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Hughes RT, Levine B, Greven KM, Frizzell BA, Porosnicu M, Lycan T, Burnett L, Winkfield KM. Feasibility of a Keratin-Based Topical Cream for Radiation Dermatitis in Patients with Head and Neck Cancer: Results of a Randomized Pilot Study. Int J Radiat Oncol Biol Phys 2023; 117:e590. [PMID: 37785786 DOI: 10.1016/j.ijrobp.2023.06.1939] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Acute radiation dermatitis (RD) is a frequent toxicity associated with radiotherapy (RT) for head and neck cancer (HNC). KeraStat Cream (KC), an emulsion-based wound dressing that acts as a protective barrier that promotes the healing of minor skin wounds and partial-thickness burns, has not yet been studied in patients receiving RT for HNC. MATERIALS/METHODS This randomized, open-label pilot study enrolled patients with HNC planned to receive definitive or postoperative RT to a total dose of at least 60 Gy. The study excluded patients with a history of prior RT, use of topical corticosteroids, scleroderma, lupus, or treatment with anti-EGFR therapy. Eligible patients were randomized to KC or routine skin care (RSC, patient choice of a variety of commercially available topical creams/lotions), applied at least twice daily during and for 1 month after RT. Assessments were performed at baseline, weekly during RT, and 1-month after RT. The primary outcome was adherence to the prescribed skin care regimen (at least 10 applications per week of treatment, starting at week 2). Secondary outcomes were the incidence rates of clinician-rated and patient-reported dermatitis (CTCAE and PRO-CTCAE grades 2+) and the Dermatologic Life Quality Index (DLQI, range 0-30 with a higher number indicating worse skin-related quality of life) at the last assessment before radiotherapy completion (end-RT). RESULTS Of 29 patients enrolled, 24 (n = 12 in each group) were randomized and completed the study. Most patients had stage III-IV disease (17, 71%), and the most common primary site was the oropharynx (n = 11, 46%), followed by the oral cavity (n = 7), larynx (n = 5), and sinonasal (n = 1). The median RT dose was 68 Gy (range 60-70), median skin V60 was 37.2 cc (range 1.5-107.6), and median skin V70 was 0 cc (range 0-24.9), with no differences between groups. The bilateral neck was treated in most patients (n = 19, 79%), primary site treated in 3 and unilateral neck treated in 2 patients. Most patients received concurrent chemotherapy (n = 18, 75%). Complete adherence to assigned skin care was observed in 7/12 (58%) patients in the RSC group vs. 10/12 (83%) patients in the KC group (p = 0.65). Nearly all patient-weeks were adherent: 64/67 patients in the KC group and 61/68 patients in the RSC group (p = 0.20). Incidence rates of G2+ RD were similar between the KC and RSC groups: CTCAE, 9/12 vs. 7/12 (p = 0.67); PRO-CTCAE, 10/12 vs. 8/12 (p = 0.64). When measured at end-RT, mean RD scores were similar between the KC and RSC groups: CTCAE, 1.4 vs. 1.8 (p = 0.30); PRO-CTCAE, 2.0 vs. 2.0 (p = 1); DLQI (4.8 vs. 4.6, p = 0.92). Repeated measures analysis showed no difference between arms for CTCAE (p = 0.72), PRO-CTCAE (p = 0.96), or DLQI (p = 0.78). CONCLUSION A randomized study of KC vs. RSC is feasible with good adherence to assigned skin care, particularly in the KC group. Future randomized trials are warranted to investigate the efficacy of this novel topical approach to RD during radiotherapy for HNC.
