1
|
Ubhi H, Ferro A, Ebelthite C, Fan K. Predictive risk factors of adverse mental health outcomes in the facial trauma patient. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00089-4. [PMID: 38637181 DOI: 10.1016/j.ijom.2024.03.011] [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: 02/26/2023] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024]
Abstract
Patients with facial trauma often experience a psychological burden from their injuries. This study aimed to identify risk factors for adverse mental health outcomes in patients affected by facial trauma, using the 'Integrating Mental and Physical Healthcare: Research, Training and Services' (IMPARTS) screening tool. All patients >18 years of age who completed more than one IMPARTS screening tool in the Oral and Maxillofacial Trauma Clinic between 2019 and 2021 were included in this study. This tool was used to assess the risk of post-traumatic stress disorder (PTSD), generalized anxiety disorder, and depression. Included patients completed the IMPARTS questionnaire at initial follow-up (mean 18 days post-trauma) and one subsequent time point (mean 82 days). 167 patients were included in the study. On multivariable analysis, a history of psychiatric illness (P = 0.015) and interpersonal violence as the mechanism of injury (P = 0.010) were identified as predictive of risk of PTSD. Risk of PTSD was lower in zygomatic injuries (P = 0.001), while nasal involvement increased at-risk status for depression (P = 0.009). 47.3% of patients screened positive on initial IMPARTS assessment, while 35.3% screened positive on follow-up IMPARTS assessment. This study supports the IMPARTS tool in allowing the prompt identification of mental health adversity in facial trauma.
Collapse
Affiliation(s)
- H Ubhi
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, London, UK; Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - A Ferro
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, London, UK; Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - C Ebelthite
- IMPARTS Mind and Body Programme, Psychological Medicine and Integrated Care Clinical Academic Group, King's College London, London, UK
| | - K Fan
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, London, UK; Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
| |
Collapse
|
2
|
Canavera K, Ghafoor S, Fan K, Cheng C, Jeha S, Pui CH, Elliott A, Morrison RR, Jacola LM. Post-PICU Cognitive and Psychological Outcomes in Children Receiving Treatments for Acute Lymphoblastic Leukemia. Pediatr Crit Care Med 2023; 24:e584-e591. [PMID: 38055007 DOI: 10.1097/pcc.0000000000003340] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES To examine neurocognitive and psychological outcomes associated with post-PICU admissions in children treated for childhood acute lymphoblastic leukemia (ALL). DESIGN Observational study from October 2007 to March 2017. SETTING Pediatric onco-critical care unit. PATIENTS All patients in this study (n = 296; ages 3-21) were treated for ALL on the St. Jude Total Therapy 16 clinical trial (NCT00549848) from 2007 to 2017. Of these, 104 patients were admitted to the PICU during protocol-directed therapy. All patients completed protocol-directed neurocognitive monitoring prospectively, at the end of cancer-directed therapy. Data on PICU stays were abstracted retrospectively from the medical record. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Demographic and critical illness variables were abstracted from institutional databases and medical records. Neurocognitive and psychosocial outcomes were prospectively obtained at the end of treatment. Children who had a PICU admission experienced significantly lower functioning compared to normative samples in several areas of cognitive functioning (working memory, processing speed, executive functions, inattention, math achievement, fine motor dexterity, and speed), daily living skills, and internalizing problems (all ps < 0.05). Compared with those without PICU admissions, patients with PICU admissions had worse performance on a measure of sustained attention (p = 0.017). The frequency of patients at risk for problems with learning and memory was significantly higher in the PICU group compared with the non-PICU group (25% vs 12%, p = 0.006). Critical illness symptom severity was not associated with neurocognitive or psychological outcomes. CONCLUSIONS Children with ALL, with or without a PICU admission, experienced lower cognitive and psychological outcomes following treatment. Future research is needed to continue identifying risk factors for post-intensive care syndrome (PICS-p) and post-PICU cognitive and psychological impairments in pediatric patients.
Collapse
Affiliation(s)
- Kristin Canavera
- Department of Pediatrics, Ochsner Hospital for Children, New Orleans, LA
| | - Saad Ghafoor
- Division of Critical Care Medicine, St. Jude Children's Research Hospital, Memphis, TN
| | - Kimberly Fan
- Division of Critical Care Medicine, St. Jude Children's Research Hospital, Memphis, TN
| | - Cheng Cheng
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Sima Jeha
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Andrew Elliott
- Department of Pediatrics, St. Jude Children's Research Hospital, Memphis, TN
| | - R Ray Morrison
- Division of Critical Care Medicine, St. Jude Children's Research Hospital, Memphis, TN
| | - Lisa M Jacola
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
3
|
Flerlage T, Fan K, Qin Y, Agulnik A, Arias AV, Cheng C, Elbahlawan L, Ghafoor S, Hurley C, McArthur J, Morrison RR, Zhou Y, Park HJ, Carcillo JA, Hines MR. Mortality Risk Factors in Pediatric Onco-Critical Care Patients and Machine Learning Derived Early Onco-Critical Care Phenotypes in a Retrospective Cohort. Crit Care Explor 2023; 5:e0976. [PMID: 37780176 PMCID: PMC10538916 DOI: 10.1097/cce.0000000000000976] [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] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVES To use supervised and unsupervised statistical methodology to determine risk factors associated with mortality in critically ill pediatric oncology patients to identify patient phenotypes of interest for future prospective study. DESIGN This retrospective cohort study included nonsurgical pediatric critical care admissions from January 2017 to December 2018. We determined the prevalence of multiple organ failure (MOF), ICU mortality, and associated factors. Consensus k-means clustering analysis was performed using 35 bedside admission variables for early, onco-critical care phenotype development. SETTING Single critical care unit in a subspeciality pediatric hospital. INTERVENTION None. PATIENTS There were 364 critical care admissions in 324 patients with underlying malignancy, hematopoietic cell transplant, or immunodeficiency reviewed. MEASUREMENTS Prevalence of multiple organ failure, ICU mortality, determination of early onco-critical care phenotypes. MAIN RESULTS ICU mortality was 5.2% and was increased in those with MOF (18.4% MOF, 1.7% single organ failure [SOF], 0.6% no organ failure; p ≤ 0.0001). Prevalence of MOF was 23.9%. Significantly increased ICU mortality risk was associated with day 1 MOF (hazards ratio [HR] 2.27; 95% CI, 1.10-6.82; p = 0.03), MOF during ICU admission (HR 4.16; 95% CI, 1.09-15.86; p = 0.037), and with invasive mechanical ventilation requirement (IMV; HR 5.12; 95% CI, 1.31-19.94; p = 0.018). Four phenotypes were derived (PedOnc1-4). PedOnc1 and 2 represented patient groups with low mortality and SOF. PedOnc3 was enriched in patients with sepsis and MOF with mortality associated with liver and renal dysfunction. PedOnc4 had the highest frequency of ICU mortality and MOF characterized by acute respiratory failure requiring invasive mechanical ventilation at admission with neurologic dysfunction and/or severe sepsis. Notably, most of the mortality in PedOnc4 was early (i.e., within 72 hr of ICU admission). CONCLUSIONS Mortality was lower than previously reported in critically ill pediatric oncology patients and was associated with MOF and IMV. These findings were further validated and expanded by the four derived nonsynonymous computable phenotypes. Of particular interest for future prospective validation and correlative biological study was the PedOnc4 phenotype, which was composed of patients with hypoxic respiratory failure requiring IMV with sepsis and/or neurologic dysfunction at ICU admission.
