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Gabrielsson A, Tromans S, Newman H, Triantafyllopoulou P, Hassiotis A, Bassett P, Watkins L, Sawhney I, Cooper M, Griffiths L, Pullen A, Roy A, Angus-Leppan H, Rh T, Kinney M, Tittensor P, Shankar R. Awareness of social care needs in people with epilepsy and intellectual disability. Epilepsy Behav 2023; 145:109296. [PMID: 37336133 DOI: 10.1016/j.yebeh.2023.109296] [Citation(s) in RCA: 1] [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: 04/30/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Nearly a quarter of people with intellectual disability (ID) have epilepsy with large numbers experiencing drug-resistant epilepsy, and premature mortality. To mitigate epilepsy risks the environment and social care needs, particularly in professional care settings, need to be met. PURPOSE To compare professional care groups as regards their subjective confidence and perceived responsibility when managing the need of people with ID and epilepsy. METHOD A multi-agency expert panel developed a questionnaire with embedded case vignettes with quantitative and qualitative elements to understand training and confidence in the health and social determinants of people with ID and epilepsy. The cross-sectional survey was disseminated amongst health and social care professionals working with people with ID in the UK using an exponential non-discriminative snow-balling methodology. Group comparisons were undertaken using suitable statistical tests including Fisher's exact, Kruskal-Wallis, and Mann-Whitney. Bonferroni correction was applied to significant (p < 0.05) results. Content analysis was conducted and relevant categories and themes were identified. RESULTS Social and health professionals (n = 54) rated their confidence to manage the needs of people with ID and epilepsy equally. Health professionals showed better awareness (p < 0.001) of the findings/recommendations of the latest evidence on premature deaths and identifying and managing epilepsy-related risks, including the relevance of nocturnal monitoring. The content analysis highlighted the need for clearer roles, improved care pathways, better epilepsy-specific knowledge, increased resources, and better multi-disciplinary work. CONCLUSIONS A gap exists between health and social care professionals in awareness of epilepsy needs for people with ID, requiring essential training and national pathways.
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Affiliation(s)
- A Gabrielsson
- Hertfordshire Partnership University NHS Trust, Hatfield, UK
| | - S Tromans
- University of Leicester, Leicester, UK; Leicestershire Partnership NHS Trust, Leicester, UK
| | - H Newman
- University of Plymouth Peninsula School of Medicine, Plymouth, UK
| | | | | | | | - L Watkins
- University of South Wales, Pontypridd, UK; Swansea Bay University Health Board, Port Talbot, UK
| | - I Sawhney
- Hertfordshire Partnership University NHS Trust, Hatfield, UK
| | - M Cooper
- National Development Team for Inclusion Bath, UK
| | - L Griffiths
- National Development Team for Inclusion Bath, UK
| | | | - A Roy
- Coventry and Warwickshire Partnership Trust, Birmingham, UK
| | | | | | - M Kinney
- Belfast Health and Social Trust, Belfast, UK
| | - P Tittensor
- Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - R Shankar
- University of Plymouth Peninsula School of Medicine, Plymouth, UK; Cornwall Partnership NHS Foundation Trust, Truro, UK.
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Horta F, Newman H, Vargas-ordaz E, Cadarso V, Nosrati R, Neild A, Vollenhoven B, Mercer S, Catt S. P-237 Non-invasive metabolic live cell imaging of early embryo development using adapted confocal microscopy; a safety study. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is it safe to use metabolic imaging to measure nicotinamide adenine dinucleotide (NADH) associated auto-fluorescence during embryo development using adapted confocal microscopy?
Summary answer
Non-invasive metabolic imaging is safe as no differences were observed between controls and illuminated embryos in terms of embryo development, blastocyst formation and implantation potential.
What is known already
Developing non-invasive methods that are reliable to assess oocyte and embryo quality has been a significant aim for assisted reproductive technologies. Changes in metabolic activity could lead to cell death or abnormal embryo development and low implantation potential. This could potentially be predicted by incorporating non-invasive measurements of metabolism. Metabolic imaging in embryos has been investigated through complex methodologies, however, scientific evidence for its utility during embryo development using simple technology remains unexplored. Measurements of metabolic activity could be a useful tool as the auto-fluorescence of molecules such as NADH is a straightforward representation of mitochondrial function.
Study design, size, duration
Super-ovulated female mice (n = 30) were subjected to mating with 10 males. In-vivo produced embryos collected at the 2-cell stage were divided in control group (n = 151), sham control group (n = 151) and illuminated group (n = 152). Illuminated embryos were assessed for NADH levels during embryo development every 3 hours using arbitrary units of autofluorescence (AU). Produced blastocysts were assessed for total cell and inner-cell-mass (ICM) number (Oct4 immuno-staining) and implantation potential through outgrowth assays in separate experiments.
Participants/materials, setting, methods
F1 (CBA/C57Bl6) mouse strain was used. NADH auto-fluorescence levels were measured during embryo development using adapted confocal microcopy (Olympus FV1200). A confocal Z-stacking function was used to record 15 focal planes using a 20x/0.95NA air objective of entire embryos, opening the confocal pinhole system completely. Then, images were collected and analysed using FIJI software (version: 2.0.0-rc-69/1.52n;ImageJ). Blastocyst cell number, formation rates and outgrowth rates for 4 days post blastocyst formation were compared between study groups.
Main results and the role of chance
Embryo culture experiments showed no significant differences in blastocyst formation rates between study groups (Control: 71.7%; Sham: 64.9%; Illuminated 71.7%; p > 0.05). Similarly, the total number of cells (Control: 82.9±5.6; Sham: 76.5±3.3; Illuminated: 77.1±4.2; ± Standard error of mean [SEM]) and ICM cells (Control: 10.8±1.3; Sham: 9.4±0.7; Illuminated: 11.9±0.8; ± SEM) did not differ between groups (p > 0.05). Outgrowth assays presented similar outgrowth areas during day5 to day8 post-blastocyst development between study groups (p > 0.05). Illuminated embryos presented significantly different NADH activity levels during embryo development, particularly between the 2-cell stage (987.1±36.2AU), morulae stage (1226±31.5AU) and blastocyst stage (649±42.9AU; ± SEM; p < 0.05). Embryos that did not reach the blastocyst stage presented a significantly different NADH activity profile during embryo development compared to those that did(p < 0.05). Additionally, abnormal embryos also presented significantly decreased NADH activity levels at the 2-cell stage (Normal: 987.1±36.2; abnormal: 726.9±121.7AU; p < 0.05) to the morulae stage (Normal: 1226±31.5; Abnormal:893.3±189AU; p < 0.05). Our study indicates that measuring NADH activity levels during early embryo development present no negative effects in embryo developmental rates, blastocyst formation and implantation potential. Thus, non-invasive measurements of NADH could be applied to determine embryo metabolic activity during embryo development using simple technology and imaging techniques.
Limitations, reasons for caution
The study was conducted using a mouse model focused in early embryo development and implantation potential. Thus, studies on live birth are required to fully assess safety to further validate potential wider applications. Validation in ageing models is also required to assess potential applications for embryo selection.
Wider implications of the findings
Non-invasive measurements of metabolic activity could be applied to determine embryo metabolic activity using simple and safe technology. Further applications could link the use of simple non-invasive metabolic imaging with the latest time-lapse technology and artificial intelligence applications.
