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Happel A, Pike J, Czesny S, Rinchard J. An empirical test of fatty acid based diet estimation models. Food Webs 2021. [DOI: 10.1016/j.fooweb.2021.e00197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Touma Z, Hoskin B, Atkinson C, Bell D, Pike J, Lofland JH, Berry P, Karyekar C, Costenbader K. AB1170 THE IMPACT OF HIGH DISEASE ACTIVITY AS MEASURED BY SLEDAI AND DRUG BURDEN-ON HEALTHCARE UTILIZATION, QUALITY OF LIFE AND WORK PRODUCTIVITY IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5872] [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:Although there is abundant literature on healthcare utilization in SLE patients, the impact of disease activity in SLE patients is not well understood.Objectives:To quantify the impact of disease activity, as measured by SLEDAI score and drug burden, in SLE patients on health care resource utilization (HCRU), health related quality of life (HRQoL) and work productivity (WP).Methods:Data were collected from a cross-sectional survey of 754 rheumatologists in US and EU5 from the Adelphi Real World 2010/2013/2015 Lupus Disease Specific Programmes (DSP). Physicians were asked to complete patient record forms (PRFs) for the next 5 prospectively consulting SLE patients; the same patients were asked to complete patient self-completion (PSC) forms describing how SLE affected them. PRFs collected data pertaining to the patient’s diagnosis, disease history, current clinical outcomes, treatment and management history. PSCs focused on similar data collection and included patient reported outcome measures (PROs). Propensity score matching was used to assess differences in HCRU and PRO scores between SLE patients who had a low disease activity and those who had a high disease activity. Low disease activity was defined as a SLEDAI score of ≤4, a steroid dose of <7.5mg/day, and not on immunosuppressant or biologic. High disease activity was a SLEDAI score of >4, or on an immunosuppressant, biologic, or steroid dose of >7.5mg/day. Patients were matched on age, sex, and ethnicity.Results:Data was extracted from 1278 PRFs, and 591 PSCs. Using the estimated propensity score each low disease activity patient (n=44) was matched with a high disease activity patient (n=1187). Using 1:1 matching, with replacement and allowing for ties, matching resulted in 414 high disease activity patients being used as matches for 44 low disease activity patients. Demographic data are reported in Table 1. Patients with a low disease activity were significantly less likely to be currently flaring, lower number of flares in last 12 months, less likely to have been hospitalized in the last 12 months, had fewer consultations in the last 12 months, reported better HrQoL (EQ5D), more favourable levels of fatigue (FACIT), and lower work impairment (WPAI). (Table 2).Table 1.Demographic dataVariableLow disease activityHigh disease activityMean age (years)38.140.0% Female90.788.2% White/Caucasian76.767.7Mean years diagnosed5.55.0Table 1.Propensity score matching resultsOutcome variableLow activity meanHigh activity meanCoefficient95% CIp-valueFlared in the last 12 months11.6337.97-0.26[-0.38 – -0.14]<0.001Number of flares in last 12 months0.210.70-0.49[-0.72 - -0.26]<0.001Hospitalised in last 12 months4.6514.98-0.10[-0.17 – -0.04]0.001Number of consults in last 12 months2.843.52-0.68[-1.19 – -0.17]0.009EQ-5D-3L0.780.880.10[0.03 – 0.17]0.004FACIT Fatigue34.6839.865.19[0.80 – 9.57]0.02WPAI overall percentage work impairment14.4245.35-30.93[-45.32 – -16.54]<0.001Conclusion:Systemic lupus erythematosus patients with lower levels of disease activity are less burdensome to the healthcare system and experience a significantly better HRQoL and lower levels of productivity impairment. There is a need to establish a universal definition of low disease activity as a treatment goal to benefit patient quality of life and reduce HCRU.Study funded by Johnson and Johnson.Disclosure of Interests:Zahi Touma Consultant of: Consultant for Janssen, Ben Hoskin Consultant of: Consultant for Janssen, Christian Atkinson Consultant of: Consultant for Janssen, David Bell Consultant of: Janssen, James Pike Consultant of: Janssen, Jennifer H. Lofland Employee of: Janssen, Pamela Berry Employee of: Janssen, Chetan Karyekar Shareholder of: Johnson & Johnson, Consultant of: Janssen, Employee of: Janssen Global Services, LLC. Previously, Novartis, Bristol-Myers Squibb, and Abbott Labs., Karen Costenbader Grant/research support from: Merck, Consultant of: Astra-Zeneca
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Criscitiello C, Spurden D, Rider A, Williams R, Corsaro M, Pike J, Law E. 87P Patient-reported and cancer-specific health-related quality of life among patients with early stage HR+/HER2- breast cancer (BC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.027] [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: 10/24/2022] Open
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Criscitiello C, Spurden D, Rider A, Williams R, Corsaro M, Pike J, Law E. 82P A multinational study of real-world treatment patterns among patients with early stage HR+/HER2- breast cancer (BC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Helzer K, Szatkowski Ozers M, Meyer M, Benkusky N, Solodin N, Reese R, Warren C, Pike J, Alarid E. OR26-4 Genome-Wide Binding Profile of Phosphorylated Estrogen Receptor Reveals Association with Direct DNA Binding. J Endocr Soc 2019. [PMCID: PMC6554808 DOI: 10.1210/js.2019-or26-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Post-translational modifications are key regulators of protein function, providing signals that alter protein interactions and activity. Phosphorylation of estrogen receptor-α (ER) at serine 118 (pS118-ER) occurs in response to multiple stimuli and is involved in modulating ER-dependent gene transcription. While the effects of pS118 on ER-DNA interactions have been investigated at specific genomic sites, the genome-wide binding profile (cistrome) of pS118-ER remains to be studied. To determine and characterize the pS118-ER cistrome, chromatin immunoprecipitation sequencing (ChIP-seq) was performed on both pS118-ER and ER and their binding profiles were compared. A subset of ER sites was found to be occupied by pS118-ER and although these sites were not found to be enriched in promoter regions relative to all ER sites, the pS118-ER sites were associated with the active enhancer mark H3K27ac as well as genes upregulated, but not downregulated, by estrogen. Additionally, pS118-ER sites were found to be enriched in the DNA binding motif for GRHL2 as well as the estrogen response element (ERE) relative to all ER sites. Utilizing a DNA binding microarray, pS118-ER was found to be more commonly associated with direct DNA binding events compared to indirect binding events. These results suggest a role for pS118-ER at active enhancers and as a regulator of direct ER-DNA interactions. Prevention of this phosphorylation event could serve as a potential treatment for ER-positive breast cancers by reducing the transcriptional activity of ER and decreasing its occupancy on DNA.
