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Thapa A, Cowell A, Peters A, Noble DJ, James A, Lamb C, Grose D, Vohra S, Schipani S, Mactier K, Mackenzie J, Srinivasan D, Laws K, Moleron R, Niblock P, Soh FY, Paterson C, Wilson C. The UK Divide: Does Having a Pembrolizumab-Chemotherapy Option in Head and Neck Cancer Matter? Real-world Experience of First-line Palliative Pembrolizumab Monotherapy and Pembrolizumab-Chemotherapy Combination in Scotland. Clin Oncol (R Coll Radiol) 2024; 36:287-299. [PMID: 38395634 DOI: 10.1016/j.clon.2024.02.004] [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: 08/29/2023] [Revised: 12/21/2023] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
AIMS The Scottish Medical Consortium recently approved first-line pembrolizumab monotherapy or in combination with chemotherapy for head and neck squamous cell carcinoma in the palliative setting, contrasting with the decision made by the National Institute for Health and Care Excellence, who approved monotherapy alone in England and Wales. The aim of this study was to provide real-world performance data for first-line pembrolizumab-containing treatments for head and neck squamous cell carcinoma in the palliative setting in Scotland. MATERIALS AND METHODS We analysed the electronic records of patients who started pembrolizumab-containing treatment between 1 March 2020 and 30 September 2021. Outcomes included overall survival, progression-free survival (PFS), the duration of response and the disease control rate. Data were compared with the KEYNOTE-048 study and clinical factors were evaluated for association with survival. RESULTS Our cohort included 91 patients (median follow-up 10.8 months). Patient characteristics were similar to those in the KEYNOTE-048 study, although our cohort had a higher proportion of patients with newly diagnosed, non-metastatic disease. For patients receiving monotherapy (n = 76), 12- and 24-month overall survival were 45% and 27%, respectively. For patients receiving pembrolizumab-chemotherapy (n = 15), 12-month overall survival was 60% (24-month overall survival had not yet been reached). Experiencing one or more immune-related adverse event (irAE; versus no irAEs), of any grade, was associated with favourable overall survival and PFS for patients receiving monotherapy in both univariable Log-rank analysis (median overall survival 17.4 months versus 8.6 months, respectively, P = 0.0033; median PFS 10.9 months versus 3.0 months, respectively, P < 0.0001) and multivariable analysis (Cox proportional hazards regression: overall survival hazard ratio 0.31, P = 0.0009; PFS hazard ratio 0.17, P < 0.0001). CONCLUSION Our real-world data support the KEYNOTE-048 study findings and the value of combination treatment options. Additionally, our data show that irAEs of any grade, as reported in routine clinical records, are associated with better outcomes in this patient group, adding to the growing body of evidence showing that irAEs are generally a positive marker of programmed death-ligand 1 (PD-L1) inhibitor response.
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Affiliation(s)
- A Thapa
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - A Cowell
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Peters
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - D J Noble
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK; Edinburgh Cancer Research Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - A James
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - C Lamb
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - D Grose
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - S Vohra
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - S Schipani
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - K Mactier
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - J Mackenzie
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - D Srinivasan
- Department of Clinical Oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - K Laws
- Aberdeen Royal Infirmary, Aberdeen, UK
| | - R Moleron
- Aberdeen Royal Infirmary, Aberdeen, UK
| | | | - F-Y Soh
- Raigmore Hospital, Inverness, UK
| | - C Paterson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
| | - C Wilson
- Beatson West of Scotland Cancer Centre, Glasgow, UK.
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Mackenzie G, Summers D, Mackenzie J, Knight R. Diagnostic accuracy of diffusion-weighted imaging in variant Creutzfeldt-Jakob disease. Neuroradiology 2023; 65:1715-1727. [PMID: 37831099 PMCID: PMC10654212 DOI: 10.1007/s00234-023-03230-w] [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: 07/14/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE This study sought to investigate the diagnostic sensitivity of diffusion-weighted imaging (DWI) in variant Creutzfeldt-Jakob disease (vCJD), a prion disease with significant public health implications on account of its transmissibility. The importance of this research stemmed from the first neuropathologically confirmed vCJD case in a PRNP heterozygous individual in 2016, which displayed DWI features typical of sporadic CJD (sCJD). The case was classified as 'probable' sCJD in life, predominantly based on these imaging findings. While DWI has proven valuable in diagnosing sCJD, its utility in vCJD diagnosis remains unclear. METHODS DWI and Fluid-attenuated inversion recovery (FLAIR) images from probable and definite vCJD cases referred to the National CJD Research and Surveillance Unit (NCJDRSU) were independently analysed by an expert neuroradiologist. Scans were reviewed within a mixed cohort of CJD cases including definite sCJD and non-CJD controls. RESULTS FLAIR sequences demonstrated greater sensitivity in identifying the pulvinar sign in vCJD compared to DWI (73% vs 41%, p-value <0.001). Basal ganglia hyperintensities were more prevalent in DWI (84%) than FLAIR (64%), and cortical hyperintensities were exclusive to DWI (24%). The pulvinar sign showed a specificity of 98% for vCJD and was rare in sCJD. CONCLUSION DWI showed reduced sensitivity compared to FLAIR imaging in detecting the pulvinar sign in vCJD. Conversely, DWI can more distinctively identify basal ganglia and cortical hyperintensities, thus leading to imaging patterns more characteristic of sCJD. Therefore, DWI should be cautiously interpreted in vCJD diagnosis, with axial FLAIR potentially providing a more precise evaluation of the pulvinar sign.