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Affiliation(s)
- R T Hughes
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
| | - B Levine
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, NC
| | - K M Greven
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC
| | - B A Frizzell
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC
| | - M Porosnicu
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University School of Medicine, Winston Salem, NC
| | - T Lycan
- Department of Internal Medicine, Section of Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, NC
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Duran P, Sesillo FB, Cook M, Burnett L, Menefee SA, Do E, French S, Zazueta-Damian G, Dzieciatkowska M, Saviola AJ, Shah MM, Sanvictores C, Osborn KG, Hansen KC, Shtrahman M, Christman KL, Alperin M. Proregenerative extracellular matrix hydrogel mitigates pathological alterations of pelvic skeletal muscles after birth injury. Sci Transl Med 2023; 15:eabj3138. [PMID: 37531414 PMCID: PMC10460616 DOI: 10.1126/scitranslmed.abj3138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
Pelvic floor disorders, including pelvic organ prolapse and urinary and fecal incontinence, affect millions of women globally and represent a major public health concern. Pelvic floor muscle (PFM) dysfunction has been identified as one of the leading risk factors for the development of these morbid conditions. Childbirth, specifically vaginal delivery, has been recognized as the most important potentially modifiable risk factor for PFM injury; however, the precise mechanisms of PFM dysfunction after parturition remain elusive. In this study, we demonstrated that PFMs exhibit atrophy and fibrosis in parous women with symptomatic pelvic organ prolapse. These pathological alterations were recapitulated in a preclinical rat model of simulated birth injury (SBI). The transcriptional signature of PFMs after injury demonstrated an impairment in muscle anabolism, persistent expression of genes that promote extracellular matrix (ECM) deposition, and a sustained inflammatory response. We also evaluated the administration of acellular injectable skeletal muscle ECM hydrogel for the prevention of these pathological alterations. Treatment of PFMs with the ECM hydrogel either at the time of birth injury or 4 weeks after injury mitigated PFM atrophy and fibrosis. By evaluating gene expression, we demonstrated that these changes are mainly driven by the hydrogel-induced enhancement of endogenous myogenesis, ECM remodeling, and modulation of the immune response. This work furthers our understanding of PFM birth injury and demonstrates proof of concept for future investigations of proregenerative biomaterial approaches for the treatment of injured pelvic soft tissues.
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Affiliation(s)
- Pamela Duran
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
- Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Francesca Boscolo Sesillo
- Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA 92037, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of California San Diego, La Jolla, CA 92093, USA
| | - Mark Cook
- Department of Integrative, Biology and Physiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Lindsey Burnett
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of California San Diego, La Jolla, CA 92093, USA
| | - Shawn A. Menefee
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Kaiser Permanente, San Diego, CA 92110, USA
| | - Emmy Do
- Department of Biology, University of California San Diego, La Jolla, CA 92093, USA
| | - Saya French
- Department of Biology, University of California San Diego, La Jolla, CA 92093, USA
| | - Gisselle Zazueta-Damian
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Kaiser Permanente, San Diego, CA 92110, USA
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Anthony J. Saviola
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Manali M. Shah
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Clyde Sanvictores
- Department of Physics, University of California San Diego, La Jolla, CA 92093, USA
| | - Kent G. Osborn
- Center for Veterinary Sciences and Comparative Medicine, Division of Comparative Pathology and Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Kirk C. Hansen
- Department of Biochemistry and Molecular Genetics, School of Medicine, University of Colorado, Aurora, CO 80045, USA
| | - Matthew Shtrahman
- Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA 92037, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Karen L. Christman
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
- Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA 92037, USA
| | - Marianna Alperin
- Sanford Consortium for Regenerative Medicine, University of California San Diego, La Jolla, CA 92037, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of California San Diego, La Jolla, CA 92093, USA
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Nager CW, Burnett L. Laparoscopic Urogynecology: Principles and Practice. Urogynecology (Phila) 2023; 29:458-459. [PMID: 37695252 DOI: 10.1097/spv.0000000000001348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
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4
