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Breinlinger E, Van Epps S, Friedman M, Argiriadi M, Chien E, Chhor G, Cowart M, Dunstan T, Graff C, Hardee D, Herold JM, Little A, McCarthy R, Parmentier J, Perham M, Qiu W, Schrimpf M, Vargo T, Webster MP, Wu F, Bennett D, Edmunds J. Targeting the Tyrosine Kinase 2 (TYK2) Pseudokinase Domain: Discovery of the Selective TYK2 Inhibitor ABBV-712. J Med Chem 2023; 66:14335-14356. [PMID: 37823891 DOI: 10.1021/acs.jmedchem.3c01373] [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: 10/13/2023]
Abstract
Tyrosine kinase 2 (TYK2) is a nonreceptor tyrosine kinase that belongs to the JAK family also comprising JAK1, JAK2, and JAK3. TYK2 is an attractive target for various autoimmune diseases as it regulates signal transduction downstream of IL-23 and IL-12 receptors. Selective TYK2 inhibition offers a differentiated clinical profile compared to currently approved JAK inhibitors. However, selectivity for TYK2 versus other JAK family members has been difficult to achieve with small molecules that inhibit the catalytically active kinase domain. Successful targeting of the TYK2 pseudokinase domain as a strategy to achieve isoform selectivity was recently exemplified with deucravacitinib. Described herein is the optimization of selective TYK2 inhibitors targeting the pseudokinase domain, resulting in the discovery of the clinical candidate ABBV-712 (21).
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Affiliation(s)
- Eric Breinlinger
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Stacy Van Epps
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Michael Friedman
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Maria Argiriadi
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Ellen Chien
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | | | | | - Theresa Dunstan
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Candace Graff
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | | | - J Martin Herold
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Andrew Little
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Richard McCarthy
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Julie Parmentier
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Matthew Perham
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | | | | | - Thomas Vargo
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | | | - Fei Wu
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Dawn Bennett
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
| | - Jeremy Edmunds
- AbbVie Bioresearch Center, 381 Plantation Street, Worcester, Massachusetts 01605, United States
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Robert A, Edmunds J, Eggo R, Henao-Restrepo AM, Gsell PS, Watson CH, Longini IM, Rambaut A, Camacho A, Hué S. A39 Reconstruction of Ebola chains of transmission using sequence and epidemiological data. Virus Evol 2019. [PMCID: PMC6736102 DOI: 10.1093/ve/vez002.038] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Transmission trees can be established through detailed contact histories, statistical inference, phylogenetic inference, or a combination of methods. Each method has its limitations, and the extent to which they succeed in revealing a ‘true’ transmission history remains unclear. Moreover, the net value of pathogen sequencing in transmission tree reconstruction is yet to be assessed. We explored the accuracy and sensitivity to biases of a range of methods for transmission chain inference. We studied eight transmission chains determined by contact tracing, each one having more than a third of its cases sequenced (87 samples over 199 cases in total). We compared three inference methods on the selected transmission chains: (i) phylogenetic inference: the Ebola virus (EBOV) sequences derived from patients were mapped onto a dated EBOV phylogeny tree including 398 EBOV sequences sampled in Guinea between March 2014 and October 2015; (ii) statistical inference: we used the maximum likelihood framework developed by Wallinga and Teunis to infer the most likely transmitter-recipient relationships from the onset dates; (iii) combined method: we inferred probabilistic transmission events using both pathogen sequences and collection dates with the R package Outbreaker2. The cases coming from each transmission chain were mostly clustered together in the phylogenetic tree. The few misclassified cases were most likely allocated to the wrong chains of transmission because of the timing of their symptom onsets. Probabilistic transmission tree using only onset dates broadly matched the contact tracing data, but multiple potential infectors were identified for each case. The combined method showed that an a priori knowledge of the number of independent imports had an important impact on the outcome. Although cases were allocated to the correct transmission chains, discrepancies were found in identifying direct case linkage and transmission generations within a chain. Phylogenetic, epidemiological, and combined approaches for transmission chain reconstructions globally concurred in their output. Sequence data proved useful (if not necessary) to place the sampled cases in a wider context, identify transmission clusters, and misclassified cases when epidemiological chains are inferred from date of symptom onset only, and to identify links between supposedly independent chains of transmission.