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Affiliation(s)
- Kyle Helzer
- University of Wisconsin - Madison, Madison, WI, United States
| | | | - Mark Meyer
- University of Wisconsin - Madison, Madison, WI, United States
| | - Nancy Benkusky
- University of Wisconsin - Madison, Madison, WI, United States
| | - Natalia Solodin
- PHYSIOLOGY DEPT, University of Wisconsin - Madison, Madison, WI, United States
| | - Rebecca Reese
- University of Wisconsin - Madison, Madison, WI, United States
| | | | - J Pike
- Dept of Biochem, University of Wisconsin - Madison, Madison, WI, United States
| | - Elaine Alarid
- McArdle Laboratory for Cancer Research, University of Wisconsin - Madison, Madison, WI, United States
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Abstract
SummaryWe determined factor VII antigen (FVIIag) levels in 705 healthy blood donors ranging in age from 17 to 79 years using a two-site solid-phase enzyme immunoassay developed in our laboratory. The mean (± SD) FVIIag level for the total population was 102 ± 31%. FVIIag levels for men (n = 375) and women (n = 330) were 101 ± 28% and 103 ± 33%, respectively. A significant increase in FVIIag was observed with age in both men (r = 0.25, p <0.0001) and women (r = 0.35, p <0.0001). FVIIag levels were significantly higher in women > 60 years when compared to men (median women: 125%; median men: 111%; p <0.05). On a subset of the study group (n = 45), FVIIag levels were correlated to total cholesterol (r = 0.27, p = 0.08) and triglyceride (r = 0.41, p <0.01). Assuming the commonly used reference interval of 60-140% for FVII, the frequencies of FVIIag values for <60% and >140% using our assay were 2.1% and 9.2%, respectively. Gender and age-related differences in FVIIag levels must be considered in a reference interval. We further suggest that assay-specific reference ranges be established, which may include values outside the commonly used values of 60-140%.
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Affiliation(s)
- P R Howard
- The University of Vermont Department of Medical Technology, Burlington, VT, USA
| | - E G Bovill
- Department of Pathology, Vermont Thrombosis Center, Burlington, VT, USA
| | - J Pike
- Department of Biochemistry, Vermont Thrombosis Center, Burlington, VT, USA
| | - W R Chruch
- Department of Biochemistry, Vermont Thrombosis Center, Burlington, VT, USA
| | - R P Tracy
- Department of Pathology, Vermont Thrombosis Center, Burlington, VT, USA
- Department of Biochemistry, Vermont Thrombosis Center, Burlington, VT, USA
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Slowinski R, Wilk S, Farion KJ, Pike J, Rubin S, Michalowski W. Design and Development of a Mobile System for Supporting Emergency Triage. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1633918] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
Our objective was to design and develop a mobile clinical decision support system for emergency triage of different acute pain presentations. The system should interact with existing hospital information systems, run on mobile computing devices (handheld computers) and be suitable for operation in weak-connectivity conditions (with unstable connections between mobile clients and a server).
Methods:
The MET (Mobile Emergency Triage) system was designed following an extended client-server architecture. The client component, responsible for triage decision support, is built as a knowledge-based system, with domain ontology separated from generic problem solving methods and used for the automatic creation of a user interface.
Results:
The MET system is well suited for operation in the Emergency Department of a hospital. The system’s external interactions are managed by the server, while the MET clients, running on handheld computers are used by clinicians for collecting clinical data and supporting triage at the bedside. The functionality of the MET client is distributed into specialized modules, responsible for triaging specific types of acute pain presentations. The modules are stored on the server, and on request they can be transferred and executed on the mobile clients. The modular design provides for easy extension of the system’s functionality. A clinical trial of the MET system validated the appropriateness of the system’s design, and proved the usefulness and acceptance of the system in clinical practice.
Conclusions:
The MET system captures the necessary hospital data, allows for entry of patient information, and provides triage support. By operating on handheld computers, it fits into the regular emergency department workflow without introducing any hindrances or disruptions. It supports triage anytime and anywhere, directly at the point of care, and also can be used as an electronic patient chart, facilitating structured data collection.
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Bendikov A, Braverman A, Pike J. Poisson statistics of eigenvalues in the hierarchical Dyson model. Theory Probab Appl 2018. [DOI: 10.1137/s0040585x97t988939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
This study describes the MR imaging appearances of the supporting ligaments of the thumb carpometacarpal joint in asymptomatic volunteers and in a group of patients following joint injury. Fourteen patients with 11 acute and three chronic injuries underwent MR imaging. The anterior oblique ligament was the most commonly injured ligament, usually on the metacarpal side where it was disrupted, or allowed dislocation because of subperiosted stripping from the base of the thumb metacarpal. The dorsal radial ligament was occasionally avulsed or partially torn from the trapezoid. Following chronic injury, MR imaging can evaluate ligamentous laxity, ganglion cyst formation or osteoarthritis. Accurate evaluation of ligament injury may identify patients who would benefit from surgery.
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Affiliation(s)
- D A Connell
- Department of Medical Imaging, Victoria House Hospital, Prahran, Victoria, Australia.
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Jones E, Pike J, Marshall T, Ye X. Quantifying the relationship between increased disability and health care resource utilization, quality of life, work productivity, health care costs in patients with multiple sclerosis in the US. BMC Health Serv Res 2016; 16:294. [PMID: 27443278 PMCID: PMC4957342 DOI: 10.1186/s12913-016-1532-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 07/07/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic progressive condition affecting the central nervous system. Progression of MS results in increased level of disability and most patients will eventually experience some degree of functional impairment and impaired mobility. Costs and burdens escalate as MS disability increases. However, there is a lack of recent data on the impact of MS disability on the cost and burden among patients in the US. METHODS Data for this study were drawn from a real world, cross-sectional survey undertaken between 2013 and 2014. Neurologists completed detailed patient report forms (PRF) for the most recent consulting patients with MS (age >18 years). Patient's perceptions of their diagnosis and health-related quality of life (HRQoL) were collected through a patient self-completion questionnaire (PSC). Regression analysis was used to evaluate the relationship between disability (determined by latest Expanded Disability Status Scale [EDSS] score) and current relapse and health care resource utilization, health care costs, HRQoL and work productivity. RESULTS PRF data were collected for 715 patients (335 also completed a PSC). Patients with higher disability scores (EDSS 3-5 and >5 vs <3 points) and current relapse (vs no current relapse) reported significantly greater health resource utilization for physician visits (p < 0.05) and hospitalizations (p < 0.05) in the preceding 12 months. In addition, they had poorer HRQoL (p < 0.05), were significantly more likely to be unemployed (p < 0.05) and to have had to stop working due to MS (p < 0.05). They also incurred significantly higher health care related costs, including costs for physician consultations, hospitalizations and therapy (p < 0.05). The total costs of care were $51,825, $57,889 and $67,116 for EDSS < 3, EDSS 3-5 and EDSS > 5 groups, respectively; $51,692 and $58,648 for non-relapse and relapse groups, respectively. CONCLUSIONS For MS patients in the US, health resource utilization and healthcare care costs increase with progression of disability. As the disability worsens, patients also exhibit diminished HRQoL and lower work productivity. There is a need for treatments that slow down or delay disability progression among MS patients.