Trial registration number
N/A
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Affiliation(s)
- F Horta
- Monash University, Obstetrics and Gynaecology , Melbourne, Australia
- Monash IVF, Research and ARTs , Melbourne, Australia
| | - H Newman
- Monash University, Obstetrics and Gynaecology , Melbourne, Australia
| | - E Vargas-ordaz
- Monash University, Mechanical and Aerospace Engineering , Melbourne, Australia
| | - V Cadarso
- Monash University, Mechanical and Aerospace Engineering , Melbourne, Australia
| | - R Nosrati
- Monash University, Mechanical and Aerospace Engineering , Melbourne, Australia
| | - A Neild
- Monash University, Mechanical and Aerospace Engineering , Melbourne, Australia
| | - B Vollenhoven
- Monash University, Obstetrics and Gynaecology , Melbourne, Australia
| | - S Mercer
- Monash University, Monash Microimaging , Melbourne, Australia
| | - S Catt
- Monash University, Obstetrics and Gynaecology , Melbourne, Australia
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Newman H, Catt S, Vining B, Vollenhoven B, Horta F. DNA repair and response to sperm DNA damage in oocytes and embryos, and the potential consequences in ART: a systematic review. Mol Hum Reprod 2021; 28:6483093. [PMID: 34954800 DOI: 10.1093/molehr/gaab071] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Sperm DNA damage is considered a predictive factor for the clinical outcomes of patients undergoing ART. Laboratory evidence suggests that zygotes and developing embryos have adopted specific response and repair mechanisms to repair DNA damage of paternal origin. We have conducted a systematic review in accordance with guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify and review the maternal mechanisms used to respond and repair sperm DNA damage during early embryonic development, how these mechanisms operate and their potential clinical implications. The literature search was conducted in Ovid MEDLINE and Embase databases until May 2021. Out of 6297 articles initially identified, 36 studies were found to be relevant through cross referencing and were fully extracted. The collective evidence in human and animal models indicate that the early embryo has the capacity to repair DNA damage within sperm by activating maternally driven mechanisms throughout embryonic development. However, this capacity is limited and likely declines with age. The link between age and decreased DNA repair capacity could explain decreased oocyte quality in older women, poor reproductive outcomes in idiopathic cases, and patients who present high sperm DNA damage. Ultimately, further understanding mechanisms underlying the maternal repair of sperm DNA damage could lead to the development of targeted therapies to decrease sperm DNA damage, improved oocyte quality to combat incoming DNA insults or lead to development of methodologies to identify individual spermatozoa without DNA damage.
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Affiliation(s)
- H Newman
- Education Program in Reproduction & Development, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
| | - S Catt
- Education Program in Reproduction & Development, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia
| | - B Vining
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Melbourne, VIC 3168, Australia.,Department of Molecular and Translational Science, Monash University, Melbourne, VIC, 3800, Australia
| | - B Vollenhoven
- Education Program in Reproduction & Development, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia.,Monash IVF, Melbourne, VIC, 3168, Australia.,Women's and Newborn Program, Monash Health, VIC, 3169, Australia
| | - F Horta
- Education Program in Reproduction & Development, Department of Obstetrics and Gynecology, Monash University, Melbourne, VIC 3168, Australia.,Monash IVF, Melbourne, VIC, 3168, Australia
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Newman H, Smale H, Barrie A, Campbell A. P–223 The necrotic oocyte: does the uncontrolled release of cell contents affect adjacently, group cultured embryos? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is embryo utilisation rate, embryo morphokinetics and the incidence of irregular divisions affected when embryos are group-cultured adjacent to a necrotic oocyte?
Summary answer
This study demonstrates that embryos cultured adjacent to necrotic oocytes appear to be unaffected both in terms of utilisation, morphokinetics and incidence of irregular divisions.
What is known already
Necrosis is a form of uncontrolled cell death, usually resulting from external injury, causing the cell’s contents to release into the surrounding environment1. A cell undergoing necrosis will first visibly swell before the collapse of the plasma membrane causes it to subsequently shrink and the cell to lyse2. An escalation of inflammation occurs due to the release of intracellular factors3. Neighbouring embryos are believed to be negatively affected by a necrotic oocyte with some laboratories choosing to remove necrotic oocytes from culture dishes, however, little is known regarding this impact.
Study design, size, duration
The project was a single site, retrospective cohort analysis using time-lapse data from August 2017 to December 2018. Only patients with at least one necrotic oocyte, a minimum of one adjacent embryo to the necrotic oocyte and those cultured in the EmbryoScope+® were included in the analysis.
Participants/materials, setting, methods
The study included 868 embryos from 89 patients. The embryos were categorised as adjacent to a necrotic oocyte (group 1, n = 208) and not adjacent to a necrotic oocyte (group 2, n = 660). The utilisation rate and irregular division rate were analysed using a Chi-squared test, the morphokinetic parameters was analysed using a t-test. Morphokinetic data included; tPB2, tPNa, tPNf, t2, t3, t4, t5, t6, t7, t8, t9, tSC, tM, tSB and tB.
Main results and the role of chance
Utilisation rate between the two groups was not significantly different (group 1; 40.9% versus group 2; 47.6%, p = 0.09). Incidence of irregular division was not significantly different between the two groups (group 1; 24.0% vs group 2; 21.7%, p = 0.51). No morphokinetic parameter was statistically significantly different when comparing group 1 to group 2, respectively: tPB2, 3.61 vs 3.73, p = 0.38; tPNa, 7.01 vs 6.91, p = 0.59; tPNf, 23.64 vs 23.66, p = 0.95; t2, 3.44 vs 2.98, p = 0.09; t3, 14.56 vs 14.41, p = 0.75; t4, 15.96 vs 15.8, p = 0.77; t5, 15.96 vs 15.8, p = 0.77; t6, 30.33 vs 30.46, p = 0.86; t7, 33.11 vs 33.16, p = 0.95; t8, 37.93 vs 36.92, p = 0.34; t9, 48.66 vs 48.97, p = 0.73; tSC, 58.04 vs 57.89, p = 0.88; tM, 74.02 vs 73.76, p = 0.8; tSB, 75.55 vs 75.42, p = 0.9; tB, 87.06 vs 87.2, p = 0.91.
Limitations, reasons for caution
The time at which the oocytes became necrotic was not analysed therefore the effect, if any, of exposure time could not be determined. Of the 169 necrotic oocytes, two were from IVF and 167 from ICSI; the increased exposure of the embryos derived from ICSI was not controlled for.
Wider implications of the findings: Necrotic oocytes are easily identified in standard culture observations and in time-lapse imaging, therefore, their removal may be an unnecessary practice. More harm could be caused by removing the dish from the incubator, as this would unnecessarily expose any viable embryos contained within the dish to a suboptimal environment.
