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McClymont E, Atkinson A, Albert A, Av-Gay G, Andrade J, Barrett J, Bogler T, Boucoiran I, Castillo E, D'Souza R, El-Chaâr D, Fadel S, Fell DB, Korchinski I, Kuret V, Ogilvie G, Poliquin V, Sadarangani M, Scott H, Snelgrove JW, Tunde-Byass M, Money D. Reactogenicity, pregnancy outcomes, and SARS-CoV-2 infection following COVID-19 vaccination during pregnancy in Canada: A national prospective cohort study. Vaccine 2023; 41:7183-7191. [PMID: 37865598 DOI: 10.1016/j.vaccine.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To describe self-reported reactogenicity, pregnancy outcomes, and SARS-CoV-2 infection following COVID-19 vaccination during pregnancy. DESIGN National, prospective cohort study. SETTING Participants across Canada were enrolled from July 2021 until June 2022. POPULATION Individuals pregnant during the COVID-19 pandemic, regardless of vaccination status, were included. METHODS The Canadian COVID-19 Vaccine Registry for Pregnant and Lactating Individuals (COVERED) was advertised through traditional and social media. Surveys were administered at baseline, following each vaccine dose if vaccinated, pregnancy conclusion, and every two months for 14 months. Changes to pregnancy or vaccination status, SARS-CoV-2 infections, or significant health events were recorded. MAIN OUTCOME MEASURES Reactogenicity (local and systemic adverse events, and serious adverse events) within 1 week post-vaccination, pregnancy and neonatal outcomes, and subsequent SARS-CoV-2 infection. RESULTS Among 2868 participants who received 1-2 doses of a COVID-19 vaccine during pregnancy, adverse events described included: headache (19.5-33.9%), nausea (4.8-13.8%), fever (2.7-10.2%), and myalgia (33.4-42.2%). Reactogenicity was highest after the 2nd dose of vaccine in pregnancy. Compared to 1660 unvaccinated participants, there were no statistically significant differences in adverse pregnancy or infant outcomes, aside from an increased risk of NICU admission ≥ 24 h among the unvaccinated group. During follow-up, there was a higher rate of participant-reported SARS-CoV-2 infection in the unvaccinated compared to the vaccinated group (18[47.4%] vs. 786[27.3%]). CONCLUSIONS Participant-reported reactogenicity was similar to reports from non-pregnant adults. There was no increase in adverse pregnancy and birth outcomes among vaccinated vs. unvaccinated participants and lower rates of SARS-CoV-2 infection were reported in vaccinated participants. TWEETABLE ABSTRACT No significant increase in adverse pregnancy or infant outcomes among vaccinated versus unvaccinated pregnant women in Canada.
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Affiliation(s)
- E McClymont
- Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, Canada
| | - A Atkinson
- Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, Canada
| | - A Albert
- Women's Health Research Institute, Vancouver, Canada
| | - G Av-Gay
- Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, Canada
| | - J Andrade
- Women's Health Research Institute, Vancouver, Canada
| | - J Barrett
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Canada
| | - T Bogler
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - I Boucoiran
- Department of Obstetrics & Gynecology and School of Public Health, Université de Montréal, Montreal, Canada
| | - E Castillo
- Department of Obstetrics & Gynecology, University of Calgary, Calgary, Canada
| | - R D'Souza
- Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada
| | - D El-Chaâr
- Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, Canada
| | - S Fadel
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - D B Fell
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - I Korchinski
- Women's Health Research Institute, Vancouver, Canada
| | - V Kuret
- Department of Obstetrics & Gynecology, University of Calgary, Calgary, Canada
| | - G Ogilvie
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - V Poliquin
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Manitoba, Winnipeg, Canada
| | - M Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - H Scott
- Department of Obstetrics & Gynecology, Dalhousie University, Halifax, Canada
| | - J W Snelgrove
- Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada
| | - M Tunde-Byass
- Department of Obstetrics & Gynecology, University of Toronto, Toronto, Canada
| | - D Money
- Department of Obstetrics & Gynecology, University of British Columbia, Vancouver, Canada; Women's Health Research Institute, Vancouver, Canada.
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Caley LR, Jarosz-Griffiths HH, Smith L, Gale L, Barrett J, Kinsey L, Davey V, Nash M, Jones AM, Whitehouse JL, Shimmin D, Floto RA, White H, Peckham DG. Body mass index and nutritional intake following Elexacaftor/Tezacaftor/Ivacaftor modulator therapy in adults with cystic fibrosis. J Cyst Fibros 2023; 22:1002-1009. [PMID: 37422432 DOI: 10.1016/j.jcf.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/01/2023] [Accepted: 06/25/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Elexacaftor/Tezacaftor/Ivacaftor (ETI) modulator therapy is often associated with increased body mass index (BMI) in people with cystic fibrosis (CF). This is thought to reflect improved clinical stability and increased appetite and nutritional intake. We explored the change in BMI and nutritional intake following ETI modulator therapy in adults with CF. METHODS Dietary intake, measured with myfood24®, and BMI were collected from adults with CF at baseline and follow-up as part of an observational study. Changes in BMI and nutritional intake in participants who commenced ETI therapy between time points were assessed. To contextualize findings, we also assessed changes in BMI and nutritional intake between study points in a group on no modulators. RESULTS In the pre and post ETI threapy group (n = 40), BMI significantly increased from 23.0 kg/m2 (IQR 21.4, 25.3) at baseline to 24.6 kg/m2 (IQR 23.0, 26.7) at follow-up (p<0.001), with a median of 68 weeks between time points (range 20-94 weeks) and median duration of ETI therapy was 23 weeks (range 7-72 weeks). There was a significant decrease in energy intake from 2551 kcal/day (IQR 2107, 3115) to 2153 kcal/day (IQR 1648, 2606), p<0.001. In the no modulator group (n = 10), BMI and energy intake did not significantly change between time points (p>0.05), a median of 28 weeks apart (range 20-76 weeks). CONCLUSIONS These findings tentatively suggest that the increase in BMI with ETI therapy may not simply be attributable to an increase in oral intake. Further exploration into the underlying aetiology of weight gain with ETI therapy is needed.
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Affiliation(s)
- L R Caley
- Leeds Institute of Medical Research at St James's, University of Leeds, UK; Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | | | - L Smith
- Leeds Institute of Health Sciences, University Hospital, University of Leeds, UK
| | - L Gale
- Cambridge Centre for Lung Infection, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - J Barrett
- West Midlands Regional Adult CF Centre, University Hospitals Birmingham NHS, Foundation Trust, Birmingham, UK
| | - L Kinsey
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, UK
| | - V Davey
- Dietetic Department, Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Oxford Road, Manchester, UK
| | - M Nash
- North East Essex Community Services, East Suffolk and North Essex NHS Foundation Trust, UK
| | - A M Jones
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, UK
| | - J L Whitehouse
- West Midlands Regional Adult CF Centre, University Hospitals Birmingham NHS, Foundation Trust, Birmingham, UK
| | - D Shimmin
- Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R A Floto
- Cambridge Centre for Lung Infection, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK; Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - H White
- Leeds Beckett University, Nutrition, Health & Environment, Leeds, UK
| | - D G Peckham
- Leeds Institute of Medical Research at St James's, University of Leeds, UK; Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Caley LR, Zagoya C, Duckstein F, White H, Shimmin D, Jones AM, Barrett J, Whitehouse JL, Floto RA, Mainz JG, Peckham DG. Diabetes is associated with increased burden of gastrointestinal symptoms in adults with cystic fibrosis. J Cyst Fibros 2023; 22:275-281. [PMID: 36710099 DOI: 10.1016/j.jcf.2023.01.010] [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: 07/13/2022] [Revised: 12/09/2022] [Accepted: 01/17/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Individuals with diabetes mellitus (DM) are known to frequently experience gastrointestinal (GI) symptoms. In contrast, the impact of cystic fibrosis-related diabetes (CFRD) on accentuating GI symptoms in people with cystic fibrosis (pwCF) is unknown. We sought to examine this. METHODS Abdominal symptoms were measured using the validated CF-specific GI symptom questionnaire - CFAbd-Score© - as part of a multicentre cohort study in pancreatic insufficient adults with CF, not on cystic fibrosis transmembrane conductance regulator (CFTR) modulators. The CFAbd-Score total score (0-100pts), its 5 domains, alongside nine specific GI symptoms associated with DM, were compared between the CFRD and non-CFRD groups. RESULTS 27 (31%) and 61 (69%) participants with CF were recruited in the CFRD and non-CFRD groups respectively. Total CFAbd-Score and the two domains: gastroesophageal reflux disease and disorders of appetite were significantly higher in the CFRD group compared to the non-CFRD group (p<0.05), with the mean total CFAbd-Score being 25.4 ± 2.5 and 18.4 ± 1.5 in the CFRD and non-CFRD groups respectively. Among the nine GI symptoms commonly reported as elevated in DM, bloating and nausea were significantly more common in individuals with CFRD compared to those without (p<0.05). CONCLUSIONS Individuals with CFRD overall, have a higher GI symptom burden, according to CFAbd-Scores. Specifically, they experience significantly more bloating and nausea. Close monitoring and further research is needed to better understand and manage GI symptoms in this group.
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Affiliation(s)
- L R Caley
- Leeds Institute of Medical Research at St James's University Hospital, University of Leeds, Leeds, United Kingdom.
