1
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Carroll P, Dervan A, McCarthy C, Woods I, Beirne C, Harte G, O’Flynn D, O’Connor C, McGuire T, Leahy LM, Gonzalez JG, Stasiewicz M, Maughan J, Quinlan J, Smith É, Moriarty F, O’Brien FJ, Flood M. The role of Patient and public involvement (PPI) in pre-clinical spinal cord research: An interview study. PLoS One 2024; 19:e0301626. [PMID: 38683786 PMCID: PMC11057720 DOI: 10.1371/journal.pone.0301626] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/19/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Patient and public involvement in research (PPI) has many benefits including increasing relevance and impact. While using PPI in clinical research is now an established practice, the involvement of patients and the public in pre-clinical research, which takes place in a laboratory setting, has been less frequently described and presents specific challenges. This study aimed to explore the perspectives of seriously injured rugby players' who live with a spinal cord injury on PPI in pre-clinical research. METHODS Semi-structured interviews were conducted via telephone with 11 seriously injured rugby players living with spinal cord injury on the island of Ireland. A purposive sampling approach was used to identify participants. Selected individuals were invited to take part via gatekeeper in a charitable organisation that supports seriously injured rugby players. Interviews were transcribed verbatim and analysed thematically. FINDINGS Six themes were identified during analysis: 'appreciating potential benefits of PPI despite limited knowledge', 'the informed perspectives of people living with spinal cord injury can improve pre-clinical research relevance', 'making pre-clinical research more accessible reduces the potential for misunderstandings to occur', 'barriers to involvement include disinterest, accessibility issues, and fear of losing hope if results are negative', 'personal contact and dialogue helps people feel valued in pre-clinical research, and 'PPI can facilitate effective dissemination of pre-clinical research as desired by people living with spinal cord injury.' CONCLUSION People affected by spinal cord injury in this study desire further involvement in pre-clinical spinal cord injury research through dialogue and contact with researchers. Sharing experiences of spinal cord injury can form the basis of PPI for pre-clinical spinal cord injury research.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Adrian Dervan
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Ian Woods
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine (Royal College of Physicians in Ireland & RCSI), Dublin, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Dónal O’Flynn
- c/o Irish Rugby Football Union Charitable Trust, Dublin, Ireland
| | - Cian O’Connor
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Tara McGuire
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Liam M. Leahy
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Javier Gutierrez Gonzalez
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Martyna Stasiewicz
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Jack Maughan
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dublin, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Fergal J. O’Brien
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Department of Anatomy and Regenerative Medicine, Tissue Engineering Research Group (TERG), Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
- Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI, Dublin, Ireland
- PPI Ignite Network, Galway, Ireland
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2
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Lin C, Jyotaki M, Quinlan J, Feng S, Zhou M, Jiang P, Matsumoto I, Huang L, Ninomiya Y, Margolskee RF, Reed DR, Wang H. Lipopolysaccharide increases bitter taste sensitivity via epigenetic changes in Tas2r gene clusters. iScience 2023; 26:106920. [PMID: 37283808 PMCID: PMC10239704 DOI: 10.1016/j.isci.2023.106920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 02/27/2023] [Accepted: 05/15/2023] [Indexed: 06/08/2023] Open
Abstract
T2R bitter receptors, encoded by Tas2r genes, are not only critical for bitter taste signal transduction but also important for defense against bacteria and parasites. However, little is known about whether and how Tas2r gene expression are regulated. Here, we show that in an inflammation model mimicking bacterial infection using lipopolysaccharide, the expression of many Tas2rs was significantly upregulated and mice displayed markedly increased neural and behavioral responses to bitter compounds. Using single-cell assays for transposase-accessible chromatin with sequencing (scATAC-seq), we found that the chromatin accessibility of Tas2rs was highly celltype specific and lipopolysaccharide increased the accessibility of many Tas2rs. scATAC-seq also revealed substantial chromatin remodeling in immune response genes in taste tissue stem cells, suggesting potential long-lasting effects. Together, our results suggest an epigenetic mechanism connecting inflammation, Tas2r gene regulation, and altered bitter taste, which may explain heightened bitter taste that can occur with infections and cancer treatments.
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Affiliation(s)
- Cailu Lin
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Masafumi Jyotaki
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - John Quinlan
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Shan Feng
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Minliang Zhou
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Peihua Jiang
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Ichiro Matsumoto
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Liquan Huang
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
- Institute of Cellular and Developmental Biology, College of Life Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yuzo Ninomiya
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
- Division of Sensory Physiology, Research and Development Center for Five-Sense Device, Kyushu University, Fukuoka, Japan
- Okayama University, Okayama, Japan
- Oral Science Research Center, Tokyo Dental College, Tokyo, Japan
| | | | - Danielle R. Reed
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
| | - Hong Wang
- Monell Chemical Senses Center, 3500 Market St., Philadelphia, PA 19104, USA
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Lin C, Jyotaki M, Quinlan J, Feng S, Zhou M, Jiang P, Matsumoto I, Huang L, Ninomiya Y, Margolskee RF, Reed DR, Wang H. Inflammation induces bitter taste oversensitization via epigenetic changes in Tas2r gene clusters. bioRxiv 2023:2023.02.08.527520. [PMID: 36798225 PMCID: PMC9934667 DOI: 10.1101/2023.02.08.527520] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
T2R bitter receptors, encoded by Tas2r genes, are not only critical for bitter taste signal transduction but also important for defense against bacteria and parasites. However, little is known about whether and how Tas2r gene expression are regulated. Here we show that, in an inflammation model mimicking bacterial infection, the expression of many Tas2rs are significantly up-regulated and mice displayed markedly increased neural and behavioral responses to bitter compounds. Using single-cell assays for transposase-accessible chromatin with sequencing (scATAC-seq), we found that the chromatin accessibility of Tas2rs was highly cell type specific and inflammation increased the accessibility of many Tas2rs . scATAC-seq also revealed substantial chromatin remodeling in immune response genes in taste tissue stem cells, suggesting potential long-term effects. Together, our results suggest an epigenetic mechanism connecting inflammation, Tas2r gene regulation, and altered bitter taste, which may explain heightened bitter taste that can occur with infections and cancer treatments.
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Timon C, Lee M, Feeley I, Quinlan J. Recording adverse events following orthopaedic trauma: Financial implications and validation of an adverse event assessment form in an Irish regional trauma unit. Injury 2023; 54:508-512. [PMID: 36414501 DOI: 10.1016/j.injury.2022.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/27/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND In Ireland, funding of orthopaedic trauma is based on an activity-based funding (ABF) model. Clinically similar cases are split into diagnostic-related groups (DRG), with base funding per DRG provided. Increased complexity of cases (length of stay; complications incurred; occurrence of adverse events) attracts additional remuneration to the base funding. In our institution these adverse events are recorded via retrospective chart-abstraction methods by administrative staff. Incidences which are not included from this review affect both follow up with family physicians and patient care; as well as skewing budgetary decisions that impact fiscal viability of the service. The aim of this study was to compare a prospectively implemented adverse events form with the current national retrospective chart abstraction method. Our outcomes in terms of pay-by-results financial implications. METHODS An adverse events database adapted from a similar validated model was used to prospectively record complications in 216 patients admitted via the orthopaedic trauma service. Data was contemporaneously collected via a GDPR compliant secure medical messaging platform. Results were compared with the same cohort using an existing data abstraction method. Both data sets were coded in accordance with current standards for case funding. RESULTS Overall, 49 adverse events were recorded during the study through prospective charting of adverse events, compared with 26 events documented by customary method (p<0.01).Anaemia requiring blood transfusion n = 11 22.4%) was the most common complication, followed by delirium n = 6 (12%), acute kidney injury n = 6 (12%), and pneumonia n = 5 (10.2%). Missed appropriate funding through conventional methods totalled €40,293 . CONCLUSION This pilot study demonstrates the ability to improve capture of adverse events through use of a well-designed assessment form. Proper perioperative data handling is a critical aspect of financial subsidies, enabling optimal allocation of funds.