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Affiliation(s)
- E Jones
- Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, SK10 5JB, UK.
| | - J Pike
- Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, Cheshire, SK10 5JB, UK
| | - T Marshall
- Abbvie Inc., 26525 Riverwoods Blvd., Mettawa, IL, 60060, USA
| | - X Ye
- Abbvie Inc., 26525 Riverwoods Blvd., Mettawa, IL, 60060, USA
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Korman NJ, Zhao Y, Roberts J, Pike J, Sullivan E, Tsang Y, Karagiannis T. Impact of psoriasis flare and remission on quality of life and work productivity: a real-world study in the USA. Dermatol Online J 2016. [DOI: 10.5070/d3227031643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Korman NJ, Zhao Y, Pike J, Roberts J, Sullivan E, Kemhus M. Satisfaction with current psoriasis treatment: misalignment between physician and patient perceptions. Dermatol Online J 2016. [DOI: 10.5070/d3227031659] [Citation(s) in RCA: 4] [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: 11/08/2022] Open
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Korman NJ, Zhao Y, Roberts J, Pike J, Sullivan E, Tsang Y, Karagiannis T. Impact of psoriasis flare and remission on quality of life and work productivity: a real-world study in the USA. Dermatol Online J 2016; 22:13030/qt4vb7q7rr. [PMID: 27617715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 06/06/2023] Open
Abstract
Although psoriasis patients often report a negative impact on health-related quality of life (HRQoL) and work productivity, less is known about how disease burden varies between periods of flare and remission. The aim of this study was tocompare HRQoL and work productivity by disease activity level. Data were extracted from Adelphi 2011/2013 Disease Specific Programmes, two real world surveys of US dermatologists and psoriasis patients. HRQoL was measured using the EuroQOL 5-Dimension Health Questionnaire (EQ-5D) and Dermatology Life Quality Index (DLQI). Work productivity was measured using the Work Productivity Activity index (WPAI). Three levels of disease activity were constructed based on physician reports: remission, active not flaring, active, and flaring. Multivariable regression analyses explored the relationship between disease activity, HRQoL and work productivity, controlling for differences in demographics and comorbidities. Out of 681 psoriasis patients 24% were in remission, 62% had active disease without flaring, and 15% experienced active disease and were currently flaring. Greater disease activity was associated with worse HRQoL. EQ-5D scores decreased with more active disease (remission vs. active not flaring vs. active and flaring: 0.93 vs. 0.90 vs. 0.82; p<0.05), while DLQI scores increased (remission vs. active not flaring vs. active and flaring: 2.0 vs. 5.00 vs. 8.7; p<0.05). WPAI scores increased with disease activity indicating increased productivity loss (remission vs. active not flaring vs. active and flaring: 5.9 vs. 14.8 vs. 26.9; p<0.05). The same trends were confirmed by multivariable regression analyses.
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Affiliation(s)
- N J Korman
- University Hospitals Case Medical Center, Cleveland, Ohio, USA.
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Korman NJ, Zhao Y, Pike J, Roberts J, Sullivan E, Kemhus M. Satisfaction with current psoriasis treatment: misalignment between physician and patient perceptions. Dermatol Online J 2016; 22:13030/qt7405k1nn. [PMID: 27617714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 06/06/2023] Open
Abstract
Psoriasis patients often report dissatisfaction with treatment. However, the extent to which patients and their treating dermatologists are aligned regarding satisfaction with psoriasis therapy is largely unknown. This was explored using data derived from the Adelphi 2011/2013 Psoriasis Disease Specific Programmes, two real world surveys of US dermatologists and their patients. Physicians and patients independently reported their satisfaction with psoriasis control (satisfied, dissatisfied). Two levels of satisfaction alignment between physician and patient responses were constructed: aligned (same responses) and misaligned (different responses). In addition, dermatologists provided patient treatment history and disease/symptom severity whereas patients reported data on health-related quality of life (HRQoL), using the EuroQOL 5-Dimension Health Questionnaire (EQ-5D) and Dermatology Life Quality Index (DLQI), and work productivity using the Work Productivity Activity index (WPAI). Multivariate regressions were employed to examine the relationship between satisfaction alignment, overall disease and symptom severity, HRQoL, and work productivity controlling for differences in patient demographics and comorbidities.From 627 paired dermatologist and psoriasis patient records, 512 (81.7%) and 115 (18.3%) cases fell into the 'aligned' and 'misaligned' groups, respectively. Compared with patients in the aligned group, those in the misaligned group had more moderate to severe psoriasis (82.3% vs. 43.7%), moderate to severe itching (45.6% vs. 27.8%), pain (23.0% vs. 10.6%), and scaling (54.8% vs. 36.1%), and had lower current biologics use (27.0% vs. 42%) (all p<0.05). The misaligned group was associated with reduced HRQoL (lower EQ-5D score: 0.86 vs. 0.91; higher DLQI score: 7.06 vs. 4.23) and greater work productivity loss (higher WPAI scores: 18.27 vs. 11.43) (all p<0.05). Multivariate analyses confirmed these results (p<0.05). Almost 1 in 5 patients were misaligned with their dermatologist's level of satisfaction with their psoriasis treatment; misalignment was associated with increased disease and symptom severity, reduced HRQoL, and reduced work productivity.
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Affiliation(s)
- N J Korman
- 1University Hospitals Case Medical Center, Cleveland, Ohio.