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Affiliation(s)
- A Robert
- Department of Infectious Disease Epidemiology, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - J Edmunds
- Department of Infectious Disease Epidemiology, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - R Eggo
- Department of Infectious Disease Epidemiology, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - P -S Gsell
- World Health Organization, Geneva, Switzerland
| | - C H Watson
- Department of Infectious Disease Epidemiology, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - I M Longini
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - A Rambaut
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, UK
- Ashworth Laboratories, Centre for Immunology, Infection and Evolution, University of Edinburgh, King’s Buildings, Edinburgh EH9 3JT, UK
| | - A Camacho
- Department of Infectious Disease Epidemiology, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Epicentre, Paris, France
| | - S Hué
- Department of Infectious Disease Epidemiology, Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Paolotti D, Carnahan A, Colizza V, Eames K, Edmunds J, Gomes G, Koppeschaar C, Rehn M, Smallenburg R, Turbelin C, Van Noort S, Vespignani A. Web-based participatory surveillance of infectious diseases: the Influenzanet participatory surveillance experience. Clin Microbiol Infect 2014; 20:17-21. [PMID: 24350723 PMCID: PMC7128292 DOI: 10.1111/1469-0691.12477] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To overcome the limitations of the state‐of‐the‐art influenza surveillance systems in Europe, we established in 2008 a European‐wide consortium aimed at introducing an innovative information and communication technology approach for a web‐based surveillance system across different European countries, called Influenzanet. The system, based on earlier efforts in The Netherlands and Portugal, works with the participation of the population in each country to collect real‐time information on the distribution of influenza‐like illness cases through web surveys administered to volunteers reporting their symptoms (or lack of symptoms) every week during the influenza season. Such a large European‐wide web‐based monitoring infrastructure is intended to rapidly identify public health emergencies, contribute to understanding global trends, inform data‐driven forecast models to assess the impact on the population, optimize the allocation of resources, and help in devising mitigation and containment measures. In this article, we describe the scientific and technological issues faced during the development and deployment of a flexible and readily deployable web tool capable of coping with the requirements of different countries for data collection, during either a public health emergency or an ordinary influenza season. Even though the system is based on previous successful experience, the implementation in each new country represented a separate scientific challenge. Only after more than 5 years of development are the existing platforms based on a plug‐and‐play tool that can be promptly deployed in any country wishing to be part of the Influenzanet network, now composed of The Netherlands, Belgium, Portugal, Italy, the UK, France, Sweden, Spain, Ireland, and Denmark.
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Bhalla V, Bolduc A, Lewis F, Hogan C, Park M, Laserna C, Edmunds J, Hentges T, Holsten S. “Resident Bedside-Procedure Competency and Efficiency Identification by Intensive Care Nursing Staff”. J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.124] [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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Van Epps S, Fiamengo B, Edmunds J, Ericsson A, Frank K, Friedman M, George D, George J, Goedken E, Kotecki B, Martinez G, Merta P, Morytko M, Shekhar S, Skinner B, Stewart K, Voss J, Wallace G, Wang L, Wang L, Wishart N. Design and synthesis of tricyclic cores for kinase inhibition. Bioorg Med Chem Lett 2012; 23:693-8. [PMID: 23265875 DOI: 10.1016/j.bmcl.2012.11.108] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 11/21/2012] [Accepted: 11/26/2012] [Indexed: 02/01/2023]
Abstract
Interest in therapeutic kinase inhibitors continues to grow beyond success in oncology. To date, ATP-mimetic kinase inhibitors have focused primarily on monocyclic and bicyclic heterocyclic cores. We sought to expand on the repertoire of potential cores for kinase inhibition by exploring tricyclic variants of classical bicyclic hinge binding motifs such as pyrrolopyridine and pyrrolopyrazine. Herein we describe the syntheses of eight alternative tricyclic cores as well as in vitro screening results for representative kinases of potential therapeutic interest.
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Affiliation(s)
- Stacy Van Epps
- Abbott Bioresearch Center, 381 Plantation St, Worcester, MA 01605, USA.