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Affiliation(s)
- Charlie Timon
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin 24, Ireland.
| | - Matthew Lee
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin 24, Ireland
| | - Iain Feeley
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin 24, Ireland
| | - John Quinlan
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin 24, Ireland
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Elrih M, Quinlan J. Hook Plate Versus Distal Locking Plate for the Fixation of Unstable Distal Clavicle Injuries, Outcomes and Complications: A Meta-Analysis. Cureus 2022; 14:e30806. [PMID: 36381853 PMCID: PMC9642879 DOI: 10.7759/cureus.30806] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Numerous interventions are advised for the surgical management of distal clavicle fractures. Hook plate (HP) and distal locking plate (DLP) are among the commonly used techniques; nonetheless, no single procedure is deemed to be the benchmark treatment. Thus, the aim of the study is to conduct a comparative analysis, hopefully, to recommend the superior method between the two operations. PubMed, Embase via Ovid and Web of science were electronically searched between January 2000 and to date for studies directly comparing HP to DLP. Comparative retrospective/prospective and randomized studies were incorporated. Constant-Murley score “CMS” at a minimum of 12 months, pain visual analogue scale “VAS”, coracoclavicular distance “CCD” and reported complications were analysed. Review manager software was used for the statistical analyses. The total number of patients was 523; 274 (52.3%) with HP and 249 (47.6%) with DLP, 81 of which were associated with CC reconstruction. The mean follow up was 38.7 and 37.03 months for HP and DLP, respectively. CMS leaned towards the DLP group with no statistically significant difference (P=0.06). VAS was in favour of the DLP with again no statistically significant difference (P=0.12). In terms of CCD, the comparison favoured the HP with a lesser CCD postoperatively and a statistically significant difference (P<0.05). Complications were significantly higher in the HP group (P<0.0001). Contrary to our hypothesis, though HP did show a better radiological outcome; nonetheless, DLP did demonstrate a better functional result with a lesser rate of complications and the ability to retain the implant avoiding a second surgery.
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6
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, O'Connor C, McGuire T, Leahy LM, Gonzalez JG, Stasiewicz M, Maughan J, Gouveia PJ, Murphy PJ, Quinlan J, Casey S, Holton A, Smith É, Moriarty F, O'Brien FJ, Flood M. Applying Patient and Public Involvement in preclinical research: A co-created scoping review. Health Expect 2022; 25:2680-2699. [PMID: 36217557 DOI: 10.1111/hex.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/29/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient and Public Involvement (PPI) in research aims to improve the quality, relevance and appropriateness of research. PPI has an established role in clinical research where there is evidence of benefit, and where policymakers and funders place continued emphasis on its inclusion. However, for preclinical research, PPI has not yet achieved the same level of integration. As more researchers, including our team, aim to include PPI in preclinical research, the development of an evidence-based approach is important. Therefore, this scoping review aimed to identify and map studies where PPI has been used in preclinical research and develop principles that can be applied in other projects. METHODS A scoping review was conducted to search the literature in Medline (PubMed), EMBASE, CINAHL, PsycInfo and Web of Science Core Collection to identify applied examples of preclinical PPI. Two independent reviewers conducted study selection and data extraction separately. Data were extracted relating to PPI in terms of (i) rationale and aims, (ii) approach used, (iii) benefits and challenges, (iv) impact and evaluation and (v) learning opportunities for preclinical PPI. Findings were reviewed collaboratively by PPI contributors and the research team to identify principles that could be applied to other projects. RESULTS Nine studies were included in the final review with the majority of included studies reporting PPI to improve the relevance of their research, using approaches such as PPI advisory panels and workshops. Researchers report several benefits and challenges, although evidence of formal evaluation is limited. CONCLUSION Although currently there are few examples of preclinical research studies reporting empirical PPI activity, their findings may support those aiming to use PPI in preclinical research. Through collaborative analysis of the scoping review findings, several principles were developed that may be useful for other preclinical researchers. PATIENT OR PUBLIC CONTRIBUTION This study was conducted as part of a broader project aiming to develop an evidence base for preclinical PPI that draws on a 5-year preclinical research programme focused on the development of advanced biomaterials for spinal cord repair as a case study. A PPI Advisory Panel comprising seriously injured rugby players, clinicians, preclinical researchers and PPI facilitators collaborated as co-authors on the conceptualization, execution and writing of this review, including refining the findings into the set of principles reported here.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Rachel Kavanagh
- Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicines, RCSI University of Medicine and Health Sciences & Royal College of Physicians in Ireland, Dublin, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, Ireland
| | - Cian O'Connor
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tara McGuire
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Liam M Leahy
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Javier Gutierrez Gonzalez
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Martyna Stasiewicz
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Jack Maughan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Pedro Jose Gouveia
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul J Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Science Foundation Ireland (SFI) Advanced Materials and BioEngineering Research (AMBER) Centre, Trinity College Dublin (TCD) and RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Schofield K, Ensslin J, Bruneau M, Quinlan J. Examination of Data Analysis Methods on Behavioral Changes in the PA SNAP Ed/Eat Right Philly Program: Eight years of Data and Analysis Techniques. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.127] [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: 10/15/2022]
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8
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Wahab EHA, Downey C, Lawlor S, O'kelly P, Shortt C, Quinlan J. Is contralateral femoral neck-shaft angle predictive of timing of subsequent hip fracture? [DOI: 10.21203/rs.3.rs-1570409/v1] [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] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
IntroductionIn 2019, research showed that in the six acute adult Dublin hospitals, 1 in 11 patients with fragility hip fracture sustained a second contralateral hip fracture. These have implications of additional patient morbidity and cost to the health service. Relationship of the contralateral femoral neck-shaft angle (NSA) and timing to the second hip fracture have not been established previously. Our study aimed to establish the relationship of the contralateral femur NSA in patient who already sustained a fragility hip fracture and determine if we could predict the timing of the second hip fracture.MethodsA 7 year single institution retrospective cohort study of patients that presented with second fragility hip fracture from 2013-2019 were reviewed. Exclusion criteria are patients who were aged less than 60 years old, high energy injuries, or had a peri-prosthetic fractures. Plain films anteroposterior (AP) pelvis radiographs were reviewed on the National Integrated Medical Imaging System (NIMIS) McKessons. NSA of the contralateral hip prior to second hip fracture were measured with a standardized method with the TraumaCAD software. Correlation analysis performed with Stata SE statistical software.Results and discussionContralateral NSA is not statistically significant in predicting the timing to second hip fracture. Causes of fragility hip fracture and subsequent second hip fracture are multifactorial and multidisciplinary approach such as fracture liaison services are essential to improve the prevention and treatment of such injuries.
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Affiliation(s)
| | | | - Sophie Lawlor
- Trinity College: The University of Dublin Trinity College
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Murphy B, Downey C, Flannery S, Daly T, Conway S, Gaffar M, Dawson P, Collins D, Kenny P, McCarthy T, Cashman J, Hurson C, O'Daly B, Quinlan J. 1235 A Multi-Site Review of Second Hip Fractures Across 6 Dublin Teaching Hospitals. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Hip fractures are a common presentation to Irish hospitals with 3,701 hip fractures recorded by 16 hospitals in the Irish Hip Fracture Database (IHFD) in 2019. Second hip fractures (HF2) make up a significant proportion of hip fractures and represent an opportunity to prevent subsequent fragility fracture.
