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Nakagawa HF, Mitchell K, Sussman WI. Rare Cause of Locked Pinky in a Golfer: A Clinical Vignette. Am J Phys Med Rehabil 2024; 103:e40-e42. [PMID: 37816187 DOI: 10.1097/phm.0000000000002346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Affiliation(s)
- Hirotaka F Nakagawa
- From the Department of Orthopedics and Rehabilitation, Tufts Medical Center, Boston, Massachusetts (HFN, WIS); and Boston Sports & Biologics, Wellesley Hills, Massachusetts (KM, WIS)
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Wenner B, Park T, Mitchell K, Kvidera S, Griswold K, Horst E, Baumgard L. Effect of zinc source (zinc sulfate or zinc hydroxychloride) on relative abundance of fecal Treponema spp. in lactating dairy cows. JDS Communications 2022; 3:334-338. [PMID: 36340900 PMCID: PMC9623701 DOI: 10.3168/jdsc.2022-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 11/29/2022]
Abstract
Cows (n = 24) were fed typical lactating diets that only differed in zinc source inclusion. Fecal samples collected from cows were extracted for prokaryotic 16S gene DNA. Feeding zinc hydroxychloride decreased the Treponema spp. recovered from fecal samples compared with cows fed zinc sulfate.
Previous research revealed a potential effect of dietary trace mineral source on both ruminal and fecal microbiota. However, the effect of Zn source, specifically, has not previously been considered. Based on reported postruminal solubility, we hypothesized that Zn hydroxychloride would decrease Treponema spp. fecal excretion relative to cows fed Zn sulfate. To test this hypothesis, lactating Holstein cows (n = 24; 685 ± 9 kg of body weight; 159 ± 8 d in milk; parity 3 ± 0.2) were randomly assigned to 1 of 2 dietary treatments: control (75 mg/kg Zn from ZnSO4) or Zn hydroxychloride (HYD; 75 mg/kg IntelliBond Z; Micronutrients USA LLC). Single fecal grab samples were collected on d 1 before dietary treatments and on d 27 after dietary treatments were applied. Fecal microbial DNA was extracted and sequenced to establish taxonomy using a universal primer for the 16S rRNA gene. Supplementation of HYD decreased the relative abundance of Treponema 2 by 3-fold (14.7% vs. 4.9%). Poor sequencing resolution at the species level limited inference of Treponema spp. toward management or gut health implications of HYD supplementation. However, the inclusion of pathogenic species among Treponema spp. indicates a potential implication of HYD feeding to reduce environmental exposure of the dairy cow to Treponema spp.
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Affiliation(s)
- B.A. Wenner
- Department of Animal Sciences, The Ohio State University, Columbus 43210
- Corresponding author
| | - T. Park
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Gyeonggi-do, Korea
| | - K. Mitchell
- Department of Animal Sciences, The Ohio State University, Columbus 43210
| | | | | | - E.A. Horst
- Department of Animal Science, Iowa State University, Ames 50011
| | - L.H. Baumgard
- Department of Animal Science, Iowa State University, Ames 50011
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Prashar A, Mitchell K, Sader M. 547 Same Day Discharge Following Percutaneous Closure of Structural Heart Conditions: A Novel and Safe Approach for Patient Management. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.554] [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: 10/23/2022]
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4
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Mitchell K, Lima AT, Van Cappellen P. Selenium in buoyant marine debris biofilm. Mar Pollut Bull 2019; 149:110562. [PMID: 31542601 DOI: 10.1016/j.marpolbul.2019.110562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/31/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
Marine debris is widespread in all the world's oceans. Currently little is understood about how marine debris affects the chemistry of the surface oceans, particularly trace elements that can adsorb to the surface of marine debris, especially plastic debris, or be taken up by biofilms and algae growing on the surface of marine debris. Selenium (Se) is a micronutrient that is essential to all living organisms. Average seawater Se concentrations in the modern ocean are <1 nM. Here we measure the concentration of Se in surface water and one deep water sample and the concentration of Se found in algae/biofilms growing on the surface of macro-debris collected in October of 2012. Concentrations of Se in biofilm varied more according to the type of biofilm rather than the type of plastic. However, further Se measurements are needed for more conclusive results.
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Affiliation(s)
- Kristen Mitchell
- Ecohydrology Research Group, Department of Earth and Environmental Sciences and Water Institute, University of Waterloo, Waterloo, Canada.
| | - Ana Teresa Lima
- Ecohydrology Research Group, Department of Earth and Environmental Sciences and Water Institute, University of Waterloo, Waterloo, Canada; Programa de Pós-Graduação Oceanografia Ambiental, Department of Oceanography, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Philippe Van Cappellen
- Ecohydrology Research Group, Department of Earth and Environmental Sciences and Water Institute, University of Waterloo, Waterloo, Canada
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Skaria T, Mitchell K, Fischer JA, Born W, Gassmann M, Vogel J. P4475Vasodilation- and blood pressure normalization-independent cardioprotective effects of endogenous, physical activity-induced alpha calcitonin gene-related peptide in chronic hypertension. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Alpha calcitonin gene-related peptide (αCGRP) is one of the strongest vasodilators and, as such, is cardioprotective in chronic hypertension when reducing the associated elevated blood pressure. However, we hypothesize that endogenous, physical activity-induced αCGRP has blood pressure independent cardioprotective effects in chronic hypertension.
Methods
Chronic hypertension was induced in WT and αCGRP−/− mice by one-kidney one-clip surgery. Chronic hypertensive WT and αCGRP−/− mice lived sedentarily or performed voluntary wheel running and were treated simultaneously with either vehicle, αCGRP or αCGRP receptor antagonist CGRP8–37. Cardiac function and tissue phenotype were evaluated echocardiographically and by ddPCR, Western blotting and histology, respectively.
Results
Blood pressure was similar among all hypertensive experimental groups. Endogenous αCGRP limited pathological cardiac remodeling and symptomatic heart failure already in sedentary, chronic hypertensive WT mice. In these mice, voluntary wheel running significantly improved cardiac tissue phenotype and function, that was abolished by CGRP8–37 treatment. In αCGRP−/− mice, αCGRP treatment, in contrast to voluntary wheel running, improved cardiac tissue phenotype and function. Specific inhibition of proliferation and myofibroblast differentiation of primary murine cardiac fibroblasts by αCGRP suggests involvement of these cells in αCGRP-mediated blunting of pathological cardiac remodeling.
Conclusion
Endogenous, physical activity-induced αCGRP has blood pressure independent cardioprotective effects and is crucial for maintaining cardiac function in chronic hypertension. Consequently, permanently inhibiting endogenous αCGRP signaling, as currently approved for migraine prophylaxis, could endanger hypertensive patients.