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Affiliation(s)
- G Mackenzie
- National CJD Research and Surveillance Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - D Summers
- Department of Neuroradiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J Mackenzie
- National CJD Research and Surveillance Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - R Knight
- National CJD Research and Surveillance Unit, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Logue M, Haylock C, Scarborough C, Mackenzie J. "If people are hesitant at all, you just want a really big front door": a rapid qualitative interview study on the Luton COVID-19 vaccination outreach clinics. BMC Public Health 2023; 23:440. [PMID: 36882718 PMCID: PMC9990003 DOI: 10.1186/s12889-023-15016-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/10/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND There is a lack of evidence on the usefulness, practicality, and acceptance of vaccination outreach clinics in the community especially during pandemics. In this qualitative study, we explored the experiences, motivations and perceptions of service users, health professionals, strategic staff, volunteers, and community workers involved in the COVID-19 vaccination outreach clinics in Luton. METHODS Semi structured face to face, telephone, online interviews, and focus groups were conducted with 31 participants including health professionals, strategic staff, volunteers, community workers and service users. The Framework Method was used to analyse the data and generate themes. RESULTS Service users expressed positivity towards the convenience and familiarity of the location of the vaccination outreach clinics and the flexibility of receiving the vaccination in a local setting. Participants involved in the planning and delivery of the service commented on the worthwhile and rewarding experience but suggested more attention should be given to preparation time, service user recruitment, the working environment, and staff welfare. CONCLUSIONS The COVID-19 mobile vaccination outreach clinics in Luton tested and developed a different model of service delivery and demonstrated a collaborative way of working: "taking the health service to the patient, not the patient to the health service". Planning and local community engagement were seen as key to successful delivery of a mobile healthcare service.
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Affiliation(s)
- M Logue
- Hertfordshire County Council, Public Health Evidence and Intelligence, Public Health, County Hall, Pegs Lane, Hertford, SG13 8DQ, UK. .,University of Southampton, Primary Care, Medical Education and Population Science, Aldermoor Health Centre, Southampton, SO16 5ST, UK.
| | - C Haylock
- Hertfordshire County Council, Public Health Evidence and Intelligence, Public Health, County Hall, Pegs Lane, Hertford, SG13 8DQ, UK
| | - C Scarborough
- Luton Borough Council Public Health, Third floor, Arndale House, The Mall, Luton, LU1 2LJ, UK
| | - J Mackenzie
- Hertfordshire County Council, Public Health Evidence and Intelligence, Public Health, County Hall, Pegs Lane, Hertford, SG13 8DQ, UK
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Challapalli A, Watkins S, Cogill G, Stewart G, Ellis S, Sykes A, Nobes J, Yip K, Barthakur U, Board R, Gadve A, O'Toole L, Kent C, Mackenzie J, Papa S, Fusi A, Fife K. Cemiplimab in advanced cutaneous squamous cell carcinoma: UK experience from the Named Patient Scheme. J Eur Acad Dermatol Venereol 2022; 36:e590-e592. [PMID: 35298050 DOI: 10.1111/jdv.18082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/09/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Affiliation(s)
- A Challapalli
- University Hospitals Bristol & Weston NHS Foundation Trust
| | - S Watkins
- University Hospitals Birmingham NHS Foundation Trust
| | - G Cogill
- University Hospitals Plymouth NHS Trust
| | | | - S Ellis
- Portsmouth Hospitals NHS Trust
| | - A Sykes
- The Christie NHS Foundation Trust
| | - J Nobes
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - K Yip
- East Suffolk and North Essex NHS Foundation Trust
| | | | - R Board
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - A Gadve
- NHS Greater Glasgow and Clyde
| | - L O'Toole
- Hull University Teaching Hospitals NHS Trust
| | - C Kent
- University Hospitals of Leicester NHS Trust
| | | | - S Papa
- School of Cancer and Pharmaceutical Studies, King's College London
| | - A Fusi
- St George's University Hospitals NHS Foundation Trust
| | - K Fife
- Cambridge University Hospitals NHS Foundation Trust, UK
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Di Loreto C, Dutschke J, Forrest M, Van Den Berg A, Chardonnet J, Mérienne F, Mackenzie J, Sandoz B. Head dynamics during emergency braking events. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714249] [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: 10/24/2022]
Affiliation(s)
- C. Di Loreto
- Arts et Metiers, IBHGC, Paris, France
- Arts et Metiers, LISPEN, Chalon-Sur-Saône, France
| | - J. Dutschke
- University of Adelaide, CASR, Adelaide, Australia
| | - M. Forrest
- University of Adelaide, CASR, Adelaide, Australia
| | | | | | - F. Mérienne
- Arts et Metiers, LISPEN, Chalon-Sur-Saône, France
| | - J. Mackenzie
- University of Adelaide, CASR, Adelaide, Australia
| | - B. Sandoz
- Arts et Metiers, IBHGC, Paris, France
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Mackenzie J, Fairbairn I, North F, Quirie C. Medical thoracoscopy in a DGH: 1-year activity. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bartlett S, Mackenzie J, Fairbairn I, Stevenson M. Indwelling pleural catheters in Fife: indications and outcomes. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30118-7] [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: 10/27/2022]
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El Tawil S, Chohan G, Mackenzie J, Rowe A, Weller B, Will RG, Knight R. Isolated language impairment as the primary presentation of sporadic Creutzfeldt Jakob Disease. Acta Neurol Scand 2017; 135:316-323. [PMID: 27072062 DOI: 10.1111/ane.12600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 03/24/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Sporadic Creutzfeldt Jakob Disease (sCJD) is a neurodegenerative disorder that typically presents as a rapidly progressive encephalopathy associated with various neurological features, culminating in akinetic mutism and death. Atypical cases, presenting with an isolated focal may cause diagnostic confusion. We described a series of patients with sCJD presenting with isolated language impairment. MATERIALS & METHODS We report a patient with sCJD referred to the NCJDRSU, who presented with isolated language impairment and subsequently identified all cases of sporadic CJD on the NCJDRSU database (covering the years 1990-2012) with an isolated language impairment presentation. RESULTS Nineteen patients (11 females) with sCJD (1.19% of all patients) had an isolated language disorder of at least 2 weeks duration as the first neurological symptom pattern. Mean age at onset was 68.28 years. No specific pattern of language affection was seen in these patients. Further progression usually affected more than one neurological domain, with all patients eventually developing cognitive decline and myoclonic jerks. The median duration of illness was 4 months. CSF 14.3.3 was positive and S100b level was elevated in all patients in whom it was performed. EEG and MRI showed typical features of sCJD in six patients each. Most patients showed MM genotype of PRNP codon 129. CONCLUSION This study highlights the fact that isolated aphasia can be the first neurological symptom approximately in 1% of patients with sCJD. The diagnosis is usually made with appearance of other clinical features and investigation results, but in a small minority, these may not be apparent for relatively long periods.