Method
Hip fracture datasheets from 2019 in six Dublin hospitals were analysed.
Results
1,284 hip fractures in total were recorded in 2019 in these six hospitals. 112 of these were second hip fractures (8.72%). 24.1% of patients had a HF2 in year 1 post their first hip fracture (HF1). 14.3% of patients had a HF2 in Year 2, 8% in Year 3, 8.9% in Year 4 and 6.3% in Year 5. 17.9% of patients had an HF2 at an unknown time in relation to their HF1. 57.6% of all patients with any hip fracture were started on bone protection medications (BPMs) during their admission. 18.9% continued a pre-admission prescription. 7% of all patients were previously assessed and determined not to require BPM. 6.9% of patients were awaiting outpatient department (OPD) assessment for bone protection. 8.6% had no assessment for bone protection conducted. Of all patients with an HF2, 48.2% were started on BPMs on admission with their HF2. 33% continued BPMs started pre-admission.
Discussion
In 2019, approximately 1 in 10 hip fractures were second hip fractures. Evidence suggests that fracture liaison services represent a viable, economic means of preventing second hip fractures to improve patient outcomes and reduce healthcare expenditure.
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Affiliation(s)
- B Murphy
- Department of Trauma & Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - C Downey
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - S Flannery
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - T Daly
- Department of Trauma & Orthopaedic Surgery, Connolly Hospital, Dublin, Ireland
| | - S Conway
- Department of Trauma & Orthopaedic Surgery, Beaumont Hospital, Dublin, Ireland
| | - M Gaffar
- Department of Trauma & Orthopaedic Surgery, St James' Hospital, Dublin, Ireland
| | - P Dawson
- Department of Trauma & Orthopaedic Surgery, Mater Misericordiae Hospital, Dublin, Ireland
| | - D Collins
- Department of Trauma & Orthopaedic Surgery, Beaumont Hospital, Dublin, Ireland
| | - P Kenny
- Department of Trauma & Orthopaedic Surgery, Connolly Hospital, Dublin, Ireland
| | - T McCarthy
- Department of Trauma & Orthopaedic Surgery, St James' Hospital, Dublin, Ireland
| | - J Cashman
- Department of Trauma & Orthopaedic Surgery, Mater Misericordiae Hospital, Dublin, Ireland
| | - C Hurson
- Department of Trauma & Orthopaedic Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - B O'Daly
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - J Quinlan
- Department of Trauma & Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
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10
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [PMID: 34522837 PMCID: PMC8420886 DOI: 10.12688/hrbopenres.13303.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing 'basic', 'fundamental', 'translational' or 'lab-based' research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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Affiliation(s)
- Pádraig Carroll
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Adrian Dervan
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Anthony Maher
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Ciarán McCarthy
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Ian Woods
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Rachel Kavanagh
- Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
| | - Cliff Beirne
- Faculty of Sports and Exercise Medicine, (RCPI & RCSI), RCSI House, 121 St Stephen's Green, Dublin 2, D02 H903, Ireland
| | - Geoff Harte
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Dónal O'Flynn
- c/o Irish Rugby Football Union (IRFU) Charitable Trust, Dublin, D04 F720, Ireland
| | - Paul Murphy
- RCSI Library, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 P796, Ireland
| | - John Quinlan
- Tallaght University Hospital, Tallaght, Dublin, D24 NR04, Ireland
| | - Alice Holton
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Sarah Casey
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Éimear Smith
- National Rehabilitation Hospital, Dún Laoghaire, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland
| | - Michelle Flood
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Tissue Engineering Research Group (TERG), Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, Trinity College Dublin, D02 W085 & RCSI Dublin, Dublin, D02 YN77, Ireland
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11
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Carroll P, Dervan A, Maher A, McCarthy C, Woods I, Kavanagh R, Beirne C, Harte G, O'Flynn D, Murphy P, Quinlan J, Holton A, Casey S, Moriarty F, Smith É, O'Brien FJ, Flood M. Patient and Public Involvement (PPI) in preclinical research: A scoping review protocol. HRB Open Res 2021; 4:61. [DOI: 10.12688/hrbopenres.13303.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Patient and public involvement (PPI) aims to improve the quality, relevance, and appropriateness of research and ensure that it meets the needs and expectations of those affected by particular conditions to the greatest possible degree. The evidence base for the positive impact of PPI on clinical research continues to grow, but the role of PPI in preclinical research (an umbrella term encompassing ‘basic’, ‘fundamental’, ‘translational’ or ‘lab-based’ research) remains limited. As funding bodies and policymakers continue to increase emphasis on the relevance of PPI to preclinical research, it is timely to map the PPI literature to support preclinical researchers involving the public, patients, or other service users in their research. Therefore, the aim of this scoping review is to explore the literature on patient and public involvement in preclinical research from any discipline. Methods: This scoping review will search the literature in Medline (PubMed), Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and OpenGrey.net to explore the application of PPI in preclinical research. This review will follow the Joanna Briggs Institute (JBI) guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Two reviewers will independently review articles for inclusion in the final review. Data extraction will be guided by the research questions. The PPI advisory panel will then collaboratively identify themes in the extracted data. Discussion: This scoping review will provide a map of current evidence surrounding preclinical PPI, and identify the body of literature on this topic, which has not been comprehensively reviewed to date. Findings will inform ongoing work of the research team, support the work of other preclinical researchers aiming to include PPI in their own research, and identify knowledge and practice gaps. Areas for future research will be identified.
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12
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Levy N, Quinlan J, El-Boghdadly K, Fawcett WJ, Agarwal V, Bastable RB, Cox FJ, de Boer HD, Dowdy SC, Hattingh K, Knaggs RD, Mariano ER, Pelosi P, Scott MJ, Lobo DN, Macintyre PE. An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients. Anaesthesia 2021; 76:520-536. [PMID: 33027841 DOI: 10.1111/anae.15262] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2020] [Indexed: 01/01/2023]
Abstract
This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid-related harm in adults.
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Affiliation(s)
- N Levy
- Department of Anaesthesia and Peri-operative Medicine, West Suffolk Hospital, Bury St. Edmunds, UK
| | - J Quinlan
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K El-Boghdadly
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's College London, London, UK
| | - W J Fawcett
- Department of Anaesthesia and Pain Medicine, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - V Agarwal
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | | | - F J Cox
- Pain Management Service, Critical Care and Anaesthesia, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - H D de Boer
- Department of Anaesthesiology, Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital Groningen, Groningen, The Netherlands
| | - S C Dowdy
- Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, USA
| | - K Hattingh
- Bendigo Health, Bendigo, Victoria, Australia
| | - R D Knaggs
- School of Pharmacy, Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
| | - E R Mariano
- Department of Anesthesiology, Peri-operative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Anesthesiology and Peri-operative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - P Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
- IRCCS for Oncology and Neurosciences, San Martino Policlinico Hospital, Genoa, Italy
| | - M J Scott
- Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, UK
- David Greenfield Metabolic Physiology Unit, MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - P E Macintyre
- Department of Anaesthesia, Pain Medicine and Hyperbaric Medicine, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia
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13
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Bazrafshan S, Kushlaf H, Kakroo M, Quinlan J, Becker RC, Sadayappan S. Genetic Modifiers of Hereditary Neuromuscular Disorders and Cardiomyopathy. Cells 2021; 10:cells10020349. [PMID: 33567613 PMCID: PMC7915259 DOI: 10.3390/cells10020349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 12/18/2022] Open
Abstract
Novel genetic variants exist in patients with hereditary neuromuscular disorders (NMD), including muscular dystrophy. These patients also develop cardiac manifestations. However, the association between these gene variants and cardiac abnormalities is understudied. To determine genetic modifiers and features of cardiac disease in NMD patients, we have reviewed electronic medical records of 651 patients referred to the Muscular Dystrophy Association Care Center at the University of Cincinnati and characterized the clinical phenotype of 14 patients correlating with their next-generation sequencing data. The data were retrieved from the electronic medical records of the 14 patients included in the current study and comprised neurologic and cardiac phenotype and genetic reports which included comparative genomic hybridization array and NGS. Novel associations were uncovered in the following eight patients diagnosed with Limb-girdle Muscular Dystrophy, Bethlem Myopathy, Necrotizing Myopathy, Charcot-Marie-Tooth Disease, Peripheral Polyneuropathy, and Valosin-containing Protein-related Myopathy. Mutations in COL6A1, COL6A3, SGCA, SYNE1, FKTN, PLEKHG5, ANO5, and SMCHD1 genes were the most common, and the associated cardiac features included bundle branch blocks, ventricular chamber dilation, septal thickening, and increased outflow track gradients. Our observations suggest that features of cardiac disease and modifying gene mutations in patients with NMD require further investigation to better characterize genotype–phenotype relationships.