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Chen M, Edmunds J, Ghani A. A Metapopulation Framework for Explaining the Socio-Demographic and Geospatial Epidemiology of Gonorrhea and Other Sexually Transmitted Infections in Heterosexual Populations. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.453] [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: 11/17/2022] Open
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Chen H, Zhang Y, Edmunds J, Bigge C, Mutlib A. Bioactivation of a Dihydropyrazole-1-carboxylic acid-(4-chlorophenyl amide) Scaffold to a Putativep-Chlorophenyl Isocyanate in Rat Liver Microsomes andIn Vivoin Rats. Chem Res Toxicol 2008; 21:1095-106. [DOI: 10.1021/tx7004019] [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: 11/30/2022]
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9
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Holsworth DD, Jeremy MS, Edmunds J, He W, Place S, Maiti S. An Expeditious Synthesis of 6-Alkyl-5-(4′-amino-phenyl)-pyrimidine-2,4-diamines. SYNTHETIC COMMUN 2003. [DOI: 10.1081/scc-120024725] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Edmunds J. 7 steps toward cesarean prevention. Midwifery Today Int Midwife 2003:31-3. [PMID: 12596404] [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: 03/01/2023]
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Edmunds J. Mamatoto. Midwifery Today Int Midwife 2002:10-1. [PMID: 12154702] [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: 02/26/2023]
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12
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Edmunds J. Providing effective prenatal care. Focus on the vision. Midwifery Today Int Midwife 2002:14-6. [PMID: 12152543] [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: 02/26/2023]
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Sharples LD, Edmunds J, Bilton D, Hollingworth W, Caine N, Keogan M, Exley A. A randomised controlled crossover trial of nurse practitioner versus doctor led outpatient care in a bronchiectasis clinic. Thorax 2002; 57:661-6. [PMID: 12149523 PMCID: PMC1746394 DOI: 10.1136/thorax.57.8.661] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [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: 11/04/2022]
Abstract
BACKGROUND With the decrease in junior doctor hours, the advent of specialist registrars, and the availability of highly trained and experienced nursing personnel, the service needs of patients with chronic respiratory diseases attending routine outpatient clinics may be better provided by appropriately trained nurse practitioners. METHODS A randomised controlled crossover trial was used to compare nurse practitioner led care with doctor led care in a bronchiectasis outpatient clinic. Eighty patients were recruited and randomised to receive 1 year of nurse led care and 1 year of doctor led care in random order. Patients were followed up for 2 years to ensure patient safety and acceptability and to assess differences in lung function. Outcome measures were forced expiratory volume in 1 second (FEV(1)), 12 minute walk test, health related quality of life, and resource use. RESULTS The mean difference in FEV(1) was 0.2% predicted (95% confidence interval -1.6 to 2.0%, p=0.83). There were no significant differences in the other clinical or health related quality of life measures. Nurse led care resulted in significantly increased resource use compared with doctor led care (mean difference pound 1497, 95% confidence interval pound 688 to pound 2674, p<0.001), a large part of which resulted from the number and duration of hospital admissions. The mean difference in resource use was greater in the first year ( pound 2625) than in the second year ( pound 411). CONCLUSIONS Nurse practitioner led care for stable patients within a chronic chest clinic is safe and is as effective as doctor led care, but may use more resources.
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Affiliation(s)
- L D Sharples
- MRC Biostatistics Unit, University of Cambridge, Cambridge CB2 2SR, UK.
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Edmunds J. Where is your birth community? Midwifery Today Int Midwife 2002:20-1. [PMID: 11984890] [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: 02/24/2023]
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Edmunds J, Calnan MW. The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practioners in the United Kingdom. Soc Sci Med 2001; 53:943-55. [PMID: 11522139 DOI: 10.1016/s0277-9536(00)00393-2] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In the light of recent developments within the British National Health Service some sociologists have suggested that the medical profession's status is under threat. They have specified a range of factors contributing to this state of affairs, such as the new consumerism; however, it is thought that attempts by other, related occupations at reprofessionalisation are particularly significant in this trend. It may be possible to understand recent initiatives at extending community pharmacists' role within this framework. This paper suggests that while community pharmacy is developing strategies to enhance its professional status, it is not so much an attempt at usurping general practitioners'(GPs) (primary care doctors') role as a bid for survival, especially on the part of the rank and file. However, GPs do not necessarily see the initiatives in this light. Although many GPs are accommodating some changes in community pharmacy, they also perceive some of the initiatives as a threat to their autonomy and control, this was especially evident in representative bodies such as the Local Medical Committee. Doctors' accommodating attitudes were qualified with traditional attitudes of dominance such as 'limitation' and 'exclusion'. Such attitudes could prevent community pharmacy from achieving professional status. However, there is also evidence that pharmacists themselves contribute to this situation because many of them also attribute ultimate authority to doctors. Moreover, they are held back by internal occupational divisions particularly between retail pharmacists and employee pharmacists, with the former being the most insecure.