Trial registration number
Not applicable
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Affiliation(s)
- H Newman
- CARE Fertility Chester, Embryology, Chester, United Kingdom
| | - H Smale
- CARE Fertility Chester, Embryology, Chester, United Kingdom
| | - A Barrie
- CARE Fertility Chester, Embryology, Chester, United Kingdom
| | - A Campbell
- CARE Fertility UK, Embryology, Nottingham, United Kingdom
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Newman H, Jilin H, Zhu B, Bradford L, Gao G. Evaluation of portable colposcopy and HPV testing for screening of cervical cancer in rural China. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Newman H, Angus-Leppan H. Dealer's Dytonia (Croupier's Cramp) - An Unusual Hazard Of Gambling. Acute Med 2019; 18:124-126. [PMID: 31127803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Dystonia takes many forms and often presents acutely to emergency care. The diagnosis is often delayed because it mimics other more common conditions. This report describes a patient with a rare occupational dystonia, the typical clinical features of dystonia in general, and differentials to consider.
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Abstract
SummaryA segmental radial defect model was used to radiographically and histologically evaluate response to ratite cancellous xenograft in pigeons. The control group showed little evidence of callus production with all fractures proceeding to nonunion. Lymphocytic response to xenograft peaked at four weeks and diminished thereafter. Fractures treated with cancellous xenograft had significant increases in new bone production.
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8
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Lehn A, Sowden D, Anstey C, Stephensen B, Newman H. Patients with Bacteraemia Discharged from the Department of Emergency Medicine: Distribution of Organisms and Associated Characteristics. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791201900506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Although blood cultures are commonly used to investigate febrile patients presenting to an emergency department, treatment decisions usually have to be made before the results are available. Methods We performed a retrospective analysis of consecutive patients presenting with community-acquired bacteraemia at the emergency department of Nambour Hospital, Queensland, Australia between 2000 and 2008. We determined their clinical characteristics, the distribution of organisms and also assessed patient characteristics associated with discharge from the emergency department. Results A total of 885 patients with 915 presentations of community-acquired bacteraemia were included. While having bacteraemia, 33 patients (3.6%) were discharged from the emergency department. Age, mode of presentation, altered mental state, presence of immunocompromise, presence of respiratory distress, C reactive protein, Charlson score, age score and estimated 10 years survival were significant factors discriminating the admitted from discharged patients. The most commonly found organism in blood cultures of discharged patients was Staphylococcus aureus (27.3%), whereas in admitted patients it was E. coli (27.7%). Methicillin-resistant Staphylococcus aureus accounted for 1.7% of cases of community-acquired bacteraemia. Conclusions Emergency physicians only rarely discharge patients with community-acquired bacteraemia using current assessment tools and decision-making rules. However, they tend to discharge younger self-presenting patients with good baseline function.
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Affiliation(s)
| | - D Sowden
- Nambour General Hospital, Department of Infectious Diseases, Hospital Road, Nambour QLD 4560, Australia; David Sowden, MBBS
| | - C Anstey
- Nambour General Hospital, Department of Intensive Care Medicine, Hospital Road, Nambour QLD 4560, Australia; Chris Anstey, MBBS, FANZCA, FCICM
| | - B Stephensen
- Nambour General Hospital, Department of Surgery, Hospital Road, Nambour QLD, 4560 Australia; Bree Stephensen, MBBS, BSc
| | - H Newman
- Nambour General Hospital, Department of Anaesthetics, Hospital Road, Nambour QLD 4560, Australia; Helen Newman, MBBS
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Jain S, Edgar D, Bothe J, Harris J, Newman H, Wilson A, Bint B, Brown M, Alexander S. Reflection on observation: A qualitative study using practice development methods to explore the experience of being a hand hygiene auditor in Australia. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.620] [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] Open
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10
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Sindone A, Erlich J, Lee C, Newman H, Suranyi M, Roger SD. Cardiovascular risk reduction in hypertension: angiotensin-converting enzyme inhibitors, angiotensin receptor blockers. Where are we up to? Intern Med J 2016; 46:364-72. [DOI: 10.1111/imj.12975] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/05/2015] [Accepted: 11/16/2015] [Indexed: 11/26/2022]
Affiliation(s)
- A. Sindone
- Heart Failure Unit and Department of Cardiac Rehabilitation; Concord Repatriation General Hospital; Concord New South Wales Australia
| | - J. Erlich
- Faculty of Medicine; University of NSW; Sydney New South Wales Australia
- Department of Nephrology; Prince of Wales Hospital; Sydney New South Wales Australia
| | - C. Lee
- Department of Cardiology; Nepean Hospital; Sydney New South Wales Australia
| | - H. Newman
- Department of Cardiology; Liverpool Hospital; Sydney New South Wales Australia
| | - M. Suranyi
- Liverpool Renal Clinical Research Centre; Liverpool Hospital; Sydney New South Wales Australia
| | - S. D. Roger
- Department of Renal Medicine; Gosford Hospital; Gosford New South Wales Australia
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Duberstein K, Lalvani S, Cobb L, Newman H. 32 An assessment of gait symmetry at the trot in non-loaded horses compared with symmetrical and asymmetrical load distribution. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2015.03.040] [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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12
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Newman H. Charles Christopher Hunter. Assoc Med J 2014. [DOI: 10.1136/bmj.g1876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Hanson G, Leong J, Newman H, Law ME, Litke A, Madaras R, Wilson R, Hofmann A, Law L, Little R, Paterson JM, Pordes R, Strauch K, Tarnopolsky G. Experimental test of quantum electrodynamics for the reaction e+e−→γγ at 4 GeV center-of-mass energy. ACTA ACUST UNITED AC 2007. [DOI: 10.1007/bf02727692] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lo DS, Zeldin RA, Skrastins R, Fraser IM, Newman H, Monavvari A, Ung Y, Joseph H, Downton T, Meharchand J. Time to treat: A system redesign focusing on decreasing the time from suspicion of lung cancer to diagnosis in a community hospital. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.17005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17005 Background: Multiple physician visits, numerous investigations, and serial wait times often result in a lengthy process from the onset of lung cancer-related symptoms until diagnosis. An unpublished retrospective chart review from a Toronto community hospital indicated suboptimal delays for patients from onset of symptoms until the diagnosis of lung cancer. Methods: The Time to Treat Program (TTT), consisting of a streamlined referral system and a clerical facilitator to fast-track patients through a diagnostic pathway algorithm, was designed for patients with clinical or radiological suspicion of lung cancer. Data on patient visits and investigations were collected. Pre- and post-implementation data on median wait times were compared. Results: From April 2005 to December 2006 over 120 physicians referred 188 females and 226 males. For the majority of patients (95.2%), the reason for referral was chest x-ray findings suspicious for lung cancer. After TTT implementation, the median time from suspicion of lung cancer to referral for specialist consultation decreased from 19.9 days to 10 days, and the median time from such referral to the actual consultation date decreased from 16.8 days to 5.3 days. The median time from specialist consultation to CT scan decreased from 52.1 days to 4 days and the median time from CT to diagnosis decreased from 39 days to 12.4 days. Overall, the median time from suspicion of lung cancer to diagnosis decreased from 127.8 days to 30 days. For 25% of the patients in the TTT it took 13 or fewer days from suspicion of lung cancer to diagnosis, while for 5% of the patients it took 90 days or more. Half of the patients in the TTT had a diagnosis by 24 days from the time of suspicion. Of all patients in the TTT, 33% were eventually diagnosed with lung cancer. The time from suspicion to diagnosis took longer for patients who eventually had confirmed lung cancer than those who did not: 36.5 days vs. 28.7 days. Conclusions: By addressing process issues in the work-up of lung cancer, the TTT was effective in shortening the time from suspicion of lung cancer to diagnosis and reduced time intervals at each step in the process. Earlier diagnosis of lung cancer may allow increased treatment options for patients. No significant financial relationships to disclose.