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Affiliation(s)
- S. El Tawil
- National CJD Research & Surveillance Unit; University of Edinburgh; Edinburgh UK
| | - G. Chohan
- National CJD Research & Surveillance Unit; University of Edinburgh; Edinburgh UK
| | - J. Mackenzie
- National CJD Research & Surveillance Unit; University of Edinburgh; Edinburgh UK
| | - A. Rowe
- Department of Clinical Neurosciences; Western General Hospital; Edinburgh UK
| | - B. Weller
- Department of Clinical Neurosciences; Western General Hospital; Edinburgh UK
| | - R. G. Will
- National CJD Research & Surveillance Unit; University of Edinburgh; Edinburgh UK
| | - R. Knight
- National CJD Research & Surveillance Unit; University of Edinburgh; Edinburgh UK
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Taylor L, Aujayeb A, Calder M, Nicholson S, Mackenzie J, Dickson M. 146: Treatment of loculated malignant effusions. Lung Cancer 2017. [DOI: 10.1016/s0169-5002(17)30196-4] [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: 10/20/2022]
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Mackenzie J, Graham G, Olivotto I. Peer Review of Radiotherapy Planning: Quantifying Outcomes and a Proposal for Prospective Data Collection. Clin Oncol (R Coll Radiol) 2016; 28:e192-e198. [DOI: 10.1016/j.clon.2016.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 06/20/2016] [Accepted: 07/20/2016] [Indexed: 11/28/2022]
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Mackenzie J, Conroy K, De P. 92 Final diagnosis for patients referred to pleural clinic. Lung Cancer 2016. [DOI: 10.1016/s0169-5002(16)30109-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mackenzie J, Schinkel C, Graham D, Bosch J, Banerjee R. 633 Comparing VMAT and IMRT for head and neck cancer throughout treatment: Which technique provides better dosimetry in the context of weight loss and tumor shrinkage? Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30369-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lew T, Creamer D, Mackenzie J, Walsh S. Post-traumatic stress disorder following drug reaction with eosinophilia and systemic symptoms. Br J Dermatol 2015; 172:836-7. [DOI: 10.1111/bjd.13375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- T.T. Lew
- Dermatology Department; King's College Hospital NHS Foundation Trust; London SE5 9RS U.K
| | - D. Creamer
- Dermatology Department; King's College Hospital NHS Foundation Trust; London SE5 9RS U.K
| | - J. Mackenzie
- Dermatology Department; King's College Hospital NHS Foundation Trust; London SE5 9RS U.K
| | - S.A. Walsh
- Dermatology Department; King's College Hospital NHS Foundation Trust; London SE5 9RS U.K
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de Bruin E, Loeber JG, Meijer A, Castillo GM, Cepeda MLG, Torres-Sepúlveda MR, Borrajo GJC, Caggana M, Giguere Y, Meyer M, Fukushi M, Devi ARR, Khneisser I, Vilarinho L, von Döbeln U, Torresani T, Mackenzie J, Zutt I, Schipper M, Elvers LH, Koopmans MPG. Evolution of an influenza pandemic in 13 countries from 5 continents monitored by protein microarray from neonatal screening bloodspots. J Clin Virol 2014; 61:74-80. [PMID: 25017954 DOI: 10.1016/j.jcv.2014.06.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Because of lack of worldwide standardization of influenza virus surveillance, comparison between countries of impact of a pandemic is challenging. For that, other approaches to allow internationally comparative serosurveys are welcome. OBJECTIVES Here we explore the use of neonatal screening dried blood spots to monitor the trends of the 2009 influenza A (H1N1) pdm virus by the use of a protein microarray. STUDY DESIGN We contacted colleagues from neonatal screening laboratories and asked for their willingness to participate in a study by testing anonymized neonatal screening bloodspots collected during the course of the pandemic. In total, 7749 dried blood spots from 13 countries in 5 continents where analyzed by using a protein microarray containing HA1 recombinant proteins derived from pandemic influenza A (H1N1) 2009 as well as seasonal influenza viruses. RESULTS Results confirm the early start of the pandemic with extensive circulation in the US and Canada, when circulation of the new virus was limited in other parts of the world. The data collected from sites in Mexico suggested limited circulation of the virus during the early pandemic phase in this country. In contrast and to our surprise, an increase in seroprevalence early in 2009 was noted in the dataset from Argentina, suggestive of much more widespread circulation of the novel virus in this country than in Mexico. CONCLUSIONS We conclude that this uniform serological testing of samples from a highly standardized screening system offers an interesting opportunity for monitoring population level attack rates of widespread diseases outbreaks and pandemics.