| | - C Zagoya
- Brandenburg Medical School, University Hospital. Klinikum Westbrandenburg, Brandenburg an der Havel, Germany
| | - F Duckstein
- Brandenburg Medical School, University Hospital. Klinikum Westbrandenburg, Brandenburg an der Havel, Germany
| | - H White
- Nutrition, Health & Environment, Leeds Beckett University, Leeds, United Kingdom
| | - D Shimmin
- Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - A M Jones
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Manchester University Hospitals NHS Foundation Trust, United Kingdom
| | - J Barrett
- West Midlands Adult CF Centre, University Hospitals Birmingham NHS, Foundation Trust, Birmingham, United Kingdom
| | - J L Whitehouse
- West Midlands Adult CF Centre, University Hospitals Birmingham NHS, Foundation Trust, Birmingham, United Kingdom
| | - R A Floto
- MRC-Laboratory of Molecular Biology, Molecular Immunity Unit, University of Cambridge Department of Medicine, Cambridge, United Kingdom; Cambridge Centre for Lung Infection, Papworth Hospital, Cambridge, United Kingdom
| | - J G Mainz
- Brandenburg Medical School, University Hospital. Klinikum Westbrandenburg, Brandenburg an der Havel, Germany; Faculty of Health Sciences Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, the Brandenburg Medical School Theodor Fontane and the University of Potsdam, Germany
| | - D G Peckham
- Leeds Institute of Medical Research at St James's University Hospital, University of Leeds, Leeds, United Kingdom; Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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Shaikh M, Dawson A, Gazala W, Zeng P, Barrett J, Nichols A. O3.2 Loss of LRP1B expression drives chemo and radiation resistance in HPV-positive head and neck cancer. Oral Oncol 2022. [DOI: 10.1016/j.oraloncology.2022.106176] [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: 11/11/2022]
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McCormick E, Brown J, Barrett J, Campbell C, Creer D, Cropley I, Lowe D, Moores R, Lipman M. Cutaneous adverse drug reactions to fixed-dose combination treatments for TB. Int J Tuberc Lung Dis 2022; 26:886-887. [PMID: 35996277 DOI: 10.5588/ijtld.22.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- E McCormick
- North Central London Tuberculosis Service, Whittington Hospital NHS Trust, London, UK
| | - J Brown
- Department of Respiratory Medicine, University College London, Royal Free Campus, London, 6UCL Respiratory, University College London, London, UK
| | - J Barrett
- North Central London Tuberculosis Service, Whittington Hospital NHS Trust, London, UK
| | - C Campbell
- North Central London Tuberculosis Service, Whittington Hospital NHS Trust, London, UK
| | - D Creer
- Department of Respiratory Medicine, University College London, Royal Free Campus, London, 6UCL Respiratory, University College London, London, UK
| | - I Cropley
- Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, University College London, Royal Free Campus, London, 6UCL Respiratory, University College London, London, UK
| | - D Lowe
- Department of Clinical Immunology, Royal Free London NHS Foundation Trust, London, UK, Institute of Immunity and Transplantation, University College London, Royal Free Campus, London, UK
| | - R Moores
- Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, University College London, Royal Free Campus, London, 6UCL Respiratory, University College London, London, UK
| | - M Lipman
- Department of Respiratory Medicine, University College London, Royal Free Campus, London, 6UCL Respiratory, University College London, London, UK, UCL Respiratory, University College London, London, UK
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MD Yusof MY, Robinson J, Davies V, Wild D, Morgan M, Taylor J, El-Sherbiny Y, Morris D, Liu L, Rawstron A, Buch MH, Plant D, Cordell H, Isaacs J, Bruce IN, Emery P, Barton A, Vyse T, Barrett J, Vital E, Morgan A. OP0190 COMPREHENSIVE GENETIC AND FUNCTIONAL ANALYSES OF Fc GAMMA RECEPTORS EXPLAIN RESPONSE TO RITUXIMAB THERAPY FOR AUTOIMMUNE RHEUMATIC DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRituximab is widely used to treat rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) but clinical response varies. Efficacy is determined by the efficiency of depletion, which may depend on a variety of Fc gamma receptor (FcγR)-dependent mechanisms. Previous research was limited by complexity of the FCGR locus, not integrating copy number variation with functional SNP, and small sample size.ObjectivesThe study objectives were to assess the effect of the full range of FcγRs variants on depletion, clinical response and functional effect on NK-cell-mediated killing in two rheumatic diseases with a view to personalised B-cell depleting therapies.MethodsA prospective longitudinal cohort study was conducted in 873 patients [RA=611; SLE=262] from four cohorts (BSRBR-RA and BILAG-BR registries, Leeds RA and Leeds SLE Biologics). For RA, the outcome measures were 3C-DAS28CRP and 2C-DAS28CRP at 6 (+/-3) months post-rituximab (adjusted for baseline DAS28). For SLE, major clinical response (MCR) was defined as improvement of active BILAG-2004 domains to grade C/better at 6 months. B-cell depletion was evaluated by highly-sensitive flow cytometry. Qualitative and quantitative polymorphisms for five major FcγRs were measured using a commercial multiplex ligation-dependent probe amplification. Median NK cell FcγRIIIa expression (CD3-CD56+CD16+) and NK-cell degranulation (CD107a) in the presence of rituximab-coated Daudi/Raji B-cell lines were assessed using flow cytometry.ResultsIn RA, for FCGR3A, carriage of V allele (coefficient -0.25 (SE 0.11); p=0.02) and increased copies of V allele (-0.20 (0.09); p=0.02) were associated with greater 2C-DAS28 response. Irrespective of FCGR3A genotype, increased gene copies were associated with a better response. In SLE, 177/262 (67.6%) achieved BILAG response [MCR=34.4%; Partial=33.2%]. MCR was associated with increased copies of FCGR3A-158V allele, OR 1.64 (95% CI 1.12-2.41) and FCGR2C-ORF allele 1.93 (1.09-3.40). Of patients with B-cells data in the combined cohort, 236/413 (57%) achieved complete depletion post-rituximab. Only homozygosity for FCGR3A-158V and increased FCGR3A-158V copy number were associated with increased odds of complete depletion. Patients with complete depletion had higher NK cell FcγRIIIa expression at rituximab initiation than those with incomplete depletion (p=0.04) and this higher expression was associated with improved EULAR response in RA. Moreover, for FCGR3A, degranulation activity was increased in V allele carriers vs FF genotype in the combined cohort; p=0.02.ConclusionFcγRIIIa is the major low affinity FcγR and increased copies of the FCGR3A-158V allele, encoding the allotype with a higher affinity for IgG1, was associated with clinical and biological responses to rituximab in two autoimmune diseases. This was supported by functional data on NK cell-mediated cytotoxicity. In SLE, increased copies of the FCGR2C-ORF allele was also associated with improved response. Our findings indicate that enhancing FcγR-effector functions could improve the next generation of CD20-depleting therapies and genotyping could stratify patients for optimal treatment protocols.ReferencesNoneAcknowledgementsThis research was funded/supported by the joint funding from the Medical Research Council (MRC) and Versus Arthritis of MATURA (grant codes 36661 and MR/K015346/1). MASTERPLANS was funded by the MRC (grant code MR/M01665X/1). The Leeds Biologics Cohort was part funded by programme grants from Versus Arthritis (grant codes 18475 and 18387), the National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC) and Diagnostic Evaluation Co-operative and the Ann Wilks Charitable Foundation. The BILAG-BR has received funding support from Lupus UK, and unrestricted grants from Roche and GSK.The functional studies were in part supported through a NIHR/HEFCE Clinical Senior Lectureship and a Versus Arthritis Foundation Fellowship (grant code 19764) to AWM, the Wellcome Trust Institutional Strategic Support Fund to JIR and MYMY (204825/Z/16/Z), NIHR Doctoral Research Fellowship to MYMY (DRF-2014-07-155) and NIHR Clinician Scientist to EMV (CS-2013-13-032). . AWM, INB, JDI and PE were supported by NIHR Senior Investigator awards. Work in JDI’s laboratory is supported by the NIHR Newcastle BRC, the Research Into Inflammatory Arthritis Centre Versus Arthritis, and Rheuma Tolerance for Cure (European Union Innovative Medicines Initiative 2, grant number 777357). INB is funded by the NIHR Manchester BRC.This article/paper/report presents independent research funded/supported by the NIHR Leeds BRC and the NIHR Guy’s and St Thomas’ BRC. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.Disclosure of InterestsMd Yuzaiful Md Yusof: None declared, James Robinson: None declared, Vinny Davies: None declared, Dawn Wild: None declared, Michael Morgan: None declared, John Taylor: None declared, Yasser El-Sherbiny: None declared, David Morris: None declared, Lu Liu: None declared, Andrew Rawstron: None declared, Maya H Buch: None declared, Darren Plant: None declared, Heather Cordell: None declared, John Isaacs: None declared, Ian N. Bruce: None declared, Paul Emery Speakers bureau: Roche, Consultant of: Roche, Grant/research support from: Roche, Anne Barton: None declared, Timothy Vyse: None declared, Jennifer Barrett: None declared, Edward Vital Consultant of: Roche, Grant/research support from: Roche, Ann Morgan Speakers bureau: Roche/Chugai, Consultant of: GSK, Roche, Chugai, AstraZeneka, Regeneron, Sanofi, Vifor, Grant/research support from: Roche, Kiniksa Pharmaceuticals
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Barrett J. Why are people still dying from TB in low-burden countries? Int J Tuberc Lung Dis 2022; 26:91-92. [PMID: 35086618 DOI: 10.5588/ijtld.21.0680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J Barrett
- London North West University Healthcare, Harrow, UK
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Cani AK, Dolce EM, Darga EP, Hu K, Brown M, Liu CJ, Pierce J, Bradbury K, Aung K, Schiavon G, Carroll D, Carr TH, Klinowska T, Lindemann J, Marshall G, Rowlands V, Harrington EA, Barrett J, Armstrong A, Baird R, Hamilton E, Im SA, Jhaveri K, Patel MR, Dive C, Tomlins SA, Udager AM, Hayes DF, Paoletti C. Abstract 3143: Monitoring circulating tumor cell (CTC) and circulating tumor DNA (ctDNA) genomic alterations in ER positive (POS)/HER2 negative (NEG) advanced breast cancer during endocrine therapy: correlative study of AZD9496 oral SERD phase I trial. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-3143] [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: 11/16/2022]
Abstract
Abstract
Purpose: The vast majority of advanced ER POS breast cancers eventually cease responding to endocrine (ET) and other therapies leading to evolution of lethal disease. However, timely monitoring of the molecular events associated with response/progression in tissue biopsies is logistically difficult. The use of liquid biopsies, such as CTC and ctDNA, in this context has been of recent interest.
Patients and Methods: Individual CTC and ctDNA were obtained at different time points from patients with advanced ER POS/HER2 NEG breast cancer enrolled in a Phase I trial of AZD9496, an oral selective estrogen receptor degrader (SERD) ET. The CTC, purified using tandem CellSearch®/DepArray™ technologies, were genomically profiled by DNA single cell next generation sequencing (scNGS). Plasma ctDNA was isolated from blood collected in Streck BCT tubes. Genomic profiling was performed by targeted gene panel scNGS for CTC and ddPCR for ERα gene (ESR1) mutations in ctDNA.
Results: 123 high-quality CTCs from 12 patients profiled by scNGS showed 100% concordance with ctDNA in detection of driver ESR1 somatic mutations. CTC scNGS additionally revealed extensive intra-patient heterogeneity of driver alterations, that would have been unresolvable by bulk ctDNA profiling, including separate subclonal CTC populations emerging within the same patient. ScNGS revealed potential opportunities for targeted therapies in 73% of patients, directed at alterations in PIK3CA, FGFR2, KIT and BRAF, at times present as 2 or more targets in the same or different cell populations. In one patient, an emergent, distinct, BRAF p.V600E targetable alteration was detected in a subpopulation of CTCs collected at the progression time point but not at baseline.
Conclusion: Serial monitoring of CTC and ctDNA genomic alterations is feasible and should enable real-time tracking of response/progression, tumor evolution and opportunities for precision medicine interventions.
Citation Format: Andi K. Cani, Emily M. Dolce, Elizabeth P. Darga, Kevin Hu, Martha Brown, Chia-Jen Liu, Jackie Pierce, Kieran Bradbury, Kimberly Aung, Gaia Schiavon, Danielle Carroll, T. H. Carr, Teresa Klinowska, Justin Lindemann, Gayle Marshall, Vicky Rowlands, Elizabeth A. Harrington, J. Barrett, Anne Armstrong, Richard Baird, Erika Hamilton, Seock-Ah Im, Komal Jhaveri, Manish R. Patel, Caroline Dive, Scott A. Tomlins, Aaron M. Udager, Daniel F. Hayes, Costanza Paoletti. Monitoring circulating tumor cell (CTC) and circulating tumor DNA (ctDNA) genomic alterations in ER positive (POS)/HER2 negative (NEG) advanced breast cancer during endocrine therapy: correlative study of AZD9496 oral SERD phase I trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 3143.
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Affiliation(s)
| | | | | | - Kevin Hu
- 1University of Michigan, Ann Arbor, MI
| | | | | | - Jackie Pierce
- 2CRUK Manchester Institute, Manchester, United Kingdom
| | | | | | | | | | - T. H. Carr
- 3AstraZeneca plc, Cambridge, United Kingdom
| | | | | | | | | | | | | | | | - Richard Baird
- 6Cancer Research UK Cambridge Centre, Cambridge, United Kingdom
| | - Erika Hamilton
- 7Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Nashville, TN
| | - Seock-Ah Im
- 8Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Komal Jhaveri
- 9Memorial Sloan Kettering Cancer Center, New York, NY
| | - Manish R. Patel
- 10Sarah Cannon Research Institute/Florida Cancer Specialists, Sarasota, FL
| | - Caroline Dive
- 2CRUK Manchester Institute, Manchester, United Kingdom
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Higgins AM, Neto AS, Bailey M, Barrett J, Bellomo R, Cooper DJ, Gabbe BJ, Linke N, Myles PS, Paton M, Philpot S, Shulman M, Young M, Hodgson CL. Predictors of death and new disability after critical illness: a multicentre prospective cohort study. Intensive Care Med 2021; 47:772-781. [PMID: 34089063 DOI: 10.1007/s00134-021-06438-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/15/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to determine the prevalence and predictors of death or new disability following critical illness. METHODS Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0. RESULTS Of 628 patients with the primary outcome available (median age of 62 [49-71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01-1.03), P = 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01-1.03), P < 0.001] and admission diagnosis. Compared to patients with a surgical admission diagnosis, patients with a cardiac arrest [OR (95% CI) 4.06 (1.89-8.68), P < 0.001], sepsis [OR (95% CI) 2.43 (1.32-4.47), P = 0.004], or trauma [OR (95% CI) 6.24 (3.07-12.71), P < 0.001] diagnosis had higher odds of death or new disability, while patients with a lung transplant [OR (95% CI) 0.21 (0.07-0.58), P = 0.003] diagnosis had lower odds. A model including these three variables had good calibration (Brier score 0.20) and acceptable discriminative power with an area under the receiver operating characteristic curve of 0.76 (95% CI 0.72-0.80). CONCLUSION Less than half of all patients mechanically ventilated for more than 24 h were alive and free of new disability at 6 months after admission to ICU. A model including age, illness severity and admission diagnosis has acceptable discriminative ability to predict death or new disability at 6 months.