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Affiliation(s)
- D. S. Lo
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - R. A. Zeldin
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - R. Skrastins
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - I. M. Fraser
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - H. Newman
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - A. Monavvari
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - Y. Ung
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - H. Joseph
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - T. Downton
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
| | - J. Meharchand
- University of Toronto, Toronto, ON, Canada; Toronto East General Hospital, Toronto, ON, Canada; Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
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Newman H, Cavanaugh R, Bunn J, Legrand I, Low S, Nae D, Ravot S, Steenberg C, Xun Su, Thomas M, van Lingen F, Yang Xia, McKee S. The UltraLight Project: The Network as an Integrated and Managed Resource for Data-Intensive Science. Comput Sci Eng 2005. [DOI: 10.1109/mcse.2005.127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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16
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Madden IM, Newman H, Hall C, Brading MG, Ketkar V, Bidinger PD. Sustained oral health improvement and use of toothbrushes and dentifrice by previous users of traditional materials in a rural population in Andhra Pradesh, India. Int Dent J 2004; 54:315-20. [PMID: 15509083 DOI: 10.1111/j.1875-595x.2004.tb00005.x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIM To follow-up, one year later, a double-blind, randomised study, which investigated the effect of regular brushing with dentifrices on the oral health of an economically disadvantaged rural population in Andhra Pradesh, India who were primarily users of traditional materials. SUBJECTS 150 of the original study population. METHOD Examination to determine whether the improvements in oral health status and oral health behaviour (use of toothbrush and dentifrice), being unsupported, had been sustained since completion of the original study. RESULTS Data analysis showed sustained, statistically significant improvements in gingival health as measured by gingival bleeding and plaque indices (GBI and PI) comparing users and non-users of toothbrushes and dentifrice in the original study (PI: p = 0.04; GBI: p = 0.03) and sustained use of toothbrushes and dentifrice by 60% of the subjects at follow-up one year later. CONCLUSIONS This study shows a beneficial effect on oral hygiene indices following the introduction of toothbrushes and dentifrices to a community using traditional oral hygiene materials and sustainability of use of these materials with motivation and support. It may therefore be concluded that it is feasible to achieve significant use of conventional toothbrushes and toothpastes, with consequent major and sustained improvements in plaque control and gingival health in a disadvantaged population hitherto often considered as not amenable to conventional oral hygiene for cultural or economic reasons.
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Affiliation(s)
- I M Madden
- Eastman Dental Institute, University College London, UK.
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Bromidge SM, Griffith K, Heightman TD, Jennings A, King FD, Moss SF, Newman H, Riley G, Routledge C, Serafinowska HT, Thomas DR. Novel (4-piperazin-1-ylquinolin-6-yl) arylsulfonamides with high affinity and selectivity for the 5-HT(6) receptor. Bioorg Med Chem Lett 2001; 11:2843-6. [PMID: 11597412 DOI: 10.1016/s0960-894x(01)00558-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The discovery of (4-piperazin-1-ylquinolin-6-yl) arylsulfonamides and their binding affinities for a selection of 5-HT and dopamine subreceptors is described. Many compounds show high affinity (pK(i)>8) for the 5-HT(6) receptor and >100-fold selectivity against a range of other receptors. Structure-activity relationships of these compounds are discussed.
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Affiliation(s)
- S M Bromidge
- Discovery Chemistry Europe, GlaxoSmithKline, Discovery Research, New Frontiers Science Park, Third Avenue, Harlow, CM19 5AW, Essex, UK
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18
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Abstract
Particulate Bioglass is a bioactive material used in the repair of periodontal defects. This material undergoes a series of surface reactions in an aqueous environment which lead to osseointegration. The aim of this study was to determine whether these reactions exerted an antibacterial effect on a range of oral bacteria. Streptococcus sanguis, Streptococcus mutans and Actinomyces viscosus were suspended in nutrient broth (NB), artificial saliva (AS) or Dulbecco's modified eagle medium plus 10% foetal calf serum (DMEM + 10%FCS), with or without particulate Bioglass. All bacteria showed reduced viability following exposure to Bioglass in all the media after 1 h. This antibacterial effect increased after 3 h. Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia and Actinobacillus actinomycetemcomitans were suspended in either BM broth or 40% horse serum (HS) in RPMI. A considerable reduction in viability was observed with all bacteria tested, in both media, compared to inert glass controls. In further experiments it was found that the viability of S. sanguis was significantly reduced following exposure to NB pre-incubated with Bioglass. Additionally, it was found that neutralisation of this highly alkaline solution eliminated the antibacterial effect. Moreover, a solution of NB and NaOH (of equivalent pH) exerted an antibacterial effect of similar magnitude to that of the solution pre-incubated with Bioglass. Thus, particulate Bioglass exerts an antibacterial effect on certain oral bacteria, possibly by virtue of the alkaline nature of its surface reactions. This may reduce bacterial colonisation of its surface in vivo.
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Affiliation(s)
- I Allan
- Department of Microbiology, Eastman Dental Institute, University College London, UK.
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19
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Bromidge SM, Clarke SE, Gager T, Griffith K, Jeffrey P, Jennings AJ, Joiner GF, King FD, Lovell PJ, Moss SF, Newman H, Riley G, Rogers D, Routledge C, Serafinowska H, Smith DR. Phenyl benzenesulfonamides are novel and selective 5-HT6 antagonists: identification of N-(2,5-dibromo-3-fluorophenyl)-4-methoxy-3-piperazin-1-ylbenzenesulfonamide (SB-357134). Bioorg Med Chem Lett 2001; 11:55-8. [PMID: 11140733 DOI: 10.1016/s0960-894x(00)00597-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Substituted N-phenyl-4-methoxy-3-piperazin-1-ylbenzenesulfonamides and conformationally restricted analogues have been identified as high affinity and selective 5-HT6 antagonists. Compounds from this series had a range of pharmacokinetic profiles in rat and in general there was a correlation between clearance and CNS penetration. Based on its overall biological profile 2 (SB-357134) was selected for further pre-clinical evaluation.
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Affiliation(s)
- S M Bromidge
- Discovery Chemistry Europe, SmithKline Beecham Pharmaceuticals, Discovery Research, Harlow, Essex, UK.