Acknowledgement/Funding
Swiss National Science Foundation, Novartis Foundation for Medical-biological Research
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Affiliation(s)
- T Skaria
- University of Zurich, Institute of Veterinary Physiology and Zurich Center for Integrative Human Physiology, Zurich, Switzerland
| | - K Mitchell
- University of Zurich, Clinic for Equine Internal Medicine, Zurich, Switzerland
| | - J A Fischer
- University Hospital Zurich, Former Research Laboratory for Calcium Metabolism, Zurich, Switzerland
| | - W Born
- University Hospital Zurich, Former Research Laboratory for Calcium Metabolism, Zurich, Switzerland
| | - M Gassmann
- University of Zurich, Institute of Veterinary Physiology and Zurich Center for Integrative Human Physiology, Zurich, Switzerland
| | - J Vogel
- University of Zurich, Institute of Veterinary Physiology and Zurich Center for Integrative Human Physiology, Zurich, Switzerland
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Sepesi B, Godoy M, William W, Vaporciyan A, Lin H, Leung C, Lee J, Mitchell K, Weissferdt A, Le X, Lam V, Fossella F, Swisher S, Heymach J, Cascone T. P2.04-90 Nodal Immune Flare (NIF) Following Neoadjuvant Anti-PD-1 and Anti-CTLA-4 Therapy in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Gaudreau P, Ajami N, Sepesi B, Karpinets T, Reuben A, Wong M, Parra E, Federico L, Gopalakrishnan V, Mitchell K, Negrao M, Spencer C, Vaporciyan A, Weissferdt A, Haymaker C, Tran H, Bernatchez C, Landry L, Roarty E, Cascone T, Heymach J, Zhang J, Wistuba I, Zhang J, Wargo J, Gibbons D. P1.04-11 Depicting the Intra-Tumoral Viral and Microbial Landscape of Localized NSCLC Using Standard Next Generation Sequencing Data. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Safran H, Breakstone R, Charpentier K, Vatkevich J, Marks EI, Cavanagh L, Mitchell K, Renaud J, Beard R, Rosati K. Toxicity of FOLFOX-abraxane (FOLFOX-A) on phase II Brown University Oncology Group (BrUOG) trials. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.354] [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: 11/20/2022] Open
Abstract
354 Background: FOLFIRINOX increases survival in pancreatic cancer. The Brown University Oncology Group developed the FOLFOX-A regimen in a phase I study. (Am J Clin Oncol, 2016). We subsequently opened phase II studies of FOLFOX-A in patients with metastatic pancreatic cancer (BrUOG 292), locally advanced/borderline pancreatic cancer (BrUOG 318) and adjuvant disease following resection (BrUOG 295). The BrUOG Data Safety Monitoring Committee met on May 22, 2018. Toxicity of FOLFOX-A reviewed at the May meeting aligned with data lock in April on phase II FOLFOX-A studies and is summarized. Methods: Patients received oxaliplatin, 85mg/m2 day 1, nab-paclitaxel, 150mg/m2 and leucovorin 400mg/m2 day 1 and fluorouracil 2400mg/m2 by continuous IV infusion over 46 hours. Myeloid growth factor support was optional. Cycles were repeated every 14 days for up to 10-12 cycles. Oxaliplatin was dose reduced to 68mg/m2 for grade 2 neurotoxicity. CTCAE version 4 toxicity scales were utilized. Results: A total of 81 patients were accrued, (22 adjuvant, 36 metastatic, 23 locally advanced disease). Cumulative fatigue was the most common toxicity and required dose reduction in 50% of patients. The incidences of grade 2, 3 and 4 neutropenia were 26%, 17% and 6%, respectively. Grade 2,3 and 4 diarrhea were 9%, 15% and 0%. The rates of grade 2,3 and 4 neuropathy were 29%, 2% and 0%. Conclusions: FOLFOX-A is well tolerated with low incidences of grade 3 neuropathy and gastrointestinal toxicity. Toxicities were less frequent in patients treated in the adjuvant setting. Clinical trial information: NCT02080221, NCT02022033, NCT02578732.
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Affiliation(s)
- Howard Safran
- Brown University Oncology Research Group, Providence, RI
| | | | | | | | | | | | | | - Jen Renaud
- Lifespan Cancer Institute, Providence, RI
| | - Rachel Beard
- Brown University Oncology Research Group, Providence, RI
| | - Kayla Rosati
- Brown University Oncology Research Group, Providence, RI
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Toulabi L, Grant C, Zingone A, Mitchell K. P2.03-21 Mechanistic Investigation of DRD1 in Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1208] [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]
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10
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Mitchell K, Webster J, Tuson C, Burton C, Sutton P, Dunn R, Chandrajay D, Narayanan D, Mansfield M, Barth J, Bandyopadhyay A, Haralambos K, Power B, Jessop J. Setting up a regional fh service; a summary of the achievements and challenges. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.07.039] [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: 11/26/2022]
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11
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Chen H, Meiers J, Wang-Hsu E, Mitchell K, Smith S. Development and validation of a conceptually novel performance-based balance scale in community-living older adults. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.791] [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: 11/26/2022]
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12
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Khan H, Mitchell K. Drilling holes for locking screws in challenging anatomy. Ann R Coll Surg Engl 2018; 101:69. [PMID: 29909674 DOI: 10.1308/rcsann.2018.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- H Khan
- Auckland City Hospital , New Zealand
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13
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Farrawell NE, Lambert-Smith I, Mitchell K, McKenna J, McAlary L, Ciryam P, Vine KL, Saunders DN, Yerbury JJ. SOD1 A4V aggregation alters ubiquitin homeostasis in a cell model of ALS. J Cell Sci 2018; 131:jcs.209122. [PMID: 29748379 DOI: 10.1242/jcs.209122] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 07/31/2017] [Accepted: 05/01/2018] [Indexed: 12/11/2022] Open
Abstract
A hallmark of amyotrophic lateral sclerosis (ALS) pathology is the accumulation of ubiquitylated protein inclusions within motor neurons. Recent studies suggest the sequestration of ubiquitin (Ub) into inclusions reduces the availability of free Ub, which is essential for cellular function and survival. However, the dynamics of the Ub landscape in ALS have not yet been described. Here, we show that Ub homeostasis is altered in a cell model of ALS induced by expressing mutant SOD1 (SOD1A4V). By monitoring the distribution of Ub in cells expressing SOD1A4V, we show that Ub is present at the earliest stages of SOD1A4V aggregation, and that cells containing SOD1A4V aggregates have greater ubiquitin-proteasome system (UPS) dysfunction. Furthermore, SOD1A4V aggregation is associated with the redistribution of Ub and depletion of the free Ub pool. Ubiquitomics analysis indicates that expression of SOD1A4V is associated with a shift of Ub to a pool of supersaturated proteins, including those associated with oxidative phosphorylation and metabolism, corresponding with altered mitochondrial morphology and function. Taken together, these results suggest that misfolded SOD1 contributes to UPS dysfunction and that Ub homeostasis is an important target for monitoring pathological changes in ALS.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Natalie E Farrawell
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 2522.,Molecular Horizons and School of Chemistry & Molecular Bioscience, University of Wollongong, NSW, Australia 2522
| | - Isabella Lambert-Smith
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 2522.,Molecular Horizons and School of Chemistry & Molecular Bioscience, University of Wollongong, NSW, Australia 2522
| | - Kristen Mitchell
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 2522.,Molecular Horizons and School of Chemistry & Molecular Bioscience, University of Wollongong, NSW, Australia 2522
| | - Jessie McKenna
- School of Medical Sciences, Faculty of Medicine, UNSW Australia 2052
| | - Luke McAlary