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Affiliation(s)
- A M Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - A Serpa Neto
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia.,Department of Intensive Care, Austin Health, Melbourne, VIC, Australia.,Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - M Bailey
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
| | - J Barrett
- Intensive Care Unit, Epworth Healthcare, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - R Bellomo
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia.,Department of Intensive Care, Austin Health, Melbourne, VIC, Australia
| | - D J Cooper
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - B J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - N Linke
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - P S Myles
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Anaesthesiology and Perioperative Medicine, The Alfred, Melbourne, VIC, Australia
| | - M Paton
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia.,Department of Physiotherapy, Monash Health, Melbourne, VIC, Australia
| | - S Philpot
- Intensive Care Unit, Cabrini Health, Melbourne, VIC, Australia
| | - M Shulman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Anaesthesiology and Perioperative Medicine, The Alfred, Melbourne, VIC, Australia
| | - M Young
- Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
| | - C L Hodgson
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia. .,Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia.
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Malley T, Jackman J, Manderson S, Saldana Pena L, Evans E, Barrett J, Soni A, Luqmani R. POS0152-HPR REMOTE CLINICAL MANAGEMENT: INCORPORATING ELECTRONIC ASSESSMENT OF PATIENTS WITH RHEUMATIC DISEASES INTO STANDARD CLINICAL PATHWAYS DURING THE COVID-19 PANDEMIC: A PILOT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Many patients with rheumatic disease require immunosuppressive medication putting them at high risk of COVID-19 infection. Reduced staffing in rheumatology due to redeployment to COVID-19 work, limited out patient capacity and patient vulnerability have had a major impact on our ability to review our patients to assess their condition and treatment (by face-to-face, video or telephone consultations). Novel strategies are essential to safely and effectively treat patients with rheumatic disease whilst minimising their risk of exposure to COVID-19 infection.Objectives:The objective was to develop a digital solution to help deliver safe, efficient and effective care for patients with rheumatic diseases. The aim was to produce a system that allowed us to integrate data recorded directly by patients with information held in our electronic health records to provide a virtual review of care.Methods:An online questionnaire was used to collect clinical information, including validated disease activity measures, to conduct a remote assessment in 175 patients awaiting follow-up appointments. This assessment was integrated within our electronic health records (EHR). The questionnaire contained measures of disease activity (DAS28 or BASDAI); patient reported outcomes; patient preferences regarding the urgency and type of appointment; any recent problems or changes in medication. This information was imported into a database for clinician review, together with previous clinical records and results of relevant investigations, to inform clinical decisions and to decide on the safest and most appropriate timing for follow-up. Report letters were sent to the patient and their primary care providers.Results:Of the 175 patients (149 with RA and 26 with AS), 108 patients (89/149 [60%] with RA [mean age=64; female=65%] and 19/26 [73%] with AS [mean age=45; female=54%]) submitted responses over a 6-week period based on which clinical decisions were made. The mean questionnaire completion time was 19 minutes for RA responders and 16 minutes for AS responders. Non responders (67/175 [mean age=61; female=63%]) remained on our list of patients awaiting follow-up arrangements to be made. Sixty-nine responders (64%) had stable disease therefore did not require any changes to their treatment and were offered an appointment within the next 6 months, of whom 12 (11%) requested face-to-face follow-up. Of the remaining 39 – with less stable disease – requiring more rapid follow-up assessment, 22 patients (56%) required a face-to-face consultation to consider treatment change. So far 9 of these patients have had follow-up, of whom 6 necessitated treatment escalation (Methotrexate increase n=2; anti-inflammatory increase n=2; intramuscular steroid n=1; anti-TNF escalation n=1). Thirty-nine patients (36%) provided feedback on the process of completing the questionnaire, 85% of whom used a mobile phone and the remainder used a computer or tablet. The majority (70%) found it “extremely easy” or “somewhat easy” to complete; remaining responses: “neutral” 20%, “somewhat difficult” 10%, “extremely difficult” 0%.Conclusion:We have created and tested a system of remote clinical management for patients with RA and AS. Amongst the 108 responders, just 31% required a face-to-face appointment, with treatment changes made accordingly. With a backlog of 3,800 awaiting allocation to follow-up appointments, remote clinical management will allow us to safely and efficiently prioritise patients requiring urgent follow-up for treatment optimisation. We will integrate this system into our standard care pathway beyond the COVID-19 pandemic to streamline our service, deliver effective care and provide evidence to support the use of costly biologic drugs.1 We plan to investigate the barriers for non-responders.References:[1]Holroyd CR, Seth R, Bukhari M, et al. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis. Rheumatology. 2019; 58 (2): e3–e42.Disclosure of Interests:Tamir Malley: None declared, John Jackman: None declared, Sarah Manderson: None declared, Larissa Saldana Pena Grant/research support from: Pfizer’s Global Medical Grants program, Ellie Evans: None declared, Joe Barrett Grant/research support from: Pfizer’s Global Medical Grants program, Anushka Soni Grant/research support from: Pfizer’s Global Medical Grants program, Raashid Luqmani Grant/research support from: Pfizer’s Global Medical Grants program
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Yu W, Barrett J, Liu P, Parameswaran A, Chiu ES, Lu CP. Novel evidence of androgen receptor immunoreactivity in skin tunnels of hidradenitis suppurativa: assessment of sex and individual variability. Br J Dermatol 2021; 185:855-858. [PMID: 34047363 DOI: 10.1111/bjd.20520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Affiliation(s)
- W Yu
- The Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA.,Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - J Barrett
- The Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA
| | - P Liu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - A Parameswaran
- The Ronald O Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | - E S Chiu
- The Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA
| | - C P Lu
- The Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA.,Department of Cell Biology, New York University School of Medicine, New York, NY, USA
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Hiersch L, Shah BR, Berger H, Geary M, McDonald SD, Murray-Davis B, Guan J, Halperin I, Retnakaran R, Barrett J, Melamed N. DEVELOPING twin-specific 75-g oral glucose tolerance test diagnostic thresholds for gestational diabetes based on the risk of future maternal diabetes: a population-based cohort study. BJOG 2021; 128:1975-1985. [PMID: 34032350 DOI: 10.1111/1471-0528.16773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To develop twin-specific outcome-based oral glucose tolerance test (OGTT) diagnostic thresholds for GDM based on the risk of future maternal type-2 diabetes. DESIGN A population-based retrospective cohort study (2007-2017). SETTING Ontario, Canada. METHODS Nulliparous women with a live singleton (n = 55 361) or twin (n = 1308) birth who underwent testing for gestational diabetes mellitus (GDM) using a 75-g OGTT in Ontario, Canada (2007-2017). We identified the 75-g OGTT thresholds in twin pregnancies that were associated with similar incidence rates of future type-2 diabetes to those associated with the standard OGTT thresholds in singleton pregnancies. RESULTS For any given 75-g OGTT value, the incidence rate of future maternal type-2 diabetes was lower for women with a twin than women with a singleton pregnancy. Using women with a negative OGTT as reference, the risk of future maternal type-2 diabetes in twin pregnancies with a positive OGTT based on the standard OGTT thresholds (9.86 per 1000 person years, adjusted hazard ratio (aHR) 4.79, 95% CI 2.69-8.51) was lower than for singleton pregnancies with a positive OGTT (18.74 per 1000 person years, aHR 8.22, 95% CI 7.38-9.16). The twin-specific OGTT fasting, 1-hour and 2-hour thresholds identified in the current study based on correlation with future maternal type-2 diabetes were 5.8 mmol/l (104 mg/dl), 11.8 mmol/l (213 mg/dl) and 10.4 mmol/l (187 mg/dl), respectively. CONCLUSIONS We identified potential twin-specific OGTT thresholds for GDM that are associated with a similar risk of future type-2 diabetes to that observed in women diagnosed with GDM in singleton pregnancies based on standard OGTT thresholds. TWEETABLE ABSTRACT Potential twin-specific OGTT thresholds for GDM were identified.
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Affiliation(s)
- L Hiersch
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Lis Maternity Hospital, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - B R Shah
- Department of Medicine and Institute for Health Policy, Management and Evaluation, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Division of Endocrinology, Sunnybrook Health Sciences Centre, Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada
| | - H Berger
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - M Geary
- Rotunda Hospital, Dublin, Ireland
| | - S D McDonald
- Division of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Radiology, and Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - B Murray-Davis
- Division of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Radiology, and Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - J Guan
- ICES, Toronto, ON, Canada
| | - I Halperin
- Department of Endocrinology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - R Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.,Division of Endocrinology, University of Toronto, Toronto, ON, Canada
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Yu W, Marohn M, Lin M, Barrett J, Chiu E, Lu C. 030 Defining adaptive and innate immune cell profiles in Hidradenitis Suppurativa at the single cell resolution. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Barrett J, Painter H, Rajgopal A, Keane D, John L, Papineni P, Whittington A. Increase in disseminated TB during the COVID-19 pandemic. Int J Tuberc Lung Dis 2021; 25:160-166. [PMID: 33656432 DOI: 10.5588/ijtld.20.0846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J Barrett
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, UK
| | - H Painter
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, UK
| | - A Rajgopal
- Faculty of Medicine, Imperial College London, London, UK
| | - D Keane
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, UK
| | - L John
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, UK
| | - P Papineni
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, UK
| | - A Whittington
- Department of Infectious Diseases, London North West University Healthcare NHS Trust, Northwick Park Hospital, London, UK
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Stratulat V, Melamed N, Barrett J, Nevo O, Hack K, Ronzoni S. Validation of upsilon (Y) zone as pathognomonic ultrasound landmark for chorionicity and amnionicity in triplet pregnancy at any gestational age. Ultrasound Obstet Gynecol 2021; 57:501-503. [PMID: 33258522 DOI: 10.1002/uog.23562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/21/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Affiliation(s)
- V Stratulat
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Departments of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - O Nevo
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - K Hack
- Departments of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - S Ronzoni
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Shinar S, Xing W, Pruthi V, Jianping C, Slaghekke F, Groene S, Lopriore E, Lewi L, Couck I, Yinon Y, Batsry L, Raio L, Amylidi-Mohr S, Baud D, Kneuss F, Dekoninck P, Moscou J, Barrett J, Melamed N, Ryan G, Sun L, Van Mieghem T. Outcome of monochorionic twin pregnancy complicated by Type-III selective intrauterine growth restriction. Ultrasound Obstet Gynecol 2021; 57:126-133. [PMID: 33073883 DOI: 10.1002/uog.23515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/15/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Type-III selective intrauterine growth restriction (sIUGR) is associated with a high and unpredictable risk of fetal death and fetal brain injury. The objective of this study was to describe the prospective risk of fetal death and the risk of adverse neonatal outcome in a cohort of twin pregnancies complicated by Type-III sIUGR and treated according to up-to-date guidelines. METHODS We reviewed retrospectively all monochorionic diamniotic twin pregnancies complicated by Type-III sIUGR managed at nine fetal centers over a 12-year period. Higher-order multiple gestations and pregnancies with major fetal anomalies or other monochorionicity-related complications at initial presentation were excluded. Data on fetal and neonatal outcomes were collected and management strategies reviewed. Composite adverse neonatal outcome was defined as neonatal death, invasive ventilation beyond the resuscitation period, culture-proven sepsis, necrotizing enterocolitis requiring treatment, intraventricular hemorrhage Grade > I, retinopathy of prematurity Stage > II or cystic periventricular leukomalacia. The prospective risk of intrauterine death (IUD) and the risk of neonatal complications according to gestational age were evaluated. RESULTS We collected data on 328 pregnancies (656 fetuses). After exclusion of pregnancies that underwent selective reduction (n = 18 (5.5%)), there were 51/620 (8.2%) non-iatrogenic IUDs in 35/310 (11.3%) pregnancies. Single IUD occurred in 19/328 (5.8%) pregnancies and double IUD in 16/328 (4.9%). The prospective risk of non-iatrogenic IUD per fetus declined from 8.1% (95% CI, 5.95-10.26%) at 16 weeks, to less than 2% (95% CI, 0.59-2.79%) after 28.4 weeks and to less than 1% (95% CI, -0.30 to 1.89%) beyond 32.6 weeks. In otherwise uncomplicated pregnancies with Type-III sIUGR, delivery was generally planned at 32 weeks, at which time the risk of composite adverse neonatal outcome was 29.0% (31/107 neonates). In twin pregnancies that continued to 34 weeks, there was a very low risk of IUD (0.7%) and a low risk of composite adverse neonatal outcome (11%). CONCLUSIONS In this cohort of twin pregnancies complicated by Type-III sIUGR and treated at several tertiary fetal centers, the risk of fetal death was lower than that reported previously. Further efforts should be directed at identifying predictors of fetal death and optimal antenatal surveillance strategies to select a cohort of pregnancies that can continue safely beyond 33 weeks' gestation. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S Shinar
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - W Xing