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Affiliation(s)
- E de Bruin
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - J G Loeber
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - A Meijer
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - G Martinez Castillo
- Unidad de Genetica, Hospital Espanol, Centro de Estudios Neonatales y Geneticos, Mexico State, Mexico
| | | | | | - G J C Borrajo
- Fundación Bioquímica Argentina, Programa de Detección de Errores Congénitos, La Plata, Argentina
| | - M Caggana
- New York State Department of Health, Biggs Laboratory, Albany, USA
| | - Y Giguere
- Programme Québécois de Dépistage Néonatal Sanguin, CHU de Québec, Québec, Canada
| | - M Meyer
- North West University, Potchefstroom Campus, Potchefstroom, South Africa
| | - M Fukushi
- Sapporo City Institute of Public Health, Sapporo, Japan
| | | | - I Khneisser
- Neonatal Screening Laboratory, Medical Genetic Unit, Saint Joseph University, Beirut, Lebanon
| | - L Vilarinho
- Neonatal Screening Unit, Genetics Department, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - U von Döbeln
- Karolinska University Hospital Huddinge, Centre for Inherited Metabolic Disease, Stockholm, Sweden
| | - T Torresani
- Universitäts Kinderklinik, Zürich, Switzerland
| | - J Mackenzie
- Yorkhill Hospital, Scottish Newborn Screening Laboratory, Glasgow, United Kingdom
| | - I Zutt
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - M Schipper
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - L H Elvers
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - M P G Koopmans
- Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands
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Barnes RA, Edghill N, Mackenzie J, Holters G, Ross GP, Jalaludin BB, Flack JR. Predictors of large and small for gestational age birthweight in offspring of women with gestational diabetes mellitus. Diabet Med 2013; 30:1040-6. [PMID: 23551273 DOI: 10.1111/dme.12207] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 12/20/2012] [Accepted: 03/22/2013] [Indexed: 12/17/2022]
Abstract
AIM To identify predictors of large and small for gestational age in women with gestational diabetes mellitus. METHODS A retrospective audit of clinical data analysed for singleton births in women diagnosed with gestational diabetes by Australasian Diabetes in Pregnancy Society guidelines from 1994 to 2009. Exclusions were: incomplete data, delivered at < 36 weeks gestation and/or last recorded weight > 4 weeks pre-delivery. We assessed: pre-pregnancy BMI, ethnicity, total maternal weight gain, weight gain before and after treatment initiation for gestational diabetes, HbA(1c) at gestational diabetes presentation and treatment modality (diet or insulin) and smoking. Birthweight was assessed using customized percentile charts (large for gestational age > 90th; small for gestational age < 10th percentile). Multiple regression analyses were undertaken; statistical significance was p < 0.05. RESULTS There were 1695 women first seen at (mean ± sd) 28.1 ± 5.3 weeks gestation (range 6-39). Ethnic mix was South-East Asian 36.7%, Middle Eastern 27.6%, European 22.4%, Indian/Pakistani 8.6%, Samoan 1.9%, African 1.5% and Maori 1.1%. Therapy was diet 69.1% and insulin 30.9%. Mean total weight gain was 12.3 ± 6.1 kg, the majority (10.6 ± 6.0 kg), gained before dietary intervention. There were 7.9% small for gestational age and 15.2% large for gestational age births. Significant independent large for gestational age predictors were: weight gain before intervention, pre-pregnancy BMI, weight gain after intervention and treatment type, but not HbA1c or smoking. Significant small for gestational age predictors were: weight gain before intervention, weight gain after intervention, but not pre-pregnancy BMI, HbA(1c) or smoking. CONCLUSION Conventional treatment for gestational diabetes mellitus concentrates on management of blood glucose levels. The trends identified here emphasize the need to also address pregnancy weight gain stratified by pre-pregnancy BMI.
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Affiliation(s)
- R A Barnes
- Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, NSW, Australia.
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Varndell W, Mackenzie J, Sands MB. CPR: STAT! OR STOP! THE END-OF-LIFE CARE ELECTRONIC RECORD (ELCER). BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.20] [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: 11/03/2022]
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Mackenzie J, Law A, Kerr G, Higgins G, Howard G, Malik J, McLaren D. 7036 POSTER Improved Outcomes With Dose Escalated Hypofractionated Radiotherapy for Prostate Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71987-6] [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: 10/17/2022]
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Mackenzie J. A Defence of the Thesis THAT "THE OPPORTUNITIES OF THE GENERAL PRACTITIONER ARE ESSENTIAL FOR THE INVESTIGATION OF DISEASE AND THE PROGRESS OF MEDICINE.". Br Med J 2011; 1:797-804. [PMID: 20770319 DOI: 10.1136/bmj.1.3153.797] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mackenzie J. A Lecture ON THE SOLDIER'S HEART AND WAR NEUROSIS: A STUDY IN SYMPTOMATOLOGY: Delivered at the Clinical Institute, St. Andrews. Br Med J 2011; 1:491-4. [PMID: 20769853 DOI: 10.1136/bmj.1.3093.491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mackenzie J. Remarks ON THE MEANING AND MECHANISM OF VISCERAL PAIN: AS SHOWN BY THE STUDY OF VISCERAL AND OTHER SYMPATHETIC (AUTONOMIC) REFLEXES. Br Med J 2011; 1:1449-54. [PMID: 20762739 DOI: 10.1136/bmj.1.2373.1449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mackenzie J. Observations on the Inception of the Rhythm of the Heart by the Ventricle: As the cause of Continuous Irregularity of the Heart. Br Med J 2011; 1:529-36. [PMID: 20761393 DOI: 10.1136/bmj.1.2253.529] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mackenzie J. SOME MANIFESTATIONS OF A HEALTHY HEART IN THE YOUNG FREQUENTLY TAKEN AS INDICATIONS FOR TREATMENT. Br Med J 2011; 2:1697-700. [PMID: 20766441 DOI: 10.1136/bmj.2.2712.1697] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mackenzie J. Remarks on the Meaning and Mechanism of Visceral Pain as Shown by the Study of Visceral and other Sympathetic (Autonomic) Reflexes. Br Med J 2011; 1:1523-8. [PMID: 20762752 DOI: 10.1136/bmj.1.2374.1523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lee AW, Farnquist B, Islam O, Mackenzie J, Taylor SAM, Pang SC, Reifel CW. Noninvasive investigation of asymmetrically conjoined tripus twins with features of rachipagus, parapagus dicephalus, and cephalopagus. Clin Anat 2011; 25:1023-9. [PMID: 21433086 DOI: 10.1002/ca.21149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 01/17/2011] [Accepted: 01/18/2011] [Indexed: 11/09/2022]
Abstract