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Affiliation(s)
- J Edmunds
- Faculty of Social and Political Sciences, University of Cambridge, UK.
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Edmunds J. A lovely way to enter the world. Midwifery Today Int Midwife 2001:28-9. [PMID: 11189586] [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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Edmunds J. What really is second stage? Midwifery Today Int Midwife 2001:16-7. [PMID: 11189553] [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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Edmunds J. Be the change you want to see. Midwifery Today Int Midwife 2001:26-7. [PMID: 11189614] [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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Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int Midwife 2001:34-5. [PMID: 11051983] [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: 02/18/2023]
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Edmunds J. My top 10 favorite complementary modalities. Midwifery Today Int Midwife 2001:9-12. [PMID: 11051973] [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: 02/18/2023]
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Bozovich M, Rubino CM, Edmunds J. Effect of a clinical pharmacist-managed lipid clinic on achieving National Cholesterol Education Program low-density lipoprotein goals. Pharmacotherapy 2000; 20:1375-83. [PMID: 11079286 DOI: 10.1592/phco.20.17.1375.34895] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Despite national guidelines for treatment of hyperlipidemia, significant numbers of individuals with coronary artery disease are not treated to their National Cholesterol Education Program (NCEP) low-density lipoprotein (LDL) goals. The potential benefits of a clinical pharmacist-managed lipid clinic would be to improve rates of success in achieving these goals, improve drug adherence and compliance with therapy, and reduce cardiovascular events. All patients who had a documented history of coronary artery disease and were under the care of one cardiologist were treated in the pharmacist-managed lipid clinic. A second cardiologist provided usual care to a group of patients with coronary artery disease who served as controls. Patients in each arm were followed for a minimum of 6 months. A protocol for therapy changes in clinic patients was developed by the clinical pharmacist and approved by the cardiologist. At the end of 6 months, 69% of patients in the pharmacist-managed clinic achieved their LDL goal, compared with 50% of controls. Compliance with laboratory tests and drug regimens also improved in clinic patients. Compliance with lipid panels went from 8% 2 months before to 89% 2 months after the start of the study. At the end of 6 months compliance with laboratory work and refills was 80%. Thus the clinical pharmacist-managed clinic was highly successful in achieving NCEP goals for secondary prevention.
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Affiliation(s)
- M Bozovich
- Drug Therapy Management, Inc., Greensboro, NC 27401, USA
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Edmunds J. Bravo, fathers! Even when we don't fully understand them.... Midwifery Today Int Midwife 2000:9-11. [PMID: 10808859] [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: 02/16/2023]
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Edmunds J. Bridging the gap: cracks & chasms. Midwifery Today Int Midwife 1999:18-9. [PMID: 10488308] [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: 02/14/2023]
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Edmunds J. Home--our birth right. Midwifery Today Int Midwife 1999:19-20. [PMID: 10478044] [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: 02/13/2023]
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Edmunds J. Hemorrhage: stay close and pay attention to your mothers. Midwifery Today Int Midwife 1999:14-6. [PMID: 10338668] [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: 02/12/2023]
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Edmunds J. The truest trust. Midwifery Today Int Midwife 1999:40-1. [PMID: 10338586] [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: 02/12/2023]
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Edmunds J. Prolonged labor: past & present. Midwifery Today Int Midwife 1999:13-4. [PMID: 10338622] [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: 02/12/2023]
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Edmunds J. Conspiracy of silence. Midwifery Today Int Midwife 1999:11-4. [PMID: 10338599] [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: 02/12/2023]
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Gautschi C, Hamilton J, Edmunds J. Do a midwife's beliefs affect the outcomes of births she attends? How (or how not)? Midwifery Today Int Midwife 1999:11. [PMID: 10338548] [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: 02/12/2023]