- Fetal Medicine Unit &Prenatal Diagnosis Center, Shanghai 1st Maternity and Infant Hospital of Tongji University, Shanghai, China
| | - V Pruthi
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - C Jianping
- Fetal Medicine Unit &Prenatal Diagnosis Center, Shanghai 1st Maternity and Infant Hospital of Tongji University, Shanghai, China
| | - F Slaghekke
- Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - S Groene
- Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - E Lopriore
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - L Lewi
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - I Couck
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Y Yinon
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - L Batsry
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - L Raio
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | - S Amylidi-Mohr
- Department of Obstetrics and Gynecology, Inselspital, University of Bern, Bern, Switzerland
| | - D Baud
- Department of Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - F Kneuss
- Department of Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - P Dekoninck
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - J Moscou
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - G Ryan
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - L Sun
- Fetal Medicine Unit &Prenatal Diagnosis Center, Shanghai 1st Maternity and Infant Hospital of Tongji University, Shanghai, China
| | - T Van Mieghem
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
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Marsden K, Patel N, Rashid R, Whitehouse J, Barrett J. P176 The benefits of changing to a cystic fibrosis-specific combined fatsoluble vitamin supplement: vitamin status, tablet burden and adherence. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01202-9] [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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McClymont E, Fell D, Albert A, Alton G, Barrett J, El-Chaar D, Harrold J, Krajden M, Lipsky N, Maan E, Malinowski A, Othman M, Raeside A, Ray J, Roberts A, Ryan G, Sadarangani M, Sauve L, van Schalkwyk J, Shah P, Snelgrove J, Sprague A, Ting J, Walker M, Whittle W, Williams C, Yudin M, Zipursky J, Abenhaim H, Boucoiran I, Castillo E, Crane J, Elwood C, Joynt C, Kotaska A, Martel J, Murphy-Kaulbeck L, Poliquin V, Ryan S, Saunders S, Scott H, Money D. Canadian surveillance of COVID-19 in pregnancy: Epidemiology and maternal and infant outcomes. Am J Obstet Gynecol 2020. [PMCID: PMC7683302 DOI: 10.1016/j.ajog.2020.08.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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VanderMeulen H, Strauss R, Lin Y, McLeod A, Barrett J, Sholzberg M, Callum J. Correction to: The contribution of iron deficiency to the risk of peripartum transfusion: a retrospective case control study. BMC Pregnancy Childbirth 2020; 20:230. [PMID: 32303200 PMCID: PMC7165365 DOI: 10.1186/s12884-020-02932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Melamed N, Murphy K, Barrett J, Asztalos E, McDonald SD, Yoon EW, Shah PS. Benefit of antenatal corticosteroids by year of birth among preterm infants in Canada during 2003-2017: a population-based cohort study. BJOG 2020; 128:521-531. [PMID: 32936996 DOI: 10.1111/1471-0528.16511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the changes in the associations of antenatal corticosteroids (ACS) with neonatal mortality and severe neurological injury over time (2003-17). DESIGN National, population-representative, retrospective cohort study. SETTING Level III neonatal intensive care units participating in the Canadian Neonatal Network. POPULATION All infants born at 230/7 -336/7 weeks of gestation (n = 43 456). METHODS We estimated the associations between exposure to ACS and neonatal outcomes by year of birth. Year of birth was considered both continuously and categorically as three consecutive epochs. MAIN OUTCOME MEASURE Neonatal mortality and severe neurological injury. RESULTS The absolute rates of neonatal mortality and severe neurological injury decreased during the study period in both the ACS and No ACS groups. For infants born at 230/7 -306/7 weeks of gestation, ACS was associated with similar reductions in neonatal mortality across the three epochs (9.0% versus 18.1%, adjusted relative risk [aRR] 0.54, 95% CI 0.47-0.61 in 2003-09; 7.6% versus 19.6%, aRR 0.51, 95% CI 0.44-0.59 in 2010-13; and 7.3% versus 14.5%, aRR 0.56, 95% CI 0.46-0.68 in 2014-17) and in severe neurological injury (13.2% versus 25.8%, aRR 0.57, 95% CI 0.50-0.64 in 2003-09; 7.4% versus 17.4%, aRR 0.53, 95% CI 0.43-0.66 in 2010-14; and 7.2% versus 14.8%, aRR 0.59, 95% CI 0.48-0.74 in 2014-17). CONCLUSION Despite the ongoing improvements in neonatal care of preterm infants, as reflected by the gradual decrease in the absolute rates of neonatal mortality and severe neurological injury, the association of ACS treatment with neonatal mortality and severe neurological injury among extremely preterm infants born at 23-30 weeks of gestation has remained stable throughout the study period of 15 years. TWEETABLE ABSTRACT Despite the gradual decrease in the rates of neonatal mortality and severe neurological injury, antenatal corticosteroids remain an important intervention in the current era of neonatal care.
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Affiliation(s)
- N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
| | - K Murphy
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
| | - E Asztalos
- Department of Newborn & Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - S D McDonald
- Division of Maternal-Fetal Medicine, Departments of Obstetrics and Gynaecology, Radiology, and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - E W Yoon
- Maternal-infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, ON, Canada
| | - P S Shah
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada.,Maternal-infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, ON, Canada
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Rosen H, Stratulat V, Aviram A, Melamed N, Barrett J, Glanc P. Mid-trimester cervical consistency index measurement and prediction of preterm birth before 34 and 37 weeks in twin pregnancy. Ultrasound Obstet Gynecol 2020; 56:626-628. [PMID: 31762115 DOI: 10.1002/uog.21927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Affiliation(s)
- H Rosen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - V Stratulat
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - A Aviram
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - P Glanc
- Department of Radiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Davis R, Day A, Barrett J, Vanlint A, Andrews JM, Costello SP, Bryant RV. Habitual dietary fibre and prebiotic intake is inadequate in patients with inflammatory bowel disease: findings from a multicentre cross‐sectional study. J Hum Nutr Diet 2020; 34:420-428. [DOI: 10.1111/jhn.12812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023]
Affiliation(s)
- R. Davis
- Inflammatory Bowel Disease Services The Department of Gastroenterology and Hepatology The Queen Elizabeth Hospital Woodville South SA Australia
- Discipline of Nutrition and Dietetics College of Nursing and Health Sciences Flinders University Adelaide SA Australia
| | - A. Day
- Inflammatory Bowel Disease Services The Department of Gastroenterology and Hepatology The Queen Elizabeth Hospital Woodville South SA Australia
- School of Medicine Faculty of Health Sciences University of Adelaide Adelaide SA Australia
| | - J. Barrett
- Department of Gastroenterology Monash University Central Clinical SchoolThe Alfred Centre Melbourne VIC Australia
| | - A. Vanlint
- Inflammatory Bowel Disease Services The Department of Gastroenterology and Hepatology The Queen Elizabeth Hospital Woodville South SA Australia
| | - J. M Andrews
- School of Medicine Faculty of Health Sciences University of Adelaide Adelaide SA Australia
- Inflammatory Bowel Disease Service Department of Gastroenterology and Hepatology Royal Adelaide Hospital Adelaide SA Australia
| | - S. P. Costello
- Inflammatory Bowel Disease Services The Department of Gastroenterology and Hepatology The Queen Elizabeth Hospital Woodville South SA Australia
- School of Medicine Faculty of Health Sciences University of Adelaide Adelaide SA Australia
| | - R. V. Bryant
- Inflammatory Bowel Disease Services The Department of Gastroenterology and Hepatology The Queen Elizabeth Hospital Woodville South SA Australia
- School of Medicine Faculty of Health Sciences University of Adelaide Adelaide SA Australia
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Aviram A, Quaglietta P, Warshafsky C, Zaltz A, Weiner E, Melamed N, Ng E, Barrett J, Ronzoni S. Utility of ultrasound assessment in management of pregnancies with preterm prelabor rupture of membranes. Ultrasound Obstet Gynecol 2020; 55:806-814. [PMID: 31332850 DOI: 10.1002/uog.20403] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/20/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate the utility of ultrasound markers in the management of pregnancies complicated by preterm prelabor rupture of membranes (PPROM) between 23 + 0 and 33 + 6 weeks' gestation, and to assess the ability of ultrasound markers to predict adverse neonatal outcomes. METHODS This was a retrospective cohort study of all patients with PPROM between 23 + 0 and 33 + 6 weeks' gestation and latency period (PPROM to delivery) > 48 h, who delivered before 34 weeks' gestation at a tertiary referral center between 2005 and 2017. All patients underwent a non-stress test daily and an ultrasound scan twice a week for assessment of amniotic fluid volume, biophysical profile (BPP) and umbilical artery (UA) pulsatility index (PI). In patients with suspected fetal growth restriction, fetal middle cerebral artery (MCA)-PI was also assessed and the cerebroplacental ratio (CPR) calculated. The last ultrasound examination performed prior to delivery was analyzed. We compared the characteristics and outcomes between women who were delivered owing to clinical suspicion of chorioamnionitis and those who were not delivered for this indication. The primary objective was to evaluate the utility of ultrasound in the management of patients with PPROM. The secondary objective was to assess the diagnostic performance of ultrasound markers (BPP score < 6, oligohydramnios, UA-PI > 95th percentile, MCA-PI < 5th percentile, CPR < 5th percentile) for the prediction of composite adverse neonatal outcome, which was defined as the presence of one or more of: perinatal death, respiratory distress syndrome, periventricular leukomalacia, intraventricular hemorrhage Grade 3 or 4, necrotizing enterocolitis, hypoxic ischemic encephalopathy, neonatal sepsis or neonatal seizures. RESULTS A total of 504 women were included in the study, comprising 120 with suspected chorioamnionitis and 384 without. Women with suspected chorioamnionitis, compared with those without, were less likely to be nulliparous (34.2% vs 45.3%; P = 0.03) and more likely to have fever (50.8% vs 2.6%; P < 0.001) and be delivered by Cesarean section (69.2% vs 42.4%; P < 0.001), mainly owing to a history of previous Cesarean section (18.3% vs 9.1%; P = 0.005) and to having non-reassuring fetal heart rate tracings (32.5% vs 14.6%; P < 0.001). No significant differences were found between the two groups with regard to the median amniotic fluid volume, overall BPP score, BPP score < 6, MCA-PI or CPR. Median UA-PI was slightly higher in the suspected-chorioamnionitis group, yet the incidence of UA-PI > 95th percentile was similar between the two groups. There was a higher incidence of composite adverse neonatal outcome in the group with suspected chorioamnionitis than in the group without (78.3% vs 64.3%, respectively; P = 0.004). However, on logistic regression analysis, none of the ultrasound markers evaluated was found to be associated with chorioamnionitis or composite adverse neonatal outcome, and they all had a poor diagnostic performance for the prediction of chorioamnionitis and composite adverse neonatal outcome. CONCLUSIONS Commonly used ultrasound markers in pregnancies complicated by PPROM were similar between women delivered for suspected chorioamnionitis and those delivered for other indications, and performed poorly in predicting composite adverse neonatal outcome. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Aviram
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - P Quaglietta
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - C Warshafsky
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A Zaltz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - E Weiner
- Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - E Ng
- Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, affiliated with the Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - S Ronzoni
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, affiliated with the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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24
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VanderMeulen H, Strauss R, Lin Y, McLeod A, Barrett J, Sholzberg M, Callum J. The contribution of iron deficiency to the risk of peripartum transfusion: a retrospective case control study. BMC Pregnancy Childbirth 2020; 20:196. [PMID: 32252681 PMCID: PMC7132873 DOI: 10.1186/s12884-020-02886-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 03/20/2020] [Indexed: 01/20/2023] Open
Abstract
Background Iron deficiency in pregnancy is associated with inferior maternal and fetal outcomes. Postpartum depression, prematurity, intrauterine growth restriction, impaired childhood cognition and transfusion are all sequelae of maternal iron deficiency anemia. Transfusion to women of childbearing age has important consequences including increasing the risk of hemolytic disease of the fetus and newborn with future pregnancies. The relative contribution of iron deficiency to transfusion rates in the peripartum period is unknown. This study aimed to identify the prevalence of iron deficiency and anemia in pregnant women that received peripartum transfusions relative to age-matched non-transfused controls. Methods We performed a retrospective case-control study of all women that were transfused in the peripartum period from January, 2014 to July, 2018. Cases were compared to the next age matched control to deliver at our institution. The primary objective was to determine the proportion of patients with iron deficiency in pregnancy or anemia in pregnancy in cases and controls. Charts were reviewed for predisposing risk factors for iron deficiency, laboratory measures of iron deficiency and anemia, iron supplementation history and maternal and fetal outcomes. Factors associated with peripartum transfusion were analyzed using a multivariate logistic regression. Results 169 of 18, 294 (0.9%) women were transfused in the peripartum period and 64 (44%) of those transfused received 1 unit. Iron deficiency or anemia were present in 103 (71%) transfused women and 74 (51%) control women in pregnancy (OR 2.34, 95% CI: 3.7–18.0). Multivariate analysis identified social work involvement (adjusted OR 4.1, 95% CI: 1.8–10.1), intravenous iron supplementation in pregnancy (adjusted OR 3.8, 95% CI: 1.2–17.4) and delivery by unscheduled cesarean section (adjusted OR 2.8, 95% CI: 1.3–6.2) as significant predictors of peripartum transfusion. Conclusions Pregnant women being followed by a social worker, receiving intravenous iron supplementation in pregnancy or who deliver by unscheduled cesarean section are more likely to receive a red blood cell transfusion. Women with iron deficiency or anemia in pregnancy are at increased risk of peripartum blood transfusions and warrant early and rigorous iron supplementation.