A hypothetical mechanism for conjoined twinning postulated by Spencer ([2003] Developmental Malformations and Clinical Implications, Baltimore: Johns Hopkins University Press, p 1-476) suggests that, after separation, monovular twins fuse in one of eight predictable homologous sites. The tripus fetal specimen under study embodies characteristics of three types therefore preventing it from classification into a simple variant of any one of the eight twin types described by Spencer. The aim of this study was to reveal internal structural anomalies of the fetal specimen by using magnetic resonance imaging and computerized tomography. Dorsally appended to the primary twin is a secondary head mass (brain tissue and ocular globe) and two spinal columns converging at T4/T5, suggesting rachipagus twinning. The ventral orientation of the secondary twin's (right lateral) lower limb suggests parapagus twinning. The caudal divergence of the spinal columns and the presence of a secondary hemipelvis, separate from the primary pelvis, suggest cephalopagus twinning. Measurements of the long bones indicate a gestational age of ∼20-23 weeks. Secondary malformations of the primary fetal body include anencephaly, cleft palate, renal agenesis, decreased left ventricular outflow, and a prematurely terminating descending aorta. This study demonstrates the possibility of using current imaging techniques to study very old, formalin-preserved human material for documentation and scientific discussion without destroying the specimen, thus keeping it intact for posterity.
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Affiliation(s)
- A W Lee
- Department of Anatomy and Cell Biology, Queen's University, Kingston, Ontario, Canada
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Srinivasan J, Hand S, Lidstone S, Vafai N, Mackenzie J, Gavinio J, Mak E, Schulzer M, Stoessl A. P1.214 Uncertainty vs. likelihood of reward: implications for the placebo effect in Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Muhle H, Bellmann B, Creutzenberg O, Fuhst R, Koch W, Mohr U, Takenaka S, Morrow P, Kilpper R, Mackenzie J, Mermelstein R. Subchronic Inhalation Study of Toner in Rats. Inhal Toxicol 2008. [DOI: 10.3109/08958379009145262] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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38
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Tong S, Mackenzie J, Pitman AJ, FitzGerald G, Nicholls N, Selvey L. Global climate change: time to mainstream health risks and their prevention on the medical research and policy agenda. Intern Med J 2008; 38:445-7. [DOI: 10.1111/j.1445-5994.2008.01688.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brem MH, Schlechtweg PM, Mackenzie J, Winalski CS, Lang P. [Molecular imaging: future uses in arthritides]. Radiologe 2007; 46:394-402. [PMID: 16715224 DOI: 10.1007/s00117-006-1373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Molecular imaging is an upcoming field in radiology as a result of great advances in imaging technology, genetics, and biochemistry in the recent past. Early-stage imaging of molecular pathological changes in cells opens the gates to new methods in medical treatment of diseases that otherwise would only be detected in advanced stages. Methods of imaging biochemical pathways with molecular agents are currently an issue of intensive research. This article reviews current modalities of molecular imaging in arthritis that should offer future perspective on early disease detection, diagnosis, and monitoring of treatment efficiency and how they can pave the way to optimized therapy.
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Affiliation(s)
- M H Brem
- Department of Radiology, Brigham and Women's Hospital of Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
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40
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Hewitt PE, Llewelyn CA, Mackenzie J, Will RG. Three reported cases of variant Creutzfeldt?Jakob disease transmission following transfusion of labile blood components. Vox Sang 2006; 91:348. [PMID: 17105612 DOI: 10.1111/j.1423-0410.2006.00837.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Hewitt PE, Llewelyn CA, Mackenzie J, Will RG. Creutzfeldt-Jakob disease and blood transfusion: results of the UK Transfusion Medicine Epidemiological Review study. Vox Sang 2006; 91:221-30. [PMID: 16958834 DOI: 10.1111/j.1423-0410.2006.00833.x] [Citation(s) in RCA: 240] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES This paper reports the results to 1 March 2006 of an ongoing UK study, the Transfusion Medicine Epidemiological Review (TMER), by the National CJD Surveillance Unit (NCJDSU) and the UK Blood Services (UKBS) to determine whether there is any evidence that Creutzfeldt-Jakob disease (CJD), including sporadic CJD (sCJD), familial CJD (fCJD), and variant CJD (vCJD) is transmissible via blood transfusion. MATERIALS AND METHODS Sporadic CJD and fCJD cases with a history of blood donation or transfusion are notified to UKBS. All vCJD cases aged > 17 years are notified to UKBS on diagnosis. A search for donation records is instigated and the fate of all donations is identified by lookback. For cases with a history of blood transfusion, hospital and UKBS records are searched to identify blood donors. Details of identified recipients and donors are checked against the NCJDSU register to establish if there are any matches. RESULTS CJD cases with donation history: 18/31 vCJD, 3/93 sCJD, and 3/5 fCJD cases reported as blood donors were confirmed to have donated labile components transfused to 66, 20, and 11 recipients respectively. Two vCJD recipients have appeared on the NCJDSU register as confirmed and probable vCJD cases. The latter developed symptoms of vCJD 6.5 years and 7.8 years respectively after receiving non-leucodepleted red blood cells (RBCs) from two different donors who developed clinical symptoms approximately 40 and 21 months after donating. A third recipient, given RBC donated by a further vCJD case approximately 18 months before onset of clinical symptoms, had abnormal prion protein in lymphoid tissue at post-mortem (5-years post-transfusion) but had no clinical symptoms of vCJD. CJD cases with history of transfusion: Hospital records for 7/11 vCJD and 7/52 sCJD cases included a history of transfusion of labile blood components donated by 125 and 24 donors respectively. Two recipients who developed vCJD were linked to donors who had already appeared on the NCJDSU register as vCJD cases (see above). No further links were established. CONCLUSION This study has identified three instances of probable transfusion transmission of vCJD infection, including two confirmed clinical cases and one pre- or sub-clinical infection. This study has not provided evidence, to date, of transmission of sCJD or fCJD by blood transfusion, but data on these forms of diseases are limited.