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Edmunds J. Just what is normal? Midwifery Today Int Midwife 1999:12-3. [PMID: 10338643] [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: 02/12/2023]
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Edmunds J. Accept the challenge to change. Midwifery Today Int Midwife 1999:12. [PMID: 10338549] [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: 02/12/2023]
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Mercer P, Sharples L, Edmunds J, Gittins R, Baines J, Wallwork J, Large S, Parameshwar J. Evaluating the donor pool: impact of using hearts from donors over the age of 49 years. Transpl Int 1998; 11 Suppl 1:S424-9. [PMID: 9665032 DOI: 10.1007/s001470050514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The shortage of hearts for transplantation has led to the use of organs from older donors in many centres. Despite the lack of coronary angiography on potential organ donors, hearts from carefully selected donors over 49 years of age have been used at this centre since 1988. In the study reported here looked at the impact of this strategy on morbidity and mortality. Between May 1988 and August 1996, 400 first heart transplants were performed, 35 recipients (31 male, 4 female; age 51 +/- 5.9 years) received hearts from donors over 49 years of age (group 1) while 365 (310 male, 55 female; age 49 +/- 9.7 years) had younger donors (group 2). The mean ischaemic time was 189 min (+/- 63.1) in group 1 and 180 min (+/- 59.2) in group 2 (n.s.). The main aetiology of heart failure in groups 1 and 2 was coronary artery disease in 46% and 51%, and dilated cardiomyopathy in 40% and 45% respectively (n.s.). There were no differences in the duration of stay on the intensive care unit or in hospital between the groups. One-year survival was 79% in group 1 and 82% in group 2 (n.s.) and actuarial 5-year survival 69% and 67%, respectively. Six patients in group 1 (17%) and 45 patients in group 2 (12%) died in the first 3 months; of these primary donor organ failure accounted for 50% in group 1 and 13.3% in group 2 (n.s.). Episodes of acute rejection (in the first 3 months) were similar in the two groups: 1.4 and 1.6 per 100 patient days, respectively. Infection rates were also similar: 0.5 and 0.6 per 100 patient days, respectively. The prevalence of coronary artery disease on surveillance coronary angiography at 2 years was 23% in group 1 and 9% in group 2 (P < 0.005). There was a greater proportion of CMV antibody donors in the older donor group, but the association between donor age and coronary artery disease persisted after adjusting for CMV status in multivariate analysis. Too few patients underwent angiography thereafter for valid comparisons. In summary, recipients of organs from donors aged 49 years and over can expect comparable survival rates and morbidity levels to recipients of organs from younger donors, at least in the first 2 years postoperation. There is evidence that older donors confer a significantly higher risk of cardiac allograft vasculopathy which may result in a greater attrition rate thereafter. Careful follow-up of these patients after 2 years is required.
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Affiliation(s)
- P Mercer
- Transplant Unit, Papworth Hospital, Cambridge, UK
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Mercer P, Sharples L, Edmunds J, Gittins R, Baines J, Wallwork J, Large S, Parameshwar J. Evaluating the donor pool: impact of using hearts from donors over the age of 49 years. Transpl Int 1998. [DOI: 10.1111/j.1432-2277.1998.tb01174.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Edmunds J. Wise owls: an assured place. Midwifery Today Childbirth Educ 1998:14-5. [PMID: 9429424] [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: 02/05/2023]
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Edmunds J. More on vitamin K. Midwifery Today Childbirth Educ 1998:8-9. [PMID: 9429418] [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: 02/05/2023]
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Edmunds J. Heart to heart. Nurs Times 1997; 93:28-30. [PMID: 9429493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Mercer P, Sharples L, Edmunds J, Gittins R, Baines J, Wallwork J, Large S, Parameshwar J. Evaluating the donor pool: impact of using hearts from donors over the age of 49 years. Transplant Proc 1997; 29:3293-6. [PMID: 9414720 DOI: 10.1016/s0041-1345(97)00916-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- P Mercer
- Transplant Unit, Papworth Hospital, Cambridge, United Kingdom
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Gittins R, Mercer P, Edmunds J. Post-operative care of transplant patients. Nurs Times 1997; 93:50-1. [PMID: 9121930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The skills involved in the post-operative management of patients undergoing transplantation are a major factor influencing their survival. This article explores the role of clinicians' assistants in providing care for patients and their families after cardiothoracic transplantation at the pioneering Papworth Hospital in Cambridgeshire.