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Affiliation(s)
- H VanderMeulen
- Department of Medicine, Division of Hematology, University of Toronto, Toronto, Canada.
| | - R Strauss
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Y Lin
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - A McLeod
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - J Barrett
- Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - M Sholzberg
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, Toronto, Canada.,Department of Medicine, St. Michael's Hospital, Toronto, Canada
| | - J Callum
- Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Canada. .,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
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25
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Weiner E, Barrett J, Zaltz A, Ram M, Aviram A, Kibel M, Lipworth H, Asztalos E, Melamed N. Amniotic fluid volume at presentation with early preterm prelabor rupture of membranes and association with severe neonatal respiratory morbidity. Ultrasound Obstet Gynecol 2019; 54:767-773. [PMID: 30834608 DOI: 10.1002/uog.20257] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/23/2019] [Accepted: 02/27/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Amniotic fluid volume (AFV) plays an important role in early fetal lung development, and oligohydramnios in early pregnancy is associated with pulmonary hypoplasia. The aim of this study was to evaluate the association between AFV at the time of presentation with early preterm prelabor rupture of membranes (PPROM) and severe neonatal respiratory morbidity and other adverse pregnancy outcomes. METHODS This was a retrospective study of all women with a singleton pregnancy, admitted to a single tertiary referral center between 2004 and 2014, for expectant management of PPROM at 20 + 0 to 28 + 6 weeks' gestation. The primary exposure was AFV at presentation, classified according to sonographic maximum vertical pocket (MVP) as: normal AFV (> 2 cm), oligohydramnios (≤ 2 cm and > 1 cm) or severe oligohydramnios (≤ 1 cm). The primary outcome was a composite variable of severe respiratory morbidity, defined as either of the following: (1) need for respiratory support in the form of mechanical ventilation using an endotracheal tube for ≥ 72 h and need for surfactant; or (2) bronchopulmonary dysplasia, defined as requirement for oxygen at postmenstrual age of 36 weeks or at the time of transfer to a Level-II facility. Adjusted odds ratios (aOR) and 95% CI for the primary and secondary outcomes were calculated for each AFV-at-presentation group (using normal AFV as the reference), adjusting for gestational age (GA) at PPROM, latency period, birth weight, mode of delivery and chorioamnionitis. RESULTS In total, 580 women were included, of whom 304 (52.4%) had normal AFV, 161 (27.8%) had oligohydramnios and 115 (19.8%) had severe oligohydramnios at presentation. The rates of severe respiratory morbidity were 16.1%, 26.7% and 45.2%, respectively. Compared with normal AFV at presentation, oligohydramnios (aOR, 3.27; 95% CI, 1.84-5.84) and severe oligohydramnios (aOR, 4.11; 95% CI, 2.26-7.56) at presentation were associated independently with severe respiratory morbidity. Other variables that were associated independently with the primary outcome were GA at PPROM (aOR, 0.54; 95% CI, 0.43-0.69), latency period (aOR, 0.94; 95% CI, 0.91-0.98) and Cesarean delivery (aOR, 2.01; 95% CI, 1.21-3.32). CONCLUSIONS In women with early PPROM, AFV at presentation, as assessed by the MVP on ultrasound examination, is associated independently with severe neonatal respiratory morbidity. This information may be taken into consideration when counseling women with early PPROM regarding neonatal outcome and management options. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- E Weiner
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - A Zaltz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - M Ram
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Lis Maternity and Women's Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - A Aviram
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Lis Maternity and Women's Hospital, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - M Kibel
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - H Lipworth
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - E Asztalos
- Department of Newborn and Developmental Pediatrics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - N Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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26
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Aker M, Altenmüller K, Arenz M, Babutzka M, Barrett J, Bauer S, Beck M, Beglarian A, Behrens J, Bergmann T, Besserer U, Blaum K, Block F, Bobien S, Bokeloh K, Bonn J, Bornschein B, Bornschein L, Bouquet H, Brunst T, Caldwell TS, La Cascio L, Chilingaryan S, Choi W, Corona TJ, Debowski K, Deffert M, Descher M, Doe PJ, Dragoun O, Drexlin G, Dunmore JA, Dyba S, Edzards F, Eisenblätter L, Eitel K, Ellinger E, Engel R, Enomoto S, Erhard M, Eversheim D, Fedkevych M, Felden A, Fischer S, Flatt B, Formaggio JA, Fränkle FM, Franklin GB, Frankrone H, Friedel F, Fuchs D, Fulst A, Furse D, Gauda K, Gemmeke H, Gil W, Glück F, Görhardt S, Groh S, Grohmann S, Grössle R, Gumbsheimer R, Ha Minh M, Hackenjos M, Hannen V, Harms F, Hartmann J, Haußmann N, Heizmann F, Helbing K, Hickford S, Hilk D, Hillen B, Hillesheimer D, Hinz D, Höhn T, Holzapfel B, Holzmann S, Houdy T, Howe MA, Huber A, James TM, Jansen A, Kaboth A, Karl C, Kazachenko O, Kellerer J, Kernert N, Kippenbrock L, Kleesiek M, Klein M, Köhler C, Köllenberger L, Kopmann A, Korzeczek M, Kosmider A, Kovalík A, Krasch B, Kraus M, Krause H, Kuckert L, Kuffner B, Kunka N, Lasserre T, Le TL, Lebeda O, Leber M, Lehnert B, Letnev J, Leven F, Lichter S, Lobashev VM, Lokhov A, Machatschek M, Malcherek E, Müller K, Mark M, Marsteller A, Martin EL, Melzer C, Menshikov A, Mertens S, Minter LI, Mirz S, Monreal B, Morales Guzmán PI, Müller K, Naumann U, Ndeke W, Neumann H, Niemes S, Noe M, Oblath NS, Ortjohann HW, Osipowicz A, Ostrick B, Otten E, Parno DS, Phillips DG, Plischke P, Pollithy A, Poon AWP, Pouryamout J, Prall M, Priester F, Röllig M, Röttele C, Ranitzsch PCO, Rest O, Rinderspacher R, Robertson RGH, Rodenbeck C, Rohr P, Roll C, Rupp S, Ryšavý M, Sack R, Saenz A, Schäfer P, Schimpf L, Schlösser K, Schlösser M, Schlüter L, Schön H, Schönung K, Schrank M, Schulz B, Schwarz J, Seitz-Moskaliuk H, Seller W, Sibille V, Siegmann D, Skasyrskaya A, Slezák M, Špalek A, Spanier F, Steidl M, Steinbrink N, Sturm M, Suesser M, Sun M, Tcherniakhovski D, Telle HH, Thümmler T, Thorne LA, Titov N, Tkachev I, Trost N, Urban K, Vénos D, Valerius K, VanDevender BA, Vianden R, Vizcaya Hernández AP, Wall BL, Wüstling S, Weber M, Weinheimer C, Weiss C, Welte S, Wendel J, Wierman KJ, Wilkerson JF, Wolf J, Xu W, Yen YR, Zacher M, Zadorozhny S, Zbořil M, Zeller G. Improved Upper Limit on the Neutrino Mass from a Direct Kinematic Method by KATRIN. Phys Rev Lett 2019; 123:221802. [PMID: 31868426 DOI: 10.1103/physrevlett.123.221802] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Indexed: 06/10/2023]
Abstract
We report on the neutrino mass measurement result from the first four-week science run of the Karlsruhe Tritium Neutrino experiment KATRIN in spring 2019. Beta-decay electrons from a high-purity gaseous molecular tritium source are energy analyzed by a high-resolution MAC-E filter. A fit of the integrated electron spectrum over a narrow interval around the kinematic end point at 18.57 keV gives an effective neutrino mass square value of (-1.0_{-1.1}^{+0.9}) eV^{2}. From this, we derive an upper limit of 1.1 eV (90% confidence level) on the absolute mass scale of neutrinos. This value coincides with the KATRIN sensitivity. It improves upon previous mass limits from kinematic measurements by almost a factor of 2 and provides model-independent input to cosmological studies of structure formation.