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Affiliation(s)
- Sholeh Bazrafshan
- Heart, Lung and Vascular Institute, Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.B.); (M.K.); (R.C.B.)
| | - Hani Kushlaf
- Department of Neurology and Rehabilitation Medicine, Neuromuscular Center, University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (H.K.); (J.Q.)
| | - Mashhood Kakroo
- Heart, Lung and Vascular Institute, Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.B.); (M.K.); (R.C.B.)
| | - John Quinlan
- Department of Neurology and Rehabilitation Medicine, Neuromuscular Center, University of Cincinnati Gardner Neuroscience Institute, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (H.K.); (J.Q.)
| | - Richard C. Becker
- Heart, Lung and Vascular Institute, Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.B.); (M.K.); (R.C.B.)
| | - Sakthivel Sadayappan
- Heart, Lung and Vascular Institute, Division of Cardiovascular Health and Disease, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.B.); (M.K.); (R.C.B.)
- Correspondence: ; Tel.: +1-513-558-7498
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14
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Quinlan J, Pantarotto J, Dennis K, Chatterjee A. A92 DOSE ESCALATION STUDY OF CYBERKNIFE® BOOST IN UNRESECTABLE LOCALLY ADVANCED PANCREATIC CANCER. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.091] [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: 11/14/2022] Open
Abstract
Abstract
Background
Pancreatic cancer is the 4th deadliest cancer in Canada, with an overall 5-year survival of only 6%. Every year, approximately 4000 Canadians are diagnosed with pancreatic cancer, and only 10–15% of these patients have surgically resectable disease. No satisfactory treatment exists for patients with inoperable locally advanced pancreatic carcinoma. The best survival has been achieved using a combination of chemotherapy and radiotherapy. Conventional radiotherapy has inadequate local disease control as the therapeutic radiation dose to the tumour is limited by the sensitivities of surrounding tissues. Stereotactic body radiotherapy (SBRT) is a minimally invasive treatment technique that allows for ultra-high doses of radiation to be delivered to small areas. The CyberKnife® Robotic Radiosurgery System is a radiation unit designed to deliver SBRT. Fiducial markers placed by endoscopic ultrasound help direct the radiotherapy. It is hypothesized that a higher overall dose of radiation will result in higher rates of local control, and potentially improved survival.
Aims
The goal of this study is to establish the safety and feasibility of using stereotactic body radiotherapy boost technique via CyberKnife in treating unresectable locally advanced pancreatic cancer, as well as to determine the maximal tolerable radiation dose (MTD) of the SBRT boost that can be safely delivered.
Methods
This is a prospective single-arm, single-institution phase I Time-to-event Continual Reassessment Methodology (TITE-CRM) radiation dose escalation trial. This study enrolled patients aged 18–84 with pathologically confirmed pancreatic cancer who were determined to have surgically unresectable disease, with an ECOG ≤2. These patients were treated with SBRT prior to starting conventional radiotherapy, which consisted of a total dose of 45 Gy in 25 fractions over 5 weeks.
Results
Between 2012 and 2018, a total of 11 patients met the eligibility criteria of this study. Their ages ranged from 61 to 84 with a mean of 71.5 years, and they were 64% (7/11) male. At the time of this analysis, 10 of the 11 patients had passed away. The mean and median survival times were 413 days and 313 days, respectively. Three of the patients had significant complications attributed to the radiotherapy, 2 gastric outlet obstructions and 1 deep duodenal ulcer. The doses used ranged from 21 Gy in 3 fractions to 50 Gy in 5 fractions.
Conclusions
This phase 1, single arm study demonstrates that stereotactic body radiotherapy in the treatment of locally advanced, unresectable pancreatic cancer is technically feasible. When combined with conventional radiotherapy, this therapy is generally well tolerated, and can effectively deliver higher doses of radiation to pancreatic malignancies. Doses up to 50 Gy in 5 fractions were tolerated, with the most common dose being 21 Gy in 3 fractions.
Funding Agencies
National Pancreatic Cancer Canada Foundation
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Affiliation(s)
- J Quinlan
- GI, University of Ottawa, Ottawa, ON, Canada
| | | | - K Dennis
- GI, University of Ottawa, Ottawa, ON, Canada
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15
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Bolderduk RF, Milas JE, Asperger H, Becker H, Chatron S, Cordier JL, DeSmedt J, Gonzalez D, Hammers A, Hoekstra J, Kanitz L, McDonagh S, Nowacki R, Oggel J, Quinlan J, Stolpenir L, Trottier YL, Van Gestel G, Van Oudenallen A, West W, Zschaler R. Salmonella Detection in Dried Milk Products by Motility Enrichment on Modified Semisolid Rappaport-Vassiliadis Medium: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/79.2.441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
A collaborative study involving 19 laboratories was performed to validate motility enrichment on modified semisolid Rappaport-Vassiliadis (MSRV) medium for rapid detection of motile Salmonella in dried milk products. The MSRV method was compared with the AOAC culture method for detection of Salmonella in nonfat milk powder, whole milk powder, whey powder, casein powder, and butter milk powder. Samples were artificially inoculated with Salmonella at 2 levels of contamination. Un-inoculated control samples were included for each type of product. The sensitivity rates were 100% for the MSRV method and 99.0% for the AOAC culture method, while the specificity rate was 100.0% for both methods. Only for the samples of whey powder, which were inoculated with H2S negative S. tennessee, was there a significant difference in the proportion of samples positive by MSRV and the culture procedure. The MSRV method for detection of motileSalmonella in dried milk products has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
- Robert F Bolderduk
- Jacobs Suchard, Corporate Microbiological Services, Montezumalaan 1, B-2200 Herentals, Belgium
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16
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Affiliation(s)
- J Quinlan
- Department of Anaesthesia and Pain Management, Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, UK
- David Greenfield Human Physiology Unit, MRCVersus Arthritis Centre for Musculoskeletal Ageing, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - N Levy
- Department of Anaesthesia and Peri-operative Medicine, West Suffolk NHS Foundation Trust, Bury St Edmunds, Suffolk, UK
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Abstract
This is a rare case of an anterior interosseous nerve (AIN) palsy in a patient as a result of a prolonged period of shoulder immobilisation. The patient had an open reduction internal fixation of a midshaft clavicle fracture. They subsequently underwent removal of metal due to symptomatic prominence of the metal work. The patient was in a shoulder immobiliser for a period of 5 months in total. They developed progressive AIN palsy as a result of a positional compression due to prolonged wearing of a shoulder immobiliser. This resolved with conservative management and careful observation.
