to a functional ambulatory status in a high percentage of patients with severe forefoot ischemia. These findings suggest that Syme amputation is an acceptable option in dysvascular patients with severe forefoot ischemia.
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Affiliation(s)
- F A Weaver
- Department of Surgery, University of Southern California School of Medicine, Los Angeles, USA
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Abstract
The true incidence and clinical relevance of fungal infection was ascertained in a prospective study of 50 consecutive patients with acute liver failure. Fungal infection was present in 16 (32%) patients (15 candida, one aspergillus) and in seven was considered the major cause of death. All six untreated died, while five of ten patients treated with anti-fungal therapy survived. The diagnosis was made on positive cultures from at least one significant site or on histological evidence of tissue invasion. All 16 had concomitant bacterial infection and shared features suggestive of a clinical syndrome: deterioration in coma grade after initial improvement; pyrexia unresponsive to antibiotics; established renal failure; and a markedly elevated white cell count. Fungal infection is a common, serious complication of acute liver failure and therapy is indicated for those with positive cultures. A prophylactic trial would be justified in those surviving 5 days, especially, with established renal failure.
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Affiliation(s)
- N Rolando
- Liver Unit, King's College Hospital, London, United Kingdom
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Rolando N, Harvey F, Brahm J, Philpott-Howard J, Alexander G, Gimson A, Casewell M, Fagan E, Williams R. Prospective study of bacterial infection in acute liver failure: an analysis of fifty patients. Hepatology 1990; 11:49-53. [PMID: 2295471 DOI: 10.1002/hep.1840110110] [Citation(s) in RCA: 253] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Fifty consecutive patients admitted with acute liver failure, minimal grade II encephalopathy, were studied prospectively to determine the incidence, timing and cause of bacterial infection, the relationship to clinical criteria for infection; and the influence of early microbiological diagnosis on clinical outcome. There were 53 proven bacterial infections in 40 patients, whereas in 5 of the remaining 10 patients infection was suspected on clinical grounds in the absence of significant cultures. Seven patients (14%) had more than one bacterial infection, and four patients had simultaneous infections caused by different organisms at each site. Fourteen infections (26.4%) were associated with bacteremia, and in six of these no source was found. Twenty-five infections (47.1%) arose from the respiratory tract, 12 (22.6%) from the urinary tract and 2 (3.7%) from central venous cannulas. Thirty-seven (69.8%) of the 53 infections were due to gram-positive bacteria; Staphylococcus aureus accounted for 19 (35.8%) of all the infections. Thirty patients died (60%), 28 of whom had bacterial infection at some time; in 24 of these the infection was diagnosed less than 24 hr before death. All nine deaths that occurred more than 7 days after admission were directly attributable to microbial infection. Clinical features such as elevated temperature and elevated peripheral white blood cell count were poor indicators of bacterial infection because these were absent in 30.2% of cases. These data show that there is a high incidence of bacterial infection early in the course of acute liver failure and suggest that prophylactic antimicrobial therapy, although unproven, might be justified.
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Affiliation(s)
- N Rolando
- Liver Unit, King's College Hospital, London, England
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O'Grady JG, Alexander GJ, Sutherland S, Donaldson PT, Harvey F, Portmann B, Calne RY, Williams R. Cytomegalovirus infection and donor/recipient HLA antigens: interdependent co-factors in pathogenesis of vanishing bile-duct syndrome after liver transplantation. Lancet 1988; 2:302-5. [PMID: 2899720 DOI: 10.1016/s0140-6736(88)92356-2] [Citation(s) in RCA: 208] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The contribution of cytomegalovirus (CMV) infection and its interrelation with HLA antigens in the development of chronic rejection (vanishing bile-duct syndrome--VBDS) was investigated in 101 patients surviving for at least 3 months after liver transplantation. A 1-2 antigen match for HLA DR antigens (30.9% vs 4.5% for zero DR match; p less than 0.002), a zero match for HLA A/B antigens (27.5% vs 10.9% for 1 or more A/B match; p less than 0.05), and active CMV infection (26.3% vs 4.4% for no CMV infection; p less than 0.005) were independently associated with an increased risk of VBDS. The coexistence of a 1-2 HLA DR match and CMV infection carried the highest relative risk (10.1) of VBDS; these two variables were probably interdependent since either alone was associated with a low relative risk (0.45 and 0.5). The association between VBDS and active CMV infection was not a consequence of alterations in immunosuppressive therapy. The findings would be consistent with precipitation of chronic rejection by CMV-induced HLA antigen expression in patients rendered susceptible by the donor/recipient HLA antigen match.
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Affiliation(s)
- J G O'Grady
- Liver Unit, King's College School of Medicine and Dentistry, London
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Abstract
A weight drop technique was used to produce a contusive injury of the spinal cord in the rat. A restricted laminectomy was carried out at T8 and the spinal column stabilized by clamps attached to the spinous processes of adjacent vertebrae. A 2.4-mm-diameter impounder was lowered onto the dura and a 10-g weight dropped 0.0, 2.5, 5.0, 7.5, 10.0, or 17.5 cm onto the impounder. The functional deficit was assessed for 4 weeks after injury and the spinal cord tissue processed for histopathologic analysis. The results indicated that groups of rats (N = 10) subjected to the weight dropped from increasing heights exhibited a graded final functional deficit as measured by scores on a modified Tarlov scale or the mean angle attained in the inclined plane test of Rivlin and Tator. Histopathologic results also indicated the production of graded lesions. Three groups of experimental animals were statistically distinguished corresponding to those with mild, moderate, or severe final functional deficit. The average functional deficit in these injury groups, produced by dropping the weight 2.5, 5.0, or 17.5 cm, respectively, was reproducible in replicate experiments. This model of spinal cord contusion in the rat may be useful in screening putative therapeutic drug regimens for subsequent clinical trials on different groups of patients with spinal cord injury.
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Harvey F. Settling the student's view of entry-level into nursing. Va Nurse 1983; 51:249. [PMID: 6560961] [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: 04/05/2023]
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Harvey F, Edelson J. Species differences in the hepatic microsomal oxidation of nalidixic acid. Arch Int Pharmacodyn Ther 1977; 229:192-8. [PMID: 413504] [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: 12/15/2022]
Abstract
The kinetics of the conversion of nalidixic acid to the 7-hydroxymethyl derivative (M-HNA) by isolated liver microsomes of several common laboratory animal species was studied under optimal conditions. The order of activity was (from greatest activity to least): monkey greater than rabbit greater than mouse greater than rat greater than dog greater than cat. The formation of 7-HNA followed apparent Michaelis-Menton kinetics in all species except the cat; the substrate concentration at half-maximal velocity was highest with mouse microsomes, while the maximum velocity was greatest with monkey microsomes. Cat, dog, mouse and rabbit microsomes formed an additional metabolite, which was identified as 6-hydroxynalidixic acid, 1-ethyl-1,4-dihydro-6-hydroxy-7-methyl-4-oxo-1,8-naphthyridine-3-carboxylic acid (6-HNA); in the cat, this was the major microsomal metabolite.
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Winters JJ, Attlee LC, Harvey F. Paired-associate learning of EMR adolescents and nonretarded children as a function of methods of presentation and training. Am J Ment Defic 1974; 79:70-6. [PMID: 4432887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Wilkus RJ, Harvey F, Ojemann LM, Lettich E. Electroencephalogram and sensory evoked potentials. Findings in an unresponsive patient with pontine infarct. Arch Neurol 1971; 24:538-44. [PMID: 4326200 DOI: 10.1001/archneur.1971.00480360072009] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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