Collapse
Affiliation(s)
- Tim Flerlage
- Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, TN
| | - Kimberly Fan
- Division of Critical Care, Department of Pediatrics, MD Anderson Cancer Center, Houston, TX
| | - Yidi Qin
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Asya Agulnik
- Department of Global Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Anita V Arias
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Cheng Cheng
- Division of Critical Care, Department Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Lama Elbahlawan
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Saad Ghafoor
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Caitlin Hurley
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Jennifer McArthur
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - R Ray Morrison
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Yinmei Zhou
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - H J Park
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Joseph A Carcillo
- Division of Pediatric Critical Care, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Melissa R Hines
- Division of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
4
|
Fan Y, Feng Z, Fan K, Yin W, Sun N, Sun P, Sun Y, Li H. [Procine recombinant NK-lysin inhibits hepatocellular carcinoma metastasis by downregulating FKBP3 and inhibiting oxidative phosphorylation and glycolysis: a proteomic analysis]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:1116-1126. [PMID: 37488794 PMCID: PMC10366521 DOI: 10.12122/j.issn.1673-4254.2023.07.08] [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] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To investigate the potential mechanisms that mediate the inhibitory effect of porcine recombinant NKlysin (prNK-lysin) against liver cancer cell metastasis. METHODS HPLC-tandem mass spectrometry was used to identify the differentially expressed proteins in prNK-lysin-treated hepatocellular carcinoma SMMOL/LC-7721 cells in comparison with the control and PBS-treated cells. GO functional annotation and KEGG pathway analysis of the differentially expressed proteins were performed using GO and KEGG databases. RT-qPCR was used to determine the mRNA expression levels of polypeptide-N-acetylgalactosaminotransferase 13 (GALNT13), transmembrane protein 51 (TMEM51) and FKBP prolyl isomerase 3 (FKBP3) in the cells, and the protein expression of FKBP3 was verified using Western blotting. RESULTS Proteomic analysis identified 1989 differentially expressed proteins in prNK-lysin-treated cells compared with the control cells, and 2753 compared with PBS-treated cells. Fifteen proteins were differentially expressed between PBS-treated and the control cells, and 1909 were differentially expressed in prNK- lysin group compared with both PBS and control groups. These differentially expressed proteins were involved mainly in the viral process, translational initiation and RNA binding and were enriched mainly in ribosome, protein process in endoplasmic reticulum, and RNA transport pathways. RT-qPCR showed that compared with the control group, prNK-lysin treatment significantly increased the mRNA expressions of GALNT13 (P < 0.05) and TMEM51 (P < 0.01) and lowered FKBP3 mRNA expression (P < 0.05). Western blotting also showed a significantly decreased expression of FKBP3 protein in prNK-lysin-treated cells (P < 0.001). CONCLUSION Treatment with prNK-lysin causes significant changes in protein expression profile of SMMOL/LC-7721 cells and inhibits hepatocellular carcinoma metastasis by downregulating FKBP3 protein and affecting the cellular oxidative phosphorylation and glycolysis pathways.
Collapse
Affiliation(s)
- Y Fan
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - Z Feng
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - K Fan
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - W Yin
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - N Sun
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - P Sun
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - Y Sun
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
- Shanxi Key Laboratory for Modernization of TCVM, Taigu 030801, China
| | - H Li
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu 030801, China
| |
Collapse
|
5
|
Fan C, Wei D, Wang L, Liu P, Fan K, Nie L, Liu X, Hou J, Huo W, Li L, Li X, Li W, Wang C, Mao Z. The association of serum testosterone with dyslipidemia is mediated by obesity: the Henan Rural Cohort Study. J Endocrinol Invest 2023; 46:679-686. [PMID: 36219315 DOI: 10.1007/s40618-022-01911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/24/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS This study aimed to evaluate the relationships of serum testosterone with dyslipidemia and blood lipid levels and test whether obesity mediated these associations by gender in Chinese rural population. METHODS AND RESULTS A total of 6150 subjects were finally analyzed in this study. Serum testosterone for each subject was detected by liquid chromatography equipped with tandem mass spectrometry. Logistic regression and linear regression were employed to evaluate the associations of serum testosterone with the prevalence of dyslipidemia and blood lipid levels. Mediation analysis was conducted to identify the mediation effects of obesity on the relationship between serum testosterone and dyslipidemia. After adjusting for multiple confounders, per unit change in serum ln-testosterone levels was associated with a decreased prevalent dyslipidemia in men (odds ratio (OR): 0.785, 95% confidence interval (CI) (0.708, 0.871)). Males with the levels of serum testosterone in the third or fourth quartiles had a 49.4% (OR: 0.506, 95% CI 0.398, 0.644) or 67.1% (OR: 0.329, 95% CI 0.253, 0.428) significantly lower odds of prevalence of dyslipidemia. In addition, a onefold increase in ln-testosterone was related to a 0.043 mmol/L (95% CI 0.028, 0.059) increase in high-density lipoprotein cholesterol (HDL-C) in men. Results of the mediation analysis suggested that obesity played a partial role in the association of testosterone with dyslipidemia in men. CONCLUSIONS These findings suggested that serum testosterone levels were negatively associated with lipid levels and prevalent dyslipidemia, and obesity mediated the effects of serum testosterone on dyslipidemia in men, implying that obesity prevention should be highlighted to decrease the prevalence of dyslipidemia related to changes in testosterone levels.
Collapse
Affiliation(s)
- C Fan
- Department of Hypertension, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - D Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - P Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - K Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Nie
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - J Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - W Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - L Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - W Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Z Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| |
Collapse
|
6
|
Fan K, Lu ML, Li DY, Li LF, Li JH, Xu FL. The Synthesis of 3D Graphene/Fe3O4 Aerogel via γ-Ray and Its Application for the Absorption of Organic Liquids. High Energy Chem 2023. [DOI: 10.1134/s0018143923010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
|
7
|
Fan K, Zhou GQ, Gao CY, Li JH, Xu FL. Preparation of Modified Membrane Based on Covalent Grafting of Poly(N-isopropyl acrylamide) on PVDF Membrane Surface by Gamma-Ray Irradiation. High Energy Chem 2023. [DOI: 10.1134/s0018143923010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
|
8
|
Li H, Yuan L, Yang H, Guo Y, Zheng W, Fan K, Deng S, Gong L, Xu H, Yang Z, Cheng J, Kang M, Deng H. Analysis of SOD1 Variants in Chinese Patients with Familial Amyotrophic Lateral Sclerosis. QJM 2023; 116:365-374. [PMID: 36661322 DOI: 10.1093/qjmed/hcad010] [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: 12/09/2022] [Revised: 12/27/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease, and genetic contributors exert a significant role in the complicated pathogenesis. Identification of the genetic causes in ALS families could be valuable for early diagnosis and management. The development of potential drugs for patients with genetic defects will shed new light on ALS therapy. AIM To identify causative variants in three Chinese families with familial ALS (FALS), reveal the pathogenic mechanism, and look for the targeted drug for ALS. DESIGN AND METHODS Whole-exome sequencing and bioinformatics were used to perform genetic analysis of the ALS families. Functional analysis was performed to study the variants' function and search for potential drug targets. RESULTS Three heterozygous missense variants of the SOD1 gene were identified in families with FALS. The clinical manifestations of these patients include spinal onset, predominant lower motor neurons presentation, and absence of cognitive involvement. Functional analysis showed that all three SOD1 variants led to increased reactive oxygen species (ROS) levels, reduced cell viability, and formation of cytoplasmic aggregates. Remarkably, the decreased cell viability induced by variants was rescued after treatment with the ROS inhibitor N-acetylcysteine. CONCLUSIONS This study identified three SOD1 variants in three families with FALS. The variant SOD1 toxicity was associated with oxidative damage and aggregation, and N-acetylcysteine could rescue the decreased cell viability induced by these variants. Our findings support a pathogenic role for ROS in SOD1 deficiencies, and provide a potential drug N-acetylcysteine for ALS therapy, especially in SOD1-patients with limb onset.
Collapse
Affiliation(s)
- H Li
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - L Yuan
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
- Disease Genome Research Center, Central South University, Changsha, China
| | - H Yang
- Department of Neurology, the Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Y Guo
- Department of Medical Information, School of Life Sciences, Central South University, Changsha, China
| | - W Zheng
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - K Fan
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - S Deng
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
| | - L Gong
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - H Xu
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Z Yang
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - J Cheng
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - M Kang
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - H Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
- Disease Genome Research Center, Central South University, Changsha, China
| |
Collapse
|
9
|
Jin YF, Li Y, Li JW, Yan ZY, Chen SY, Lou XM, Fan K, Wu F, Cao YY, Hu FY, Chen L, Xie YQ, Cheng C, Yang HY, Duan GC. [Epidemiological investigation on the local epidemic situation in Zhengzhou High-Tech Zone caused by SARS-CoV-2 Delta variant]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:43-47. [PMID: 36655256 DOI: 10.3760/cma.j.cn112150-20220315-00247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study collected epidemic data of COVID-19 in Zhengzhou from January 1 to January 20 in 2022. The epidemiological characteristics of the local epidemic in Zhengzhou High-tech Zone caused by the SARS-CoV-2 Delta variant were analyzed through epidemiological survey and big data analysis, which could provide a scientific basis for the prevention and control of the Delta variant. In detail, a total of 276 close contacts and 599 secondary close contacts were found in this study. The attack rate of close contacts and secondary close contacts was 5.43% (15/276) and 0.17% (1/599), respectively. There were 10 confirmed cases associated with the chain of transmission. Among them, the attack rates in close contacts of the first, second, third, fourth and fifth generation cases were 20.00% (5/25), 17.86% (5/28), 0.72% (1/139) and 14.81% (4/27), 0 (0/57), respectively. The attack rates in close contacts after sharing rooms/beds, having meals, having neighbor contacts, sharing vehicles with the patients, having same space contacts, and having work contacts were 26.67%, 9.10%, 8.33%, 4.55%, 1.43%, and 0 respectively. Collectively, the local epidemic situation in Zhengzhou High-tech Zone has an obvious family cluster. Prevention and control work should focus on decreasing family clusters of cases and community transmission.