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Affiliation(s)
| | - Christopher Fenelon
- Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland
| | - Michael Alexander
- Department of Neurophysiology, Tallaght University Hospital, Dublin, Ireland
| | - John Quinlan
- Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland
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18
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Quinlan J, Dennis K, Al Shamji F, Chatterjee A. A279 A NOVEL TECHNIQUE AND INDICATION FOR EUS-GUIDED FIDUCIAL IMPLANTATION. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.278] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Quinlan
- GI, University of Ottawa, Ottawa, ON, Canada
| | - K Dennis
- GI, University of Ottawa, Ottawa, ON, Canada
| | - F Al Shamji
- GI, University of Ottawa, Ottawa, ON, Canada
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19
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O'Sullivan J, Collins J, Cooper D, Magdalina A, Meehan F, Kumar L, Quinlan J, O'Connor D, Fitzpatrick G. Optimisation of perioperative investigations among elective orthopaedic patients in a Dublin-based teaching hospital. J Perioper Pract 2018; 29:291-299. [PMID: 30565523 DOI: 10.1177/1750458918813254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The current National Institute for Health and Care Excellence guidelines, in accordance with the Association of Anaesthetists of Great Britain and Ireland guidelines, recommend the following haematological investigations for all patients undergoing major elective surgery: full blood count, renal profile and coagulation screen if clinically indicated. However, the guidelines fail to specify a time-interval for which normal blood results remain valid. Currently all patients in Ireland undergoing substantial elective surgery requiring general or regional anaesthetic have a preoperative assessment prior to the surgery. Patients have phlebotomy performed as part of this assessment. Patients admitted for elective surgery often have these bloods repeated on the morning of surgery. Objectives To determine if blood investigations taken over a one-year period prior to surgery can be used as a baseline for clinically stable patients undergoing elective surgery. Study design and methods All consecutive day of surgery admission patients >18 years of age undergoing elective orthopaedic surgery in Tallaght Hospital between 1 December 2014 and 1 December 2015 were identified using hospital records. Their blood results in the one-year period prior to surgery were compared to the blood results on the morning of surgery, using a McNemar’s test. A further clinical analysis was performed. Results There was no statistically significant change between blood results from three months prior to the surgery and the morning of surgery (P < 0.05). Furthermore, the blood results remained largely unchanged in the one year prior to surgery. No patient had the operation deferred due to aberrant blood results, following previously normal results prior to surgery. The potential cost-saving of omitting bloods is enormous. Conclusions There appears to be neither a statistical nor clinical benefit to repeating blood tests on the morning of surgery, following normal bloods <3 months in a clinically stable individual.
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Affiliation(s)
- Jane O'Sullivan
- 1 Department of Anaesthetics, Letterkenny University Hospital, Letterkenny, Ireland.,2 Tallaght University Hospital, Dublin, Ireland
| | - Jack Collins
- 1 Department of Anaesthetics, Letterkenny University Hospital, Letterkenny, Ireland.,2 Tallaght University Hospital, Dublin, Ireland
| | - David Cooper
- 3 Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Ana Magdalina
- 4 Department of Statistics, University of Limerick, Limerick, Ireland
| | - Frances Meehan
- 5 Department of Anaesthetics, Tallaght University Hospital, Dublin, Ireland
| | - Lachmann Kumar
- 6 Department of Medicine, Tallaght University Hospital, Dublin, Ireland
| | - John Quinlan
- 7 Department of Orthopaedics, Tallaght University Hospital, Dublin, Ireland
| | - Donal O'Connor
- 3 Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Gerry Fitzpatrick
- 5 Department of Anaesthetics, Tallaght University Hospital, Dublin, Ireland
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20
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Affiliation(s)
- R Pollard
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - H Higham
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - J Quinlan
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - R Webster
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - J Lie
- Oxford University Hospitals NHS Trust, Oxford, UK
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21
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Din USU, Brook MS, Selby A, Quinlan J, Boereboom C, Abdulla H, Franchi M, Narici MV, Phillips BE, Williams JW, Rathmacher JA, Wilkinson DJ, Atherton PJ, Smith K. A double-blind placebo controlled trial into the impacts of HMB supplementation and exercise on free-living muscle protein synthesis, muscle mass and function, in older adults. Clin Nutr 2018; 38:2071-2078. [PMID: 30360984 PMCID: PMC6876270 DOI: 10.1016/j.clnu.2018.09.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/11/2018] [Accepted: 09/24/2018] [Indexed: 01/06/2023]
Abstract
Age-related sarcopenia and dynapenia are associated with frailty and metabolic diseases. Resistance exercise training (RET) adjuvant to evidence-based nutritional intervention(s) have been shown as mitigating strategies. Given that β-hydroxy-β-methyl-butyrate (HMB) supplementation during RET improves lean body mass in younger humans, and that we have shown that HMB acutely stimulates muscle protein synthesis (MPS) and inhibits breakdown; we hypothesized that chronic supplementation of HMB free acid (HMB-FA) would enhance MPS and muscle mass/function in response to RET in older people. We recruited 16 healthy older men (Placebo (PLA): 68.5 ± 1.0 y, HMB-FA: 67.8 ± 1.15 y) for a randomised double-blind-placebo controlled trial (HMB-FA 3 × 1 g/day vs. PLA) involving a 6-week unilateral progressive RET regime (6 × 8 repetitions, 75% 1-RM, 3 · wk−1). Deuterium oxide (D2O) dosing was performed over the first two weeks (0–2 wk) and last two weeks (4–6 wk) with bilateral vastus lateralis (VL) biopsies at 0–2 and 4–6 wk (each time 75 ± 2 min after a single bout of resistance exercise (RE)) for quantification of early and later MPS responses and post-RE myogenic gene expression. Thigh lean mass (TLM) was measured by DXA, VL thickness and architecture (fibre length and pennation angle) by ultrasound at 0/3/6 wk, and strength by knee extensor 1-RM testing and MVC by isokinetic dynamometry (approx. every 10 days). RET induced strength increases (1-RM) in the exercised leg of both groups (398 ± 22N to 499 ± 30N HMB-FA vs. 396 ± 29N to 510 ± 43N PLA (both P < 0.05)). In addition, maximal voluntary contraction (MVC) also increased (179 ± 12 Nm to 203 ± 12 Nm HMB-FA vs. 185 ± 10 Nm to 217 ± 11 Nm PLA (both P < 0.05); with no group differences. VL muscle thickness increased significantly in the exercised leg in both groups, with no group differences. TLM (by DXA) rose to significance only in the HMB-FA group (by 5.8%–5734 ± 245 g p = 0.015 vs. 3.0% to 5644 ± 323 g P = 0.06 in PLA). MPS remained unchanged in the untrained legs (UT) 0–2 weeks being 1.06 ± 0.08%.d−1 (HMB-FA) and 1.14 ± 0.09%.d−1 (PLA), the trained legs (T) exhibited increased MPS in the HMB-FA group only at 0–2-weeks (1.39 ± 0.10%.d−1, P < 0.05) compared with UT: but was not different at 4–6-weeks: 1.26 ± 0.05%.d−1. However, there were no significant differences in MPS between the HMB-FA and PLA groups at any given time point and no significant treatment interaction observed. We also observed significant inductions of c-Myc gene expression following each acute RE bout, with no group differences. Further, there were no changes in any other muscle atrophy/hypertrophy or myogenic transcription factor genes we measured. RET with adjuvant HMB-FA supplements in free-living healthy older men did not enhance muscle strength or mass greater than that of RET alone (PLA). That said, only HMB-FA increased TLM, supported by early increases in chronic MPS. As such, chronic HMB-FA supplementation may result in long term benefits in older males, however longer and larger studies may be needed to fully determine the potential effects of HMB-FA supplementation; translating to any functional benefit.