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20
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Hillary F, Schatz P, Newman H, Chute D. Vehicular factors affect injury location, severity and outcome. Arch Clin Neuropsychol 2000. [DOI: 10.1093/arclin/15.8.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Routledge C, Bromidge SM, Moss SF, Price GW, Hirst W, Newman H, Riley G, Gager T, Stean T, Upton N, Clarke SE, Brown AM, Middlemiss DN. Characterization of SB-271046: a potent, selective and orally active 5-HT(6) receptor antagonist. Br J Pharmacol 2000; 130:1606-12. [PMID: 10928964 PMCID: PMC1572216 DOI: 10.1038/sj.bjp.0703457] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.9] [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: 11/05/1999] [Revised: 03/30/2000] [Accepted: 05/04/2000] [Indexed: 11/09/2022] Open
Abstract
SB-271046, potently displaced [(3)H]-LSD and [(125)I]-SB-258585 from human 5-HT(6) receptors recombinantly expressed in HeLa cells in vitro (pK(i) 8.92 and 9.09 respectively). SB-271046 also displaced [(125)I]-SB-258585 from human caudate putamen and rat and pig striatum membranes (pK(i) 8.81, 9.02 and 8.55 respectively). SB-271046 was over 200 fold selective for the 5-HT(6) receptor vs. 55 other receptors, binding sites and ion channels. In functional studies on human 5-HT(6) receptors SB-271046 competitively antagonized 5-HT-induced stimulation of adenylyl cyclase activity with a pA(2) of 8.71. SB-271046 produced an increase in seizure threshold over a wide-dose range in the rat maximal electroshock seizure threshold (MEST) test, with a minimum effective dose of < or =0.1 mg kg(-1) p.o. and maximum effect at 4 h post-dose. The level of anticonvulsant activity achieved correlated well with the blood concentrations of SB-271046 (EC(50) of 0.16 microM) and brain concentrations of 0.01-0.04 microM at C(max). These data, together with the observed anticonvulsant activity of other selective 5-HT(6) receptor antagonists, SB-258510 (10 mg kg(-1), 2-6 h pre-test) and Ro 04-6790 (1-30 mg kg(-1), 1 h pre-test), in the rat MEST test, suggest that the anticonvulsant properties of SB-271046 are likely to be mediated by 5-HT(6) receptors. Overall, these studies demonstrate that SB-271046 is a potent and selective 5-HT(6) receptor antagonist and is orally active in the rat MEST test. SB-271046 represents a valuable tool for evaluating the in vivo central function of 5-HT(6) receptors.
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Affiliation(s)
- C Routledge
- Department of Neuroscience Research, SmithKline Beecham Pharmaceuticals, New Frontiers Science Park, Third Avenue, Harlow, Essex, CM19 5AW.
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22
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Battino M, Bullon P, Wilson M, Newman H. Oxidative injury and inflammatory periodontal diseases: the challenge of anti-oxidants to free radicals and reactive oxygen species. Crit Rev Oral Biol Med 2000; 10:458-76. [PMID: 10634583 DOI: 10.1177/10454411990100040301] [Citation(s) in RCA: 210] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In recent years, there has been a tremendous expansion in medical and dental research concerned with free radicals, reactive oxygen species, and anti-oxidant defense mechanisms. This review is intended to provide a critical, up-to-date summary of the field, with particular emphasis on its implications for the application of "anti-oxidant therapy" in periodontal disease. We have reviewed the nomenclature, mechanisms of actions, features, and sources of most common free radicals and reactive oxygen species, as well as analyzed the typical biological targets for oxidative damage. Based on a review of direct and indirect anti-oxidant host defenses, particularly in relation to the key role of polymorphonuclear neutrophils in periodontitis, we review current evidence for oxidative damage in chronic inflammatory periodontal disease, and the possible therapeutic effects of anti-oxidants in treating and/or preventing such pathology, with special attention to vitamin E and Co-enzyme Q.
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Affiliation(s)
- M Battino
- Institute of Biochemistry, Faculty of Medicine, University of Ancona, Italy
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Gregor A, Lind M, Newman H, Grant R, Hadley DM, Barton T, Osborn C. Phase II studies of RMP-7 and carboplatin in the treatment of recurrent high grade glioma. RMP-7 European Study Group. J Neurooncol 1999; 44:137-45. [PMID: 10619497 DOI: 10.1023/a:1006379332212] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The selective bradykinin analogue, RMP-7, transiently increases the permeability of the blood brain barrier and the delivery of hydrophilic agents into brain tumours. In 87 recurrent glioma patients (WHO Grade III/IV, median age 46, Karnofsky 70%) clinical and Magnetic Resonance Imaging (MRI) responses to i.v. cycles (q 28 days) of RMP-7 (300 ng/kg given as a 10 min infusion) and carboplatin (AUC 4-9) were assessed. 45 of these patients were chemotherapy naive (CN-RMP) and 42 had received one prior course of chemotherapy (CP-RMP). Neurological impairment, performance status and steroid use were measured prior to dosing at each cycle and tumour volume by 3-D MRI at the end of cycles 2, 4, 6, 9 and 12. Clinical evaluation of response demonstrated that 61% of CN-RMP patients were either stable or improved whilst this was 39% for CP-RMP patients, of which 37% and 8% improved respectively. Radiological evaluation showed 79% of CN-RMP patients were either stable, partial or complete responses and 24% for CP-RMP patients, of which 32% and 5% were CR or PR respectively. The median duration of response was 30.3 weeks in CN-RMP patients and 19.6 weeks in the CP-RMP group. Lack of response was associated with substantial baseline tumour volume. Drug toxicity was as previously reported for carboplatin. 11 patients had treatment-associated transient focal seizures. These results indicate that RMP-7 and carboplatin have significant activity in recurrent malignant glioma following radiotherapy.
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Affiliation(s)
- A Gregor
- Department of Clinical Oncology, University of Edinburgh, Western General Hospital, UK
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24
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Purinton SC, Newman H, Castro MI, Wood CE. Ontogeny of estrogen sulfatase activity in ovine fetal hypothalamus, hippocampus, and brain stem. Am J Physiol 1999; 276:R1647-52. [PMID: 10362743 DOI: 10.1152/ajpregu.1999.276.6.r1647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ovine parturition is initiated by increases in fetal hypothalamus-pituitary-adrenal (HPA) axis activity, which in turn increase placental estrogen biosynthesis and ultimately increase uterine contractility. In addition to the action in the uterus, estrogens augment fetal ACTH secretion. In late gestation, estrone sulfate is more abundant in fetal plasma than is unconjugated estrone. We studied hypothalamus, hippocampus, and brain stem tissue from fetal, neonatal, and adult sheep to test the hypothesis that the ovine brain contains estrogen sulfatase activity. We found that the activity in the hippocampus was significantly increased in late-gestation fetuses compared with both younger and older animals. No significant change in either hypothalamus or brain stem was revealed; however, the activity in all brain areas was high. Immunohistochemistry revealed the presence of estrogen sulfatase in the paraventricular nucleus of the hypothalamus, the nucleus of the solitary tract, and the rostral ventrolateral medulla. We conclude that ovine fetal hypothalamus, hippocampus, and brain stem contain estrogen sulfatase activity and that the activity in the hippocampus is developmentally regulated.