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Korman NJ, Zhao Y, Pike J, Roberts J. Relationship between psoriasis severity, clinical symptoms, quality of life and work productivity among patients in the USA. Clin Exp Dermatol 2016; 41:514-21. [PMID: 27061102 DOI: 10.1111/ced.12841] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Psoriasis is a chronic disease, and many patients experience itching, painful skin and scaling. The relationship between psoriasis severity and symptom severity, quality of life (QoL) and work productivity is not fully understood. AIM To examine how QoL, work productivity and clinical symptoms vary between patients with mild, moderate and severe psoriasis. METHODS During a recent US survey, dermatologists provided information on overall disease severity, symptom severity and comorbidities. Patients with psoriasis completed QoL and work productivity instruments: the EuroQoL 5-Dimension Health (EQ-5D) questionnaire, the Dermatology Life Quality Index (DLQI), and the Work Productivity and Activity Impairment (WPAI) questionnaire. Multivariate regression was used to explore the relationship between these outcome variables and psoriasis severity, controlling for differences in demographics and comorbidities. RESULTS The study analysed 694 patients (55% male; mean age: 44 years); 48%, 46% and 6% had mild, moderate and severe psoriasis, respectively. Scaling was the most common symptom, which was experienced by 82% of patients, followed by itching (73%) and pain (32%). Increased psoriasis severity was associated with increased itching, pain and scaling, and with reduced QoL (decrease in EQ-5D scores: moderate vs. mild -0.04, severe vs. mild -0.18; increase in DLQI: moderate vs. mild 2.97, severe vs. mild 7.95). WPAI scores increased with severity, indicating greater impairment (moderate vs. mild: 11.77, severe vs. mild 18.73). CONCLUSIONS Patients with more severe psoriasis experienced more severe symptoms and had a greater reduction in QoL and work productivity. It is important that physicians recognize the impact of severe disease on patients' lives and take steps to address this.
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Affiliation(s)
- N J Korman
- Clinical Trials Unit, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Y Zhao
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - J Pike
- Adelphi Real World, Macclesfield, UK
| | - J Roberts
- Adelphi Real World, Macclesfield, UK
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Korman NJ, Zhao Y, Pike J, Roberts J, Sullivan E. Patient satisfaction with current psoriasis treatment: a real-world study in the USA. Dermatol Online J 2016; 22. [PMID: 27267186 DOI: 10.1177/247553031600100207] [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: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 11/15/2022] Open
Abstract
Psoriasis patients often report dissatisfaction with treatment. However, it is less clear how the severity of key psoriasis symptoms (painful skin, itching, and scaling) as well as overall disease severity influence patient dissatisfaction levels. Using the Adelphi 2011/2013 Psoriasis Disease Specific Programmes, two "real world" surveys of US dermatologists and their patients, patient satisfaction was evaluated. Dermatologists provided data on disease characteristics, while patients indicated their satisfaction with existing treatment. Physician-reported severity (none, mild, moderate/severe) of psoriasis-related itching, pain, and scaling, overall disease severity (mild, moderate and severe) and therapy type were compared by patient satisfaction levels (satisfied vs. dissatisfied). Multivariate regressions examined the relationship between patient satisfaction, clinical symptoms, and psoriasis overall disease severity, controlling for differences in patient demographics and comorbidities. The sample comprised 633 psoriasis patients (56% male) with a mean age of 45. Overall, 18% of patients reported dissatisfaction with their psoriasis treatment. Dissatisfied patients were more likely to have moderate (65% vs. 40%) or severe (21% vs 3%) psoriasis compared to patients who were satisfied (both p<0.05). Dissatisfied patients were also more likely to have more severe pain (30% moderate-to-severe pain vs. 9%), more severe itching (61% moderate-to-severe itching vs. 25%), and more severe scaling (68% moderate-to-severe scaling vs. 33%) than satisfied patients (all p< 0.05). Multivariate analyses confirmed these results. Clinicians should be aware that some psoriasis patients, especially those with severe overall disease or symptoms, may be dissatisfied and are in need of better treatment.
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Affiliation(s)
- N J Korman
- University Hospitals Case Medical Center,
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Korman NJ, Zhao Y, Pike J, Roberts J, Sullivan E. Patient satisfaction with current psoriasis treatment: a real-world study in the USA. Dermatol Online J 2016. [DOI: 10.5070/d3222030081] [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: 11/08/2022] Open
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Schneider M, Mosca M, Pego-Reigosa JM, Hachulla E, Teh LS, Perna A, Koscielny V, Pike J, Lobosco S, Apolone G. Understanding remission in real-world lupus patients across five European countries. Lupus 2015; 25:505-12. [PMID: 26635245 DOI: 10.1177/0961203315619030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 11/02/2015] [Indexed: 02/01/2023]
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with increased mortality and significant personal, psychological and socioeconomic consequences. An agreed definition of remission is needed and lacking. We sought to visualize 'remission in SLE' in European patients considered by their physicians to be 'in remission' by comparing the reported symptom burden as reported by treating physicians for patients considered to be 'in remission' and those not considered to be 'in remission'. Data for 1227 patients drawn from a multinational, real-world survey of patients with SLE consulting practising rheumatologists and nephrologists in France, Germany, Italy, Spain, and the UK show that physicians classed their patients as 'in remission' despite a considerable ongoing symptom burden and intensive immunosuppressive medication. Patients considered to be 'in remission' still had a mean of 2.68 current symptoms vs 5.48 for those considered to be not 'in remission' (p < 0.0001). The most common symptoms among those seen to be 'in remission' were joint symptoms, fatigue, pain, mucocutaneous involvement, haematological manifestations and kidney abnormalities. The current analysis highlights important ongoing disease activity, symptom burden and immunosuppressive medication in European patients with SLE considered by their treating physician to be 'in remission'. For a further improvement of outcome, there is an urgent need for an international consensus on the definitions for remission among patients with SLE.