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Hochstedler BR, Burnett L, Price TK, Jung C, Wolfe AJ, Brubaker L. Urinary microbiota of women with recurrent urinary tract infection: collection and culture methods. Int Urogynecol J 2022; 33:563-570. [PMID: 33852041 PMCID: PMC8514570 DOI: 10.1007/s00192-021-04780-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 11/11/2020] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Many clinicians utilize standard culture of voided urine to guide treatment for women with recurrent urinary tract infections (RUTI). However, despite antibiotic treatment, symptoms may persist and events frequently recur. The cyclic nature and ineffective treatment of RUTI suggest that underlying uropathogens pass undetected because of the preferential growth of Escherichia coli. Expanded quantitative urine culture (EQUC) detects more clinically relevant microbes. The objective of this study was to assess how urine collection and culture methods influence microbial detection in RUTI patients. METHODS This cross-sectional study enrolled symptomatic adult women with an established RUTI diagnosis. Participants contributed both midstream voided and catheterized urine specimens for culture via both standard urine culture (SUC) and EQUC. Presence and abundance of microbiota were compared between culture and collection methods. RESULTS Forty-three symptomatic women participants (mean age 67 years) contributed specimens. Compared to SUC, EQUC detected more unique bacterial species and consistently detected more uropathogens from catheterized and voided urine specimens. For both collection methods, the most commonly detected uropathogens by EQUC were E. coli (catheterized: n = 8, voided: n = 12) and E. faecalis (catheterized: n = 7, voided: n = 17). Compared to catheterized urine samples assessed by EQUC, SUC often missed uropathogens, and culture of voided urines by either method yielded high false-positive rates. CONCLUSIONS In women with symptomatic RUTI, SUC and assessment of voided urines have clinically relevant limitations in uropathogen detection. These results suggest that, in this population, catheterized specimens analyzed via EQUC provide clinically relevant information for appropriate diagnosis.
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Affiliation(s)
- Baylie R. Hochstedler
- Maywood, IL. Dept. of Microbiology and Immunology, Loyola University Chicago, Maywood, IL
| | - Lindsey Burnett
- La Jolla, CA. Dept. of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA
| | - Travis K. Price
- Maywood, IL. Dept. of Microbiology and Immunology, Loyola University Chicago, Maywood, IL,Present address: University of California Los Angeles, Los Angeles, CA
| | - Carrie Jung
- La Jolla, CA. Dept. of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA,Present address: Dept. of Obstetrics and Gynecology, Division of Urogynecology, Kaiser Permanente, San Francisco, CA
| | - Alan J. Wolfe
- Maywood, IL. Dept. of Microbiology and Immunology, Loyola University Chicago, Maywood, IL
| | - Linda Brubaker
- La Jolla, CA. Dept. of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA
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Cherneski N, Burnett L, Fleig L, Milne K, Giangregorio L, Clemson L, Ashe M. REACH FOR AN ACTIVE LIFESTYLE: PROGRAM FEASIBILITY AND PARTICIPANT PERCEPTIONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1451] [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)
- N. Cherneski
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - L. Burnett
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - L. Fleig
- Freie Universität Berlin, Berlin, Germany,
| | - K. Milne
- Cardea Health Consulting, Vancouver, British Columbia, Canada,
| | | | - L. Clemson
- University of Sydney, Sydney, New South Wales, Australia
| | - M.C. Ashe
- Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada,
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
- The University of Adelaide, Adelaide, South Australia, Australia,
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Burnett L, Cherneski N, Fleig L, Milne K, Giangregorio L, Clemson L, Ashe M. REACH LIFESTYLE INTERVENTION: FEASIBILITY OF DELIVERING AN INSTRUCTOR TRAINING COURSE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1973] [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)
- L. Burnett
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - N. Cherneski
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
| | - L. Fleig
- Freie Universität Berlin, Berlin, Germany,
| | - K. Milne
- Cardea Health Consulting, Vancouver, British Columbia, Canada,
| | | | - L. Clemson
- University of Sydney, Sydney, New South Wales, Australia
| | - M.C. Ashe
- Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada,
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada,
- The University of Adelaide, Adelaide, South Australia, Australia,
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Burnett L. James Ingram Watson. Assoc Med J 2014. [DOI: 10.1136/bmj.g6724] [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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8
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Shen S, Kim R, Benhabib S, Araujo J, Burnett L, Duan J, Popple R, Wu X, Cardan R, Brezovich I. SU-E-T-507: Interfractional Variation of Fiducial Marker Position During HDR Brachytherapy with Cervical Interstitial Needle Template. Med Phys 2014. [DOI: 10.1118/1.4888840] [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: 11/07/2022] Open