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 2522.,Molecular Horizons and School of Chemistry & Molecular Bioscience, University of Wollongong, NSW, Australia 2522.,Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada V6T 2B5
| | - Prajwal Ciryam
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK.,Department of Molecular Biosciences, Rice Institute for Biomedical Research, Northwestern University, Evanston, IL 60208-3500, USA.,Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY 10032-3784, USA
| | - Kara L Vine
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 2522.,Molecular Horizons and School of Chemistry & Molecular Bioscience, University of Wollongong, NSW, Australia 2522
| | - Darren N Saunders
- School of Medical Sciences, Faculty of Medicine, UNSW Australia 2052
| | - Justin J Yerbury
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia 2522 .,Molecular Horizons and School of Chemistry & Molecular Bioscience, University of Wollongong, NSW, Australia 2522
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Constantinou M, Vezeridis MP, Weinstock MA, Walker J, Miner TJ, Barth P, Rosati K, Mitchell K, Dionson S, Turchetti W, Vatkevich J, Rafelson WM, Mantripragada KC, Safran H. BrUOG 324: Adjuvant nivolumab and low-dose ipilimumab for stage IIC, III, and resected stage IV melanoma: A phase II Brown University Oncology Research Group trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.tps202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS202 Background: Adjuvant ipilimumab improves survival in stage III melanoma. Adjuvant nivolumab improves progression-free survival as compared to ipilimumab with reduced toxicity. Checkpoint 067 showed that the combination of ipilimumab and nivolumab is more active in advanced melanoma than either agent alone. The Brown University Oncology Research Group sought to evaluate dual checkpoint inhibition in the adjuvant setting. This may be particularly beneficial to patients with melanoma with low PD-L1 expression. To balance safety and efficacy, the combination of low dose ipilimumab and standard dose nivolumab was investigated. Methods: Patients with stage IIc, III and resected stage IV disease are eligible. No prior treatment for melanoma other than surgery or radiation was allowed. All patients received nivolumab 3mg/kg (maximum 240 mg) every 2 weeks and ipilimumab 1mg/kg every 6 weeks for 6 months. The primary goal is to determine the toxicity of adjuvant ipilimumab and nivolumab in patients with melanoma. Unacceptable toxicity has been defined as the development of grade 4 hematologic toxicity (neutropenia or thrombocytopenia), any transient grade ≥3 or persistent grade 2 treatment-related non-hematologic toxicity that prevents completion of the planned 6 month course of treatment in more than 35% of the enrolled patients; thus, if such events occur in 10 or more patients out of 25 evaluable patients, the study will have exceeded the limit for unacceptable adverse events. Secondary objectives are to determine the recurrence-free and overall survival. Results: Between August 2016 and August 2017, 17 patients have been enrolled, 11 male and 6 female. Median age is 59 (range 25-84). Twelve patients were Stage III disease, 2 patients were stage IIC and 3 were stage IV. Conclusions: BrUOG 324 represents one of the first trials investigating adjuvant dual checkpoint inhibition in melanoma. Preliminary safety and efficacy are being assessed. Acknowledgements: This study was supported in part by the Washington Trust Company and LIFEcycle Clinical trial information: NCT02656.
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Safran H, Charpentier K, Mantripragada KC, Breakstone R, Miner TJ, DiPetrillo TA, Marks EI, Rosati K, Mitchell K, Rossiter R, Luppe D, Rago M, Schumacher A, Cavanagh L. Adjuvant FOLFOX-Nab-paclitaxel (FOLFOX-A) for pancreatic cancer: A phase II Brown University Oncology Research Group (BrUOG) trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.tps550] [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: 11/20/2022] Open
Abstract
TPS550 Background: The FOLFOX-A regimen was developed by BrUOG, in response to the activity of nab-paclitaxel (nP) in metastatic pancreatic cancer (mPC), by substituting nP for irinotecan in FOLFIRINOX. In a phase I/II study of FOLFOX-A in mPC, median overall survival (OS) was 15 months (Safran H, et al. Am J Clin Oncol, 2016 Dec;39(6):619-622), which motivated evaluation of the tolerability and efficacy of this aggressive regimen in the adjuvant setting. Therefore, a phase II study of FOLFOX-A was initiated for patients with resected pancreatic cancer. Methods: Eligibility criteria included potentially curative resection of pancreatic adenocarcinoma (positive margins allowed if all gross tumor was removed), pathologic stages T1-3/N0-1/M0, interval between surgery and registration of 21-70 days and post resection serum CA19-9 ≤ 180 units/mL. All patients received nab-paclitaxel 150mg/m2, oxaliplatin 85mg/m2 and leucovorin 400mg/m2, followed by fluorouracil 2400mg/m2 infused over 46 hours. Cycles were repeated every 2 weeks. The primary objective is to assess the feasibility of administering at least 10 of 12 planned cycles of FOLFOX-A without unacceptable toxicity in 25 patients. Secondary endpoints include progression-free survival and OS. Results: Between June 2014-August 2017, 19 patients have been enrolled, 8 male and 11 female. Median age is 63 (43-68). Fifteen patients had positive lymph nodes on pathology with stages T1N0(n = 2), T3N0(n = 2), T1N1(n = 1), T3N1(n = 14) [AJCC Cancer Staging Manual, 7th Edition (2010)]. Conclusions: This study is testing the tolerability of administering adjuvant FOLFOX-A to patients with resected pancreatic cancer. Accrual is expected to be complete by January 2018. Clinical trial information: NCT02022033.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Molly Rago
- Brown University Oncology Group, Providence, RI
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17
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Windrim CM, Crosby DA, Mitchell K, Brophy C, Mahony R, Higgins M. Vitamin D supplementation in pregnancy-a survey of compliance with recommendations. Ir J Med Sci 2017; 187:709-712. [PMID: 29159790 DOI: 10.1007/s11845-017-1707-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/23/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Vitamin D deficiency in pregnancy has important maternal and fetal implications, with increased risk of developing gestational diabetes, preeclampsia, preterm birth and small for gestational age birthweight. It is recommended that every pregnant woman should take 5 μg (200 IU) of vitamin D per day during pregnancy and lactation. AIMS This study aimed to determine the prevalence of women taking vitamin D supplementation and to identify the reasons for patients not taking supplementation within women attending an antenatal clinic in Dublin. METHODS Survey of women attending the antenatal clinic of the National Maternity Hospital Dublin during 2 weeks in January 2017. Women were asked to record demographics, medical comorbidities and use of vitamin D supplementation or any other supplements in pregnancy, as well as reasons for non-use if appropriate. RESULTS Three hundred women were invited to participate and 175 completed the questionnaire (58%). Overall, 38.9% (n = 68) reported to be taking vitamin D supplementation. Of the women that reported not to be taking vitamin D supplementation, 57.9% (n = 62) were taking a pregnancy multivitamin that contained vitamin D, and 28.0% (n = 30) did not know that it was recommended in pregnancy. Therefore, a total of 45 women (25.7%) in our cohort were taking no vitamin D supplementation during pregnancy. There was no difference in non-use based on maternal age, BMI, parity, or country of origin. CONCLUSIONS Of the women surveyed, 74.3% reported supplementation with vitamin D, either knowingly or unknowingly. Public health initiatives need to utilize this relatively safe, low-cost intervention to maximize maternal and fetal health. This could reduce the rates of antenatal conditions with associated high morbidity and healthcare burden such as gestational diabetes and preeclampsia.