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Affiliation(s)
- U S U Din
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - M S Brook
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK; Nottingham NIHR BRC, UK
| | - A Selby
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - J Quinlan
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - C Boereboom
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - H Abdulla
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - M Franchi
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - M V Narici
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - B E Phillips
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK; Nottingham NIHR BRC, UK
| | - J W Williams
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - J A Rathmacher
- Metabolic Technologies, Inc, Iowa State University Research Park, 2711 S. Loop Drive, Ste 4400, Ames, IA, 50010, USA
| | - D J Wilkinson
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK; Nottingham NIHR BRC, UK
| | - P J Atherton
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK; Nottingham NIHR BRC, UK
| | - K Smith
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, UK; Nottingham NIHR BRC, UK.
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Quinlan J, Borgaonkar M, Antle S, Pace D, McGrath JS. A214 AN ANALYSIS OF FIT RESULTS AND NEOPLASTIC FINDINGS FROM THE NEWFOUNDLAND AND LABRADOR COLON CANCER SCREENING PROGRAM. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.215] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Quinlan
- Medicine, Memorial University, St. John’s, Canada
| | - M Borgaonkar
- Medicine, Memorial University, St. John’s, Canada
| | - S Antle
- Gastroenterology, Eastern Health, St. John’s, Canada
| | - D Pace
- Medicine, Memorial University, St. John’s, Canada
| | - J S McGrath
- Medicine, Memorial University, St. John’s, Canada
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Quinlan J, Borgaonkar M, Antle S, Pace D, McGrath JS. A139 ASYMPTOMATIC IBD IS A COMMON FINDING IN FIT POSITIVE INDIVIDUALS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.140] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Quinlan
- Medicine, Memorial University, St. John’s, Canada
| | - M Borgaonkar
- Medicine, Memorial University, St. John’s, Canada
| | - S Antle
- Gastroenterology, Eastern Health, St. John’s, Canada
| | - D Pace
- Medicine, Memorial University, St. John’s, Canada
| | - J S McGrath
- Medicine, Memorial University, St. John’s, Canada
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Montoya-Williams D, Quinlan J, Clukay C, Mulligan C. Association of Maternal Prenatal Stress, Methylation Changes in IGF-1 and
IGF-2, and Birth Weight in Mother-Newborn Dyads. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.486] [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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Coveney E, Quinlan J, Cleary M. Trends in discharge locations for patients post hip fractures: A 10 year experience from an irish trauma centre. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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McSorley K, Quinlan J. Trauma Training and Workload: A National Survey. Ir Med J 2015; 108:238-240. [PMID: 26485831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Trauma is a major source of mortality and morbidity throughout Ireland. Training in trauma is dependant on experience gained by trainees within specific posts. Trauma services are a topical issue at present with much discussion about delivery and restructuring. With this in mind we conducted an online survey of trainees in emergency medicine, orthopaedic and general surgery to assess current experience and opinions with regard to trauma. The survey was vetted and distributed by the relevant training bodies. 59(98.33%) respondents believed smaller units should be bypassed for major trauma and 55 (91.67%) believed that larger hospitals receiving major trauma should have a trauma theatre available 24-hours a day. 55 (91.67%) also foresaw themselves covering major trauma as consultants, consequently these trainees will be the consultants developing, moulding and working in this restructured trauma service.
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Stoneham M, Quinlan J. ‘Putting the TEA back into teaching’: are trainees being taught optimal epidural techniques? Br J Anaesth 2015; 114:872-4. [DOI: 10.1093/bja/aev066] [Citation(s) in RCA: 3] [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: 01/04/2023] Open
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Sopu A, Green C, McHugh G, Quinlan J. A Case Report of Primary Extranodal Non-hodgkin Lymphoma First Presentation as a Soft Tissue Swelling Around the Wrist. J Orthop Case Rep 2015; 5:3-5. [PMID: 27299029 PMCID: PMC4722583 DOI: 10.13107/jocr.2250-0685.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Primary musculoskeletal extranodal non-Hodgkin lymphoma is a rare presentation and account for 5% of all primary extranodal non-Hodgkin lymphomas. Treatment uses a combination of chemotherapy and radiotherapy with good prognosis in unifocal manifestation. We report an unusual case of primary musculoskeletal extranodal lymphoma presenting as a soft tissue swelling around the wrist. Case Report: A 75 year old lady was referred to the Orthopaedic Outpatients Department with a painless, slowly growing mass on the dorsum of the right wrist. Clinical examination revealed a 6 X 9 cm round painless mass on the dorsum of the distal radius adherent to both the underlying structures and skin. MRI of the wrist showed a large mass causing extensive osteolysis of the distal radius and extending proximally with abnormal replacement of the marrow. The patient was brought to theatre for biopsy and subsequent histopathological examination confirmed a B-cell non-Hodgkin lymphoma. The patient was referred to the Haematology Service for further treatment and follow-up. She received chemotherapy and radiotherapy with satisfactory results. Conclusion: Lymphoma presenting as a soft tissue mass is relatively uncommon and can easily be confused with a wide variety of inflammatory conditions, more common neoplasias as well as infectious diseases (tuberculosis). Though rare, extranodal lymphoma should be regularly included in the differential diagnosis of mass lesions.
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Affiliation(s)
- Alexandra Sopu
- Department of Trauma and Orthopaedics, Royal College of Surgeons, Ireland
| | - Connor Green
- Department of Trauma and Orthopaedics, Royal College of Surgeons, Ireland
| | - Gavin McHugh
- Department of Trauma and Orthopaedics, Royal College of Surgeons, Ireland
| | - John Quinlan
- Department of Trauma and Orthopaedics, Royal College of Surgeons, Ireland
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Merchant R, Kelly I, Quinlan J. Fracture of Uncemented Revision Femoral Stems in three Arthroplasty Patients: A Case Series with three different brands. J Orthop Case Rep 2014; 4:12-5. [PMID: 27298992 PMCID: PMC4719260 DOI: 10.13107/jocr.2250-0685.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Fracture of stems in primary total hip arthroplasty is a known complication and has been attributed to varus positioning, excessive weight of the patient, resorption of the femoral calcar and failure of the cement mantle. Fractures in uncemented revision femoral stems are rare and are attributed to reduction in proximal support either in the form of bone loss or an extended trochanteric osteotomy [ETO] against a distally well- fixed stem. Also, undersized stems and high BMI to increase the risk of stem fracture. CASE REPORT We report 3 cases of uncemented revision stem fractures. Case 1 is a 77 year old male, Case 2 is a 71- year-old female, case 3 an 82-year-old male. All three patients had significant proximal femoral osteolysis. All three had an extended trochanteric osteotomy for the revision surgery. The hips had remained in-situ for 4, 2 and 5 years respectively prior to fracture. CONCLUSION When planning complex revision cases involving long uncemented stems, attention should be given to the above-mentioned variables. ETO non-union and proximal bone loss play an important role in stem fractures. Stem failure can occur irrespective of the make, and factors such as adequate stem size and good diaphyseal fit are non negotiable.