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Burcher S, Berman Y, Burnett L, Proos A, Clifton-Bligh R, Dwight T. Cardiac health professionals’ attitudes towards genetic testing for hereditary causes of cardiovascular disease. Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.07.016] [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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10
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Benhabib S, Kim R, Duan J, Burnett L, Popple R, Wu X, Cardan R, Brezovich I, Shen S. SU-E-T-344: Interfractional Needle Displacement During HDR Brachytherapy for Patients with Gynecological Cancer Using Interstitial Needle Template. Med Phys 2013. [DOI: 10.1118/1.4814778] [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: 11/07/2022] Open
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11
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Nunez FA, Kislukin V, Smith TL, Callahan MF, Burnett L, VanDyke ME. Hemodynamic response after hypovolemic shock and resuscitation with low‐volume 6% hetastarch (HS) and high‐volume lactated Ringer's (LR) solution. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.1132.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fiesky A. Nunez
- Orthopaedic SurgeryWake Forest School of MedicineWinston SalemNC
| | | | - T. L. Smith
- Orthopaedic SurgeryWake Forest School of MedicineWinston SalemNC
| | - M. F. Callahan
- Orthopaedic SurgeryWake Forest School of MedicineWinston SalemNC
| | | | - M. E. VanDyke
- Institute for Regenerative MedicineWake Forest School of MedicineWinston SalemNC
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Sugiyama H, Burnett L, Xiang X, Olson J, Willis S, Miao A, Akema T, Bieber AL, Chandler DE. Purification and multimer formation of allurin, a sperm chemoattractant from Xenopus laevis egg jelly. Mol Reprod Dev 2009; 76:527-36. [PMID: 18951371 DOI: 10.1002/mrd.20969] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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
Allurin, a sperm chemoattractant isolated from Xenopus laevis egg jelly, can be purified in one step from an extract of diffusible jelly proteins ("egg water") using a FPLC or HPLC anion exchange column and a multi-step NaCl gradient. Allurin homomultimers were detected by Western blotting with antibodies prepared against the purified protein or peptides within the protein. Allurin multimers were stable and resisted dissociation by SDS and beta-mercaptoethanol. Alkylation of allurin provided evidence for two free sulfhydryl groups but did not eliminate multimer formation, suggesting that intermolecular disulfide bond formation is not required for allurin aggregation. Concentration of egg water was accompanied by a reduction of chemoattractant activity that could not be fully accounted for by homomultimer formation. Rather, the presence of a multiphasic dose-activity curve upon partial purification and formation of hetero-allurin complexes during concentration suggested that egg water may contain allurin-binding proteins that reduce multimer formation and activity.
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Affiliation(s)
- Hitoshi Sugiyama
- Department of Physiology, St. Marianna University School of Medicine, Kawasaki, Japan
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13
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Burnett K, Williams H, Macey B, Mancia A, Gross P, Warr G, Chapman R, Burnett L. Resilience and sensitivity to environmental stress in the American oyster, Crassostrea virginica. Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.04.408] [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]
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Xiang X, Burnett L, Rawls A, Bieber A, Chandler D. The sperm chemoattractant "allurin" is expressed and secreted from the Xenopus oviduct in a hormone-regulated manner. Dev Biol 2005; 275:343-55. [PMID: 15501223 DOI: 10.1016/j.ydbio.2004.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Revised: 08/03/2004] [Accepted: 08/06/2004] [Indexed: 10/26/2022]
Abstract
Recently, we cloned and sequenced the cDNA of allurin, a sperm chemoattractant isolated from the jelly of Xenopus laevis eggs [Proc. Natl. Acad. Sci. U.S.A. 78 (2001) 11205]. In this report, we demonstrate that allurin mRNA is expressed almost exclusively in the oviduct and that its expression is increased 2.5-fold by human chorionic gonadotropin over a 12-h period. Both dot blots and immunocytochemistry show that allurin is secreted from the upper two thirds of the oviduct that includes the pars recta and the proximal pars convoluta. Allurin appears to be deposited on the ciliated surfaces of luminal epithelial cells that come in direct contact with eggs as they move through the oviduct. Immune staining also demonstrates the presence of allurin in the serosal capsule of the oviduct. In contrast, allurin is not found within the tubular jelly-secreting glands or ducts that constitute a major portion of the oviduct wall. Therefore, we hypothesize that allurin is synthesized by nonciliated secretory cells in the luminal epithelium of the oviduct, is displayed on the ciliary layer and then mechanically mixed with jelly, and applied to eggs as they progress down the oviduct. This hypothesis is consistent with the fact that eggs progressing down the oviduct initially show evidence of allurin being incorporated into the J1 layer. Subsequently, allurin within J1 diffuses outward to J3 and eggs stored in the uterus now demonstrate a J3 localization of this chemoattractant.