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Affiliation(s)
- C M Windrim
- Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin, Holles St, Dublin 2, Ireland
| | - D A Crosby
- Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin, Holles St, Dublin 2, Ireland
| | - K Mitchell
- National Maternity Hospital, Dublin, Ireland
| | - C Brophy
- Midwifery, National Maternity Hospital, Dublin, Ireland
| | - R Mahony
- Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin, Holles St, Dublin 2, Ireland
| | - M Higgins
- Obstetrics and Gynaecology, National Maternity Hospital, University College Dublin, Holles St, Dublin 2, Ireland.
- UCD Perinatal Research Center, National Maternity Hospital, University College Dublin, Dublin, Ireland.
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Chen H, Wang-Hsu E, Meiers J, Mitchell K, Smith S. A CONCEPTUALLY NOVEL PERFORMANCE-BASED BALANCE SCALE FOR USE WITH COMMUNITY-LIVING OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H. Chen
- Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania,
| | | | - J. Meiers
- Penn Care at Home, Philadelphia, Pennsylvania
| | - K. Mitchell
- Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania,
| | - S.S. Smith
- Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania,
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Kaupp G, Mitchell K. Ultrasound diagnosis of a diaphragmatic hernia in a 23-year-old Hanoverian gelding. SCHWEIZ ARCH TIERH 2017; 159:301-304. [PMID: 28475485 DOI: 10.17236/sat00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- G Kaupp
- Equine Department, Vetsuisse Faculty, University of Zurich
| | - K Mitchell
- Equine Department, Vetsuisse Faculty, University of Zurich
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20
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Broux B, De Clercq D, Decloedt A, Ven S, Vera L, van Steenkiste G, Mitchell K, Schwarzwald C, van Loon G. Heart rate variability parameters in horses distinguish atrial fibrillation from sinus rhythm before and after successful electrical cardioversion. Equine Vet J 2017; 49:723-728. [DOI: 10.1111/evj.12684] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/14/2017] [Indexed: 12/22/2022]
Affiliation(s)
- B. Broux
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - D. De Clercq
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - A. Decloedt
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - S. Ven
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - L. Vera
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - G. van Steenkiste
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - K. Mitchell
- Equine Clinic; University of Zurich; Zurich Switzerland
| | | | - G. van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
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Mitchell K. What are cancer advanced nurse practitioners’ perceptions and experiences of introducing Holistic Needs Assessment (HNA) into clinical practice to address individual cancer patient’s needs? Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pellegrini G, Seebeck P, Marowsky A, Mitchell K, Schwarzwald C, Kipar A. Cardiovascular Histopathological Changes Associated with Chronically-Implanted Blood Pressure Telemetry Devices in Mice. J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mitchell K, Weaver J, Becker K, Watson E, Ford S, Montgomery J, Giddins M, Vincent-Pennisi C, Alderson S. Identifying Complications in Outpatients Post Elective Angiography and Angioplasty. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.641] [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: 10/19/2022]
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Abstract
INTRODUCTION This report describes 2 sheep with enzootic calcinosis characterized by abnormal cardiovascular and respiratory findings and ascites causing abdominal distension. Both sheep were anorexic and listless and had increased heart and respiratory rates. Auscultation of the heart revealed a gallop rhythm in sheep 1 and a loud systolic heart murmur in sheep 2. The activities of liver enzymes were severely increased in both sheep. Abdominal ultrasonography showed severe ascites and congestion of the liver and caudal vena cava. Echocardiography in sheep 2 showed hyperechoic and markedly thickened mitral and aortic valves with moderate-severe mitral insufficiency and generalized cardiomegaly. Both sheep were euthanized and examined postmortem. In addition to ascites and pleural effusion, the principal lesions were nodular thickening of the heart valves and calcification of the aorta and other arteries. Nutrition of the sheep did not include hay pellets, but the sheep were kept together with alpacas and lamas and had access to the hay pellets of these animals. In addition visitors were allowed to feed the sheep with hay pellets offered by the zoo in a dispenser. The two types of hay pellets had Vit D concentrations of 9'900 IU VitD3/kg and 7'000 IU Vit D2/kg, respectively. The definitive diagnosis was enzootic calcinosis.