Collapse
Affiliation(s)
- Y F Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Li
- Zhengzhou High-tech Zone Center for Disease Control and Prevention,Zhengzhou 450001, China
| | - J W Li
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Z Y Yan
- Zhengzhou High-tech Zone Center for Disease Control and Prevention,Zhengzhou 450001, China
| | - S Y Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X M Lou
- Department of Maternal, Child and Adolescent Health, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - K Fan
- Zhengzhou High-tech Zone Center for Disease Control and Prevention,Zhengzhou 450001, China
| | - F Wu
- Zhengzhou High-tech Zone Center for Disease Control and Prevention,Zhengzhou 450001, China
| | - Y Y Cao
- Zhengzhou High-tech Zone Center for Disease Control and Prevention,Zhengzhou 450001, China
| | - F Y Hu
- Zhengzhou High-tech Zone Center for Disease Control and Prevention,Zhengzhou 450001, China
| | - L Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Q Xie
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - C Cheng
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - H Y Yang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - G C Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| |
Collapse
|
10
|
Fan K, Li DY, Li LF, Li JH. Graphene Fibers with Silver Nanoparticles Prepared by Chemical Reduction-induced Self-assembly. High Energy Chem 2022. [DOI: 10.1134/s0018143922040063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
11
|
Fan K, Lu RS, Liang KK, Hou ZC. Effect of Irradiation Absorbed Dose and Organic Solvent on the Grafting Rate of PVDF-g-PHEMA through Gamma-ray Irradiation in a Homogenous Solution. High Energy Chem 2022. [DOI: 10.1134/s0018143922040075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
12
|
Khalil K, Sooriyamoorthy T, Tahim A, Fan K. Use of a webinar series to improve exposure to oral & maxillofacial surgery during a global pandemic. Advances in Oral and Maxillofacial Surgery 2022. [DOI: 10.1016/j.adoms.2022.100268] [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
|
13
|
Ding YQ, Fan K, Wang Y, Fang WP, Zhu XJ, Chen L, Sun LT, Qiu C, Ding ZT. [Drought and Heat Stress-Mediated Modulation of Alternative Splicing in the Genes Involved in Biosynthesis of Metabolites Related to Tea Quality]. Mol Biol (Mosk) 2022; 56:321-322. [PMID: 35403623 DOI: 10.31857/s0026898422020057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 07/31/2021] [Indexed: 06/14/2023]
Abstract
Alternative splicing (AS) regulates mRNAs at the post-transcriptional level to affect both their amounts and the protein function. However, little is known about the roles of AS in regulation of biosynthesis of amino acids, flavonoids, and volatile compounds in tea plants. In this study, we used Iso-seq and transcriptome deep sequencing (RNA-seq) to identify AS events, and analyzed the expression of respective mRNAs in tea plants under drought (DS), heat stress (HS), and their combination (HD). By RT-PCR, we validated the AS events in nine genes involved in the biosynthesis of amino acids and flavonoids. The genes accumulating AS transcripts under DS, HS, and HD conditions included those encoding for anthocyanidin reductase (ANR), dihydrofavonol-4-reductase-like (DFRA), and chalcone isomerase (CHI). Similarly, genes directly or indirectly involved in the biosynthesis of volatile compounds such as lipoxygenase (LOX), terpenoid/terpene synthase (TPS), and 1-deoxy-D-xylulose 5-phosphate reductoisomerase (DXR) also had AS events. Our study revealed that AS might specifically regulate the biosynthesis of amino acids in tea plants under stressful conditions. Moreover, we suggest that the AS events within the ANR and DFRA transcripts might play an important role in the regulation of flavonoid biosynthesis under DS, HS, and HD conditions. This study improved our understanding of the genetic drivers of the changes in the content of bioactive ingredients of tea plants subjected to abiotic stresses.
Collapse
Affiliation(s)
- Y Q Ding
- Tea Research Institute, Shandong Academy of Agricultural Sciences, Rizhao, 276800 China
| | - K Fan
- Tea Research Institute, Shandong Academy of Agricultural Sciences, Rizhao, 276800 China
| | - Y Wang
- Tea Research Institute, Shandong Academy of Agricultural Sciences, Rizhao, 276800 China
| | - W P Fang
- College of Horticulture, Nanjing Agricultural University, Nanjing, 210095 China
| | - X J Zhu
- College of Horticulture, Nanjing Agricultural University, Nanjing, 210095 China
| | - L Chen
- Tea Research Institute, Chinese Academy of Agricultural Sciences, Hangzhou, 310008 China
| | - L T Sun
- Tea Research Institute, Shandong Academy of Agricultural Sciences, Rizhao, 276800 China
| | - C Qiu
- Tea Research Institute, Shandong Academy of Agricultural Sciences, Rizhao, 276800 China
| | - Z T Ding
- Tea Research Institute, Shandong Academy of Agricultural Sciences, Rizhao, 276800 China
| |
Collapse
|
14
|
Ghafoor S, Fan K, Di Nardo M, Talleur AC, Saini A, Potera RM, Lehmann L, Annich G, Wang F, McArthur J, Sandhu H. Extracorporeal Membrane Oxygenation Candidacy in Pediatric Patients Treated With Hematopoietic Stem Cell Transplant and Chimeric Antigen Receptor T-Cell Therapy: An International Survey. Front Oncol 2022; 11:798236. [PMID: 35004323 PMCID: PMC8727600 DOI: 10.3389/fonc.2021.798236] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/06/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction Pediatric patients who undergo hematopoietic cell transplant (HCT) or chimeric antigen receptor T-cell (CAR-T) therapy are at high risk for complications leading to organ failure and the need for critical care resources. Extracorporeal membrane oxygenation (ECMO) is a supportive modality that is used for cardiac and respiratory failure refractory to conventional therapies. While the use of ECMO is increasing for patients who receive HCT, candidacy for these patients remains controversial. We therefore surveyed pediatric critical care and HCT providers across North America and Europe to evaluate current provider opinions and decision-making and institutional practices regarding ECMO use for patients treated with HCT or CAR-T. Methods An electronic twenty-eight question survey was distributed to pediatric critical care and HCT providers practicing in North America (United States and Canada) and Europe through the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and individual emails. Responses to the survey were recorded in a REDCap® database. Results Two-hundred and ten participants completed the survey. Of these, 159 (76%) identified themselves as pediatric critical care physicians and 47 (22%) as pediatric HCT physicians or oncologists. The majority (99.5%) of survey respondents stated that they would consider patients treated with HCT or CAR-T therapy as candidates for ECMO support. However, pediatric critical care physicians identified more absolute and relative contraindications for ECMO than non-pediatric critical care physicians. While only 0.5% of respondents reported that they consider HCT as an absolute contraindication for ECMO, 6% of respondents stated that ECMO is contraindicated in HCT patients within their institution and only 23% have an institutional protocol or policy to guide the evaluation for ECMO candidacy of these patients. Almost half (49.1%) of respondents would accept a survival to hospital discharge of 20-30% for pediatric HCT patients requiring ECMO as adequate. Conclusions ECMO use for pediatric patients treated with HCT and CAR-T therapy is generally acceptable amongst physicians. However, there are differences in the evaluation and decision-making regarding ECMO candidacy amongst providers across medical specialties and institutions. Therefore, multidisciplinary collaboration is an essential component in establishing practice guidelines and advancing ECMO outcomes for these patients.