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Affiliation(s)
- M Aker
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Altenmüller
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- IRFU (DPhP & APC), CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - M Arenz
- Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Nussallee 14-16, 53115 Bonn, Germany
| | - M Babutzka
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - J Barrett
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - S Bauer
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - M Beck
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - A Beglarian
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - J Behrens
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - T Bergmann
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - U Besserer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Blaum
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - F Block
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Bobien
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Bokeloh
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - J Bonn
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - B Bornschein
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Bornschein
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H Bouquet
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Brunst
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - T S Caldwell
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - L La Cascio
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Chilingaryan
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - W Choi
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - T J Corona
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - K Debowski
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - M Deffert
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - M Descher
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - P J Doe
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - O Dragoun
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - G Drexlin
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - J A Dunmore
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Dyba
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - F Edzards
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - L Eisenblätter
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Eitel
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - E Ellinger
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - R Engel
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Enomoto
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M Erhard
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - D Eversheim
- Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Nussallee 14-16, 53115 Bonn, Germany
| | - M Fedkevych
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - A Felden
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Fischer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Flatt
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - J A Formaggio
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - F M Fränkle
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - G B Franklin
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - H Frankrone
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - F Friedel
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - D Fuchs
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - A Fulst
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - D Furse
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - K Gauda
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - H Gemmeke
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - W Gil
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - F Glück
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Görhardt
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Groh
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Grohmann
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R Grössle
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R Gumbsheimer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Ha Minh
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - M Hackenjos
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - V Hannen
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - F Harms
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - J Hartmann
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N Haußmann
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - F Heizmann
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - K Helbing
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - S Hickford
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - D Hilk
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - B Hillen
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - D Hillesheimer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - D Hinz
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Höhn
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Holzapfel
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Holzmann
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Houdy
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - M A Howe
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - A Huber
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - T M James
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Jansen
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Kaboth
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - C Karl
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - O Kazachenko
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - J Kellerer
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - N Kernert
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Kippenbrock
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M Kleesiek
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - M Klein
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - C Köhler
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - L Köllenberger
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Kopmann
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Korzeczek
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - A Kosmider
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Kovalík
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - B Krasch
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Kraus
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - H Krause
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Kuckert
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Kuffner
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N Kunka
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T Lasserre
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- IRFU (DPhP & APC), CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - T L Le
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - O Lebeda
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - M Leber
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - B Lehnert
- Institute for Nuclear and Particle Astrophysics and Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Letnev
- University of Applied Sciences (HFD) Fulda, Leipziger Straße 123, 36037 Fulda, Germany
| | - F Leven
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - S Lichter
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - V M Lobashev
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - A Lokhov
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - M Machatschek
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - E Malcherek
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Müller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Mark
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Marsteller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - E L Martin
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - C Melzer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Menshikov
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Mertens
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
- Institute for Nuclear and Particle Astrophysics and Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L I Minter
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Mirz
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Monreal
- Department of Physics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - P I Morales Guzmán
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - K Müller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - U Naumann
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - W Ndeke
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - H Neumann
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Niemes
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Noe
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N S Oblath
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - H-W Ortjohann
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - A Osipowicz
- University of Applied Sciences (HFD) Fulda, Leipziger Straße 123, 36037 Fulda, Germany
| | - B Ostrick
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - E Otten
- Institut für Physik, Johannes-Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - D S Parno
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - D G Phillips
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - P Plischke
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - A Pollithy
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - A W P Poon
- Institute for Nuclear and Particle Astrophysics and Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Pouryamout
- Department of Physics, Faculty of Mathematics and Natural Sciences, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - M Prall
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - F Priester
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Röllig
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - C Röttele
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - P C-O Ranitzsch
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - O Rest
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - R Rinderspacher
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - R G H Robertson
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - C Rodenbeck
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - P Rohr
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Ch Roll
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - S Rupp
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - M Ryšavý
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - R Sack
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - A Saenz
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - P Schäfer
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Schimpf
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - K Schlösser
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Schlösser
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - L Schlüter
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - H Schön
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Schönung
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - M Schrank
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - B Schulz
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstraße 15, 12489 Berlin, Germany
| | - J Schwarz
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H Seitz-Moskaliuk
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - W Seller
- University of Applied Sciences (HFD) Fulda, Leipziger Straße 123, 36037 Fulda, Germany
| | - V Sibille
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - D Siegmann
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - A Skasyrskaya
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - M Slezák
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - A Špalek
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - F Spanier
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Steidl
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - N Steinbrink
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - M Sturm
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Suesser
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Sun
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - D Tcherniakhovski
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - H H Telle
- Departamento de Química Física Aplicada, Universidad Autonoma de Madrid, Campus de Cantoblanco, 28049 Madrid, Spain
| | - T Thümmler
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - L A Thorne
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - N Titov
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - I Tkachev
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - N Trost
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K Urban
- Technische Universität München, James-Franck-Straße 1, 85748 Garching, Germany
- Max-Planck-Institut für Physik, Föhringer Ring 6, 80805 München, Germany
| | - D Vénos
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - K Valerius
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - B A VanDevender
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - R Vianden
- Helmholtz-Institut für Strahlen- und Kernphysik, Rheinische Friedrich-Wilhelms-Universität Bonn, Nussallee 14-16, 53115 Bonn, Germany
| | - A P Vizcaya Hernández
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - B L Wall
- Center for Experimental Nuclear Physics and Astrophysics, and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Wüstling
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - M Weber
- Institute for Data Processing and Electronics (IPE), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - C Weinheimer
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - C Weiss
- Project, Process, and Quality Management (PPQ), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - S Welte
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - J Wendel
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - K J Wierman
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J F Wilkerson
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J Wolf
- Institute of Experimental Particle Physics (ETP), Karlsruhe Institute of Technology (KIT), Wolfgang-Gaede-Straße 1, 76131 Karlsruhe, Germany
| | - W Xu
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
| | - Y-R Yen
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - M Zacher
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
| | - S Zadorozhny
- Institute for Nuclear Research of Russian Academy of Sciences, 60th October Anniversary Prospect 7a, 117312 Moscow, Russia
| | - M Zbořil
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 9, 48149 Münster, Germany
- Nuclear Physics Institute of the CAS, v. v. i., CZ-250 68 Řež, Czech Republic
| | - G Zeller
- Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
- Institute for Technical Physics (ITEP), Karlsruhe Institute of Technology (KIT), Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
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Roden C, Barrett J, Glennon E, Osborne T, Whitehouse J, Rashid R, Nash E. WS09-6 Dietary practices in adults with cystic fibrosis taking CFTR modulator therapies. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Barrett J, Slatter G, Rashid R, Whitehouse J, Nash E. WS09-5 Perception, experience and relationship with food and eating in adults with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30170-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Margarido C, Ferns J, Chin V, Ribeiro T, Nascimento B, Barrett J, Herer E, Halpern S, Andrews L, Ballatyne G, Chapmam M, Gomes J, Callum J. Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review. Int J Obstet Anesth 2018; 38:37-45. [PMID: 30509680 DOI: 10.1016/j.ijoa.2018.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/24/2018] [Accepted: 10/13/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and assess compliance by the clinical team. METHODS A multidisciplinary team set the institutional quality indicators for the massive hemorrhage protocol review. A retrospective review of all obstetrical massive hemorrhage protocol activation events from September 2010 to January 2015 was performed. All protocol events occurred before the creation of the quality indicators. Data were retrieved from patient records. RESULTS There were 17 (0.09%) protocol activations for 19 790 deliveries during the study period. All 17 (100%) patients received at least one unit of red blood cells. Overactivation, defined as the transfusion of <2 units of red blood cells, occurred in two cases (12%). Common causes of non-compliance were: 24% (4/17) temperature monitoring, 18% (3/17) lactate measurement, 41% (7/17) arterial blood gas sampling, and 18% (3/17) hemoglobin maintenance within the target range of 55-95 g/L. Admission to intensive care and peripartum hysterectomy occurred in 12 and 5 cases (71% and 29%), respectively. CONCLUSIONS Suboptimal compliance was found in multiple areas, which may be attributable to the low frequency of activation of our massive haemorrhage protocol in obstetrics. The quality targets identified in this report can act as a basis for other institutions developing quality indicators to evaluate performance.
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Affiliation(s)
- C Margarido
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
| | - J Ferns
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - V Chin
- Department of Transfusion Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - T Ribeiro
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - B Nascimento
- Department of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J Barrett
- Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - E Herer
- Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S Halpern
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Andrews
- Department of Women and Babies, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - G Ballatyne
- Department of Women and Babies, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M Chapmam
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J Gomes
- Department of Evaluative Clinical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - J Callum
- Department of Transfusion Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Cadieux EL, Wilson G, Tanic M, Demeulemeester J, Barrett J, Birkbak N, Swanton C, Beck S, Loo PV. PO-342 Integrating copy number analysis and tumour DNA methylation profiling. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.854] [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] Open
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Tuck C, Ly E, Bogatyrev A, Costetsou I, Gibson P, Barrett J, Muir J. Fermentable short chain carbohydrate (FODMAP) content of common plant-based foods and processed foods suitable for vegetarian- and vegan-based eating patterns. J Hum Nutr Diet 2018; 31:422-435. [DOI: 10.1111/jhn.12546] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- C. Tuck
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - E. Ly
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - A. Bogatyrev
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - I. Costetsou
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - P. Gibson
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - J. Barrett
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - J. Muir
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
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Roe G, Barrett J, Hargreaves L, Hutchinson P, Macklam R, Nash N, Richards A, Sakthivel K, Somers K, Whiteside M, Wolstenhulme S. Letter of response to article by Milner and Snaith, Are reporting radiographers fulfilling the role of advanced practitioner? Radiography 2017 23 : 48–54. Radiography (Lond) 2017; 23:365. [DOI: 10.1016/j.radi.2017.06.007] [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] [Received: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
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Seligmann J, Wood H, Richman S, Elliott F, Taylor M, Tinkler-Hundal E, Barrett J, Seymour M, Quirke P. Epidermal growth factor receptor (EGFR) copy number (CN) as a biomarker of prognosis and panitumumab (Pan) benefit in RAS-wt advanced colorectal cancer (aCRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.071] [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: 11/14/2022] Open
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Levinson M, Mills A, Oldroyd J, Gellie A, Barrett J, Staples M, Stephenson G. The impact of intensive care in a private hospital on patients aged 80 and over: health-related quality of life, functional status and burden versus benefit. Intern Med J 2017; 46:694-702. [PMID: 27009846 DOI: 10.1111/imj.13079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 03/01/2016] [Accepted: 03/09/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Greater numbers of persons aged over 80 years are admitted to intensive care units (ICU) compared with 15 years ago. Outcomes other than death such as physical dependence and cognitive impairment and treatment burden are important to older people. AIMS The aims of this study were to determine the long-term outcomes of functional impairment, health-related quality of life (HRQoL) and the self-reported burden of treatment in a sample of patients aged 80 years and above admitted to ICU. Half of the cohort were admitted for elective cardiac surgery, the rest for non-cardiac surgery and medical conditions. METHODS In this longitudinal cohort study, in a tertiary level ICU, we measured HRQoL using the SF-36 and functional status using the modified Barthel Index at several time points over a 2-year follow-up period. We also assessed treatment burden by asking participants whether they thought the episode of care was worthwhile. RESULTS A total of 348 patients was recruited into the study. One-fifth of the cohort had died by the 2-year follow-up data collection point. There was an improvement in physical functioning in the cardiac surgery group at 6 months which was not sustained. There was no change in HRQoL at 2 years in either group. The majority valued the episode of care. CONCLUSION We demonstrated that HRQoL and previous lifestyle is preserved in the majority following ICU admission, associated with a high level of patient valuation of the episode of care.
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Affiliation(s)
- M Levinson
- Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - A Mills
- Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia
| | - J Oldroyd
- Monash Centre for Health Research and Implementation, Melbourne, Victoria, Australia
| | - A Gellie
- Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia
| | - J Barrett
- Intensive Care Unit, Cabrini Health, Melbourne, Victoria, Australia
| | - M Staples
- Cabrini Institute for Research and Education, Melbourne, Victoria, Australia
| | - G Stephenson
- Department of Medicine, Cabrini-Monash University, Cabrini Institute for Research and Education, Melbourne, Victoria, Australia
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Glennon E, Roden C, Barrett J, Osborne T, Sunsoa H, Rashid R, Whitehouse J, Nash E. 328 Going the distance – patient opinion on an adult CF centre dietetic and diabetes home visit service. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30666-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Egan H, Mantzios M, Nash E, Barrett J, Regan A. 329 A qualitative study: mindful eating attitudes and behaviours in a cystic fibrosis population. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30667-7] [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: 12/01/2022]
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37
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Jordan K, Barrett J, Murney S, Whipp A, Elliott JO. Educational programme to enhance stethoscope hygiene behaviour. J Hosp Infect 2017; 96:67-68. [PMID: 28412177 DOI: 10.1016/j.jhin.2017.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Affiliation(s)
- K Jordan
- Department of Medical Education, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA.
| | - J Barrett
- Department of Infectious Disease, The Ohio State University, Columbus, OH, USA
| | - S Murney
- Central Ohio Primary Care Physicians, Inc., Columbus, OH, USA
| | - A Whipp
- Department of Medical Education, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA
| | - J O Elliott
- Department of Medical Education, OhioHealth Riverside Methodist Hospital, Columbus, OH, USA; OhioHealth Research Institute, Columbus, OH, USA
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Jarde A, Lutsiv O, Park CK, Beyene J, Dodd JM, Barrett J, Shah PS, Cook JL, Saito S, Biringer AB, Sabatino L, Giglia L, Han Z, Staub K, Mundle W, Chamberlain J, McDonald SD. Effectiveness of progesterone, cerclage and pessary for preventing preterm birth in singleton pregnancies: a systematic review and network meta-analysis. BJOG 2017; 124:1176-1189. [PMID: 28276151 DOI: 10.1111/1471-0528.14624] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preterm birth (PTB) is the leading cause of infant death, but it is unclear which intervention is best to prevent it. OBJECTIVES To compare progesterone, cerclage and pessary, determine their relative effects and rank them. SEARCH STRATEGY We searched Medline, EMBASE, CINAHL, Cochrane CENTRAL and Web of Science (to April 2016), without restrictions, and screened references of previous reviews. SELECTION CRITERIA We included randomised trials of progesterone, cerclage or pessary for preventing PTB in women with singleton pregnancies at risk as defined by each study. DATA COLLECTION AND ANALYSIS We extracted data by duplicate using a piloted form and performed Bayesian random-effects network meta-analyses and pairwise meta-analyses. We rated evidence quality using GRADE, ranked interventions using SUCRA and calculated numbers needed to treat (NNT). MAIN RESULTS We included 36 trials (9425 women; 25 low risk of bias trials). Progesterone ranked first or second for most outcomes, reducing PTB < 34 weeks [odds ratio (OR) 0.44; 95% credible interval (CrI) 0.22-0.79; NNT 9; low quality], <37 weeks (OR 0.58; 95% CrI 0.41-0.79; NNT 9; moderate quality), and neonatal death (OR 0.50; 95% CrI 0.28-0.85; NNT 35; high quality), compared with control, in women overall at risk. We found similar results in the subgroup with previous PTB, but only a reduction of PTB < 34 weeks in women with a short cervix. Pessary showed inconsistent benefit and cerclage did not reduce PTB < 37 or <34 weeks. CONCLUSIONS Progesterone was the best intervention for preventing PTB in singleton pregnancies at risk, reducing PTB < 34 weeks, <37 weeks, neonatal demise and other sequelae. TWEETABLE ABSTRACT Progesterone was better than cerclage and pessary to prevent preterm birth, neonatal death and more in network meta-analysis.