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Affiliation(s)
- U Braun
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - K Mitchell
- Equine Clinic, Vetsuisse Faculty, University of Zurich
| | - S Schramm
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - S Nogler
- Department of Farm Animals, Vetsuisse Faculty, University of Zurich
| | - J Hatt
- Clinic for Zoo Animals, Exotic Pets and Wildlife, Vetsuisse Faculty, University of Zurich
| | - A Malbon
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich
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Mitchell K. A critical exploration of challenges relating to newly qualified physiotherapists. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Theadom A, Mitchell K, Roxburgh R, Rodrigues M, Taylor T, Baker R, Jones K, Stewart J, Poke G, Hammond-Tooke G, O'Grady G, Love D, Ranta A, Ao BT, Parmar P, Vandal A, Krishnamurthi R, Brown P, Feigin V. Unmet needs of people living with myotonic dystrophy: Data from a national, population-based study. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.395] [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: 10/21/2022]
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Bazzo S, Black D, Mitchell K, Marini F, Moino G, Riscica P, Fattori G. 'Too Young To Drink'. An international communication campaign to raise public awareness of fetal alcohol spectrum disorders. Public Health 2016; 142:111-115. [PMID: 27600792 DOI: 10.1016/j.puhe.2016.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 08/03/2016] [Accepted: 08/05/2016] [Indexed: 11/25/2022]
Affiliation(s)
- S Bazzo
- European FASD Alliance, Landskrona, Sweden.
| | - D Black
- European FASD Alliance, Landskrona, Sweden
| | - K Mitchell
- National Organization on Fetal Alcohol Syndrome, Washington, DC, USA
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Hsu CH, Brown CM, Murphy JM, Haskell MG, Williams C, Feldman K, Mitchell K, Blanton JD, Petersen BW, Wallace RM. Perceptions and Practices of Mass Bat Exposure Events in the Setting of Rabies Among U.S. Public Health Agencies. Zoonoses Public Health 2016; 64:127-136. [PMID: 27389926 PMCID: PMC5525325 DOI: 10.1111/zph.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Indexed: 12/25/2022]
Abstract
Current guidelines in the setting of exposures to potentially rabid bats established by the Advisory Committee on Immunization Practices (ACIP) address post-exposure prophylaxis (PEP) administration in situations where a person may not be aware that a bite or direct contact has occurred and the bat is not available for diagnostic testing. These include instances when a bat is discovered in a room where a person awakens from sleep, is a child without an adult witness, has a mental disability or is intoxicated. The current ACIP guidelines, however, do not address PEP in the setting of multiple persons exposed to a bat or a bat colony, otherwise known as mass bat exposure (MBE) events. Due to a dearth of recommendations for response to these events, the reported reactions by public health agencies have varied widely. To address this perceived limitation, a survey of 45 state public health agencies was conducted to characterize prior experiences with MBE and practices to mitigate the public health risks. In general, most states (69% of the respondents) felt current ACIP guidelines were unclear in MBE scenarios. Thirty-three of the 45 states reported prior experience with MBE, receiving an average of 16.9 MBE calls per year and an investment of 106.7 person-hours annually on MBE investigations. PEP criteria, investigation methods and the experts recruited in MBE investigations varied between states. These dissimilarities could reflect differences in experience, scenario and resources. The lack of consistency in state responses to potential mass exposures to a highly fatal disease along with the large contingent of states dissatisfied with current ACIP guidance warrants the development of national guidelines in MBE settings.
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Affiliation(s)
- C H Hsu
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA.,Epidemic Intelligence Service, Atlanta, GA, USA
| | - C M Brown
- Massachusetts Department of Public Health State Laboratory Institute, Jamaica Plain, MA, USA
| | - J M Murphy
- Virginia Department of Health, Office of Epidemiology, Richmond, VA, USA
| | - M G Haskell
- Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - C Williams
- Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - K Feldman
- Center for Zoonotic and Vector-borne Diseases, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA
| | - K Mitchell
- Center for Zoonotic and Vector-borne Diseases, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA
| | - J D Blanton
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA
| | - B W Petersen
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA
| | - R M Wallace
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA
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Costantino S, Bonzanni M, Legchenko E, Paneni F, Mitchell K, Berrino L, Schwarzwald C, Volpe M, Luscher TF, Cosentino F, Napoli A, Landi S, Bucchi A, Vernillo G, Baruscotti M, La Torre A, Difrancesco D, Barbuti A, Kueffner R, Hansmann G. Epigenetics in Cardiac Health and Disease225miR-218 and mi-R34a drive persistent myocardial oxidative stress by targeting chromatin remodelers DNMT3b and SIRT1: new mechanistic insights in diabetic cardiomyopathy226Effects of miRNAs modulated by endurance training on cardiomyocyte excitability227Differential transcriptome and microRNA expression signatures in the healthy heart (RV vs. LV) and the failing, pressure-overloaded right ventricle (SuHx model). Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jarvis P, Davies T, Mitchell K, Taylor I, Baker M. Does rapid assessment shorten the amount of time patients spend in the emergency department? Br J Hosp Med (Lond) 2015; 75:648-51. [PMID: 25383437 DOI: 10.12968/hmed.2014.75.11.648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Overcrowding in the emergency department is a common phenomenon. This study assessed the impact of introducing a consultant-supported rapid assessment model, known as EDIT, and point of care testing upon the length of time patients spend in the emergency department. METHODS A prospective, observational cohort study was conducted in an emergency department in a district general hospital in the UK. The study consisted of two phases. Patients who attended the emergency department during phase 1 were assessed using a nurse-led triage model with blood samples being analysed in a centralized hospital laboratory. Phase 2 patients were assessed by a consultant-supported rapid assessment model with blood tests being analysed using point of care testing. The time from patient arrival in the emergency department to the time that care was complete and the patient was ready to move on to the next destination of care was recorded. These times from the two phases were compared using the Wilcoxon rank sum test. RESULTS A total of 11 213 patients attended the emergency department during the whole study period, of whom 4622 patients were eligible for the study. Phase 1 contained 3835 patients and phase 2 had 787 patients. The median time for patients to be declared ready to leave the emergency department in phase 1 was 129 minutes compared to 76 minutes for phase 2 (P=0.0025). This was a reduction in the median of 53 minutes or 41.1% (95% confidence interval 39.7-42.3%). CONCLUSIONS This study demonstrates that a consultant-supported rapid assessment model using point of care testing significantly shortens the time patients spend in the emergency department.
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Affiliation(s)
- Pre Jarvis
- Consultant in Emergency Medicine, Calderdale & Huddersfield NHS Foundation Trust, Calderdale Royal Hospital, Halifax, West Yorkshire HX3 0PW
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Beail N, Mitchell K, Vlissides N, Jackson T. Concordance of the mini-Psychiatric Assessment Schedule for Adults who have Developmental Disabilities (PASADD) and the Brief Symptom Inventory. J Intellect Disabil Res 2015; 59:170-175. [PMID: 23889753 DOI: 10.1111/jir.12073] [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] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND When assessing the mental health needs of people who have intellectual disabilities (ID) it is important to use measures that have good validity and reliability to ensure accurate case recognition and reliable and valid outcome data. Measures developed for this purpose tend to be self-report or by informant report. Multi-trait screening tools developed to identify psychological and psychiatric disorders in people who have ID tend to be informant based. Research examining the concordance of different tools has found this to be high but not for specific diagnoses. Multi-trait self-report measures are fewer and have not been compared with informant approaches. This study aims to examine the concordance between two multi-trait measures of mental health used with people who have ID. One administered to informants [the Mini-Psychiatric Assessment Schedule for Adults who have Developmental Disabilities (PASADD)] and one self-report [Brief Symptom Inventory (BSI)] METHOD The measures were completed with 109 adults who have ID and with someone who knows them well. RESULTS Level of agreement across the four scales in common was good for three. The poorest convergence was for the obsessive compulsive disorder sub-scales. However, a high level of concordance was found between most sub-scales. CONCLUSION The BSI and the PASSAD seem to be good indicators of psychiatric problems and psychological distress; however, similar to other multi-trait measures they did not demonstrate appropriate specificity for particular disorders.