Collapse
Affiliation(s)
- Saad Ghafoor
- Department of Pediatric Medicine, Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Kimberly Fan
- Department of Pediatric Medicine, Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States.,Division of Pediatric Critical Care, University of Tennessee (IT) Health Science Center, Memphis, TN, United States
| | - Matteo Di Nardo
- Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Aimee C Talleur
- Department of Bone Marrow Transplant and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Arun Saini
- Division of Pediatric Critical Care, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, United States
| | - Renee M Potera
- Division of Pediatric Critical Care, University of Tennessee (UT) Southwestern Medical Center, Dallas, TX, United States
| | - Leslie Lehmann
- Pediatric Hematology-Oncology, Dana Farber Boston Children's Cancer and Blood Disorder Center, Boston, MA, United States
| | - Gail Annich
- Department of Critical Care Medicine, University of Toronto/The Hospital for Sick Children, Toronto, ON, Canada
| | - Fang Wang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jennifer McArthur
- Department of Pediatric Medicine, Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States.,Division of Pediatric Critical Care, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Hitesh Sandhu
- Division of Pediatric Critical Care, University of Tennessee (IT) Health Science Center, Memphis, TN, United States
| |
Collapse
|
15
|
Ding YQ, Fan K, Wang Y, Fang WP, Zhu XJ, Chen L, Sun LT, Qiu C, Ding ZT. Drought and Heat Stress-Mediated Modulation of Alternative Splicing in the Genes Involved in Biosynthesis of Metabolites Related to Tea Quality. Mol Biol 2022. [DOI: 10.1134/s0026893322020042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
16
|
Fan K, Wei D, Liu X, He Y, Tian H, Tu R, Liu P, Nie L, Zhang L, Qiao D, Liu X, Hou J, Li L, Wang C, Huo W, Zhang G, Mao Z. Negative associations of morning serum cortisol levels with obesity: the Henan rural cohort study. J Endocrinol Invest 2021; 44:2581-2592. [PMID: 33829394 DOI: 10.1007/s40618-021-01558-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
AIMS To evaluate the associations of morning serum cortisol levels with obesity defined by different indices in Chinese rural populations. MATERIALS AND METHODS A cross-sectional study was performed including 6198 participants (2566 males and 3632 females). Serum cortisol was collected in morning and quantified by liquid chromatography-tandem mass spectrometry. Obesity was defined by body mass index (BMI), body fat percentage (BFP), waist-to-height ratio (WHtR), waist circumference (WC), visceral fat index (VFI) and waist-to-hip ratio (WHR). Both multivariable liner regression, logistic regression and restrictive cubic splines models were used to estimate the gender-specific relationships between cortisol levels and obesity defined by different indices, respectively. RESULTS After adjusting for potential confounders, serum cortisol was negatively associated with different obesity measures, except obese females defined by BFP (for instance, overall obesity defined by BMI, Quartile 4 vs. Quartile 1, odds ratio (OR) = 0.25, 95% confidence interval (CI):0.15, 0.41 in males, and OR = 0.58, 95% CI: 0.42,0.80 in females, central obesity defined by WC, OR = 0.52, 95% CI:0.39,0.69 in males and OR = 0.63, 95% CI:0.51,0.77 in females). Similarly, restrictive cubic splines showed the nonlinear relationship between high levels of cortisol and different obesity indices. Furthermore, ROC curve analysis indicated that cortisol could improve the discrimination of model with common biomarkers. CONCLUSION Morning serum cortisol were negatively related to obesity defined by different indices in Chinese rural populations. In addition, cortisol could be as a biomarker for prediction of obesity in males.
Collapse
Affiliation(s)
- K Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - D Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y He
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - H Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - R Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - P Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Nie
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - D Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - J Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - W Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - G Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| | - Z Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| |
Collapse
|
17
|
Fan K, Liu C, Zeng H, Li JH. Intramolecular Crosslinking of Polyvinylidene Fluoride by Homogeneous Solution Irradiation. High Energy Chem 2021. [DOI: 10.1134/s0018143921060059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
18
|
Ferro A, Kotecha S, Auzinger G, Yeung E, Fan K. Systematic review and meta-analysis of tracheostomy outcomes in COVID-19 patients. Br J Oral Maxillofac Surg 2021; 59:1013-1023. [PMID: 34294476 PMCID: PMC8130586 DOI: 10.1016/j.bjoms.2021.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/07/2021] [Indexed: 01/04/2023]
Abstract
A systematic review and meta-analysis of the entire COVID-19 Tracheostomy cohort was conducted to determine the cumulative incidence of complications, mortality, time to decannulation and ventilatory weaning. Outcomes of surgical versus percutaneous and outcomes relative to tracheostomy timing were also analysed. Studies reporting outcome data on patients with COVID-19 undergoing tracheostomy were identified and screened by 2 independent reviewers. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Outcome data were analysed using a random-effects model. From 1016 unique studies, 39 articles reporting outcomes for a total of 3929 patients were included for meta-analysis. Weighted mean follow-up time was 42.03±26 days post-tracheostomy. Meta-analysis showed that 61.2% of patients were weaned from mechanical ventilation [95%CI 52.6%-69.5%], 44.2% of patients were decannulated [95%CI 33.96%-54.67%], and cumulative mortality was found to be 19.23% [95%CI 15.2%-23.6%] across the entire tracheostomy cohort. The cumulative incidence of complications was 14.24% [95%CI 9.6%-19.6%], with bleeding accounting for 52% of all complications. No difference was found in incidence of mortality (RR1.96; p=0.34), decannulation (RR1.35, p=0.27), complications (RR0.75, p=0.09) and time to decannulation (SMD 0.46, p=0.68) between percutaneous and surgical tracheostomy. Moreover, no difference was found in mortality (RR1.57, p=0.43) between early and late tracheostomy, and timing of tracheostomy did not predict time to decannulation. Ten confirmed nosocomial staff infections were reported from 1398 tracheostomies. This study provides an overview of outcomes of tracheostomy in COVID-19 patients, and contributes to our understanding of tracheostomy decisions in this patient cohort.
Collapse
Affiliation(s)
- A. Ferro
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, Denmark Hill, SE1 9RT London, United Kingdom
| | - S. Kotecha
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, Denmark Hill, SE1 9RT London, United Kingdom
| | - G. Auzinger
- Liver Intensive Care Unit, Department of Critical Care, King's College Hospital NHS Foundation Trust, Denmark Hill, SE1 9RT London, United Kingdom
| | - E. Yeung
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, Denmark Hill, SE1 9RT London, United Kingdom
| | - K. Fan
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Foundation Trust, Denmark Hill, SE1 9RT London, United Kingdom,Corresponding author at: King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, United Kingdom. Tel.: +4420 3299 5754
| |
Collapse
|
19
|
Karia R, Miskry S, Fan K. 1633 Developing Confidence in Dental Core Trainees; A National Review of The Trainee Experience. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.647] [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: 11/13/2022]
Abstract
Abstract
Aim
In the U.K, Dental Core Training (DCT) is an elective postgraduate training programme. There are over 700 DCT jobs with the majority in Oral and Maxillofacial Surgery (OMFS). Our focus was to measure the confidence and skills of 103 DCTs, as they mature during a year in OMFS.
Method
OMFS DCTs answered questionnaires in month 1, 3 and 6 of their training post, regarding confidence and proficiency in assessment of dental infections, facial fractures, swellings, pathology, airway risk, imaging and performing suturing.
Results
In month 1, 55% of DCTs were ‘somewhat confident’ in performing intra-oral suturing and assessing dento-facial infection out of the skills assessed. Only 22% of DCTs were ‘extremely confident’ in any competencies. Specifically, DCTs felt ‘not at all confident’ with interpretation of scans (78%) and assessment of facial fractures (35%). Between month 1 and month 6 there has been an increase in confidence across all competencies. Notably, a 42% confidence increase in extra-oral suturing and 61% increase in assessing mandibular fractures.
Conclusions
We demonstrate that an OMFS training year improves confidence in clinical skills and that an adequate time in a post is required to attain that. Our results highlight areas where DCTs lack confidence early in their posts. These could be targeted at dental school, during the hospital induction process or through guided support and training in the initial phase of their jobs. This study adds clarity to both dentists and doctors contemplating a training year in OMFS and gives insight into how to support and train them.
Collapse
Affiliation(s)
- R Karia
- Kings College London, London, United Kingdom
| | - S Miskry
- Kings College London, London, United Kingdom
| | - K Fan
- Kings College London, London, United Kingdom
| |
Collapse
|
20
|
Fan K, Liu C, Su J, Li JH. Preparation and Characterization of Functional Multi-Walled Carbon Nanotubes (MWCNTs) through Acidification and Radiation Induced Graft Polymerization. High Energy Chem 2021. [DOI: 10.1134/s001814392104007x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
21
|
Howson K, Yeung E, Rayner L, Fan K. Real-time screening tool for identifying post-traumatic stress disorder in facial trauma patients in a UK maxillofacial trauma clinic. Int J Oral Maxillofac Surg 2021; 50:1464-1470. [PMID: 33712316 DOI: 10.1016/j.ijom.2021.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/26/2020] [Accepted: 01/28/2021] [Indexed: 11/18/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a distressing consequence of a traumatic event associated with an increased suicide risk and reduced quality of life. Surgeons often have low confidence in identifying psychological problems. The prevalence of PTSD following facial trauma ranges from 23% to 41%. This highlights the importance of identifying and managing at-risk patients to optimize both mental and physical recovery. IMPARTS (Integrating Mental and Physical healthcare: Research, Training and Services) provides electronic screening tools to guide the non-mental health clinician in the 'real-time' identification, documentation, and management of potential mental health problems. The bespoke IMPARTS facial trauma screening tool was piloted in a UK oral and maxillofacial surgery trauma clinic from July 2015 to November 2017. A total of 199 patients completed screening, with 48 (24%) screening positive for possible PTSD. Further analysis of these 48 patients revealed that four (8%) had PTSD symptoms alone; three (6%) also screened positive for depression, 17 (35%) for co-existing symptoms of anxiety, and 24 (50%) for PTSD, anxiety, and depression. IMPARTS was found to be a highly effective tool aiding the non-mental health clinician to screen for PTSD and initiate prompt management. The data captured informs planning of the psychological support service.