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Affiliation(s)
- Xueyu Xiang
- Molecular and Cellular Biology Program, School of Life Sciences, Arizona State University, Tempe, AZ 85287-4501, USA
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15
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McKenzie S, Deane EM, Burnett L. Are serum cortisol levels a reliable indicator of wellbeing in the tammar wallaby, Macropus eugenii? Comp Biochem Physiol A Mol Integr Physiol 2004; 138:341-8. [PMID: 15313489 DOI: 10.1016/j.cbpb.2004.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2004] [Revised: 05/02/2004] [Accepted: 05/02/2004] [Indexed: 10/26/2022]
Abstract
Serum corticosteroid levels were measured in six female tammar wallabies (Macropus eugenii) at Macquarie University, NSW, Australia, to assess their reliability as indicators of wellbeing in this species. Animals were challenged with a change in conditions over the course of approximately 3 weeks, comprising (i) isolation and movement; (ii) altered feeding routine, in order to impose a disturbance to homeostasis ("stress"). Blood samples were collected five times during the study period, and analysed for corticosteroid concentration and a number of haematological and biochemical measures. The use of enzyme immunoassay for the measurement of corticosteroids in marsupial serum was validated. We found that there was no significant change in serum corticosteroid concentrations in response to either of the changed conditions suggesting that serum corticosteroid concentrations are not reflective of a change in wellbeing. Cortisol was the dominant serum corticosteroid, with concentrations up to 50 times higher than corticosterone. Significant differences were observed in aspartate amino-transferase, alanine amino-transferase, haemoglobin, total erythrocyte count and mean corpuscular haemoglobin concentration over the period of study. However, no significant correlations emerged to justify any of these measures, or serum corticosteroid levels, as reliable indicators of compromised wellbeing in the tammar wallaby.
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Affiliation(s)
- S McKenzie
- Division of Environmental and Life Sciences, Macquarie University, North Ryde, New South Wales 2109, Australia
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Abstract
This study reports, for the first time, the carrier frequency of Canavan disease in the Ashkenazi Jewish population in Australia, and the identification of a novel mutation in the ASPA gene.