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Affiliation(s)
- N Beail
- Barnsley Adult Specialist Learning Disability Health Service, South West Yorkshire Partnership NHS Foundation Trust, The Keresforth Centre, Barnsley, UK; Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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Mitchell K, Yates J, Huk A, Burge J. Quantifying contributions of natural image variability to neural representations of speed in Area MT. J Vis 2014. [DOI: 10.1167/14.15.48] [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: 11/24/2022] Open
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Abstract
Background Classic teaching suggests that diminished availability of oxygen leads to increased tissue oxygen extraction yet evidence to support this notion in the context of hypoxaemia, as opposed to anaemia or cardiac failure, is limited. Methods At 75 m above sea level, and after 7–8 days of acclimatization to 4559 m, systemic oxygen extraction [C(a−v)O2] was calculated in five participants at rest and at peak exercise. Absolute [C(a−v)O2] was calculated by subtracting central venous oxygen content (CcvO2) from arterial oxygen content (CaO2) in blood sampled from central venous and peripheral arterial catheters, respectively. Oxygen uptake (V˙O2) was determined from expired gas analysis during exercise. Results Ascent to altitude resulted in significant hypoxaemia; median (range) SpO2 87.1 (82.5–90.7)% and PaO2 6.6 (5.7–6.8) kPa. While absolute C(a−v)O2 was reduced at maximum exercise at 4559 m [83.9 (67.5–120.9) ml litre−1vs 99.6 (88.0–151.3) ml litre−1 at 75 m, P=0.043], there was no change in oxygen extraction ratio (OER) [C(a−v)O2/CaO2] between the two altitudes [0.52 (0.48–0.71) at 4559 m and 0.53 (0.49–0.73) at 75 m, P=0.500]. Comparison of C(a−v)O2 at peak V˙O2 at 4559 m and the equivalent V˙O2 at sea level for each participant also revealed no significant difference [83.9 (67.5–120.9) ml litre1vs 81.2 (73.0–120.7) ml litre−1, respectively, P=0.225]. Conclusion In acclimatized individuals at 4559 m, there was a decline in maximum absolute C(a−v)O2 during exercise but no alteration in OER calculated using central venous oxygen measurements. This suggests that oxygen extraction may have become limited after exposure to 7–8 days of hypoxaemia.
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Affiliation(s)
- D S Martin
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK
| | - A Cobb
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK
| | - P Meale
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK
| | - K Mitchell
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Mailpoint 810, Sir Henry Wellcome Laboratories, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK Anaesthesia and Critical Care Research Unit, GICU, Mailpoint 27, Level D, Centre Block, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK NIHR Southampton Respiratory Biomedical Research Unit, Southampton, UK
| | - M Edsell
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK Department of Anaesthesia, St George's Hospital, London, UK
| | - M G Mythen
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK
| | - M P W Grocott
- UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, University College London Centre for Altitude Space and Extreme Environment Medicine, 170 Tottenham Court Road, London W1 T 7HA, UK Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Mailpoint 810, Sir Henry Wellcome Laboratories, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK Anaesthesia and Critical Care Research Unit, GICU, Mailpoint 27, Level D, Centre Block, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK NIHR Southampton Respiratory Biomedical Research Unit, Southampton, UK
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Johnson-Warrington V, Mitchell K, Singh S. P119 Is A Practice Incremental Shuttle Walk Test Needed For Patients With Chronic Obstructive Pulmonary Disease Admitted To Hospital For An Acute Exacerbation? Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Frazier J, Stein C, Tseytlin E, Mitchell K, Bekhuis T. Finding and visualizing information about potential prognostic biomarkers of oral squamous cell carcinoma: a pathology informatics study. Oral Surg Oral Med Oral Pathol Oral Radiol 2014. [DOI: 10.1016/j.oooo.2014.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jassam N, Mbagaya W, Kallner A, Hill R, Carless D, Barth JH, Delaney H, Lippiatt C, Shepherd J, Glover S, Slack S, Mitchell K, Strafen A, Bosomworth MP. Does creatinine analytical performance support robust identification of acute kidney injury within individual laboratories in a region. Clin Chem Lab Med 2014; 53:e63-5. [PMID: 25274945 DOI: 10.1515/cclm-2014-0785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 08/25/2014] [Indexed: 11/15/2022]
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Langford R, Brown I, Vickery J, Mitchell K, Pritchard C, Creanor S. Study protocol for a double blind, randomised, placebo-controlled trial of continuous subpectoral local anaesthetic infusion for pain and shoulder function following mastectomy: SUB-pectoral Local anaesthetic Infusion following MastEctomy (SUBLIME) study. BMJ Open 2014; 4:e006318. [PMID: 25270861 PMCID: PMC4179566 DOI: 10.1136/bmjopen-2014-006318] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Over 16 000 mastectomies are performed in England and Wales annually. Acute postoperative pain and nausea are common. The most frequently occurring long-term complications are chronic pain (up to 50%) and reduced shoulder function (reported at 35%). Regional techniques that improve acute postoperative pain relief may reduce the incidence of these complications. This study assesses the effectiveness of a 24-hour continuous local anaesthetic in the subpectoral plane in improving postoperative pain and quality of life in patients undergoing mastectomy. METHODS AND ANALYSIS This is a randomised, double blind, placebo-controlled, two-centre, parallel group trial in women undergoing mastectomy with or without axillary involvement. One hundred and sixty participants will be randomised in a 1:1 ratio to receive either 0.25% levobupivacaine or 0.9% saline by subpectoral infusion postoperatively for 24 h. All participants will be provided with an intravenous morphine patient-controlled analgesia (PCA) system. Participants will be followed-up for 24 h in hospital and at approximately 14 days and 6 months postoperatively. Joint primary outcome measures are total morphine consumption and total pain score (captured via patient-recorded visual analogue scale (VAS) 4 hourly) during the first 24 h postoperatively. Primary statistical analysis of total pain is based on the area under the curve of pain versus time graph. Secondary outcomes include PCA attempts in first 24 h; VAS pain scores and shoulder function by goniometry at 24 h, 14 days (approximately) and 6 months; Verbal Rating Scale pain scores in first 24 h; Brief Pain Inventory and Oxford Shoulder Score at 6 months; duration of hospital stay; incidence of postoperative nausea and vomiting; cost-effectiveness. ETHICS AND DISSEMINATION The study is approved by the South West England Research Ethics Committee (12/SW/0149). RESULTS will be published in a peer-reviewed journal and presented at local, national and international scientific meetings. TRIAL REGISTRATION ISRCTN46621916. EudraCT 2011-005775-16.