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Affiliation(s)
- S C Purinton
- Department of Physiology, College of Medicine, University of Florida, Gainesville, Florida 32610, USA
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25
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Bromidge SM, Brown AM, Clarke SE, Dodgson K, Gager T, Grassam HL, Jeffrey PM, Joiner GF, King FD, Middlemiss DN, Moss SF, Newman H, Riley G, Routledge C, Wyman P. 5-Chloro-N-(4-methoxy-3-piperazin-1-yl- phenyl)-3-methyl-2-benzothiophenesulfon- amide (SB-271046): a potent, selective, and orally bioavailable 5-HT6 receptor antagonist. J Med Chem 1999; 42:202-5. [PMID: 9925723 DOI: 10.1021/jm980532e] [Citation(s) in RCA: 151] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S M Bromidge
- Departments of Medicinal Chemistry, SmithKline Beecham Pharmaceuticals, Discovery Research, New Frontiers Science Park, Third Avenue, Harlow, Essex CM19 5AW, England, UK
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26
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Abstract
Interleukin 6 (IL-6) is a multi-functional cytokine which has a major role in tissue damage. It is secreted by many types of cell, including oral fibroblasts, and has been implicated in the pathogenesis of periodontal diseases, particularly those associated with sex hormones. In the present study we investigated whether the androgen dihydrotestosterone (DHT) affects the expression and regulation of IL-6 in gingival fibroblasts. Using a 'capture' ELISA assay, it was found that increasing DHT concentrations progressively reduced IL-6 production by gingival cells from normal individuals and from patients with gingival inflammation and gingival hyperplasia. In contrast, cells from periodontal ligament tissue produced only barely detectable levels of IL-6. The anti-androgen cyproterone acetate acted as an androgen analogue in the gingival fibroblasts, potently inhibiting IL-6 production, and did not reverse the DHT-mediated downregulation of the cytokine. Flutamide also failed to abrogate DHT inhibition of IL-6 production, and it had no effect on IL-6 production in the absence of DHT. Moreover, semi-quantitative RT-PCR showed that DHT acted at the level of transcription of the IL-6 gene, causing a marked reduction in the relative level of IL-6 mRNA in the gingival cells.
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Affiliation(s)
- M Parkar
- Department of Periodontology, Eastman Dental Institute for Oral Health Care Sciences, University of London, UK
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27
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Newman H. Do not confuse the bone loss of periodontitis with root exposure due to supereruption. Factors affecting the lifespan of the human dentition in Britain prior to the seventeenth century. Br Dent J 1998; 184:229. [PMID: 9606077 DOI: 10.1038/sj.bdj.4809649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- H Newman
- Department of Periodontology, Eastman Dental Institute for Oral Health Care Sciences
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Wood CE, Barkoe D, The A, Newman H, Cudd TA, Purinton S, Castro MI. Fetal pulmonary immunoreactive adrenocorticotropin: molecular weight and cellular localization. Regul Pept 1998; 73:191-6. [PMID: 9556082 DOI: 10.1016/s0167-0115(98)00004-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The hypothalamus-pituitary-adrenal axis of the sheep fetus plays a critical role in fetal development, responsiveness to stress, and initiation of parturition. We have recently reported that the fetal lung contains and secretes significant amounts of immunoreactive adrenocorticotropin (iACTH). The present study was designed to identify the molecular weight profile and the cellular location of iACTH in this tissue. iACTH extracted from fetal lung was immunoprecipitated, electrophoresed, and immunoblotted. Pulmonary iACTH was found in several molecular forms. The largest peptides appeared as doublets, and had molecular weights similar to POMC (32, 33 kD). Smaller peptides appeared in molecular weights (17, 24, and 27 kD) which were not consistent with the post-translational processing of POMC in fetal pituitary, but which were consistent with known processing of POMC by chromaffin granule aspartyl protease. None of the molecular forms of iACTH were glycosylated. Immunohistochemistry revealed that the iACTH was contained within bronchial epithelium and within groups of cells within the parenchyma of the lung. Both of these types of cells are consistent with pulmonary neuroendocrine cells. The distribution of neuroendocrine cells and apparent concordance with the iACTH-positive cells was confirmed by immunostaining for neuron specific enolase, a marker for neuroendocrine cells within the lung. We conclude that the lung contains unprocessed and partially processed POMC within cells known to contain neuropeptides. We speculate that secretion of the POMC-related peptides from these cells is physiologically important in the late-gestation fetus.
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Affiliation(s)
- C E Wood
- Department of Physiology, University of Florida College of Medicine, Gainesville 32610, USA.
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29
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Abstract
OBJECTIVE The purpose of this study was to evaluate the technique of cortical optical imaging (COI) of intrinsic cortical optical signals related to neuronal activation. The specific goals of the study were to evaluate some of the technical aspects of COI and thus maximize the intensity of the image of this intrinsic signaling process and to determine the physiological reliability of COI in a well-defined animal system. METHODS The intrinsic optical signal of activated whisker barrel cortex of rat was imaged using a computer-based technique for rapid acquisition of enhanced images. Single-unit microelectrode recordings of cortical neuronal responses to whisker movement were used to confirm the locations of the whisker barrels. RESULTS Narrow band incident light at 600- to 610-nm wavelength was most effective for producing optical images. Images could be obtained during activation by a single long (40 s) stimulus or by averaging the signal generated by repeated shorter (1-8 s) stimuli. Focusing slightly below the cortical surface, minimizing movement, and abolishing extraneous light were all important in increasing the signal-to-noise ratio. The locations of whisker movement-evoked cortical activity determined using COI are consistent with the known functional anatomy of rat whisker barrel cortex. The images obtained with this experimental arrangement are shown to be accurate predictors of the location of neuronal activity determined by comparing the locations of active sites identified with COI with locations of areas of neuronal activity determined using single-cell recording techniques. CONCLUSIONS COI is able to rapidly identify areas of cortex containing elicited neuronal activity. The technique allows cortical activation maps to be made rapidly with a very high degree of spatial resolution. COI is reliable and consistent over time. COI, if used carefully, holds promise as an intraoperative technique to study both human and experimental animal cortical function.
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Affiliation(s)
- C J Hodge
- Department of Neurosurgery, Health Science Center at Syracuse, New York, USA
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30
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Abstract
Comorbid diagnoses were examined in 55 principal generalized anxiety disorder (GAD) clients, and the effect of treatment for the principal disorder on those conditions was evaluated. High rates of comorbid diagnoses were present at pretherapy, with social and simple phobia being most common. The presence of additional diagnoses declined dramatically from pretherapy to follow-up and was significantly greater among clients for whom the GAD therapy had been successful than among clients for whom GAD outcome had been ambiguous. This was generally true regardless of whether clients reported at follow-up that they had received further therapy since the posttherapy assessment.
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Affiliation(s)
- T D Borkovec
- Department of Psychology, Pennsylvania State University, University Park 16802, USA
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31
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Abstract
Comorbid diagnoses were examined in 55 principal generalized anxiety disorder (GAD) clients, and the effect of treatment for the principal disorder on those conditions was evaluated. High rates of comorbid diagnoses were present at pretherapy, with social and simple phobia being most common. The presence of additional diagnoses declined dramatically from pretherapy to follow-up and was significantly greater among clients for whom the GAD therapy had been successful than among clients for whom GAD outcome had been ambiguous. This was generally true regardless of whether clients reported at follow-up that they had received further therapy since the posttherapy assessment.