Collapse
Affiliation(s)
- K Howson
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, UK
| | - E Yeung
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, UK
| | - L Rayner
- IMPARTS Mind and Body Programme, Psychological Medicine and Integrated Care Clinical Academic Group, King's College London, London, UK
| | - K Fan
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, UK; Faculty of Dentistry, Oral & Craniofacial Sciences.
| |
Collapse
|
22
|
Ghafoor S, Fan K, Williams S, Brown A, Bowman S, Pettit KL, Gorantla S, Quillivan R, Schwartzberg S, Curry A, Parkhurst L, James M, Smith J, Canavera K, Elliott A, Frett M, Trone D, Butrum-Sullivan J, Barger C, Lorino M, Mazur J, Dodson M, Melancon M, Hall LA, Rains J, Avent Y, Burlison J, Wang F, Pan H, Lenk MA, Morrison RR, Kudchadkar SR. Beginning Restorative Activities Very Early: Implementation of an Early Mobility Initiative in a Pediatric Onco-Critical Care Unit. Front Oncol 2021; 11:645716. [PMID: 33763377 PMCID: PMC7982584 DOI: 10.3389/fonc.2021.645716] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/01/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction Children with underlying oncologic and hematologic diseases who require critical care services have unique risk factors for developing functional impairments from pediatric post-intensive care syndrome (PICS-p). Early mobilization and rehabilitation programs offer a promising approach for mitigating the effects of PICS-p in oncology patients but have not yet been studied in this high-risk population. Methods We describe the development and feasibility of implementing an early mobility quality improvement initiative in a dedicated pediatric onco-critical care unit. Our primary outcomes include the percentage of patients with consults for rehabilitation services within 72 h of admission, the percentage of patients who are mobilized within 72 h of admission, and the percentage of patients with a positive delirium screen after 48 h of admission. Results Between January 2019 and June 2020, we significantly increased the proportion of patients with consults ordered for rehabilitation services within 72 h of admission from 25 to 56% (p<0.001), increased the percentage of patients who were mobilized within 72 h of admission to the intensive care unit from 21 to 30% (p=0.02), and observed a decrease in patients with positive delirium screens from 43 to 37% (p=0.46). The early mobility initiative was not associated with an increase in unplanned extubations, unintentional removal of central venous catheters, or injury to patient or staff. Conclusions Our experience supports the safety and feasibility of early mobility initiatives in pediatric onco-critical care. Additional evaluation is needed to determine the effects of early mobilization on patient outcomes.
Collapse
Affiliation(s)
- Saad Ghafoor
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Kimberly Fan
- Department of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sarah Williams
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Amanda Brown
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Sarah Bowman
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Kenneth L Pettit
- Office of Quality and Patient Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Shilpa Gorantla
- Office of Quality and Patient Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Rebecca Quillivan
- Office of Quality and Patient Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Sarah Schwartzberg
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Amanda Curry
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Lucy Parkhurst
- Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Marshay James
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jennifer Smith
- Department of Child Life, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Kristin Canavera
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Andrew Elliott
- Division of Psychiatry, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Michael Frett
- Division of Anesthesiology, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Deni Trone
- Department of Pharmaceutical Services, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jacqueline Butrum-Sullivan
- Department Critical Care/Pulmonary Medicine-Respiratory Therapy, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Cynthia Barger
- Department of Inpatient Units-Nursing, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Mary Lorino
- Department of Inpatient Units-Nursing, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jennifer Mazur
- Department of Nursing Administration- Nursing Education, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Mandi Dodson
- Department of Nursing Administration- Nursing Education, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Morgan Melancon
- Department of Nursing Administration- Nursing Education, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Leigh Anne Hall
- Department of Inpatient Units-Nursing, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jason Rains
- Department Critical Care/Pulmonary Medicine-Respiratory Therapy, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Yvonne Avent
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jonathan Burlison
- Department of Pharmaceutical Sciences- Patient Safety, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Fang Wang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Haitao Pan
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Mary Anne Lenk
- Department of Quality Improvement Education and Training, Cincinnati Children's Hospital- James M. Anderson Center for Health Systems Excellence, Cincinnati, OH, United States
| | - R Ray Morrison
- Division of Critical Care Medicine, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Sapna R Kudchadkar
- Departments of Anesthesiology and Critical Care Medicine, Pediatrics and Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| |
Collapse
|
23
|
|
24
|
Petringa G, Pandola L, Agosteo S, Catalano R, Colautti P, Conte V, Cuttone G, Fan K, Mei Z, Rosenfeld A, Selva A, Cirrone GAP. Monte Carlo implementation of new algorithms for the evaluation of averaged-dose and -track linear energy transfers in 62 MeV clinical proton beams. ACTA ACUST UNITED AC 2020; 65:235043. [DOI: 10.1088/1361-6560/abaeb9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
25
|
Fan K, Cao AM, Barto W, De Lacavalerie P. Perineal stapled prolapse resection for external rectal prolapse: a systematic review and meta-analysis. Colorectal Dis 2020; 22:1850-1861. [PMID: 32865320 DOI: 10.1111/codi.15338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 03/13/2020] [Accepted: 08/18/2020] [Indexed: 12/29/2022]
Abstract
AIM Rectal prolapse is an uncommon but debilitating pelvic floor disorder that significantly decreases the quality of life of affected patients. Perineal stapled prolapse resection is a relatively new perineal approach that offers an promising alternative technique in the surgical management of rectal prolapse. It appears to be a simple, reproducible and efficient method. However, long-term outcomes are limited. The aims of this review are to assess the safety and effectiveness of perineal stapled prolapse resection in the management of rectal prolapse. METHOD A systematic review of all articles describing this approach was searched using MEDLINE, Embase, PubMed, Cochrane, Scopus, Web of Science and China National Knowledge Infrastructure. Included in this review were all randomized and nonrandomized prospective and retrospective studies reporting patients (aged 16 years and older) with complete rectal prolapse who underwent perineal stapled prolapse resection for the surgical treatment of the rectal prolapse. RESULTS A total of 408 patients across 20 articles were included. There were 58 cases of recurrence out of 368 patients over a median length of follow-up of 18 months (interquartile range 12-34 months). The total weighted overall recurrence was 12%. There were 51 cases of postoperative complications in 350 cases, bleeding being the most common complication. CONCLUSION The recurrence rate is comparable to those of the well-established Altemeier and Delorme procedures. However, given the heterogeneity of studies and variations in lengths of follow-up, further randomized prospective studies are needed to adequately compare this technique against other procedures for complete rectal prolapse.
Collapse
Affiliation(s)
- K Fan
- Colorectal Surgery department, Nepean Hospital, Kingswood, New South Wales, Australia
| | - A M Cao
- Colorectal Surgery department, Nepean Hospital, Kingswood, New South Wales, Australia
| | - W Barto
- Colorectal Surgery department, Nepean Hospital, Kingswood, New South Wales, Australia
| | - P De Lacavalerie
- Department of Surgery, Nepean Private Hospital, Kingswood, New South Wales, Australia.,University of Sydney Nepean Clinical School, Kingswood, New South Wales, Australia
| |
Collapse
|
26
|
Wang D, Fan K, Yan Y, Fu W. Totally laparoscopic subtotal gastrectomy and radical anterior resection for synchronous gastric and rectal cancer with natural orifice specimen extraction (NOSE) - a video vignette. Colorectal Dis 2020; 22:2361. [PMID: 32990352 DOI: 10.1111/codi.15374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/14/2020] [Indexed: 12/13/2022]
Affiliation(s)
- D Wang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - K Fan
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Y Yan
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - W Fu
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
27
|
Yeung E, Hopkins P, Auzinger G, Fan K. Challenges of tracheostomy in COVID-19 patients in a tertiary centre in inner city London. Int J Oral Maxillofac Surg 2020; 49:1385-1391. [PMID: 32912655 PMCID: PMC7451123 DOI: 10.1016/j.ijom.2020.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/14/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023]
Abstract
The rapid global spread of SARS-CoV-2, the causative agent of COVID-19, has dominated healthcare services, with exponential numbers requiring mechanical ventilation in the intensive care unit (ICU). Tracheostomy facilitates respiratory and sedative weaning but risks potential viral transmission. This study reviewed the tracheostomy provision, techniques, and outcomes for a single-centre prospective cohort during the resource-pressured COVID-19 period. Seventy-two of 176 patients underwent tracheostomy at a median 17 days: 44 surgical (open), 28 percutaneous. Their median age was 58 years, the male to female ratio was 2.4:1, 75.1% were of BAME backgrounds, 76% had a BMI≥25kg/m2, and 65% had ≥2 major co-morbidities. Seventy-nine percent of patients were weaned from sedation at a median 2 days, 61% were weaned from mechanical ventilation at a median 10 days, 39% were discharged from the ICU at a median 11.5 days, and 19.4% were discharged home at a median 24 days. All patients survived the procedure. The mortality rate was 9.7% at a median 12 days. No clinician reported COVID-19 symptoms within 14 days of the procedure. The role of tracheostomy in COVID-19 is currently unclear. Delivery of tracheostomy by maxillofacial surgeons relieved the workload pressure from ICU clinicians. The choice of technique was influenced by the patient and resource factors, resulting in a mixed cohort of open and percutaneous tracheostomy in COVID-19 patients. Preliminary data suggest that open tracheostomy is as favourable as percutaneous tracheostomy for COVID-19 patients, and is safe for clinicians.