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Affiliation(s)
- Rajiv Merchant
- Department of Orthopaedic, Waterford Regional Hospital, Waterford, Ireland
| | - Ian Kelly
- Department of Orthopaedic, Waterford Regional Hospital, Waterford, Ireland
| | - John Quinlan
- Department of Orthopaedic, Waterford Regional Hospital, Waterford, Ireland
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Quinlan J. The Use of a Subanesthetic Infusion of Intravenous Ketamine to Allow Withdrawal of Medically Prescribed Opioids in People with Chronic Pain, Opioid Tolerance and Hyperalgesia: Outcome at 6 Months: Table 1. Pain Med 2012; 13:1524-5. [DOI: 10.1111/j.1526-4637.2012.01486.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Magill P, Quinlan J, Kelly I. Spinal fracture in an under-age rugby player. Ir Med J 2012; 105:315. [PMID: 23240293] [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: 06/01/2023]
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Spina S, Van Laar AD, Murrell JR, Hamilton RL, Kofler JK, Epperson F, Farlow MR, Lopez OL, Quinlan J, DeKosky ST, Ghetti B. Phenotypic variability in three families with valosin-containing protein mutation. Eur J Neurol 2012; 20:251-8. [PMID: 22900631 DOI: 10.1111/j.1468-1331.2012.03831.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 06/29/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE The phenotype of IBMPFD [inclusion body myopathy with Paget's disease of the bone and frontotemporal dementia (FTD)] associated with valosin-containing protein (VCP) mutation is described in three families. METHODS Probands were identified based on a pathological diagnosis of frontotemporal lobar degeneration with TDP-43-positive inclusions type IV. VCP sequencing was carried out. Clinical data on affected family members were reviewed. RESULTS Ohio family: four subjects presented muscle weakness and wasting. (One subject had both neuropathic and myopathic findings and another subject showed only evidence of myopathy. The etiology of weakness could not be ascertained in the remaining two subjects.) Two individuals also showed Parkinsonism (with associated FTD in one of the two). The proband's brain displayed FTLD-TDP type IV and Braak stage five Parkinson's disease (PD). A VCP R191Q mutation was found. Pennsylvania family: 11 subjects developed IBMPFD. Parkinsonism was noted in two mutation carriers, whilst another subject presented with primary progressive aphasia (PPA). A novel VCP T262A mutation was found. Indiana family: three subjects developed IBMPFD. FTD was diagnosed in two individuals and suspected in the third one who also displayed muscle weakness. A VCP R159C mutation was found. CONCLUSIONS We identified three families with IBMPFD associated with VCP mutations. Clinical and pathological PD was documented for the first time in members of two families. A novel T262A mutation was found. One individual had PPA: an uncommon presentation of IBMPFD.
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Affiliation(s)
- S Spina
- Department of Pathology and Laboratory Medicine, Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Cullen E, Quinlan J, Fogarty E, Keogh P. Multimodality treatment of a complex series of parallel pathologies in a 16-year-old male that ultimately leads to bilateral hip arthroplasty surgery: A case report. Int J Surg Case Rep 2012; 3:372-4. [PMID: 22609705 DOI: 10.1016/j.ijscr.2012.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 04/12/2012] [Accepted: 04/30/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Femoral head osteonecrosis is associated with significant sequelae for the patient in the long-term. A combination of factors are thought to contribute to the pathophysiology behind this debilitating disease process. PRESENTATION OF CASE We report on a 16-year-old adolescent male requiring staged bilateral hybrid hip arthroplasty within 3years of diagnosis of acute lymphoblastic leukaemia that ran a complicated course of multimodality treatment. DISCUSSION The case examines the literature on femoral head osteonecrosis in this population cohort and the challenge for the orthopaedic surgeon in the management of this increasingly prevalent condition. CONCLUSION In a young population cohort, it is important to have arthroplasty surgery as part of the management armamentarium, especially when coupled with complex pathology.
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Affiliation(s)
- Emmet Cullen
- Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
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Ahmed M, Durcan L, O'Beirne J, Quinlan J, Pillay I. Fracture liaison service in a non-regional orthopaedic clinic--a cost-effective service. Ir Med J 2012; 105:24-27. [PMID: 22397210] [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: 05/31/2023]
Abstract
Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs.
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Affiliation(s)
- M Ahmed
- South Tipperary General Hospital, Western road, Clonmel, Co Tipperary
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Johnston KD, Quinlan J. The effect of combining dexamethasone with ondansetron for nausea and vomiting associated with fentanyl-based intravenous patient-controlled analgesia. Anaesthesia 2011; 66:840-1; author reply 841. [PMID: 21831078 DOI: 10.1111/j.1365-2044.2011.06830.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The Duracon total knee replacement and its forerunner the Porous-Coated Anatomic (PCA) knee system have been associated with good results. This study reviews a series of 181 knee replacements performed with these systems by seven general orthopedic surgeons with follow-up to a mean of 6.7 years. The mean Knee Society knee and function scores were 72 and 68. The mean Western Ontario and MacMaster Universities Osteoarthritis Index score was 76, and the mean 12-Item Short-Form Health Survey result was 55. A mean flexion of 104 degrees was recorded, and 93.8% of patients rated their satisfaction as good to excellent. Fifty-five percent of patients had minor radiographic lucencies-these were of questionable clinical significance. Seven patients required revision. These knee systems used in a relatively low-volume general unit provide consistent results comparable with those from larger arthroplasty units.
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Affiliation(s)
- Jonathon Pennington
- Department of Orthopaedic Surgery, University of Otago, Dunedin, New Zealand
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Spina S, Van Laar AD, Murrell JR, Courten-Myers G, Hamilton RL, Vidal R, Farlow MR, Quinlan J, DeKosky ST, Ghetti B. O2‐05–03: Inclusion body myopathy with paget disease of the bone and frontotemporal dementia: New families, a novel mutation, and a new clinical presentation. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Salvatore Spina
- Indiana University - Indiana Alzheimer Disease CenterIndianapolisINUSA
| | | | - Jill R. Murrell
- Indiana University - Indiana Alzheimer Disease CenterIndianapolisINUSA
| | | | | | - Ruben Vidal
- Indiana University - Indiana Alzheimer Disease CenterIndianapolisINUSA
| | - Martin R. Farlow
- Indiana University - Indiana Alzheimer Disease CenterIndianapolisINUSA
| | | | | | - Bernardino Ghetti
- Indiana University - Indiana Alzheimer Disease CenterIndianapolisINUSA
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Spina S, Van Laar AD, Murrell JR, Courten‐Myers G, Hamilton RL, Farlow MR, Quinlan J, DeKosky ST, Ghetti B. Frontotemporal dementia associated with a
Valosin‐Containing Protein
mutation: report of three families. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.58.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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]
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Collins J, Wong B, McCullough A, Quinlan J. T.P.2 10 The effects of prednisone on exercised-induced muscle damage in mdx mice. Neuromuscul Disord 2006. [DOI: 10.1016/j.nmd.2006.05.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Russell R, Quinlan J, Reynolds F. Motor block during epidural infusions for nulliparous women in labour: a randomized double-blind study of plain bupivacaine and low dose bupivacaine with fentanyl. Int J Obstet Anesth 2005; 4:82-8. [PMID: 15636983 DOI: 10.1016/0959-289x(95)82997-o] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 10/25/2022]
Abstract
Sixty nulliparous women received epidural infusions in labour of either 0.125% plain bupivacaine or 0.0625% bupivacaine containing 2.5 mcg/ml fentanyl both starting at 12 ml/h and titrated to maintain a sensory block to T10. Those women who received low dose bupivacaine with fentanyl took significantly longer to reach full cervical dilation (P < 0.05). There was no statistical difference between the groups in the number of additional epidural bolus doses required during the infusions. Of the women receiving low dose bupivacaine with fentanyl, 77% required one or no additional top-up doses compared to 87% in the plain bupivacaine group. There was no reduction in the incidence of perineal pain in the group who received fentanyl. Significantly more women who received 0.125% bupivacaine had motor block after 2 h of the infusion (P < 0.05). The mode of delivery was similar in the two groups as was the satisfaction with epidural analgesia in both the first and second stages of labour and with labour overall. There were no significant differences in Apgar scores, umbilical cord blood pH levels or neurologic and adaptive capacity scores at 2 or 24 h. There was no significant difference in the incidence of symptoms 24 h after delivery.