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Affiliation(s)
- T D Borkovec
- Department of Psychology, Pennsylvania State University, University Park 16802, USA
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Kurreck H, Aguirre S, Dieks H, Gätschmann J, Gersdorff J, Newman H, Schubert H, Speck M, Stabingis T, Sobek J, Tian P, Wiehe A. Mimicking primary processes in photosynthesis—covalently linked porphyrin quinones. Radiat Phys Chem Oxf Engl 1993 1995. [DOI: 10.1016/0969-806x(94)e0037-j] [Citation(s) in RCA: 4] [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: 10/27/2022]
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Dische S, Chassagne D, Hope-Stone H, Dawes P, Roberts J, Yosef H, Bey P, Horiot JC, Jacobson A, Frankendal B, Gonzales Gonzales D, Nguyen TD, Daly N, Le Floch O, Newman H, Vieiro E, Bennett M, Bichel P, Duvillard P, Jacobson A, Cook P, Everett V, Machin D, Dische S, Machin D. A trial of Ro 03-8799 (pimonidazole) in carcinoma of the uterine cervix: an interim report from the Medical Research Council Working Party on advanced carcinoma of the cervix. Radiother Oncol 1993. [DOI: 10.1016/0167-8140(93)90089-q] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wilson JJ, Balsys A, Newman H, Lychacz B. IVC thrombosis: successful treatment with low dose streptokinase. J Cardiovasc Surg (Torino) 1992; 33:109-11. [PMID: 1544988] [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: 12/27/2022]
Abstract
Thrombosis of the inferior vena cava (IVC) is an infrequent cause of thrombosis when large series of patients with deep vein thrombosis are examined. It may provide a diagnostic challenge in that lower extremity edema may be absent. The management has varied in published series with different authors recommending anticoagulant therapy (heparin or fibrinolytic therapy), surgical venous thrombectomy, or IVC interruption. We describe a case of IVC thrombosis presenting with pulmonary emboli, successfully treated with low-dose infusional Streptokinase.
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Affiliation(s)
- J J Wilson
- Department of Medicine, Humber Memorial Hospital, Weston, Ontario, Canada
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35
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Abstract
We report our results in eight consecutive patients with idiopathic subclavian-axillary vein thrombosis treated at a community hospital with systemic streptokinase therapy. Seven of the eight patients were treated within 1 week of symptoms. All seven patients had partial or total recanalization documented by venography. One patient developed rethrombosis that did not respond to therapy with tPA and had mild persisting symptoms of postphlebitic syndrome. None of the other patients had symptoms of postphlebitic syndrome on follow-up up to 5 years' duration.
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Affiliation(s)
- J J Wilson
- Department of Medicine, Humber Memorial Hospital, Weston, Ontario, Canada
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36
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Peroutka SJ, Newman H, Harris H. Subjective effects of 3,4-methylenedioxymethamphetamine in recreational users. Neuropsychopharmacology 1988; 1:273-7. [PMID: 2908020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA; Ecstasy) is a serotonergic neurotoxin in laboratory animals that has been used for recreational purposes by humans. The subjective effects of this drug were determined in recreational users at a university campus. Of individuals who had admitted to using MDMA recreationally, 100 of 143 agreed to complete a detailed questionnaire concerning the subjective effects of this Schedule I compound. The most common effect of MDMA was a heightened sense of "closeness" with other people (90% of subjects). Tachycardia, dry mouth, bruxism and/or trismus were reported by the majority of users. These effects probably result from the amphetaminelike properties of the drug. Visual hallucinations were reported by 20% of users. Untoward side effects were most common on the day following the use of MDMA, with complaints of muscle aches, fatiguability, depression, and difficulty concentrating noted by 21% to 36% of subjects. Sixty-seven percent of frequent users of the drug (six or more separate doses) reported that the "positive" effects of the drug decreased with successive doses while the "negative" effects increased. Although these observations should be considered preliminary, they represent the first documentation of the subjective effects of MDMA in recreational users and confirm previous reports obtained from patients treated with this drug.
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Affiliation(s)
- S J Peroutka
- Department of Neurology, Stanford University School of Medicine, CA 94305
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37
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Adeva B, Anderhub H, Ansari S, Becker U, Becker-Szendy R, Berdugo J, Boehm A, Bourquin M, Branson JG, Burger JD, Camps C, Cerrada M, Chang CC, Chang YH, Chen HS, Chen M, Chen ML, Chen MY, Commichau V, Deffur E, Deiters K, Dhina M, Fehlmann J, Fesefeldt HS, Fong D, Friebel W, Fukushima M, Garrido L, Guo KZ, Han RD, Hangarter K, Hausammann R, Herten G, Herten U, Hofer H, Hueser-Teuchert D, Ilyas MM, Krenz W, Leiste R, Li QZ, Linnhoeffer D, Luckey D, Ma H, Ma W, Mana C, Marquina MA, Martinez M, Mnich J, Newman H, Nierobisch H, Nowak WD, Nusbaumer M, Pohl M, Rau RR, Ren D, Rodriguez S, Rohde M, Rose J, Rubio JA, Rykaczewski H, Sachwitz M, Salicio J, Schreiber HJ, Schroeder U. Electroweak studies in e+e- collisions: 12< sqrt s<46.78 GeV. Phys Rev D Part Fields 1988; 38:2665-2678. [PMID: 9959436 DOI: 10.1103/physrevd.38.2665] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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38
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O'Rourke M, Baron D, Keogh A, Kelly R, Nelson G, Barnes C, Raftos J, Graham K, Hillman K, Newman H. Limitation of myocardial infarction by early infusion of recombinant tissue-type plasminogen activator. Circulation 1988; 77:1311-5. [PMID: 3131040 DOI: 10.1161/01.cir.77.6.1311] [Citation(s) in RCA: 202] [Impact Index Per Article: 5.6] [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: 01/04/2023]
Abstract
In a double-blind randomized trial involving five Sydney hospitals and the city ambulance paramedical service, 145 patients with a first evolving myocardial infarction and with onset of pain less than 2.5 (mean 1.9 +/- 0.5 [SD]) hr previously were allocated to intravenous infusion of 100 mg recombinant tissue-type plasminogen activator (rt-PA) or placebo over 3 hr. The groups at entry were similar. At assessment 21 days later, left ventricular ejection fraction measured both by contrast and radionuclide ventriculography was higher in the rt-PA compared with the placebo group (61 +/- 13%, n = 64, vs 54 +/- 14%, n = 62, contrast, 2p = .006; 52 +/- 13%, n = 66, vs 48 +/- 13%, n = 62 isotope, 2p = .08). This indicates limitation of myocardial infarction by rt-PA.
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Affiliation(s)
- M O'Rourke
- St. Vincent's Hospital, Darlinghurst, NSW, Australia
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Newman H, Melman A. Semantics in the field of impotence. Urology 1987; 30:189-90. [PMID: 3617310 DOI: 10.1016/0090-4295(87)90196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abraham RD, Freedman SB, Dunn RF, Newman H, Roubin GS, Harris PJ, Kelly DT. Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning. Am J Cardiol 1986; 58:423-7. [PMID: 3751910 DOI: 10.1016/0002-9149(86)90008-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect; 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.