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Affiliation(s)
- R Langford
- Department of Anaesthesia, Royal Cornwall Hospital, Truro, UK
| | - I Brown
- Department of Surgery, Royal Cornwall Hospital, Truro, UK
| | - J Vickery
- Peninsula Clinical Trials Unit, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - K Mitchell
- Department of Anaesthesia, Royal Cornwall Hospital, Truro, UK
| | - C Pritchard
- NIHR Research Design Service (South West), Truro, UK
| | - S Creanor
- Centre for Biostatistics, Bioinformatics & Biomarkers, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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Avolio E, Mangialardi G, Riu F, Katare R, Mitchell K, Dang Z, Spencer H, Meloni M, Beltrami AP, Madeddu P. P593Human vascular pericytes and cardiac progenitor cells combined transplantation for heart repair. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu098.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fowler J, Mitchell K, Bukhari M. SAT0472 The Effect of Aromatase Inhibitors on Different Sites of the Human Skeleton – an Observational Case-Control Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND Studies have demonstrated the beneficial effect of normal and high body mass index (BMI) upon risk of osteoporosis (OP). No study has investigated the prevalence of OP in an older population with a very high BMI (higher than 40 kg/m(2) ). METHODS Data of patients aged over 50 years that attended for a dual energy X-ray absorptiometry scan at a UK district general hospital were collated. The population was divided according to BMI increments of 5 kg/m(2) . The prevalence of OP for each BMI category was ascertained. Logistic regression analysis was used to investigate for significant associations between BMI and OP prevalence, adjusted for age, sex and number of OP risk factors. RESULTS Data of 10,796 study subjects were collated. Mean age was 67.34 years. Decreasing prevalence of OP was associated with increasing BMI up to 40 kg/m(2) , above which increasing BMI was associated with increasing prevalence of OP. CONCLUSIONS The protective effect of increasing BMI exists up to 40 kg/m(2) . A BMI higher than 40 kg/m(2) is associated with increased prevalence of OP. This finding may be attributable to reduced level of bone weight bearing in individuals with a very high BMI.
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Affiliation(s)
- A Oldroyd
- Lancaster Medical School, Lancaster University, Lancaster, UK
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Fowler J, Mitchell K, Bukhari M. SAT0473 Predictive Factors of Longitudinal Bone Loss in Patients Treated with Aromatase Inhibitors for Breast Cancer. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mitchell K, Diggle P, Bukhari M. FRI0063 Changes in Bone Mass over Time in Subjects with Rheumatoid Arthritis: an Observational Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Safran H, Perez K, Charpentier K, Austin TC, Mantripragada KC, Bishop KD, Lombardo A, Houlihan L, Mitchell K, Rosati K, Martel D, Shaw L. Nab-paclitaxel (nab-P) combined with FOLFOX for advanced pancreatic cancer: A phase I study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.4123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Howard Safran
- Brown University Oncology Research Group, Providence, RI
| | - Kimberly Perez
- Brown University Oncology Research Group, Providence, RI
| | | | | | | | | | - Alise Lombardo
- Brown University Oncology Research Group, Providence, RI
| | | | | | - Kayla Rosati
- Brown University Oncology Research Group, Providence, RI
| | | | - Lynn Shaw
- Brown University Oncology Research Group, Providence, RI
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Wallace RM, Stanek D, Griese S, Krulak D, Vora NM, Pacha L, Kan V, Said M, Williams C, Burgess TH, Clausen SS, Austin C, Gabel J, Lehman M, Finelli LN, Selvaggi G, Joyce P, Gordin F, Benator D, Bettano A, Cersovsky S, Blackmore C, Jones SV, Buchanan BD, Fernandez AI, Dinelli D, Agnes K, Clark A, Gill J, Irmler M, Blythe D, Mitchell K, Whitman TJ, Zapor MJ, Zorich S, Witkop C, Jenkins P, Mora P, Droller D, Turner S, Dunn L, Williams P, Richards C, Ewing G, Chapman K, Corbitt C, Girimont T, Franka R, Recuenco S, Blanton JD, Feldman KA. A large-scale, rapid public health response to rabies in an organ recipient and the previously undiagnosed organ donor. Zoonoses Public Health 2014; 61:560-70. [PMID: 24673934 DOI: 10.1111/zph.12105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Indexed: 11/29/2022]
Abstract
This article describes and contrasts the public health response to two human rabies cases: one organ recipient diagnosed within days of symptom onset and the transplant donor who was diagnosed 18 months post-symptom onset. In response to an organ-transplant-related rabies case diagnosed in 2013, organ donor and recipient investigations were conducted by multiple public health agencies. Persons with potential exposure to infectious patient materials were assessed for rabies virus exposure. An exposure investigation was conducted to determine the source of the organ donor's infection. Over 100 persons from more than 20 agencies spent over 2700 h conducting contact investigations in healthcare, military and community settings. The 564 persons assessed include 417 healthcare workers [5.8% recommended for post-exposure prophylaxis (PEP)], 96 community contacts (15.6% recommended for PEP), 30 autopsy personnel (50% recommended for PEP), and 21 other persons (4.8% recommended for PEP). Donor contacts represented 188 assessed with 20.2% recommended for PEP, compared with 5.6% of 306 recipient contacts recommended for PEP. Human rabies cases result in substantial use of public health and medical resources, especially when diagnosis is delayed. Although rare, clinicians should consider rabies in cases of encephalitis of unexplained aetiology, particularly for cases that may result in organ donation.