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Affiliation(s)
- V M Howell
- Pacific Laboratory Medicine Services (PaLMS), Royal North Shore Hospital (RNSH), St. Leonards, NSW, Australia
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Barlow-Stewart K, Burnett L, Proos A, Howell V, Huq F, Lazarus R, Aizenberg H. A genetic screening programme for Tay-Sachs disease and cystic fibrosis for Australian Jewish high school students. J Med Genet 2003; 40:e45. [PMID: 12676918 PMCID: PMC1735444 DOI: 10.1136/jmg.40.4.e45] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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18
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Bahar AY, Taylor PJ, Andrews L, Proos A, Burnett L, Tucker K, Friedlander M, Buckley MF. The frequency of founder mutations in the BRCA1, BRCA2, and APC genes in Australian Ashkenazi Jews: implications for the generality of U.S. population data. Cancer 2001; 92:440-5. [PMID: 11466700 DOI: 10.1002/1097-0142(20010715)92:2<440::aid-cncr1340>3.0.co;2-o] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Several studies have shown that Ashkenazi Jews in the United States and Israel have a high prevalence of the founder mutations BRCA1 185delAG, BRCA1 5382insC, BRCA2 6174delT, and APC I1307K at frequencies of 1.0--1.1%, 0.2--0.3%, 0.6--1.4%, and 6.1--7.0%, respectively. The objective of this study was to compare the prevalence of these alleles in the Australian Jewish population with that of U.S. Jews. Australian Jews have a different history of migration, with less opportunity for changes in allele frequency due to conversion or intermarriage with non-Jewish Australians. The results obtained therefore can be used to assess whether U.S. data can be generalized to other Jewish populations. SUBJECTS AND METHODS. Subject samples were ascertained through a screening program for Tay-Sachs disease as part of a community-based screening program in New South Wales and Victoria. DNA extracted from 1200 deidentified blood samples was tested using amplification refractory mutation system polymerase chain reaction. RESULTS The allele frequencies found were as follows: BRCA1 185delAG 1.25% (95% confidence interval [CI], 0.62--1.88%), BRCA1 5382insC 0.25% (95% CI, 0--0.53%), BRCA2 6174delT 1.08% (95% CI, 0.50--1.67%), and APC I1307K 8.67% (95% CI, 7.07--10.26%). The prevalence of breast carcinoma predisposition alleles therefore is greater than 2.5% in Australian Ashkenazim. CONCLUSIONS There were no significant differences between the allele frequencies in Australian Ashkenazim and those identified in other studies with similar ascertainment strategies, despite the different migration patterns of Australian Jews. This suggests the broad applicability of the U.S. and Israeli data, not only to Australian Ashkenazim, but also to Ashkenazi communities throughout the world.
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Affiliation(s)
- A Y Bahar
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia
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Watts B, Burnett L, Chesher D. Measurement of total protein is not a useful inclusion in liver function test profiles. Clin Chem 2000; 46:1022-3. [PMID: 10894857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Abstract
PURPOSE To determine whether associations exist between cataract and established cardiovascular risk factors (other than smoking) - hypertension, body mass index, serum lipids and plasma fibrinogen. METHODS The Blue Mountains Eye Study is a large (n=3654) population-based cross-sectional study conducted among people aged 49-97 years residing in the Blue Mountains, a region west of Sydney, Australia. Risk factor data were collected using standardised clinical procedures. Lens photographs were taken and graded for presence and severity of cortical, nuclear, and posterior subcapsular cataracts. RESULTS Cortical cataract was associated with a history of myocardial infarction, higher plasma fibrinogen, and higher serum cholesterol. Nuclear cataract was associated with a higher platelet count but hypertension was associated with lower prevalence of nuclear cataract. Posterior subcapsular cataract was associated with higher plasma fibrinogen and lower body mass index. Some of these associations appeared to be stronger in women than in men: fibrinogen and cortical cataract and body mass index and posterior subcapsular cataract. CONCLUSIONS Several risk factors for cardiovascular disease are associated with presence of cataract, perhaps explaining the observation in several studies that people with cataract have increased mortality rates. The possibility of strong associations between plasma fibrinogen and cataract merits further epidemiological and laboratory research.