Collapse
Affiliation(s)
- E Yeung
- King's College London Hospital NHS Foundation Trust, Denmark Hill, London, SE1 9RT, UK
| | - P Hopkins
- King's College London Hospital NHS Foundation Trust, Denmark Hill, London, SE1 9RT, UK
| | - G Auzinger
- King's College London Hospital NHS Foundation Trust, Denmark Hill, London, SE1 9RT, UK
| | - K Fan
- King's College London Hospital NHS Foundation Trust, Denmark Hill, London, SE1 9RT, UK.
| |
Collapse
|
28
|
Barker M, Pepper T, Dua R, Fan K. Electric scooters: convenient transport or ED headache? Br J Oral Maxillofac Surg 2020; 60:199-200. [PMID: 34922774 DOI: 10.1016/j.bjoms.2020.09.038] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Abstract
Electric scooters (e-scooters) provide a potentially attractive means of private transportation in the pandemic era, during which use of public transport is discouraged. E-scooter use has become widespread recently, and we have noticed a concomitant rise in related craniomaxillofacial injuries, often associated with alcohol consumption and lack of protective equipment. We present here the first-published UK data on electric scooter injuries which, in the post-lockdown period, included facial lacerations, mandibular and midface fractures, avulsed teeth, and cervical spine injury. We urge that forthcoming legislation make e-scooters subject to at least the same requirements in lighting, helmet wear, and sobriety as bicycles and that, in this way, their benefits can be enjoyed while reducing associated morbidity and mortality.
Collapse
Affiliation(s)
- M Barker
- Dental Core trainee Oral Maxillofacial Surgery at King's College Hospital, United Kingdom.
| | - T Pepper
- Specialist Trainee in Oral Maxillofacial Surgery at Institute of Naval Medicine, Defence Medical Services, United Kingdom.
| | - R Dua
- Specialist Trainee in Oral Maxillofacial Surgery at King's College Hospital, United Kingdom.
| | - K Fan
- Professor Oral Maxillofacial Surgery King's College Hospital, United Kingdom / King's College London.
| |
Collapse
|
29
|
Bruce-Hickman K, Fan K, Plaat F, Sheth S. Decision-making on the labour ward during the COVID-19 pandemic. Int J Obstet Anesth 2020; 45:150-151. [PMID: 33218871 PMCID: PMC7564509 DOI: 10.1016/j.ijoa.2020.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/23/2020] [Accepted: 10/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
- K Bruce-Hickman
- Department of Anaesthesia, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | - K Fan
- Department of Anaesthesia, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - F Plaat
- Department of Anaesthesia, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - S Sheth
- Department of Anaesthesia, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
30
|
Green AO, Chellappah AD, Fan K, Stenhouse PD. Novel way to determine the size of tracheostomy tubes using computed tomographic Thorax or Pulmonary Angiogram scans during the COVID-19 pandemic. Br J Oral Maxillofac Surg 2020; 58:e335-e337. [PMID: 33008625 PMCID: PMC7435322 DOI: 10.1016/j.bjoms.2020.08.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022]
Affiliation(s)
- A O Green
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS.
| | - A D Chellappah
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS.
| | - K Fan
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS.
| | - P D Stenhouse
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London SE5 9RS.
| |
Collapse
|
31
|
Fan K, McArthur J, Morrison RR, Ghafoor S. Diffuse Alveolar Hemorrhage After Pediatric Hematopoietic Stem Cell Transplantation. Front Oncol 2020; 10:1757. [PMID: 33014865 PMCID: PMC7509147 DOI: 10.3389/fonc.2020.01757] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022] Open
Abstract
Pulmonary complications are common following hematopoietic cell transplantation (HCT) and contribute significantly to its morbidity and mortality. Diffuse alveolar hemorrhage is a devastating non-infectious complication that occurs in up to 5% of patients post-HCT. Historically, it carries a high mortality burden of 60–100%. The etiology remains ill-defined but is thought to be due to lung injury from conditioning regimens, total body irradiation, occult infections, and other comorbidities such as graft vs. host disease, thrombotic microangiopathy, and subsequent cytokine release and inflammation. Clinically, patients present with hypoxemia, dyspnea, and diffuse opacities consistent with an alveolar disease process on chest radiography. Diagnosis is most commonly confirmed with bronchoscopy findings of progressively bloodier bronchoalveolar lavage or the presence of hemosiderin-laden macrophages on microscopy. Treatment with glucocorticoids is common though dosing and duration of therapy remains variable. Other agents, such as aminocaproic acid, tranexamic acid, and activated recombinant factor VIIa have also been tried with mixed results. We present a review of diffuse alveolar hemorrhage with a focus on its pathogenesis and treatment options.
Collapse
Affiliation(s)
- Kimberly Fan
- Division of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Jennifer McArthur
- Division of Critical Care, St. Jude Children's Research Center, Memphis, TN, United States
| | - R Ray Morrison
- Division of Critical Care, St. Jude Children's Research Center, Memphis, TN, United States
| | - Saad Ghafoor
- Division of Critical Care, St. Jude Children's Research Center, Memphis, TN, United States
| |
Collapse
|
32
|
Radia R, Suffern R, Pepper T, Fan K. A blacksmith's tale: use of a rare earth magnet to facilitate safe removal of a metallic fragment from the face. Br J Oral Maxillofac Surg 2020; 58:e317-e319. [PMID: 32807596 DOI: 10.1016/j.bjoms.2020.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/22/2020] [Indexed: 11/19/2022]
Abstract
A 48-year-old blacksmith presented to A&E after sustaining facial injuries while operating a metal punch press. Radiographs revealed the presence of a metallic foreign body within the cheek, but this was clinically impalpable. By using a neodymium rare earth magnet extraorally, it was possible to identify the position of the fragment several centimetres lateral to the entry wound. Triangulation of the fragment's position allowed retrieval under local anaesthetic through the original penetration wound, without need for cross sectional imaging or extensive exploration under general anaesthetic. This case highlights an application for magnets in detection and removal of impalpable metallic foreign bodies embedded in superficial soft tissues.
Collapse
Affiliation(s)
- R Radia
- Department of Oral and Maxillofacial Surgery, King's College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London SE5 9RS, UK.
| | - R Suffern
- Department of Oral and Maxillofacial Surgery, King's College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London SE5 9RS, UK.
| | - T Pepper
- Department of Oral and Maxillofacial Surgery, King's College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London SE5 9RS, UK.
| | - K Fan
- Department of Oral and Maxillofacial Surgery, King's College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London SE5 9RS, UK.
| |
Collapse
|
33
|
Politi I, McParland E, Smith R, Crummey S, Fan K. The impact of COVID-19 on cervicofacial infection of dental aetiology. Br J Oral Maxillofac Surg 2020; 58:1029-1033. [PMID: 32811723 PMCID: PMC7382926 DOI: 10.1016/j.bjoms.2020.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/17/2020] [Indexed: 01/12/2023]
Abstract
Cervicofacial infections of dental aetiology can be life-threatening and with the closure of dental practices following the onset of the COVID-19, it would be anticipated that their prevalence presenting to maxillofacial surgery would increase and services may be overwhelmed, with patients presenting later with a potential subsequent increase in morbidity. A retrospective analysis of patients with cervicofacial infection of dental aetiology referred to maxillofacial surgery during the initial six weeks of COVID-19 lockdown in 2020 was carried out and compared with the equivalent period in the two preceding years. Unexpectedly, during COVID-19 lockdown, there was a reduction in patients seen with cervicofacial infection of dental aetiology. This may have resulted from patient adherence to government guidelines “Stay at home”, successful triaging of patients in primary care and emergency treatment provided by urgent dental care centres. Proportionally more patients who presented to hospital had received prior antibiotic therapy and required in-patient admission. All patients admitted received incision and drainage, with an increase extraoral drainage and an associated reduction in length of stay. During COVID-19 lockdown, maxillofacial managed a reduced number of patients with cervicofacial infection, likely resulting from primary and secondary dental care working together. The rate of incision and drainage of patients not admitted increased under local anaesthesia with increase of extraoral drainage and reduced length of stay for those admitted.