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Affiliation(s)
- P E Hewitt
- National Blood Service, Colindale Centre, London, UK.
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Collins SJ, Sanchez-Juan P, Masters CL, Klug GM, van Duijn C, Poleggi A, Pocchiari M, Almonti S, Cuadrado-Corrales N, de Pedro-Cuesta J, Budka H, Gelpi E, Glatzel M, Tolnay M, Hewer E, Zerr I, Heinemann U, Kretszchmar HA, Jansen GH, Olsen E, Mitrova E, Alpérovitch A, Brandel JP, Mackenzie J, Murray K, Will RG. Determinants of diagnostic investigation sensitivities across the clinical spectrum of sporadic Creutzfeldt-Jakob disease. Brain 2006; 129:2278-87. [PMID: 16816392 DOI: 10.1093/brain/awl159] [Citation(s) in RCA: 197] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To validate the provisional findings of a number of smaller studies and explore additional determinants of characteristic diagnostic investigation results across the entire clinical spectrum of sporadic Creutzfeldt-Jakob disease (CJD), an international collaborative study was undertaken comprising 2451 pathologically confirmed (definite) patients. We assessed the influence of age at disease onset, illness duration, prion protein gene (PRNP) codon 129 polymorphism (either methionine or valine) and molecular sub-type on the diagnostic sensitivity of EEG, cerebral MRI and the CSF 14-3-3 immunoassay. For EEG and CSF 14-3-3 protein detection, we also assessed the influence of the time point in a patient's illness at which the investigation was performed on the likelihood of a typical or positive result. Analysis included a large subset of patients (n = 743) in whom molecular sub-typing had been performed using a combination of the PRNP codon 129 polymorphism and the form of protease resistant prion protein [type 1 or 2 according to Parchi et al. (Parchi P, Giese A, Capellari S, Brown P, Schulz-Schaeffer W, Windl O, Zerr I, Budka H, Kopp N, Piccardo P, Poser S, Rojiani A, Streichemberger N, Julien J, Vital C, Ghetti B, Gambetti P, Kretzschmar H. Classification of sporadic Creutzfeldt-Jakob disease based on molecular and phenotypic analysis of 300 subjects. Ann Neurol 1999; 46: 224-233.)] present in the brain. Findings for the whole group paralleled the subset with molecular sub-typing data available, showing that age at disease onset and disease duration were independent determinants of typical changes on EEG, while illness duration significantly influenced positive CSF 14-3-3 protein detection; changes on brain MRI were not influenced by either of these clinical parameters, but overall, imaging data were less complete and consequently conclusions are more tentative. In addition to age at disease onset and illness duration, molecular sub-type was re-affirmed as an important independent determinant of investigation results. In multivariate analyses that included molecular sub-type, time point of the investigation during a patient's illness was found not to influence the occurrence of a typical or positive EEG or CSF 14-3-3 protein result. A typical EEG was most often seen in MM1 patients and was significantly less likely in the MV1, MV2 and VV2 sub-types, whereas VV2 patients had an increased likelihood of a typical brain MRI. Overall, the CSF 14-3-3 immunoassay was the most frequently positive investigation (88.1%) but performed significantly less well in the very uncommon MV2 and MM2 sub-types. Our findings confirm a number of determinants of principal investigation results in sporadic CJD and underscore the importance of recognizing these pre-test limitations before accepting the diagnosis excluded or confirmed. Combinations of investigations offer the best chance of detection, especially for the less common molecular sub-types such as MV2 and MM2.
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Affiliation(s)
- S J Collins
- Australian National Creutzfeldt-Jakob disease Registry, Department of Pathology, The University of Melbourne, Parkville, Vic., Australia.
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43
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Jones JH, Mackenzie J, Croft GA, Beaton S, Young D, Donaldson MDC. Improvement in screening performance and diagnosis of congenital hypothyroidism in Scotland 1979-2003. Arch Dis Child 2006; 91:680-5. [PMID: 16595645 PMCID: PMC2083034 DOI: 10.1136/adc.2005.088427] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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] [Accepted: 03/10/2006] [Indexed: 11/04/2022]
Abstract
AIM To assess the Scottish newborn screening programme for congenital hypothyroidism from 1994 to 2003 (period 2) for performance and compare with an initial audit covering 1979 to 1993 (period 1). DESIGN Performance data-age at blood spot sampling, notification by screening laboratory, start of treatment, and the prevalence of late testing, notification or treatment-were compared, together with the incidence of congenital hypothyroidism. RESULTS Comparing data for period 2 with period 1, the mean annual incidence of true congenital hypothyroidism was 1:3655 live births v 1:4363. Median age for Guthrie sampling (all referrals) was 6 v 7 days (p<0.0001). Late sampling (>10 days) had fallen from 10.7% to 7%. For infants requiring repeat sampling before notification, the median (range) interval between initial and final repeat samples was 11 (1 to 52) compared with 14 (3 to 73) days. Median age at notification for true congenital hypothyroidism was 10 v 12 days (p <0.0001). Late notification (>15 days) was justifiable (mild TSH elevation) in 10 of 13 patients in period 2. Median age at start of treatment for true congenital hypothyroidism had improved to 11 days from 13.5 days. For true congenital hypothyroidism, late treatment (>16 days) occurred in 7% of patients compared with 19% (p<0.0001). CONCLUSIONS There has been an improvement in performance measures for the congenital hypothyroidism screening programme in Scotland. However, late sampling, occurring primarily in inpatients and which is never justified, remains a problem, while the interval between initial and recall sampling is a further source of delay.