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Affiliation(s)
- M Schneider
- Policlinic of Rheumatology, Heinrich-Heine University, Dusseldorf, Germany
| | - M Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - J M Pego-Reigosa
- Rheumatology Section, Hospital do Meixoeiro (Complexo Hospitalario Universitario de Vigo), Instituto de Investigación Biomédica de Vigo (IBIV), Vigo, Spain
| | - E Hachulla
- National Centre for Auto-immune and Systemic Diseases, Internal Medicine Department, Hôpital Claude Huriez, University of Lille Nord de France, Lille, France
| | - L-S Teh
- Department of Rheumatology, Royal Blackburn Hospital, Blackburn, UK
| | - A Perna
- Immune Inflammation & Infectious Diseases Global Franchise GlaxoSmithKline, Brentford, UK
| | - V Koscielny
- Immune Inflammation & Infectious Diseases Global Franchise GlaxoSmithKline, Brentford, UK
| | - J Pike
- Adelphi Real World, Adelphi Mill, Bollington, UK
| | - S Lobosco
- Adelphi Real World, Adelphi Mill, Bollington, UK
| | - G Apolone
- Scientific Directorate, IRCCS Arcispedale S. Maria Nuova, Reggio-Emilia, Italy
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Mouw K, Amin-Mansour A, Braunstein L, Pike J, Damish A, Hornick J, D'Andrea A, Van Allen E, Mamon H. Genomic Analysis of Chemoradiation Therapy Response in Anal Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.297] [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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Korman NJ, Zhao Y, Pike J, Roberts J, Sullivan E. Increased severity of itching, pain, and scaling in psoriasis patients is associated with increased disease severity, reduced quality of life, and reduced work productivity. Dermatol Online J 2015; 21:13030/qt1x16v3dg. [PMID: 26632793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 10/15/2015] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Psoriasis patients report that this disease can impact on their health-related quality of life (HR-QoL) and work productivity. It is important to understand how this is influenced by the clinical characteristics of psoriasis such as symptom severity. Common symptoms include itching, pain, and scaling but the psychosocial impact these features have on patients is not well understood. OBJECTIVE To explore the impact of psoriasis symptoms (itching, pain, and scaling) on HR-QoL and work productivity. METHOD Data were extracted from the Adelphi 2011 and 2013 Psoriasis Disease Specific Programmes - two real world surveys of US dermatologists and their psoriasis patients. HR-QoL was measured using the Dermatology Life Quality Index (DLQI) and EuroQOL 5-Dimension Health Questionnaire (EQ-5D). Work productivity loss was measured by the Work Productivity and Activity Impairment (WPAI) questionnaire. The impact of symptom severity (none, mild, moderate/severe) for itching, pain, and scaling on DLQI, EQ-5D, and WPAI scores were examined, controlling for differences in demographics and co-morbidities. RESULTS Patient mean age was 44 years and 55% were male. Moderate/severe itching, pain, and scaling were experienced by 33%, 13%, and 41% of patients, respectively. Controlling for differences in demographics and co-morbidities, increased symptom severity was associated with reduced HR-QoL. Accordingly, EQ-5D scores decreased with itching severity (moderate/severe vs. none: -0.07; 95% confidence interval [CI] =-0.09, -0.04), whereas DLQI scores increased (moderate/severe versus none: 4.9; CI = 3.9, 5.9) (both p<0.05). WPAI scores increased with itching severity, indicating increased work productivity loss (moderate/severe versus none: 17.6, CI = 11.8, 23.5, p<0.05). The same pattern was observed for pain and scaling. CONCLUSIONS Among the patients studied, increased severity of psoriasis-related itching, pain, and scaling was associated with reduced health-related QoL and work productivity.
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Affiliation(s)
- N J Korman
- University Hospitals Case Medical Center
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Naoshy S, Pike J, Jones E, Watson C. Relapse rates and work productivity among patients receiving disease modifying therapy (dmt) for multiple sclerosis (ms). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.136] [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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Odlaug BL, Gual A, DeCourcy J, Perry R, Pike J, Heron L, Rehm J. Alcohol Dependence, Co-occurring Conditions and Attributable Burden. Alcohol Alcohol 2015; 51:201-9. [PMID: 26246514 DOI: 10.1093/alcalc/agv088] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 07/13/2015] [Indexed: 11/12/2022] Open
Abstract
AIMS Alcohol dependence is associated with high rates of co-occurring disorders which impact health-related quality of life (HRQoL) and add to the cost-of-illness. This study investigated the burden of alcohol dependence and associated co-occurring conditions on health and productivity. METHODS A cross-sectional survey was conducted in eight European countries. Physicians (Psychiatrists and General Practitioners) completed patient record forms, which included assessment of co-occurring conditions, and patients completed matching self-completion forms. Drinking risk level (DRL) was calculated and the relationship between DRL, co-occurring conditions, work productivity, hospitalisations and rehabilitation stays was explored. RESULTS Data were collected for 2979 alcohol-dependent patients (mean age 48.8 ± 13.6 years; 70% male). In total, 77% of patients suffered from moderate-to-severe co-occurring psychiatric and/or somatic conditions. High DRL was significantly associated with depression, greater work productivity losses, increased hospitalisations and rehabilitation stays. Co-occurring conditions were significantly associated with poorer HRQoL and decreased work productivity, with a statistical trend towards an increased frequency of rehabilitation stays. CONCLUSIONS Alcohol-dependent patients manifest high rates of co-occurring psychiatric and somatic conditions, which are associated with impaired work productivity and HRQoL. The continued burden of illness observed in these already-diagnosed patients suggests an unmet need in both primary and secondary care.
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Affiliation(s)
- B L Odlaug
- Department of Public Health, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - A Gual
- Department of Psychiatry, Alcohol Unit, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain
| | | | - R Perry
- Adelphi Real World, Bollington, UK
| | - J Pike
- Adelphi Real World, Bollington, UK
| | - L Heron
- Adelphi Values, Bollington, UK
| | - J Rehm
- Centre for Addiction and Mental Health, Toronto, Canada
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Korman NJ, Zhao Y, Pike J, Roberts J, Sullivan E. Increased severity of itching, pain, and scaling in psoriasis patients is associated with increased disease severity, reduced quality of life, and reduced work productivity. Dermatol Online J 2015. [DOI: 10.5070/d32110028943] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Harrow B, Price D, Pike J, Higgins V, Small M, Piercy J. Establishing the Relationship of Inhaler Satisfaction, Adherence, Smoking History and Allergic Rhinitis With Patient Outcomes: Real World Observations in US Adult Asthma Patients. Value Health 2014; 17:A599. [PMID: 27202066 DOI: 10.1016/j.jval.2014.08.2074] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- B Harrow
- Meda Pharmaceuticals, Inc., Somerset, NJ, USA
| | - D Price
- University of Aberdeen, Aberdeen, UK
| | - J Pike
- Adelphi Real World, Macclesfield, UK
| | - V Higgins
- Adelphi Real World, Macclesfield, UK
| | - M Small
- Adelphi Real World, Macclesfield, UK
| | - J Piercy
- Adelphi Real World, Macclesfield, UK
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Nwankwo C, Sung AH, Pike J. Self-Reported Health Related Quality Of Life Of Hepatitis C Virus (Hcv) Genotype 1 Patients With And Without Comorbid Conditions. Value Health 2014; 17:A369-A370. [PMID: 27200780 DOI: 10.1016/j.jval.2014.08.837] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - A H Sung
- St. John's University, Queens, NY, USA
| | - J Pike
- Adelphi Real World, Macclesfield, UK
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Osinski V, St. John H, Pike J. Vitamin D hormone regulates the expression of hedgehog coreceptor genes Boc and Cdon in osteocytes (946.4). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.946.4] [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: 11/11/2022]