Collapse
Affiliation(s)
- I Politi
- Department of Oral & Maxillofacial Surgery, King's College Hospital, London, SE5 9RS
| | - E McParland
- Department of Oral & Maxillofacial Surgery, King's College Hospital, London, SE5 9RS
| | - R Smith
- Department of Oral & Maxillofacial Surgery, King's College Hospital, London, SE5 9RS
| | - S Crummey
- Department of Oral & Maxillofacial Surgery, King's College Hospital, London, SE5 9RS
| | - K Fan
- King's College London, Faculty of Dentistry, Oral & Craniofacial Sciences.
| |
Collapse
|
34
|
Fan K, Hurley C, McNeil MJ, Agulnik A, Federico S, Qudeimat A, Saini A, McArthur J, Morrison RR, Sandhu H, Shah S, Ghafoor S. Case Report: Management Approach and Use of Extracorporeal Membrane Oxygenation for Diffuse Alveolar Hemorrhage After Pediatric Hematopoietic Cell Transplant. Front Pediatr 2020; 8:587601. [PMID: 33520888 PMCID: PMC7838496 DOI: 10.3389/fped.2020.587601] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Diffuse alveolar hemorrhage (DAH) is an early pulmonary complication of hematopoietic cell transplantation (HCT) associated with severe hypoxemic respiratory failure and mortality. Extracorporeal membrane oxygenation (ECMO) support is often used for respiratory failure refractory to conventional interventions; however, its use has been limited in HCT patients with DAH due to potential for worsening alveolar hemorrhage and reported high mortality. Case Presentation: We report two cases of DAH following HCT who developed refractory hypoxemic respiratory failure despite cessation of bleeding and were successfully supported with ECMO. Conclusion: DAH after HCT should not automatically preclude ECMO support; rather, these patients must be evaluated individually for ECMO within the context of their overall clinical picture.
Collapse
Affiliation(s)
- Kimberly Fan
- Division of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Caitlin Hurley
- Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Michael J McNeil
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Asya Agulnik
- Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Sara Federico
- Division of Solid Tumor, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Amr Qudeimat
- Department of Bone Marrow Transplant, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Arun Saini
- Division of Pediatric Critical Care, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, United States
| | - Jennifer McArthur
- Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Ronald Ray Morrison
- Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Hitesh Sandhu
- Division of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Samir Shah
- Division of Pediatric Critical Care, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Saad Ghafoor
- Division of Critical Care, St. Jude Children's Research Hospital, Memphis, TN, United States
| |
Collapse
|
35
|
Boyes H, Fan K. Maxillofacial injuries associated with domestic violence: experience at a major trauma centre. Br J Oral Maxillofac Surg 2019; 58:185-189. [PMID: 31848019 DOI: 10.1016/j.bjoms.2019.11.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/14/2019] [Indexed: 11/26/2022]
Abstract
Domestic violence continues to be a global public health issue, and facial injuries in these cases are common with a reported incidence of up to 94%. Our aims were to identify patients with facial injuries caused by domestic violence, and to find out how confident members of the oral and maxillofacial surgical (OMFS) team were at assessing them. In this 18-month retrospective study of patients seen at King's College Hospital we identified 18 and obtained details on sex, age, nature of maxillofacial injury, mechanism of injury, time to presentation, and alleged assailant, from their electronic records. Most of the patients were female and the mean (range) age was 28 (16-44) years. In 10 cases, the alleged assailant was the patient's current partner. A total of 15 patients presented on the same day as their injury, and only 3 the following day. Punching was the most common mechanism (n=13) followed by use of a weapon. We also circulated a questionnaire among the OMFS team to gain an insight into their attitudes regarding screening for domestic violence. Most OMFS clinicians were only "somewhat confident" at recognising and asking about domestic violence, and few were "very" or "extremely confident". Targeted training for frontline staff in OMFS teams is likely to increase their confidence to identify and manage these patients, and to refer them appropriately.
Collapse
Affiliation(s)
- H Boyes
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, SE5 9RS
| | - K Fan
- Oral and Maxillofacial Surgery Department, King's College Hospital, Denmark Hill, London, SE5 9RS.
| |
Collapse
|
36
|
Pender A, Titmuss E, Pleasance E, Fan K, Pearson H, Bonakdar M, Taylor G, Mungall K, Moore R, Lavoie JM, Yip S, Lim H, Renouf D, Jones S, Marra M, Laskin J. Predictive markers of checkpoint inhibitor activity in adult metastatic solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.081] [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: 11/13/2022] Open
|
37
|
Madadian MA, Benning A, Fan K, Pandis N, Seehra J. Quality assessment of clinical practice guidelines used in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2019; 49:403-410. [PMID: 31466829 DOI: 10.1016/j.ijom.2019.08.003] [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: 04/25/2019] [Revised: 07/23/2019] [Accepted: 08/06/2019] [Indexed: 11/26/2022]
Abstract
An assessment of the quality of oral and maxillofacial surgery clinical practice guidelines is lacking. The aim of this investigation was to assess the quality of guidelines using the RIGHT (Reporting Items for practice Guidelines in HealThcare) checklist. The primary outcome was to assess the score (quality) of guidelines based on the RIGHT checklist and to identify predictors (region, type, single or multi-centre, and speciality/non-speciality) influencing the quality score. In this review, following a search of electronic databases and national society websites, a total of 25 guidelines were independently assessed by two assessors against the 22-item RIGHT checklist. Inter-assessor reliability was assessed. Deficiencies in the reporting of items relating to limitations, funding, declaration and management of interests, healthcare questions, and quality assurance were evident. The median overall score for the guidelines was 28 (range 14-66). Guidelines produced by multiple centres (β=57.15, 95% confidence interval -26.62 to 87.68, P= 0.001, multivariate analysis) and non-speciality societies (β=20, 95% confidence interval -0.03 to 40.03, P=0.05, univariate analysis) tended to have higher quality scores. Overall, the quality of clinical practice guidelines used in oral and maxillofacial surgery was deemed suboptimal. If clinical practice guidelines are to be used in making treatment decisions for patients, clinicians should be aware of their possible limitations.