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Affiliation(s)
- J H Jones
- Department of Child Health, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
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Shiarli AM, Jennings R, Shi J, Bailey K, Davidson Y, Tian J, Bigio EH, Ghetti B, Murrell JR, Delisle MB, Mirra S, Crain B, Zolo P, Arima K, Iseki E, Murayama S, Kretzschmar H, Neumann M, Lippa C, Halliday G, Mackenzie J, Khan N, Ravid R, Dickson D, Wszolek Z, Iwatsubo T, Pickering-Brown SM, Mann DMA. Comparison of extent of tau pathology in patients with frontotemporal dementia with Parkinsonism linked to chromosome 17 (FTDP-17), frontotemporal lobar degeneration with Pick bodies and early onset Alzheimer's disease. Neuropathol Appl Neurobiol 2006; 32:374-87. [PMID: 16866983 DOI: 10.1111/j.1365-2990.2006.00736.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In order to gain insight into the pathogenesis of frontotemporal lobar degeneration (FTLD), the mean tau load in frontal cortex was compared in 34 patients with frontotemporal dementia linked to chromosome 17 (FTDP-17) with 12 different mutations in the tau gene (MAPT), 11 patients with sporadic FTLD with Pick bodies and 25 patients with early onset Alzheimer's disease (EOAD). Tau load was determined, as percentage of tissue occupied by stained product, by image analysis of immunohistochemically stained sections using the phospho-dependent antibodies AT8, AT100 and AT180. With AT8 and AT180 antibodies, the amount of tau was significantly (P < 0.001 in each instance) less than that in EOAD for both FTDP-17 (8.5% and 10.0% respectively) and sporadic FTLD with Pick bodies (16.1% and 10.0% respectively). With AT100, the amount of tau detected in FTDP-17 was 54% (P < 0.001) of that detected in EOAD, but no tau was detected in sporadic FTLD with Pick bodies using this particular antibody. The amount of insoluble tau deposited within the brain in FTDP-17 did not depend in any systematic way upon where the MAPT mutation was topographically located within the gene, or on the physiological or structural change generated by the mutation, regardless of which anti-tau antibody was used. Not only does the amount of tau deposited in the brain differ between the three disorders, but the pattern of phosphorylation of tau also varies according to disease. These findings raise important questions relating to the role of aggregated tau in neurodegeneration - whether this represents an adaptive response which promotes the survival of neurones, or whether it is a detrimental change that directly, or indirectly, brings about the demize of the affected cell.
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Affiliation(s)
- A-M Shiarli
- Clinical Neuroscience Research Group, University of Manchester, Greater Manchester Neurosciences Centre, Hope Hospital, Salford, UK
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Pocchiari M, Puopolo M, Croes EA, Budka H, Gelpi E, Collins S, Lewis V, Sutcliffe T, Guilivi A, Delasnerie-Laupretre N, Brandel JP, Alperovitch A, Zerr I, Poser S, Kretzschmar HA, Ladogana A, Rietvald I, Mitrova E, Martinez-Martin P, de Pedro-Cuesta J, Glatzel M, Aguzzi A, Cooper S, Mackenzie J, van Duijn CM, Will RG. Predictors of survival in sporadic Creutzfeldt-Jakob disease and other human transmissible spongiform encephalopathies. ACTA ACUST UNITED AC 2004; 127:2348-59. [PMID: 15361416 DOI: 10.1093/brain/awh249] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A collaborative study of human transmissible spongiform encephalopathies has been carried out from 1993 to 2000 and includes data from 10 national registries, the majority in Western Europe. In this study, we present analyses of predictors of survival in sporadic (n = 2304), iatrogenic (n = 106) and variant Creutzfeldt-Jakob disease (n = 86) and in cases associated with mutations of the prion protein gene (n = 278), including Gerstmann-Sträussler-Scheinker syndrome (n = 24) and fatal familial insomnia (n = 41). Overall survival for each disease type was assessed by the Kaplan-Meier method and the multivariate analyses by the Cox proportional hazards model. In sporadic disease, longer survival was correlated with younger age at onset of illness, female gender, codon 129 heterozygosity, presence of CSF 14-3-3 protein and type 2a prion protein type. The ability to predict survival based on patient covariates is important for diagnosis and counselling, and the characterization of the survival distributions, in the absence of therapy, will be an important starting point for the assessment of potential therapeutic agents in the future.
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Affiliation(s)
- M Pocchiari
- Istituto Superiore di Sanità, Department of Cell Biology and Neurosciences Rome, Italy
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Abstract
Several novel viruses recently described in bats of the genus Pteropus (sub-order Megachiroptera) in Australia and southeast Asia cause encephalitic disease in animals and humans. These viruses include Hendra virus and Nipah virus (genus Henipavirus, family Paramyxoviridae) and Australian bat lyssavirus (ABLV; genus Lyssavirus, family Rhabdoviridae). Broadly, strategies for disease prevention and control in the spillover host are directed at minimising direct or indirect contact with the natural host, improving farm-gate and on-farm biosecurity, and better disease recognition and diagnosis. Additional strategies for ABLV include the use of rabies vaccine for effective pre- and post-exposure prophylaxis in humans. Effective management strategies in the natural host are predicated on an understanding of the ecology of the disease in the natural host, and the identification and avoidance of factors putatively associated with emergence, such as habitat loss, land use change and demographic shifts. A possible future management strategy for ABLV in reservoir populations is immunisation using bait or plant-derived vaccination.