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Adeva B, Ansari S, Becker U, Becker-Szendy R, Berdugo J, Boehm A, Branson JG, Burger JD, Capell M, Cerrada M, Chang CC, Chang YH, Chen HS, Chen M, Chen ML, Chen MY, Chi YK, Deffur E, Deiters K, Demarteau M, Dhina M, Dong BZ, Duinker P, Fesefeldt HS, Fong D, Fukushima M, Garrido L, Han RD, Harting D, Herten G, Ho MC, Hueser D, Hussain M, Ilyas MM, Jiang DZ, Klein M, Krenz W, Kuijer P, Leiste R, Li QZ, Linnhoefer D, Luckey D, Luit EJ, Ma H, Mana C, Marquina MA, Martinez M, Massaro GG, Mnich J, Nadeem K, Newman H, Nowak WD, Nusbaumer M, Pohl M, Poschmann FP, Rau RR, Rodriguez S, Rohde M, Rubio JA, Rykaczewski H, Sachwitz M, Salicio J, Schreiber HJ, Schroeder U. Study of hadron and inclusive muon production from e+e- annihilation at 39.79 <= sqrt s <= 46.78 GeV. Phys Rev D Part Fields 1986; 34:681-691. [PMID: 9957198 DOI: 10.1103/physrevd.34.681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Wilson JJ, Zahn CA, Ross SD, Newman H. Association of embolic stroke in pregnancy with the lupus anticoagulant. A case report. J Reprod Med 1986; 31:725-8. [PMID: 3095546] [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: 01/04/2023]
Abstract
Recently the association of recurrent spontaneous abortions and intrauterine fetal death was linked to the lupus anticoagulant (LA). LA is an immunoglobulin directed against phospholipid, causing characteristic changes in coagulation tests, and is associated with an increased risk of thrombosis. We treated a pregnant woman who presented with an embolic stroke and laboratory evidence of LA.
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Metcalfe S, Newman H, Workman P. Increase of oleic acid in erythrocytes associated with malignancies. West J Med 1985. [DOI: 10.1136/bmj.291.6497.740-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Adeva B, Becker U, Becker-Szendy R, Berdugo J, Boehm A, Branson JG, Burger JD, Capell M, Cerrada M, Chang CC, Chang YH, Chen HS, Chen M, Chen ML, Chen MY, Chu YS, Deffur E, Deiters K, Demarteau M, Dong BZ, Duinker P, Fesefeldt HS, Fong D, Fukushima M, Garrido L, Han RD, Harting D, Herten G, Ho MC, Hueser D, Hussain M, Ilyas MM, Jiang DZ, Klein M, Krenz W, Kuijer P, Leiste R, Li QZ, Linnhoefer D, Luckey D, Luit EJ, Mana C, Marquina MA, Martinez M, Massaro GG, Mnich J, Mount R, Nadeem K, Newman H, Nowak WD, Pohl M, Poschmann FP, Rau RR, Rodriguez S, Rohde M, Rubio JA, Rykaczewski H, Sachwitz M, Salicio J, Schreiber HJ, Schroeder U, Schug J, Stone H, Swider GM. Measurement of e+e---> micro+ micro-: A test of electroweak theories. Phys Rev Lett 1985; 55:665-668. [PMID: 10032415 DOI: 10.1103/physrevlett.55.665] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Newman H, Sugrue D, Oakley CM, Goodwin JF, McKenna WJ. Relation of left ventricular function and prognosis in hypertrophic cardiomyopathy: an angiographic study. J Am Coll Cardiol 1985; 5:1064-74. [PMID: 4039343 DOI: 10.1016/s0735-1097(85)80006-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Left ventricular cineangiograms performed at the time of diagnosis in 88 patients with hypertrophic cardiomyopathy were digitized to evaluate the relation of left ventricular function and prognosis in hypertrophic cardiomyopathy. Eleven patients died suddenly after a mean follow-up period of 7.5 +/- 7 years, 10 patients died of congestive heart failure or after cardiac surgery and 67 were alive after a mean follow-up period of 8.6 +/- 4 years. Measurements of left ventricular volume, ejection fraction, peak rate of ejection and filling and time to peak rate of ejection and filling were derived from curves of ventricular volume and its rate of change during the cardiac cycle. Patients who died suddenly had a lower peak rate of ventricular ejection (stroke volume-normalized peak ejection rate 5.41 +/- 0.69 versus 6.24 +/- 1.33 s-1; p = 0.006) and lower peak rate of ventricular filling (end-diastolic volume-normalized peak filling rate 4.02 +/- 0.94 versus 4.88 +/- 1.53 s-1; p = 0.02) and stroke volume-normalized peak filling rate (4.75 +/- 1.08 versus 5.82 +/- 1.70 s-1; p = 0.01) compared with survivors. Stepwise regression analysis revealed that sudden death was best predicted by the combination of increased end-diastolic volume, small end-systolic volume and low peak filling rate (predictive accuracy 32%, false negative 18% and false positive 28%). The addition of clinical features and hemodynamic measurements to the analysis improved predictive accuracy to 43% (false negative 18% and false positive 18%). Ambulatory electrocardiographic monitoring performed in 57 of the 88 patients 1 month to 17 years (median 8 years) after diagnosis revealed ventricular tachycardia in 14 (25%). Of these, 10 who survived had hyperkinetic systolic function at diagnosis, whereas the 4 who died suddenly had impaired systolic function (end-diastolic volume-normalized peak ejection rate 5.93 +/- 1.2 versus 4.01 +/- 1.2 s-1, respectively; p = 0.04). In hypertrophic cardiomyopathy, ventricular tachycardia is a sensitive but nonspecific marker of adults who are at risk of sudden death. Impaired systolic function may be an important determinant of which patients with ventricular tachycardia die suddenly. This study shows that indexes of ventricular function contribute to the identification of patients at particular risk of sudden death. However, the predictive power of the clinical features and hemodynamic and angiographic measurements that could be assessed was poor.(ABSTRACT TRUNCATED AT 400 WORDS)
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Adeva B, Becker U, Becker-Szendy R, Berdugo J, Boehm A, Branson JG, Burger JD, Capell M, Cerrada M, Chang CC, Chang YH, Chen HS, Chen M, Chen ML, Chen MY, Deffur E, Demarteau M, Dong BZ, Duinker P, Fesefeldt HS, Fong D, Fukushima M, Garrido L, Han RD, Harting D, Herten G, Ho MC, Hueser D, Hussain M, Ilyas MM, Jiang DZ, Krenz W, Kuijer P, Li QZ, Linnhoefer D, Luckey D, Luit EJ, Mana C, Marquina MA, Martinez M, Massaro GG, Mnich J, Mount R, Nadeem K, Newman H, Pohl M, Poschmann FP, Rau RR, Rodriguez S, Rohde M, Rubio JA, Rykaczewski H, Salicio J, Schroeder U, Stone H, Swider GM, Tang HW, Teuchert D, Ting SC, Tung KL, Wang MQ, White M, Wu HG, Wu SX. Measurement of the strong-coupling constant alpha s to second order for 22 <= sqrt s <= 46.78 GeV. Phys Rev Lett 1985; 54:1750-1753. [PMID: 10031130 DOI: 10.1103/physrevlett.54.1750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Sugrue DD, Dickie S, Newman H, Myers MJ, Lavender JP, McKenna WJ. Comparison of equilibrium radionuclide and contrast angiographic measurements of left ventricular peak ejection and filling rates and their time intervals. Nucl Med Commun 1984; 5:619-25. [PMID: 6099528 DOI: 10.1097/00006231-198410000-00003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Wilson JJ, Lesk D, Newman H. Subclavian-axillary vein thrombosis: successful treatment with streptokinase. Can Med Assoc J 1984; 130:891-3. [PMID: 6704841 PMCID: PMC1875990] [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: 01/21/2023]
Abstract
Proximal vein thrombosis has been associated with residual disability from the postphlebetic syndrome in patients receiving symptomatic therapy or heparin and sodium warfarin. This paper describes a man with painless swelling of the right arm secondary to subclavian-axillary vein thrombosis that was successfully treated with streptokinase and conventional anticoagulant therapy.
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