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Affiliation(s)
- R Russell
- Department of Anaesthetics, St Thomas' Hospital, London, UK
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Tang PH, Miles MV, Miles L, Quinlan J, Wong B, Wenisch A, Bove K. Measurement of reduced and oxidized coenzyme Q9 and coenzyme Q10 levels in mouse tissues by HPLC with coulometric detection. Clin Chim Acta 2004; 341:173-84. [PMID: 14967174 DOI: 10.1016/j.cccn.2003.12.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2003] [Revised: 11/24/2003] [Accepted: 12/01/2003] [Indexed: 12/01/2022]
Abstract
BACKGROUND Ubiquinone-responsive multiple respiratory chain dysfunction due to coenzyme Q(10) (CoQ(10)) deficiency has been previously identified in muscle biopsies. However, previous methods are unreliable for estimating CoQ(10) redox status in tissue. We developed an accurate method for measuring tissue concentrations of reduced and oxidized coenzyme Q (CoQ). METHODS Mouse tissues were weighed in the frozen state and homogenized with cold 1-propanol on ice. After solvent extraction, centrifugation and filtration, the filtrate was subsequently analyzed by reversed-phase HPLC with coulometric detection. RESULTS Reference calibration curves were used to determine reduced and oxidized coenzyme Q(9) (CoQ(9)) and CoQ(10) concentrations in tissues. The method is sensitive ( approximately 15 microg/l), reproducible (6% CV) for CoQ(9) and CoQ(10), and linear up to 20 mg/l for CoQ(9) and CoQ(10). Analytical recoveries were 90-104%. In mouse tissues the amounts of total CoQ (TQ) ranged from 261 to 1737 nmol/g of protein. Total CoQ(9) levels are comparable with the values of those previously reported. CoQ is found to be mostly in the reduced form in mouse liver ( approximately 87%), heart ( approximately 60%), and muscle tissues ( approximately 58%); in the brain, most of the CoQ is in the oxidized state ( approximately 65%). CONCLUSION This procedure provides a precise, sensitive, and direct assay method for the determination of reduced and oxidized CoQ(9) and CoQ(10) in mouse hindleg muscle, heart, brain, and liver tissues.
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Affiliation(s)
- Peter H Tang
- Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
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Murphy SM, Connolly P, Browne RFJ, Quinlan J, Torreggiani W, McElwain JP. Computed tomography wire localisation-assisted operative retrieval of a migrated symphysis pubis plate from the ischiorectal fossa. Ir Med J 2003; 96:25-6. [PMID: 12622053] [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: 03/01/2023]
Abstract
We report an unusual case of migration of a metal plate from the symphysis pubis to the left ischiorectal fossa, and a technique of using pre-operative CT guided wire localisation of the plate as a successful method of assisting plate retrieval.
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Affiliation(s)
- S M Murphy
- Department of Orthopaedic Trauma and Reconstructive Surgery, Adelaide and Meath Hospital, Tallaght, Dublin 24.
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Zussman BD, Davie CC, Kelly J, Murdoch RD, Clark DJ, Schofield JP, Walls C, Birrell C, Webber D, Quinlan J, Ritchie SY, Carr A. Bioavailability of the oral selective phosphodiesterase 4 inhibitor cilomilast. Pharmacotherapy 2001; 21:653-60. [PMID: 11401178 DOI: 10.1592/phco.21.7.653.34569] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [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
STUDY OBJECTIVE To determine the absolute bioavailability of cilomilast, and assess the effects of food, dosing time, and coadministration of antacid agents on its bioavailability and pharmacokinetics in healthy volunteers. SETTING Clinical pharmacology unit. DESIGN Five prospective pharmacokinetic studies: one single-blind, dose-escalating, placebo-controlled trial; four open-label, randomized studies. SUBJECTS Ninety-six healthy adult volunteers who were nonsmokers. INTERVENTION In the first study, four subjects received intravenous cilomilast 1, 2, and 4 mg. In the second study, 16 subjects received oral cilomilast 15 mg or intravenous cilomilast 4 mg. In the other three studies, a total of 76 subjects were given single oral 15-mg doses; one study compared its effects in fed versus fasted subjects, one looked for differences of morning versus evening dosing, and one examined coadministration with aluminum hydroxide-magnesium hydroxide. MEASUREMENTS AND MAIN RESULTS After intravenous administration of cilomilast, plasma concentrations increased in an approximately dose-proportional manner; the half-life, approximately 6.5 hours, was dose independent. Cilomilast clearance and volume of distribution were small. After oral dosing, the absolute bioavailability was consistently close to 100%. Absorption was slower in fed subjects than in fasted (median 2-hr delay in time to reach maximum plasma concentration, average 39% reduction in maximum plasma concentration), but the area under the concentration-time curve from time zero to infinity (systemic availability) was unaffected. Pharmacokinetic parameters were not influenced by time of dosing or coadministration of antacid. CONCLUSION The absolute bioavailability of oral cilomilast was 100%; it was not adversely affected by time of dosing or coadministration with food or antacid.
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Affiliation(s)
- B D Zussman
- Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Parmaceutical, Welwyn, Herts, United Kingdom
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Hill DA, Chez RA, Quinlan J, Fuentes A, LaCombe J. Uterine rupture and dehiscence associated with intravaginal misoprostol cervical ripening. J Reprod Med 2000; 45:823-6. [PMID: 11077631] [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: 02/18/2023]
Abstract
OBJECTIVE To evaluate if the prostaglandin E1 analogue misoprostol, when used as an agent for cervical ripening, is associated with uterine rupture. STUDY DESIGN We performed a two-year retrospective chart review to determine the incidence of uterine rupture in patients with a previous cesarean delivery undergoing cervical ripening or the induction of labor. RESULTS Uterine dehiscence occurred in 1 and uterine rupture occurred in 3 of 48 women with a prior cesarean delivery treated with 50 micrograms doses of intravaginal misoprostol for cervical ripening. Uterine rupture was found in 1 of 89 women who had an oxytocin infusion for induction of labor and none of the 24 patients who received intravaginal prostaglandin E2 placed for cervical ripening. CONCLUSION Intravaginal misoprostol appears to be associated with an increased incidence of uterine rupture when used in patients undergoing a trial of labor after cesarean.
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Affiliation(s)
- D A Hill
- Department of Obstetrics and Gynecology, Florida Hospital Family Practice Residency, Orlando, USA.
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Quinlan J, Blumenthal D, Fishman M. An academic medical center reaches out. Health Forum J 2000; 43:39-42. [PMID: 11010164] [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: 02/17/2023]
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Murray DP, Quinlan J, Verghese C. Pulmonary aspiration of blood following traumatic laryngeal mask airway insertion. Anaesth Intensive Care 1999; 27:116-7. [PMID: 10050236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Quinlan J, Ohlund G. Psychiatric home care: an introduction. Home Healthc Nurse 1995; 13:20-24. [PMID: 7635745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Healthcare has undergone many changes in the past 5 years. Hospitalization has become extremely expensive to the consumer and the payor. Alternative healthcare services are being considered and used, with the emphasis on cost containment and cost and clinical effectiveness. Psychiatric home care is clinically effective and less costly.
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Russell R, Quinlan J, Reynolds F. Motor block during epidural infusions for nulliparous women in labour. Int J Obstet Anesth 1994. [DOI: 10.1016/0959-289x(94)90240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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