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Affiliation(s)
- A Jarde
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - O Lutsiv
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - C K Park
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - J Beyene
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - J M Dodd
- Department of Obstetrics and Gynaecology, University of Adelaide, Adelaide, SA, Australia
| | - J Barrett
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - P S Shah
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - J L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada.,Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada
| | - S Saito
- Department of Obstetrics and Gynaecology, University of Toyama, Toyama, Japan
| | - A B Biringer
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - L Sabatino
- Midwifery Education Program, McMaster University, Hamilton, ON, Canada
| | - L Giglia
- Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Z Han
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - K Staub
- Canadian Premature Babies Foundation, Sherwood Park, AB, Canada
| | - W Mundle
- Maternal Fetal Medicine Clinic, Windsor Regional Hospital, Windsor, ON, Canada
| | - J Chamberlain
- Save the Mothers, Uganda Christian University, Mukono, Uganda
| | - S D McDonald
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
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39
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Jarde A, Lutsiv O, Park CK, Barrett J, Beyene J, Saito S, Dodd JM, Shah PS, Cook JL, Biringer AB, Giglia L, Han Z, Staub K, Mundle W, Vera C, Sabatino L, Liyanage SK, McDonald SD. Preterm birth prevention in twin pregnancies with progesterone, pessary, or cerclage: a systematic review and meta-analysis. BJOG 2017; 124:1163-1173. [DOI: 10.1111/1471-0528.14513] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 12/14/2022]
Affiliation(s)
- A Jarde
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
| | - O Lutsiv
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
| | - CK Park
- Department of Clinical Epidemiology and Biostatistics; McMaster University Hamilton, ON Canada
| | - J Barrett
- Sunnybrook Health Sciences Centre; Toronto ON Canada
| | - J Beyene
- Department of Clinical Epidemiology and Biostatistics; McMaster University Hamilton, ON Canada
| | - S Saito
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - JM Dodd
- Department of Obstetrics and Gynecology; University of Adelaide; Adelaide Australia
| | - PS Shah
- Department of Paediatrics; University of Toronto; Toronto ON Canada
| | - JL Cook
- The Society of Obstetricians and Gynaecologists of Canada; Ottawa ON Canada
| | - AB Biringer
- Department of Family and Community Medicine; University of Toronto; Toronto ON Canada
| | - L Giglia
- Department of Pediatrics; McMaster University; Hamilton ON Canada
| | - Z Han
- The First Affiliated Hospital of Xi'an Jiaotong University; Xi'an Shaanxi Province China
| | - K Staub
- Canadian Premature Babies Foundation; Sherwood Park AB Canada
| | - W Mundle
- Maternal Fetal Medicine Clinic; Windsor Regional Hospital; Windsor ON Canada
| | - C Vera
- Division of Obstetrics and Gynecology; Escuela de Medicina; Pontificia Universidad Católica de Chile; Santiago Chile
| | - L Sabatino
- Midwifery Education Program; McMaster University; Hamilton ON Canada
| | - SK Liyanage
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
| | - SD McDonald
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
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Javaid MK, Forestier-Zhang L, Watts L, Turner A, Ponte C, Teare H, Gray D, Gray N, Popert R, Hogg J, Barrett J, Pinedo-Villanueva R, Cooper C, Eastell R, Bishop N, Luqmani R, Wordsworth P, Kaye J. The RUDY study platform - a novel approach to patient driven research in rare musculoskeletal diseases. Orphanet J Rare Dis 2016; 11:150. [PMID: 27825362 PMCID: PMC5101709 DOI: 10.1186/s13023-016-0528-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 10/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research into rare diseases is becoming more common, with recognition of the significant diagnostic and therapeutic care gaps. Registries are considered a key research methodology to address rare diseases. This report describes the structure of the Rare UK Diseases Study (RUDY) platform that aims to improve research processes and address many of the challenges of carrying out rare musculoskeletal disease research. RUDY is an internet-based platform with online registration, initial verbal consent, online capture of patient reported outcome measures and events within a dynamic consent framework. The database structure, security and governance framework are described. RESULTS There have been 380 participants recruited into RUDY with completed questionnaire rates in excess of 50 %. There has been one withdrawal and two participants have amended their consent options. CONCLUSIONS The strengths of RUDY include low burden for the clinical team, low research administration costs with high participant recruitment and ease of data collection and access. This platform has the potential to be used as the model for other rare diseases globally.
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Affiliation(s)
- M K Javaid
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. .,The Botnar Research Centre, NIHR Oxford Musculoskeletal BRU, NDORMS, University of Oxford, Oxford, OX3 7HE, UK.
| | - L Forestier-Zhang
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - L Watts
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - A Turner
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Ponte
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - H Teare
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - D Gray
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - N Gray
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - R Popert
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - J Hogg
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - J Barrett
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - R Pinedo-Villanueva
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Cooper
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - R Eastell
- Academic Unit of Bone Metabolism, Metabolic Bone Centre, Northern General Hospital, Sheffield, UK
| | - N Bishop
- Academic Unit of Child Health, University of Sheffield, Sheffield, UK
| | - R Luqmani
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - P Wordsworth
- Oxford NIHR Musculoskeletal Biomedcial Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - J Kaye
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Rivas MA, Graham D, Sulem P, Stevens C, Desch AN, Goyette P, Gudbjartsson D, Jonsdottir I, Thorsteinsdottir U, Degenhardt F, Mucha S, Kurki MI, Li D, D'Amato M, Annese V, Vermeire S, Weersma RK, Halfvarson J, Paavola-Sakki P, Lappalainen M, Lek M, Cummings B, Tukiainen T, Haritunians T, Halme L, Koskinen LLE, Ananthakrishnan AN, Luo Y, Heap GA, Visschedijk MC, MacArthur DG, Neale BM, Ahmad T, Anderson CA, Brant SR, Duerr RH, Silverberg MS, Cho JH, Palotie A, Saavalainen P, Kontula K, Färkkilä M, McGovern DPB, Franke A, Stefansson K, Rioux JD, Xavier RJ, Daly MJ, Barrett J, de Lane K, Edwards C, Hart A, Hawkey C, Jostins L, Kennedy N, Lamb C, Lee J, Lees C, Mansfield J, Mathew C, Mowatt C, Newman B, Nimmo E, Parkes M, Pollard M, Prescott N, Randall J, Rice D, Satsangi J, Simmons A, Tremelling M, Uhlig H, Wilson D, Abraham C, Achkar JP, Bitton A, Boucher G, Croitoru K, Fleshner P, Glas J, Kugathasan S, Limbergen JV, Milgrom R, Proctor D, Regueiro M, Schumm PL, Sharma Y, Stempak JM, Targan SR, Wang MH. A protein-truncating R179X variant in RNF186 confers protection against ulcerative colitis. Nat Commun 2016; 7:12342. [PMID: 27503255 PMCID: PMC4980482 DOI: 10.1038/ncomms12342] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/24/2016] [Indexed: 01/05/2023] Open
Abstract
Protein-truncating variants protective against human disease provide in vivo validation of therapeutic targets. Here we used targeted sequencing to conduct a search for protein-truncating variants conferring protection against inflammatory bowel disease exploiting knowledge of common variants associated with the same disease. Through replication genotyping and imputation we found that a predicted protein-truncating variant (rs36095412, p.R179X, genotyped in 11,148 ulcerative colitis patients and 295,446 controls, MAF=up to 0.78%) in RNF186, a single-exon ring finger E3 ligase with strong colonic expression, protects against ulcerative colitis (overall P=6.89 × 10(-7), odds ratio=0.30). We further demonstrate that the truncated protein exhibits reduced expression and altered subcellular localization, suggesting the protective mechanism may reside in the loss of an interaction or function via mislocalization and/or loss of an essential transmembrane domain.