Affiliation(s)
- Victoria Osinski
- Department of Biochemistry University of Wisconsin ‐ MadisonMadisonWIUnited States
| | - Hillary St. John
- Department of Biochemistry University of Wisconsin ‐ MadisonMadisonWIUnited States
| | - J Pike
- Department of Biochemistry University of Wisconsin ‐ MadisonMadisonWIUnited States
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Goetz T, Okada M, Scott A, Pike J. CHRONIC DISTAL BICEPS TENDON RUPTURE: RETROSPECTIVE REVIEW OF OUTOCOMES OF A NOVEL TECHNIQUE OF RECONSTRUCTION WITH TENDON GRAFT. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092459.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Elyas R, Guerra LA, Pike J, DeCarli C, Betolli M, Bass J, Chou S, Sweeney B, Rubin S, Barrowman N, Moher D, Leonard M. Is staging beneficial for Fowler-Stephens orchiopexy? A systematic review. J Urol 2010; 183:2012-8. [PMID: 20303527 DOI: 10.1016/j.juro.2010.01.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Fowler and Stephens showed that by dividing the spermatic vessels a high intra-abdominal testis could be placed in the scrotum. Testicular atrophy is a potential complication of this technique. We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability. MATERIALS AND METHODS We searched electronic databases, clinical trial registries and gray literature. We included reports describing boys younger than 18 years with a primary outcome of "testicular viability and position." We performed a meta-analysis using random effects models. Heterogeneity was assessed using forest plot and I(2) statistic. RESULTS We identified 1,807 citations and included 61 articles. Single stage Fowler-Stephens orchiopexy was discussed in 9 articles, a 2-stage procedure in 36 and both approaches in 16. There were no randomized controlled trials, and most studies were cohort or case series. The pooled estimate of success rates was 80% for single stage Fowler-Stephens orchiopexy (95% CI 75 to 86) and 85% for 2-stage Fowler-Stephens orchiopexy (95% CI 81 to 90). The pooled odds ratio of single stage vs 2-stage Fowler-Stephens orchiopexy was 2.0 (95% CI 1.1 to 3.9) favoring the 2-stage procedure. There was no difference in the success rate between laparoscopic and open techniques in either single or 2-stage Fowler-Stephens orchiopexy. There was no evidence of asymmetry on the funnel plot. There were no complications reported with single stage, while ileus, hematoma and infection were the most common complications with 2-stage Fowler-Stephens orchiopexy. CONCLUSIONS Both techniques have a fairly high success rate but 2-stage Fowler-Stephens orchiopexy appears to carry a higher rate of success than the single stage approach (85% vs 80%, OR 2 in favor of 2-stage). Laparoscopic and open techniques had the same success rate. However, the level of evidence of the studies was low, and a study of a more robust design, such as a randomized controlled trial, should be performed.
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Affiliation(s)
- R Elyas
- Queens University, Kingston, Ontario, Canada
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Taylor D, Lonczak A, Pike J, Tao X, Treff N, Scott R. A recessive PTEN haplotype is associated with fewer mature follicles in in vitro fertilization patients. Fertil Steril 2009. [DOI: 10.1016/j.fertnstert.2009.07.1034] [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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Keays M, Guerra L, Mihill J, Raju G, Al-Asheeri N, Geier P, Gaboury I, Matzinger M, Pike J, Leonard M. Reliability Assessment of Society for Fetal Urology Ultrasound Grading System for Hydronephrosis. J Urol 2008; 180:1680-2; discussion1682-3. [DOI: 10.1016/j.juro.2008.03.107] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Indexed: 11/28/2022]
Affiliation(s)
- M.A. Keays
- Division of Pediatric Urology, University of Ottawa, Ontario, Canada
| | - L.A. Guerra
- Division of Pediatric Urology, University of Ottawa, Ontario, Canada
| | - J. Mihill
- Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - G. Raju
- Division of Pediatric Urology, University of Ottawa, Ontario, Canada
| | - N. Al-Asheeri
- Division of Pediatric Urology, University of Ottawa, Ontario, Canada
| | - P. Geier
- Division of Nephrology, University of Ottawa, Ontario, Canada
| | - I. Gaboury
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ontario, Canada
| | - M. Matzinger
- Department of Pediatric Radiology, University of Ottawa, Ontario, Canada
| | - J. Pike
- Division of Pediatric Urology, University of Ottawa, Ontario, Canada
| | - M.P. Leonard
- Division of Pediatric Urology, University of Ottawa, Ontario, Canada
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Keays M, Guerra L, Mihill J, Raju G, Al-Asheeri N, Geier P, Gaboury I, Matzinger M, Pike J, Leonard M. MP-02.02: Reliability and validity assessment of society for fetal urology ultrasound grading system for hydronephrosis. Urology 2007. [DOI: 10.1016/j.urology.2007.06.185] [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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Guerra L, Moher D, Barrowman N, Sampson M, Pike J, Leonard M. POS-02.119: Intravesical oxybutynin for children with poorly compliant neurogenic bladders: a Systematic Review. Urology 2007. [DOI: 10.1016/j.urology.2007.06.1055] [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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Al-Taheini K, Pike J, Leonard M. MP-16.20. Urology 2006. [DOI: 10.1016/j.urology.2006.08.402] [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: 10/24/2022]
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Al-Taheini K, Leonard M, Pike J. MP-16.21. Urology 2006. [DOI: 10.1016/j.urology.2006.08.403] [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: 10/24/2022]
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Masci L, Pike J, Malara F, Phillips B, Bennell K, Brukner P. Use of the one-legged hyperextension test and magnetic resonance imaging in the diagnosis of active spondylolysis. Br J Sports Med 2006; 40:940-6; discussion 946. [PMID: 16980534 PMCID: PMC2465027 DOI: 10.1136/bjsm.2006.030023] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [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: 01/19/2023]
Abstract
BACKGROUND Active spondylolysis is an acquired lesion in the pars interarticularis and is a common cause of low back pain in the young athlete. OBJECTIVES To evaluate whether the one-legged hyperextension test can assist in the clinical detection of active spondylolysis and to determine whether magnetic resonance imaging (MRI) is equivalent to the clinical gold standard of bone scintigraphy and computed tomography in the radiological diagnosis of this condition. METHODS A prospective cohort design was used. Young active subjects with low back pain were recruited. Outcome measures included clinical assessment (one-legged hyperextension test) and radiological investigations including bone scintigraphy (with single photon emission computed tomography (SPECT)) and MRI. Computed tomography was performed if bone scintigraphy was positive. RESULTS Seventy one subjects were recruited. Fifty pars interarticulares in 39 subjects (55%) had evidence of active spondylolysis as defined by bone scintigraphy (with SPECT). Of these, 19 pars interarticulares in 14 subjects showed a fracture on computed tomography. The one-legged hyperextension test was neither sensitive nor specific for the detection of active spondylolysis. MRI revealed bone stress in 40 of the 50 pars interarticulares in which it was detected by bone scintigraphy (with SPECT), indicating reduced sensitivity in detecting bone stress compared with bone scintigraphy (p = 0.001). Conversely, MRI revealed 18 of the 19 pars interarticularis fractures detected by computed tomography, indicating concordance between imaging modalities (p = 0.345). There was a significant difference between MRI and the combination of bone scintigraphy (with SPECT)/computed tomography in the radiological visualisation of active spondylolysis (p = 0.002). CONCLUSIONS These results suggest that there is a high rate of active spondylolysis in active athletes with low back pain. The one-legged hyperextension test is not useful in detecting active spondylolysis and should not be relied on to exclude the diagnosis. MRI is inferior to bone scintigraphy (with SPECT)/computed tomography. Bone scintigraphy (with SPECT) should remain the first-line investigation of active athletes with low back pain followed by limited computed tomography if bone scintigraphy is positive.