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Mercer P, Edmunds J, Gittins R. Transplants. Life in the balance. Nurs Times 1996; 92:28-30. [PMID: 8932186] [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: 02/03/2023]
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Edmunds J. Mandatory prenatal HIV testing: why not? Midwifery Today Childbirth Educ 1996:53-54. [PMID: 8826386] [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: 05/22/2023]
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Edmunds J. Twin pregnancy: exercising your options. Midwifery Today Childbirth Educ 1996:18-9. [PMID: 9016038] [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: 02/03/2023]
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Edmunds J. The grand finale to birth. Midwifery Today Childbirth Educ 1995:17-18. [PMID: 7787894] [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: 05/22/2023]
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Edmunds J. Remembering why we are midwives. Midwifery Today Childbirth Educ 1994:12-41. [PMID: 7620494] [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: 05/21/2023]
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Davy CW, Fulleylove M, Edmunds J, Allsop D, Eichler DA, Rushton B, Walker JM. The histochemical location of three diagnostic enzymes in the marmoset liver. J Appl Toxicol 1989; 9:109-11. [PMID: 2565922 DOI: 10.1002/jat.2550090207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 01/01/2023]
Abstract
The histochemical locations of alkaline phosphate (ALP), leucine aminopeptidase (LAP) and gamma glutamyltransferase (GGT) were demonstrated in the liver of the marmoset (Callithrix jacchus). Although all three enzymes were located in cell membranes, the location of LAP was demonstrated by a chromogenic substrate, in the canalicular membrane. GGT was seen in a vascular network, provisionally identified as the peribiliary arterial plexus. Possible diagnostic applications in toxicology are discussed.
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Barsanti JA, Blue J, Edmunds J. Urinary tract infection due to indwelling bladder catheters in dogs and cats. J Am Vet Med Assoc 1985; 187:384-8. [PMID: 4030472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Urine samples were collected from 27 dogs and 4 cats with indwelling urinary catheters connected to a closed system. Twenty-one animals had sterile urine at the initiation of catheterization. Eleven of these 21 animals developed positive urine culture after 4 (mean) days (range 1 to 10 days) of catheterization. Infections persisted after catheter removal in 6 of 8 animals. The 10 animals that did not develop bacteriuria had a shorter duration of catheterization (3 days vs 12 days, mean). Antibiotics (chloramphenicol, trimethoprim/sulfonamide, cephradine, lincomycin, gentamicin, or ampicillin) were used during the period of catheterization in 17 of 21 animals, 8 of which developed bacteriuria and 9 of which did not. Ten animals had bacteriuria at the initiation of urine collection for culture. The type of bacteria changed during the catheterization period in 6 animals, all of which were given antibiotics. Bacteria isolated from animals given antibiotics seemed to become increasingly antibiotic-resistant.
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Abstract
The effects on animal performance were measured when machine milking was compared with restricted access suckling of four, three and two calves per cow, and when machine milking was alternated with restricted access multiple suckling. Calves were allowed access to cows twice daily, and supplementary grain feeding was provided to half the calves. A stimulus to milk and butterfat production from cows returning to machine milking after a period of suckling occurred, but was not significant. Cow breeding performance and liveweight changes were unaffected by the suckling treatments. Clinical mastitis did not occur during suckling in comparison with 36 cases of mastitis during machine milking. Teat damage in suckling cows in early lactation was the only cow health care problem of consequence, and was controllable by udder salves. The average daily liveweight gain to 140 days over all treatments was 0.735 kg. Grain supplementation pre-weaning increased liveweight gain from 0.71 kg to 0.76 kg day-1 (P < 0.05). Calf health was excellent, apart from some nutritional diahorrhea in unsupplemented calves. Neither enteritis nor deaths occurred in calves pre-weaning.
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Edmunds J. THE KNOCK-OUT BLOW ON THE POINT OF THE JAW. West J Med 1903. [DOI: 10.1136/bmj.1.2206.884] [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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Edmunds J. Caesarean Section: A Correction. West J Med 1902. [DOI: 10.1136/bmj.2.2186.1682-e] [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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