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Affiliation(s)
- Manuel A. Rivas
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Daniel Graham
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | | | - Christine Stevens
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - A. Nicole Desch
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Philippe Goyette
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada H1T1C8
| | - Daniel Gudbjartsson
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, 101 Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- Department of Immunology, Landspitali, the National University Hospital of Iceland, 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Frauke Degenhardt
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Sören Mucha
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Mitja I. Kurki
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Dalin Li
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
| | - Mauro D'Amato
- Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Stockholm, Sweden
- BioCruces Health Research Institute and IKERBASQUE, Basque Foundation for Science, 48903 Bilbao, Spain
| | - Vito Annese
- Unit of Gastroenterology, Istituto di Ricovero e Cura a Carattere Scientifico-Casa Sollievo della Sofferenza (IRCCS-CSS) Hospital, 71013 San Giovanni Rotondo, Italy
- Strutture Organizzative Dipartimentali (SOD) Gastroenterologia 2, Azienda Ospedaliero Universitaria (AOU) Careggi, 50134 Florence, Italy
| | - Severine Vermeire
- Department of Clinical and Experimental Medicine, Translational Research in GastroIntestinal Disorders (TARGID), Katholieke Universiteit (KU) Leuven, Leuven 3000, Belgium
- Division of Gastroenterology, University Hospital Gasthuisberg, BE-3000 Leuven, Belgium
| | - Rinse K. Weersma
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Jonas Halfvarson
- Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, SE 701 82 Örebro, Sweden
| | - Paulina Paavola-Sakki
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
- Clinic of Gastroenterology, Helsinki University Hospital, 00100 Helsinki, Finland
| | - Maarit Lappalainen
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
- Research Programs Unit, Immunobiology, and Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland
| | - Monkol Lek
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Beryl Cummings
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Taru Tukiainen
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Talin Haritunians
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
| | - Leena Halme
- Department of Transplantation and Liver Surgery, University of Helsinki, 00100 Helsinki, Finland
| | - Lotta L. E. Koskinen
- Research Programs Unit, Immunobiology, and Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, 00100 Helsinki, Finland
| | - Ashwin N. Ananthakrishnan
- Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Division of Medical Sciences, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Yang Luo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Graham A. Heap
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - Marijn C. Visschedijk
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Daniel G. MacArthur
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Benjamin M. Neale
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Tariq Ahmad
- Peninsula College of Medicine and Dentistry, Exeter PL6 8BU, UK
| | - Carl A. Anderson
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Steven R. Brant
- Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, 21205, USA
| | - Richard H. Duerr
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Mark S. Silverberg
- Department of Medicine, Inflammatory Bowel Disease Centre, Mount Sinai Hospital, Toronto, Ontario, Canada M5G 1X5
| | - Judy H Cho
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut 06510, USA
| | - Aarno Palotie
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Institute for Molecular Medicine Finland, University of Helsinki, 00100 Helsinki, Finland
- Massachusetts General Hospital, Center for Human Genetic Research, Psychiatric and Neurodevelopmental Genetics Unit, Boston, Massachusetts 02114, USA
| | - Päivi Saavalainen
- Research Programs Unit, Immunobiology, University of Helsinki, 00100 Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
| | - Martti Färkkilä
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
- Clinic of Gastroenterology, Helsinki University Hospital, 00100 Helsinki, Finland
| | - Dermot P. B. McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Kari Stefansson
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - John D. Rioux
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada H1T1C8
- Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada H3T 1J4
| | - Ramnik J. Xavier
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Mark J. Daly
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - J. Barrett
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - K. de Lane
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - C. Edwards
- Department of Gastroenterology, Torbay Hospital, Devon, UK
| | - A. Hart
- Department of Medicine, St. Mark's Hospital, Middlesex, UK
| | - C. Hawkey
- Nottingham Digestive Disease Centre, Queens Medical Centre, Nottingham, UK
| | - L. Jostins
- Wellcome Trust Centre for Human Genetics, University of Oxford, Headington, UK
- Christ Church, University of Oxford, Oxford, UK
| | - N. Kennedy
- Gastrointestinal Unit, Wester General Hospital, University of Edinburgh, Edinburgh, UK
| | - C. Lamb
- Newcastle University, Newcastle upon Tyne, UK
| | - J. Lee
- Inflammatory Bowel Disease Research Group, Addenbrooke's Hospital, Cambridge, UK
| | - C. Lees
- Gastrointestinal Unit, Wester General Hospital, University of Edinburgh, Edinburgh, UK
| | | | - C. Mathew
- Department of Medical and Molecular Genetics, Guy's Hospital, London, UK
- Department of Medical and Molecular Genetics, King's College London School of Medicine, Guy's Hospital, London, UK
| | - C. Mowatt
- Department of Medicine, Ninewells Hospital and Medical School, Dundee, UK
| | - B. Newman
- Genetic Medicine, Manchester Academic Health Science Centre, Manchester, UK
- The Manchester Centre for Genomic Medicine, University of Manchester, Manchester, UK
| | - E. Nimmo
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - M. Parkes
- Inflammatory Bowel Disease Research Group, Addenbrooke's Hospital, Cambridge, UK
| | - M. Pollard
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - N. Prescott
- Department of Medical and Molecular Genetics, Guy's Hospital, London, UK
- Department of Medical and Molecular Genetics, King's College London School of Medicine, Guy's Hospital, London, UK
| | - J. Randall
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - D. Rice
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - J. Satsangi
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - A. Simmons
- Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - M. Tremelling
- Gastroenterology & General Medicine, Norfolk and Norwich University Hospital, Norwich, UK
| | - H. Uhlig
- Translational Gastroenterology Unit and the Department of Pediatrics, University of Oxford, Oxford, UK
| | - D. Wilson
- Pediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - C. Abraham
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - J. P. Achkar
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - A. Bitton
- Division of Gastroenterology, Royal Victoria Hospital, Montréal, Québec, Canada
| | - G. Boucher
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada H1T1C8
| | - K. Croitoru
- Inflammatory Bowel Disease Group, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - P. Fleshner
- Department of Transplantation and Liver Surgery, University of Helsinki, 00100 Helsinki, Finland
| | - J. Glas
- Division of Gastroenterology, Royal Victoria Hospital, Montréal, Québec, Canada
| | - S. Kugathasan
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J. V. Limbergen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Ontario, Canada
| | - R. Milgrom
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut 06510, USA
| | - D. Proctor
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - M. Regueiro
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - P. L. Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Y. Sharma
- Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - J. M. Stempak
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut 06510, USA
| | - S. R. Targan
- Department of Transplantation and Liver Surgery, University of Helsinki, 00100 Helsinki, Finland
| | - M. H. Wang
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA
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Kelly D, Hawdon G, Reeves J, Morris A, Cunningham M, Barrett J. Safety of intravenous metoprolol use in unmonitored wards: a single-centre observational study. Intern Med J 2016; 45:934-8. [PMID: 26109478 DOI: 10.1111/imj.12842] [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: 01/01/2015] [Accepted: 06/10/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM This study aims to examine and quantify the risks associated with the use of intravenous metoprolol on unmonitored wards. METHOD This study was a retrospective single-centre observational study from 1 January 2009 to 31 December 2013. The study hospital was a 415-bed, private hospital in Melbourne, Victoria. The study population was all patients who received intravenous metoprolol on an unmonitored ward. The primary outcome measure was the rate of serious adverse events (SAE), defined as a complication of intravenous metoprolol resulting in transfer to a critical-care environment, a medical emergency team call or death. RESULTS Six hundred and nine patients received a total of 8260 doses of intravenous metoprolol. Seven cases were identified with a SAE deemed possibly related to beta-blocker use and there was one death. All SAE were hypotension, giving an overall rate of hypotension of 7/609 or 1.1% (95% confidence interval (CI), 0.5 to 2.4%) with a rate per dose delivered of 0.8/1000 doses (95% CI 0.3 to 1.7). The death occurred in a 94-year-old woman with abdominal sepsis. After case file review, consensus opinion deemed this to be unrelated to intravenous metoprolol. CONCLUSION The use of intravenous metoprolol on unmonitored wards appears to be safe. The complication rate was low, suggesting that this may be a sensible approach to the management of in-hospital populations at risk of beta-blocker withdrawal.
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Affiliation(s)
- D Kelly
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - G Hawdon
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - J Reeves
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - A Morris
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - M Cunningham
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
| | - J Barrett
- Intensive Care, Cabrini Hospital - Malvern, Melbourne, Victoria, Australia
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Yao C, Tuck C, Barrett J, Canale K, Philpott H, Gibson P. Reproducibility of lactulose and fructose breath hydrogen testing and impact on clinical utility. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.258] [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: 10/21/2022] Open
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Barrett J, Yudelev M. SU-G-201-05: Comparison of Different Methods for Output Verification of Eleckta Nucletron's Valencia Skin Applicators. Med Phys 2016. [DOI: 10.1118/1.4956878] [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: 11/07/2022] Open
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Barrett J, Rosen H, Melamed N, Nevo O, Freeman H, Okby R, Glanc P. O-OBS-MFM-MD-114 The Role of Cervical Length in Triplets compared with Twins. Journal of Obstetrics and Gynaecology Canada 2016. [DOI: 10.1016/j.jogc.2016.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Carter A, Ortega-Loayza AG, Barrett J, Nunley J. Calciphylaxis with evidence of hypercoagulability successfully treated with unfractionated heparin: a multidisciplinary approach. Clin Exp Dermatol 2015; 41:275-8. [PMID: 26290127 DOI: 10.1111/ced.12729] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 02/05/2023]
Abstract
Calciphylaxis is characterized by abnormal calcification of vessels and skin; however, its aetiology and pathogenesis remain unclear. Entities frequently associated with calciphylaxis are end-stage renal disease, diabetes mellitus, hypercalcaemia, hyperphosphataemia, elevated calcium-phosphate product, hyperparathyroidism and possible hypercoagulable states. Skin lesions may remain quiescent or may develop suddenly and progress rapidly. They are more common on the legs. Treatment of calciphylaxis is very challenging and requires interdisciplinary management. We present a case that highlights the difficulty of treating calciphylaxis. A multidisciplinary approach was vital for the proper treatment of our patient. This case also demonstrates the importance of searching for underlying hypercoagulable states, especially in recalcitrant cases. In cases of calciphylaxis with vessel occlusion from microthrombi, heparin therapy would be a logical next step. The effect of anticoagulation may be rapid and impressive.
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Affiliation(s)
- A Carter
- Department of Dermatology, New York Medical College, New York, NY, USA
| | - A G Ortega-Loayza
- Department of Dermatology, Division of Hematology/Oncology, Virginia Commonwealth University, Richmond, VA, USA
| | - J Barrett
- Department of Internal Medicine, Division of Hematology/Oncology, Virginia Commonwealth University, Richmond, VA, USA
| | - J Nunley
- Department of Dermatology, Division of Hematology/Oncology, Virginia Commonwealth University, Richmond, VA, USA
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Kumagai Y, Cai H, Barrett J, Shiraishi T, Hayashi Y, Sonehara Y, Nagahama F. Evaluation of Cardiovascular safety of Darinaparsin (organic arsenic compound) in Japanese and Korean patients with peripheral T-cell Lymphoma. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.269] [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: 11/26/2022]
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Ewen SC, Barrett J, Paul D, Askew D, Webb G, Wilkin A. When a patient's ethnicity is declared, medical students' decision-making processes are affected. Intern Med J 2015; 45:805-12. [DOI: 10.1111/imj.12800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
Affiliation(s)
- S. C. Ewen
- Melbourne Poche Centre for Indigenous Health; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - J. Barrett
- Melbourne Poche Centre for Indigenous Health; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - D. Paul
- Aboriginal Health; School of Medicine; University of Notre Dame; Fremantle Western Australia Australia
| | - D. Askew
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care; Queensland Health; Brisbane Queensland Australia
- Discipline of General Practice; The University of Queensland; Brisbane Queensland Australia
| | - G. Webb
- School of Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - A. Wilkin
- Melbourne School of Population and Global Health; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
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Barrett J. Re: Predictive value of cervical length in women with twin pregnancy presenting with threatened preterm labor. N. Melamed, L. Hiersch, R. Gabbay-Benziv, R. Bardin, I. Meizner, A. Wiznitzer and Y. Yogev. Ultrasound Obstet Gynecol 2015; 46: 73-81. Ultrasound Obstet Gynecol 2015; 46:12-13. [PMID: 26134730 DOI: 10.1002/uog.14908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- J Barrett
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada.
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Vo PT, Pantin J, Ramos C, Cook L, Cho E, Kurlander R, Khuu H, Barrett J, Leitman S, Childs RW. Conditioning with rabbit versus horse ATG dramatically alters clinical outcomes in identical twins with severe aplastic anemia transplanted with the same allogeneic donor. J Hematol Oncol 2015; 8:78. [PMID: 26113077 PMCID: PMC4487559 DOI: 10.1186/s13045-015-0173-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 06/12/2015] [Indexed: 12/28/2022] Open
Abstract
Severe aplastic anemia (SAA) is a rare disorder leading to bone marrow failure, which if left untreated, is invariably fatal. Conventional therapies with immunosuppressive therapy or allogeneic hematopoietic stem cell transplantation (HSCT) are highly effective. HSCT can offer a greater outcome in younger patients who have an available HLA match-related donor. Recent studies showing the addition of antithymocyte globulin (ATG) to the conditioning regimen improves engraftment and reduces the risk of graft-versus-host disease (GVHD).There are currently two ATG preparations in the USA, equine (or horse) and rabbit ATG. These agents are pharmacologically distinct, having significant differences in their pharmacokinetics and in vivo immunosuppressive effects [N Engl J Med 365(5):430–438, 2011]. Here, we report a case of two monozygotic twins with constitutional SAA that evolved to myelodysplastic syndrome (MDS) who both underwent allogeneic peripheral blood stem cell transplantation (PBSC) from the same single HLA antigen mismatched sibling donor with the only difference in the transplant regimen being the type of ATG used in the preparative regimen; one twin received horse ATG and the other received rabbit ATG during conditioning. This report emphasizes that dramatic differences in donor T cell chimerism and clinical outcomes including GVHD can occur as a consequence of the type of ATG that is utilized in the transplant conditioning regimen. These differences highlight that these agents should not be considered interchangeable drugs when used in this setting.
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Affiliation(s)
- P T Vo
- Hematology Branch, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA.
| | - J Pantin
- Department of Hematology and Oncology, Georgia Regents University, Augusta, GA, USA
| | - C Ramos
- Hematology Branch, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
| | - L Cook
- Hematology Branch, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
| | - E Cho
- Hematology Branch, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
| | - R Kurlander
- Department of Clinical Pathology, Hematology Services, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
| | - H Khuu
- Cell Lab Processing Section, Department of Transfusion Medicine, National Institute of Health (NIH) Blood Bank, Bethesda, MD, USA
| | - J Barrett
- Stem Cell Allogenic Transplantation, Hematology Branch, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
| | - S Leitman
- Department of Transfusion Medicine, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
| | - R W Childs
- Transplantation Immunotherapy, Hematology Branch, National Heart Lung and Blood Institute (NHLBI), National Institute of Health (NIH), Bethesda, MD, USA
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