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Affiliation(s)
- H Field
- Animal Research Institute, Department of Primary Industries, Yeerongpilly, Queensland, Australia.
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Pickering-Brown SM, Baker M, Nonaka T, Ikeda K, Sharma S, Mackenzie J, Simpson SA, Moore JW, Snowden JS, de Silva R, Revesz T, Hasegawa M, Hutton M, Mann DMA. Frontotemporal dementia with Pick-type histology associated with Q336R mutation in the tau gene. ACTA ACUST UNITED AC 2004; 127:1415-26. [PMID: 15047590 DOI: 10.1093/brain/awh147] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In this report, we describe the clinical and neuropathological features of a case of familial frontotemporal dementia (FTD), with onset at 58 years of age and disease duration of 10 years, associated with a novel mutation, Q336R, in the tau gene (tau). In vitro studies concerning the properties of tau proteins bearing this mutation, with respect to microtubule assembly and tau filament aggregation, are reported. Clinically, the patient showed alterations in memory, language and executive functions and marked behavioural change consistent with FTD, although the extent of memory impairment was more than is characteristic of FTD. At autopsy, there was degeneration of the frontal and temporal lobes associated with the presence of hyperphosphorylated tau proteins in swollen (Pick) cells and intraneuronal inclusions (Pick bodies). By immunohistochemistry, the Pick bodies contained both 3-repeat and 4-repeat tau proteins although, because no fresh tissues were available for analysis, the exact isoform composition of the aggregated tau proteins could not be determined. Neurons within frontal cortex contained neurofibrillary tangle-like structures, comprising both straight and twisted tubules, or Pick bodies in which the filaments were short and randomly orientated. In vitro, and in common with other tau missense mutations, Q336R caused an increase in tau fibrillogenesis. However, in contrast to most other tau missense mutations, Q336R increased, not decreased, the ability of mutant tau to promote microtubule assembly. Nonetheless, this latter functional change may likewise be detrimental to neuronal function by inducing a compensatory phosphorylation that may yield increased intracellular hyperphosphorylated tau species that are also liable to fibrillize. We believe the mutation is indeed pathogenic and disease causing and not simply a coincidental rare and benign polymorphism. Since this mutation is segregating with the FTD clinical and neuropathological phenotype, it has not been found in unaffected individuals and it has novel functional properties in vitro which are likely to be detrimental to neuronal function in vivo.
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Affiliation(s)
- S M Pickering-Brown
- Greater Manchester Neurosciences Centre, Humphrey Booth Building, Hope Hospital, Stott Lane, Salford M6 8HD, UK
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Abstract
BACKGROUND Variant Creutzfeldt-Jakob disease (vCJD) is a novel human prion disease caused by infection with the agent of bovine spongiform encephalopathy (BSE). Epidemiological evidence does not suggest that sporadic CJD is transmitted from person to person via blood transfusion, but this evidence may not apply to vCJD. We aimed to identify whether vCJD is transmissible through blood transfusion. METHODS The national CJD surveillance unit reported all cases of probable or definite vCJD to the UK blood services, which searched for donation records at blood centres and hospitals. Information on named recipients and donors was provided to the surveillance unit to establish if any matches existed between recipients or donors and the database of cases of vCJD. Recipients were also flagged at the UK Office of National Statistics to establish date and cause of death. FINDINGS 48 individuals were identified as having received a labile blood component from a total of 15 donors who later became vCJD cases and appeared on the surveillance unit's register. One of these recipients was identified as developing symptoms of vCJD 6.5 years after receiving a transfusion of red cells donated by an individual 3.5 years before the donor developed symptoms of vCJD. INTERPRETATION Our findings raise the possibility that this infection was transfusion transmitted. Infection in the recipient could have been due to past dietary exposure to the BSE agent. However, the age of the patient was well beyond that of most vCJD cases, and the chance of observing a case of vCJD in a recipient in the absence of transfusion transmitted infection is about 1 in 15000 to 1 in 30000.
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Affiliation(s)
- C A Llewelyn
- National Blood Service, Cambridge Centre, Cambridge CB2 2PT, UK
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Tong S, Bi P, Hayes J, Donald K, Mackenzie J. Geographic variation of notified Ross River virus infections in Queensland, Australia, 1985-1996. Am J Trop Med Hyg 2001; 65:171-6. [PMID: 11561698 DOI: 10.4269/ajtmh.2001.65.171] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The spatial and temporal variations of Ross River virus infections reported in Queensland, Australia, between 1985 and 1996 were studied by using the Geographic Information System. The notified cases of Ross River virus infection came from 489 localities between 1985 and 1988, 805 between 1989 and 1992, and 1,157 between 1993 and 1996 (chi2(df = 2) = 680.9; P < 0.001). There was a marked increase in the number of localities where the cases were reported by 65 percent for the period of 1989-1992 and 137 percent for 1993-1996, compared with that for 1985-1988. The geographic distribution of the notified Ross River virus cases has expanded in Queensland over recent years. As Ross River virus disease has impacted considerably on tourism and industry, as well as on residents of affected areas, more research is required to explore the causes of the geographic expansion of the notified Ross River virus infections.
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Affiliation(s)
- S Tong
- Centre for Public Health Research and School of Planning, Landscape Architecture, Surveying, Queensland University of Technology, Brisbane, Australia
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50
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Abstract
Pteropid bats (flying foxes), species of which are the probable natural host of both Hendra and Nipah viruses, occur in overlapping populations from India to Australia. Ecological changes associated with land use and with animal husbandry practices appear most likely to be associated with the emergence of these two agents.
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Affiliation(s)
- H Field
- Animal Research Institute, Queensland Department of Primary Industries, LMB 4 Moorooka 4105, Brisbane, Australia.
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