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Affiliation(s)
- L Masci
- Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Victoria 3010, Australia.
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Affiliation(s)
- C R McLean
- Department of Orthopaedics and Trauma, University Hospital Lewisham, Lewisham High Street, Lewisham SE13 6LH London, United Kingdom.
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Buluwela L, Pike J, Mazhar D, Kamalati T, Hart SM, Al-Jehani R, Yahaya H, Patel N, Sarwar N, Sarwarl N, Heathcote DA, Schwickerath O, Phoenix F, Hill R, Aboagye E, Shousha S, Waxman J, Lemoine NR, Zelent A, Coombes RC, Ali S. Inhibiting estrogen responses in breast cancer cells using a fusion protein encoding estrogen receptor-alpha and the transcriptional repressor PLZF. Gene Ther 2005; 12:452-60. [PMID: 15647773 DOI: 10.1038/sj.gt.3302421] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 11/09/2022]
Abstract
Estrogen receptor alpha (ERalpha) is a ligand-inducible transcription factor that acts to regulate gene expression by binding to palindromic DNA sequence, known as the estrogen response element, in promoters of estrogen-regulated genes. In breast cancer ERalpha plays a central role, where estrogen-regulated gene expression leads to tumor initiation, growth and survival. As an approach to silencing estrogen-regulated genes, we have studied the activities of a fusion protein between ERalpha and the promyelocytic leukemia zinc-finger (PLZF) protein, a transcriptional repressor that acts through chromatin remodeling. To do this, we have developed lines from the estrogen-responsive MCF-7 breast cancer cell line in which the expression of the fusion protein PLZF-ERalpha is conditionally regulated by tetracycline and shows that these feature long-term silencing of the expression of several well-characterized estrogen-regulated genes, namely pS2, cathepsin-D and the progesterone receptor. However, the estrogen-regulated growth of these cells is not inhibited unless PLZF-ERalpha expression is induced, an observation that we have confirmed both in vitro and in vivo. Taken together, these results show that PLZF-ERalpha is a potent repressor of estrogen-regulated gene expression and could be useful in distinguishing estrogen-regulated genes required for the growth of breast cancer cells.
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Affiliation(s)
- L Buluwela
- Department of Cancer Medicine, Imperial College London, London, UK
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Buluwela L, Pike J, Mazhar D, Kamalati T, Hart SM, Al-Jehani R, Yahaya H, Patel N, Sarwarl N, Heathcote DA, Schwickerath O, Phoenix F, Hill R, Aboagye E, Shousha S, Waxman J, Lemoine NR, Zelent A, Coombes RC, Ali S. Erratum: Inhibiting estrogen responses in breast cancer cells using a fusion protein encoding estrogen receptor-α and the transcriptional repressor PLZF. Gene Ther 2005. [DOI: 10.1038/sj.gt.3302506] [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: 11/09/2022]
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King I, Luo X, Feng M, Ittensohn M, Li Z, Belcourt M, Lin S, Le T, Pike J, Troy K, Sznol M, Clairmont C, Bermudes D, Zheng LM. Tumour therapy using Salmonella. ACTA ACUST UNITED AC 2005. [DOI: 10.1517/14728214.5.2.211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Michalowski W, Slowinski R, Wilk S, Farion KJ, Pike J, Rubin S. Design and development of a mobile system for supporting emergency triage. Methods Inf Med 2005; 44:14-24. [PMID: 15778790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Our objective was to design and develop a mobile clinical decision support system for emergency triage of different acute pain presentations. The system should interact with existing hospital information systems, run on mobile computing devices (handheld computers) and be suitable for operation in weak-connectivity conditions (with unstable connections between mobile clients and a server). METHODS The MET (Mobile Emergency Triage) system was designed following an extended client-server architecture. The client component, responsible for triage decision support, is built as a knowledge-based system, with domain ontology separated from generic problem solving methods and used for the automatic creation of a user interface. RESULTS The MET system is well suited for operation in the Emergency Department of a hospital. The system's external interactions are managed by the server, while the MET clients, running on handheld computers are used by clinicians for collecting clinical data and supporting triage at the bedside. The functionality of the MET client is distributed into specialized modules, responsible for triaging specific types of acute pain presentations. The modules are stored on the server, and on request they can be transferred and executed on the mobile clients. The modular design provides for easy extension of the system's functionality. A clinical trial of the MET system validated the appropriateness of the system's design, and proved the usefulness and acceptance of the system in clinical practice. CONCLUSIONS The MET system captures the necessary hospital data, allows for entry of patient information, and provides triage support. By operating on handheld computers, it fits into the regular emergency department workflow without introducing any hindrances or disruptions. It supports triage anytime and anywhere, directly at the point of care, and also can be used as an electronic patient chart, facilitating structured data collection.
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Affiliation(s)
- W Michalowski
- School of Management, University of Ottawa, 136 Jean-Jacques Lussier St., Ottawa, Ontario K1N 6N5, Canada.
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Abstract
OBJECTIVE The objective of this study was to describe the suprascapular nerve block using CT guidance and to evaluate the short- and medium-term efficacy in a range of shoulder pathologies. DESIGN AND PATIENTS CT-guided infiltration around the suprascapular nerve was performed with bupivacaine and Celestone Chronodose on 40 consecutive patients presenting with chronic shoulder pathologies unresponsive to conventional treatment. Patients were interviewed using the Shoulder Pain and Disability Index (SPADI) before the procedure, 30 min after the procedure and at 3 days, 3 weeks and 6 weeks afterwards. RESULTS Within 30 min of the block overall pain scores decreased from a mean (+/-SEM) pain score of 7.0 (+/-0.4) to 3.5 (+/-0.5) ( n=39, P<0.001). At 3 days after the procedure, the mean overall improvement of the pain and disability scores were 20.4% (+/-4.9, P<0.001) and 16.8% (+/-4.8, P=0.004) respectively. Sustained pain relief and reduced disability were achieved in 10 of 35 (29%) patients at 3 weeks and longer. Patients suffering from soft tissue pathologies were the most likely patients to benefit from the injection. No serious side effects were noted. CONCLUSIONS In some patients with chronic soft tissue pathologies who do not respond to conventional treatment, a CT-guided suprascapular nerve block can provide safe short- and medium-term relief from pain and disability.