Collapse
Affiliation(s)
- M A Madadian
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - A Benning
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - K Fan
- Department of Oral and Maxillofacial Surgery, King's College London Dental Institute, Kings College Hospital NHS Foundation Trust, London, UK
| | - N Pandis
- Department of Orthodontics and Dentofacial Orthopaedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| | - J Seehra
- Department of Orthodontics, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
| |
Collapse
|
38
|
Fan K, Wong M, Cheng K. Denovo Malignancy in Chinese Patients Post-Heart Transplant in Current Era-A “Not So Bad Prognosis”? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
39
|
Fan K, Balekian A, Hsia D, Chang C. DR JEKYLL AND MR HYDE: WHAT IS COMPETENCY IN EBUS-TBNA? Chest 2019. [DOI: 10.1016/j.chest.2019.02.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
40
|
Shu M, Fan K, Eddib A. The Impact of Tunneling During Robotic-Assisted Abdominal Laparoscopic Sacrocolpoperineopexy. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.540] [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: 11/27/2022]
|
41
|
Shu M, Fan K, Eddib A. Sacrocolpoperineopexy: The Buffalo Experience. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.233] [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: 10/28/2022]
|
42
|
Wang AZ, Fan K, Zhou QH, Wang C, Niu Q, Chan Y. A lateral approach to ultrasound-guided sacral plexus block in the supine position. Anaesthesia 2018; 73:1043-1044. [PMID: 30117581 DOI: 10.1111/anae.14368] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - K. Fan
- Sixth People's Hospital; Shanghai China
| | | | - C. Wang
- Shanghai Children's Hospital; Shanghai China
| | - Q. Niu
- Shenzhen Hospital; Hong Kong China
| | - Y. Chan
- Shenzhen Hospital; Hong Kong China
| |
Collapse
|
43
|
Mayor P, Fan K, Etter J, Morrell K, Eng K, Szender J, Akers S, Frederick P, Lele S, Odunsi K, Zsiros E. Performing combined breast and gynecologic surgery does not increase the rate of postoperative morbidity. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
44
|
Mayor P, Gay L, Fan K, Frederick P, Eskander R, Sun J, Ross J, Kurzrock R, Akers S, Lele S, Odunsi K, Zsiros E, Elvin J. A comprehensive genomic analysis of neuroendocrine carcinoma of gynecologic and breast tumors. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.075] [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: 11/27/2022]
|
45
|
Lawrence M, Fan K. Swallowed partial denture. Br Dent J 2018. [DOI: 10.1038/sj.bdj.2018.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
46
|
Wang B, Liu X, Liu H, Guo J, Zhang T, Zhou N, Ma Y, Yu H, Chen L, Ren Z, Fan K, Tian X. Differential expressions of MDM2 and TAP73 in cancer and cancer-adjacent tissues in patients with non-small-cell lung carcinoma. Pulmonology 2018; 24:S2173-5115(17)30153-7. [PMID: 29452959 DOI: 10.1016/j.rppnen.2017.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 01/15/2023] Open
Abstract
AIM To investigate the differences in mRNA and protein expressions of MDM2 (mouse double minute 2 homolog) and P73 in cancer and cancer-adjacent tissues in patients with non-small-cell lung carcinoma (NSCLC). MATERIALS AND METHODS We compared the protein expressions of MDM2 and P73 in lung cancer and cancer-adjacent tissues in NSCLC patients by IHC (immunohistochemistry) and WB (Western blot). We divided the NSCLC patients into two subgroups, adenocarcinoma and squamous carcinoma. The mRNA expressions of two main isoforms of P73, TAP73 and DNP73, as well as the ratio of DNP73/TAP73 were analyzed by qPCR (quantitative real-time PCR) in the two tissues in all NSCLC patients and in patients with adenocarcinoma or squamous carcinoma, respectively. RESULTS WB results did not show significant differences in MDM2 and P73 protein expressions in lung cancer and cancer-adjacent tissues. However, IHC results indicated that MDM2 expression significantly increased in cancer tissues in female patients, but not male patients. In addition, TAP73 mRNA expression significantly increased in cancer tissues in all NSCLC patients (p=0.002) and in patients with adenocarcinoma (p=0.01); while there was no significant difference in DNP73 mRNA expression. Hence the fold-change of DNP73/TAP73 ratio significantly decreased (p=0.0003) in cancer tissues in all NSCLC patients and in patients with adenocarcinoma. CONCLUSIONS TAP73 mRNA expression significantly increased in cancer tissues than cancer-adjacent tissues in all NSCLC patients and in patients with adenocarcinoma. Meanwhile, the fold-change of DNP73/TAP73 ratio was similar to TAP73. MDM2 protein expression significantly increased in cancer tissues in female NSCLC patients.
Collapse
Affiliation(s)
- B Wang
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - X Liu
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - H Liu
- Department of Thoracic Surgery, PLA 309 Hospital, Beijing, China
| | - J Guo
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - T Zhang
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - N Zhou
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - Y Ma
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - H Yu
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - L Chen
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - Z Ren
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - K Fan
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - X Tian
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
47
|
Bhat Kumble V, Bernhart E, Fan K, Wadsack C, Rechberger G, Becker J, Sattler W. 608 Interference with sphingosine 1-phosphate synthesis affects Merkel cell carcinoma proliferation in vitro. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.805] [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]
|
48
|
Yeung E, Abou-Foul A, Matcham F, Poate T, Fan K. Integration of mental health screening in the management of patients with temporomandibular disorders. Br J Oral Maxillofac Surg 2017; 55:594-599. [DOI: 10.1016/j.bjoms.2017.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
|
49
|
Haq J, Olding J, Chegini S, Huppa C, Bentley R, Fan K. Development of a financially viable model for the management of mandibular fractures as day cases in a level 1 major trauma centre. Br J Oral Maxillofac Surg 2017; 55:618-622. [PMID: 28465038 DOI: 10.1016/j.bjoms.2017.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 04/11/2017] [Indexed: 11/27/2022]
Abstract
There is a subgroup of patients with mandibular fractures who could safely and effectively be managed in an outpatient day-care unit. Suitability depends on medical, social, and operative factors, and identification of the correct criteria will govern management after that in the emergency department. Reduced use of beds would lead to less money being spent on emergency treatment, and increased capacity for elective surgery. The aims of this study were to identify a group of patients with mandibular fractures whose duration of operation and period of recovery would be suitable for treatment in the day-care unit, and to evaluate the potential financial benefits. Inpatients were assessed for day surgery using medical, social, and surgical criteria. Each patient's suitability for discharge was assessed two, three, and five hours postoperatively. A financial feasibility study was made retrospectively on a larger sample of patients with mandibular fractures. The discharge criteria from the day-care unit were fully met by 26/40 patients at five hours postoperatively, mean (range) duration of operation was 145 (40-285) minutes, and mean (SD) Mandibular Injury Severity Score was 13 (3), range 7-20. When all the criteria were combined (n=100), 12 of the patients were suitable for day care. With 24 bed-day savings/100 patients, potential earnings would increase to around £80 000/year at this hospital. In conclusion, we have identified a group of patients who were suitable for management of mandibular fractures in the day-care unit. Considerable cost savings are anticipated.
Collapse
Affiliation(s)
- J Haq
- Dept. of Oral & Maxillofacial Surgery, King's College Hospital, Denmark Hill, London. SE5 9RS.
| | - J Olding
- Dept. of Oral & Maxillofacial Surgery, King's College Hospital, Denmark Hill, London. SE5 9RS.
| | - S Chegini
- Dept. of Oral & Maxillofacial Surgery, King's College Hospital, Denmark Hill, London. SE5 9RS.
| | - C Huppa
- Dept. of Oral & Maxillofacial Surgery, King's College Hospital, Denmark Hill, London. SE5 9RS.
| | - R Bentley
- Dept. of Oral & Maxillofacial Surgery, King's College Hospital, Denmark Hill, London. SE5 9RS.
| | - K Fan
- Dept. of Oral & Maxillofacial Surgery, King's College Hospital, Denmark Hill, London. SE5 9RS.
| |
Collapse
|
50
|
Liu GY, Bian S, Li F, Li XF, Fan K, An HZ, Jia XX. [Effect of allogenic mesenchymal stem cells transplantation on the expression of interleukin-22 and matrix metalloproteinase-3 in rats with collagen induced arthritis]. Zhonghua Yi Xue Za Zhi 2017; 97:698-702. [PMID: 28297833 DOI: 10.3760/cma.j.issn.0376-2491.2017.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the effect of allogeneic bone marrow mesenchymal stem cells transplantation on the expression of interleukin -22 (IL-22), matrix metalloproteinase -3 (MMP-3) in serum and synovial of rats with collagen induced arthritis. Methods: Type Ⅱ collagen were injected twice to establish the collagen induced arthritis (CIA) rat model. Forty-eight rats were randomly divided into 3 groups: control group, CIA control group, CIA experiment group. Rat bone marrow mesenchymal stem cells were cultured by bone marrow method combined with adherent culture method. After identify, the remaining cells were injected in the CIA experimental group. Enzyme linked immunosorbent assay (ELISA) and immunohistochemistry were used to detect the expression of IL-22 and MMP-3 in serum and anklebone joint's synovium of rats, respectively. Synovial cells were isolated and cultured, and were treated with different concentrations of IL-22. MMP-3 protein and mRNA were detected before and after stimulation by Western blot and real-time quantitative polymerase chain reaction (RT-qPCR). Results: After MSC transplantation, arthritis index, X-ray, HE staining of CIA rat showed that joint damage significantly reduced compared with the control group. The ELISA results showed that the expression of MMP-3 and IL-22 in CIA control group was higher than those in the control group (125.79±9.12 vs 102.00±7.63 ng/ml, P<0.05), (292.35±31.23 vs 257.27±13.99 ng/ml, P<0.05) and CIA experiment group (125.79±9.12 vs 97.94±9.50 ng/ml, P<0.05), (292.35±31.23 vs 262.16±22.02 ng/ml, P<0.05) with statistically significant difference (P<0.05). There was no significant difference between the control group and CIA experimental group. Immunohistochemical showed similar results with ELISA. Western blotting and RT-qPCR showed that MMP-3 protein and mRNA expression was increased after IL-22 stimulation in a dose-dependent manner. Conclusion: IL-22 and MMP-3 play an important role in the pathogenesis of rheumatoid arthritis. IL-22 could regulate the expression of MMP-3, and bone marrow mesenchymal stem cells could reduce the expression of MMP-3 in the treatment of rheumatoid arthritis by reducing the expression of IL-22.
Collapse
Affiliation(s)
- G Y Liu
- Department of Rheumatism, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | | | | | | | | | | | | |
Collapse
|