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Affiliation(s)
- R M Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology (DHCPP), Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Safran H, Charpentier K, Perez K, Mantripragada K, Austin TC, Nadeem O, Lombardo A, Houlihan L, Fontes-Borts L, Kolberg I, Mitchell K, Rosati K. FOLFOX and nab-paclitaxel (nab-P) for advanced pancreatic cancer: A phase I study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.3_suppl.258] [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: 11/20/2022] Open
Abstract
258 Background: FOLFIRINOX improves survival in advanced pancreatic cancer, however the contribution of irinotecan is uncertain. The addition of irinotecan to gemcitabine was not superior to gemcitabine alone in pancreatic cancer, however nab-P demonstrates a survival benefit. This phase I study was designed to evaluate the maximum tolerated dose (MTD) of the addition of nab-P to fluorouracil, leucovorin, oxaliplatin (FOLFOX-A). Methods: Patients with metastatic or locally advanced pancreatic adenocarcinoma without prior treatment received oxaliplatin, 85 mg/m2, leucovorin 400 mg/m2 and 5-FU 2400 mg/m2 with 3 dose levels of nab-P (125, 150 and 175 mg/m2) every 2 weeks. Pegfilgrastim was required during the first 2 cycles. Dose limiting toxicities (DLTs) were defined in the first 2 cycles of treatment. Results: Fifteen patients were entered: Dose level 1 (n=6), dose level 2 (N=6), dose level 3 (N=3). The median age was 64 (35-81). Ten patients had metastatic and 5 had locally advanced disease. DLTs of nausea and fatigue occurred in 2 of 3 patients at dose level 3. Two patients developed grade 3 neuropathy after >= 10 cycles of treatment. One patient had grade 3/4 neutropenia. Eight of fifteen patients (53%) had a partial response. Conclusions: The MTD of nab-P is 150mg/m2 every 2 weeks with FOLFOX. Cumulative peripheral neuropathy, similar to other FOLFOX regimens, is the most significant toxicity generally occurring after >= 10 cycles of treatment. FOLFOX-A has substantial activity and may represent a promising regimen in pancreatic cancer. Patients are currently being accrued to an expansion phase utilizing dose level 2. Supported by the Davis and Browning families and LIFEcycle. Clinical trial information: NCT01744353.
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Affiliation(s)
- Howard Safran
- Brown University Oncology Research Group, Providence, RI
| | | | - Kimberly Perez
- Brown University Oncology Research Group, Providence, RI
| | | | | | - Omar Nadeem
- Brown University Oncology Research Group, Providence, RI
| | - Alise Lombardo
- Brown University Oncology Research Group, Providence, RI
| | | | | | - Irene Kolberg
- Brown University Oncology Research Group, Providence, RI
| | | | - Kayla Rosati
- Brown University Oncology Research Group, Providence, RI
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Antony K, Ma J, Mitchell K, Racusin D, Petrosino J, Versalovic J, Aagaard K. 69: Excess gestational weight gain (GWG) is associated with alterations in metabolic function of the microbiome. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.102] [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: 10/25/2022]
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Romezi M, Antony K, Mitchell K, Montealegre J, Suter M, Venable S, Aagaard K. 690: Distinguishing the effect of excess gestational weight gain (GWG) from obesity on pregnancy outcomes and inflammatory markers. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.723] [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: 10/25/2022]
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Chong W, Zhang Y, Qian Y, Lai L, Parker G, Mitchell K. Computational hemodynamics analysis of intracranial aneurysms treated with flow diverters: correlation with clinical outcomes. AJNR Am J Neuroradiol 2013; 35:136-42. [PMID: 24287091 DOI: 10.3174/ajnr.a3790] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Recent studies have shown promising results regarding intracranial aneurysms treated with flow diverters. However, these have had adverse effects, including delayed aneurysm occlusion, posttreatment symptoms, and rupture. The hemodynamic profiles of aneurysms treated with flow diverters were analyzed to determine the ones associated with successful and failed treatments. MATERIALS AND METHODS Patient-specific computational fluid dynamics were used to simulate hemodynamic profiles, including the presence of jet flow, energy loss, volume flow, and wall shear stress in 4 successful occlusions of aneurysms and 4 failed cases after flow-diverter deployment. In these 4 failed cases, hemodynamic profiles were examined again after a hypothetic second intervention. This involved replacing the failed flow diverter with a hypothetic optimally deployed flow diverter or simulated placement of a second flow diverter within the first (double hypothetic optimally deployed). RESULTS Where successful occlusions were achieved, a marked obliteration of jet flow was observed. Flow entering the aneurysm sac was diverted via the center of the flow diverter and joined smoothly with the continuation of flow leaving the aneurysm sac into the parent arteries. These observations were supplemented by a reduction in the other hemodynamic profiles. Aneurysm neck geometry might influence the efficacy of the flow diverter. CONCLUSIONS Hemodynamic indices, as calculated by using computational fluid dynamics techniques, have close correlation with flow-diverter treatment outcome. Computational fluid dynamics could be potentially useful as a planning tool for neurointerventionists by simulating an optimized flow-diverter deployment strategy before the procedure and evaluating posttreatment outcome.
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Affiliation(s)
- W Chong
- Monash Medical Centre, Melbourne, Victoria, Australia
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Horton E, Mitchell K, Johnson-Warrington V, Apps L, Young H, Singh S, Singh S. S24 A self-management programme of activity, coping and education (SPACE) for COPD: A randomised non-inferiority trial in a pulmonary rehabilitation population: Abstract S24 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Levitt AJ, Mitchell K, Pareti L, DeGenova J, Heller A, Hannigan A, Gholston J. Randomized trial of intensive housing placement and community transition services for episodic and recidivist homeless families. Am J Public Health 2013; 103 Suppl 2:S348-54. [PMID: 24148053 DOI: 10.2105/ajph.2013.301521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared Home to Stay, a pilot of intensive housing placement and community transition services for episodic and recidivist homeless families, with a standard services approach. METHODS Using intention-to-treat analyses, we conducted a modified randomized trial of 138 Home to Stay client families and a control group of 192 client families receiving standard shelter services. RESULTS Home to Stay clients exited shelter more quickly than clients in the control group (Cox regression, P < .001), more commonly exited shelter with housing subsidies (75% vs 56%), stayed out of shelter longer (Cox regression, P = .011), and spent fewer total days in shelter (376 days vs 449 days). Home to Stay performed best with clients who entered shelter within 180 days of the pilot's start date and had less impact on clients entering shelter before that time. CONCLUSIONS Relative to standard services, Home to Stay services can accelerate exit from shelter and reduce return to shelter and total sheltered days for episodic and recidivist homeless families. Standard shelter services may be able to narrow this performance gap by incentivizing work with all episodic and recidivist homeless families.
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Affiliation(s)
- Aaron J Levitt
- Aaron J. Levitt, Lauren Pareti, Joe DeGenova, Anthony Hannigan, and Jennifer Gholston are with the Center for Urban Community Services (CUCS), New York, NY. Kristen Mitchell and Anne Heller are with the New York City Department of Homeless Services, New York, NY
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