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Affiliation(s)
- M E Schneider-Kolsky
- Department of Medical Imaging, Victoria House Private Hospital, 316 Malvern Road, Prahran 3181, Melbourne, Victoria, Australia.
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Sauvé P, Redfern D, Pike J. Locked posterior dislocation of the shoulder with ipsilateral humeral shaft fracture—a management option. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.injury.2003.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pike J, Rebenstorf M, Slomp G, MacKellar F. Additions and Corrections - Addition of Alkyl Vinyl Ethers to Δ16-20-Keto Steroids. I. J Org Chem 2002. [DOI: 10.1021/jo01035a625] [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: 11/29/2022]
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Shen ZM, Wang L, Pike J, Jue CK, Zhao H, de Nobel H, Kurjan J, Lipke PN. Delineation of functional regions within the subunits of the Saccharomyces cerevisiae cell adhesion molecule a-agglutinin. J Biol Chem 2001; 276:15768-75. [PMID: 11278672 DOI: 10.1074/jbc.m010421200] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 11/06/2022] Open
Abstract
a-Agglutinin from Saccharomyces cerevisiae is a cell adhesion glycoprotein expressed on the surface of cells of a mating type and consists of an anchorage subunit Aga1p and a receptor binding subunit Aga2p. Cell wall attachment of Aga2p is mediated through two disulfide bonds to Aga1p (Cappellaro, C., Baldermann, C., Rachel, R., and Tanner, W. (1994) EMBO J. 13, 4737-4744). We report here that purified Aga2p was unstable and had low molar specific activity relative to its receptor alpha-agglutinin. Aga2p co-expressed with a 149-residue fragment of Aga1p formed a disulfide-linked complex with specific activity 43-fold higher than Aga2p expressed alone. Circular dichroism of the complex revealed a mixed alpha/beta structure, whereas Aga2p alone had no periodic secondary structure. A 30-residue Cys-rich Aga1p fragment was partially active in stabilization of Aga2p activity. Mutation of either or both Aga2p cysteine residues eliminated stabilization of Aga2p. Thus the roles of Aga1p include both cell wall anchorage and cysteine-dependent conformational restriction of the binding subunit Aga2p. Mutagenesis of AGA2 identified only C-terminal residues of Aga2p as being essential for binding activity. Aga2p residues 45-72 are similar to sequences in soybean Nod genes, and include residues implicated in interactions with both Aga1p (including Cys(68)) and alpha-agglutinin.
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Affiliation(s)
- Z M Shen
- Department of Biological Sciences and the Institute for Biomolecular Structure and Function, Hunter College of the City University of New York, New York 10021, USA
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Abstract
Dating the onset of deep-water flow between the Arctic and North Atlantic oceans is critical for modelling climate change in the Northern Hemisphere and for explaining changes in global ocean circulation throughout the Cenozoic era (from about 65 million years ago to the present). In the early Cenozoic era, exchange between these two ocean basins was inhibited by the Greenland-Scotland ridge, but a gateway through the Faeroe-Shetland basin has been hypothesized. Previous estimates of the date marking the onset of deep-water circulation through this basin-on the basis of circumstantial evidence from neighbouring basins-have been contradictory, ranging from about 35 to 15 million years ago. Here we describe the newly discovered Southeast Faeroes drift, which extends for 120 km parallel to the basin axis. The onset of deposition in this drift has been dated to the early Oligocene epoch ( approximately 35 million years ago) from a petroleum exploration borehole. We show that the drift was deposited under a southerly flow regime, and conclude that the initiation of deep-water circulation from the Norwegian Sea into the North Atlantic Ocean took place much earlier than is currently assumed in most numerical models of ancient ocean circulation.
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Affiliation(s)
- R Davies
- ExxonMobil International Limited, St Catherine's House, 2 Kingsway, PO Box 393, London WC2B 6WF, UK
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Pike J. Spring joint meeting of the BIPP Medical Photography Group, the Royal Photographic Society's Medical Group and the Institute of Medical Illustrators, Kodak House, Hemel Hempstead, UK, April 8, 2000. J Audiov Media Med 2000; 23:132-3. [PMID: 11203056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Clairmont C, Lee KC, Pike J, Ittensohn M, Low KB, Pawelek J, Bermudes D, Brecher SM, Margitich D, Turnier J, Li Z, Luo X, King I, Zheng LM. Biodistribution and genetic stability of the novel antitumor agent VNP20009, a genetically modified strain of Salmonella typhimurium. J Infect Dis 2000; 181:1996-2002. [PMID: 10837181 DOI: 10.1086/315497] [Citation(s) in RCA: 223] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/1999] [Revised: 03/10/2000] [Indexed: 11/03/2022] Open
Abstract
VNP20009 is a genetically modified strain of Salmonella typhimurium possessing an excellent safety profile, including genetically stable attenuated virulence (a deletion in the purI gene), reduction of septic shock potential (a deletion in the msbB gene), and antibiotic susceptibility. VNP20009 is genetically stable after multiple generations in vitro and in vivo. In mice, VNP20009 is rapidly cleared from the blood from a peak level of 1x104 cfu/mL to undetectable levels in 24 h. In tumor-bearing mice, VNP20009 accumulates preferentially in tumors over livers at a ratio of 1000&rcolon;1. In nonhuman primates, VNP20009 was also rapidly cleared from the blood, from a peak level of 1.0x106 cfu/mL to undetectable levels in 24 h. VNP20009 was detected in the liver, spleen, and bone marrow of monkeys; the amount decreased over time, and VNP20009 was cleared from all organs by day 41; no VNP20009 could be detected in the urine or feces of the monkeys. VNP20009 is genetically stable after many generations of growth (>140) both in vitro and in vivo.
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Affiliation(s)
- C Clairmont
- Vion Pharmaceuticals, Quality Control/Analytical Development, New Haven, CT 06511, USA.
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Abstract
We carried out a retrospective study of fracture morbidity of radial forearm osteocutaneous donor sites. During a period of three-and-a-half years, 12 patients had had composite flaps taken, and 5 of them had subsequently fractured the radius. We then elected to plate the radius prophylactically and found that over a period of just over two years, none of the 8 patients who had had prophylactic plating at the original harvesting operation had subsequently fractured the radius.
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Affiliation(s)
- V A Nuñez
- St Richard's Hospital, Chichester, Sussex
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