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Affiliation(s)
- M E Goodrich
- University of Sydney, Department of Ophthalmology, Sydney, Australia
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Abstract
PURPOSE To describe the prevalence of self-reported diabetes and undiagnosed diabetes using new fasting plasma glucose (FPG) criteria, and vascular associations with diabetes history in a representative sample of older Australians attending the population-based Blue Mountains Eye Study. METHODS 3654 people aged 49 years or older, representing 88% of permanent residents in two postcode areas west of Sydney, underwent a detailed medical and eye examination. This included history of diabetes, vascular events and vascular risk factors. Fasting pathology tests, including glucose, were obtained for 88% of these subjects. RESULTS A diabetes history was given by 217 people (5.9%), including 7.0% of men and 5.2% of women. Elevated FPG (> or = 7.0 mmol/l) was found in a further 66 people (2.2% of persons who had FPG performed) and Impaired Fasting Glucose (FPG > or = 6.1 mmol/l and < 7.0 mmol/l) was found in a further 127 people (4.2%). History of diabetes was associated with an increased prevalence of obesity, elevated mean blood pressure and serum triglycerides, and lower mean serum cholesterol and HDL-cholesterol. Statistically significant associations were found between diabetes history and history of angina, acute myocardial infarction, stroke, gout and thyroid disease, after adjusting for age and sex using logistic regression. The vascular relationships with diabetes were stronger among people who currently smoked. CONCLUSIONS This study has found similar diabetes prevalence to recently published Australian National Health Survey findings. Strong cross-sectional associations between diabetes history and vascular events and increased prevalence of vascular risk factors among older subjects with diabetes emphasise the need to address vascular risk factors in this group.
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Affiliation(s)
- P Mitchell
- Department of Ophthalmology, the University of Sydney, Westmead, NSW, Australia.
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Abstract
Ovarian remnants occur after a portion of ovarian tissue is left behind unintentionally after oophorectomy. The ovarian remnant may be functional and cystic, producing pelvic pain and, in some patients, extrinsic compression of the distal ureter. Ovarian remnants frequently are associated with adhesions from previous pelvic surgery for endometriosis or pelvic inflammatory disease. Ovarian remnants also may be included within pelvic peritoneal inclusion cysts. In this retrospective study, the sonographic features of ovarian remnants in 10 patients with surgical proof or clinical follow-up data are described. Most ovarian remnants were simple cysts (seven of 10), three had multiple septations, and six had a rim of presumably ovarian tissue with arterial and venous flow. Three patients with ovarian remnant masses that were aspirated had symptomatic relief without recurrence. In one patient, guided aspiration was unsuccessful, probably owing to the presence of organized hemorrhage within the mass. Extrinsic compression of the distal ureter was observed in one patient, who was treated with gonadotropin releasing hormone agonist (Lupron). The sonographic findings of a completely cystic or multiseptated pelvic mass with a rim of vascularized solid tissue in a postoophorectomy patient, although such cases are rare, suggest the diagnosis of an ovarian remnant. If the diagnosis can be established with a high degree of certainty, sonographically guided aspiration may be attempted in an effort to provide symptomatic relief. Otherwise, sonography is useful in serial assessment of these masses in patients receiving medical treatment.
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Affiliation(s)
- A C Fleischer
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2675, USA
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Tsang CW, Lazarus R, Smith W, Mitchell P, Koutts J, Burnett L. Hematological indices in an older population sample: derivation of healthy reference values. Clin Chem 1998; 44:96-101. [PMID: 9550565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Factors affecting hematological values were explored, and healthy reference values were estimated from a cross-sectional survey of a population (n = 4433), ages 49 years or more, residing permanently in a defined geographic region. Nursing home residents were excluded. Details of medication use and medical history were obtained by interview, and participants were asked to return after an overnight fast for blood sampling. The participation rate was 82.4%, of whom 88.4% provided a fasting blood sample. Hemoglobin, hematocrit, and erythrocyte counts were higher in men, whereas platelet counts were higher in women. Statistical associations between each hematological index and smoking, alcohol intake, use of certain drugs, chronic disease, and high creatinine values were tested by unpaired t-tests. Separate reference groups were defined for each hematological index by excluding subjects with any of the factors found to be of importance. The resulting reference values are particularly appropriate for evaluating hematological test results in older individuals.
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Affiliation(s)
- C W Tsang
- Department of Public Health and Community Medicine, University of Sydney, NSW, Australia
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24
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Chesher D, Burnett L. Equivalence of critical error calculations and process capability index Cpk. Clin Chem 1997; 43:1100-101. [PMID: 9191580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Affiliation(s)
- E M Deane
- Department of Biological Sciences, University of Western Sydney Nepean, Kingswood, New South Wales
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Burnett L, Hegedus G, Chesher D, Burnett J, Costaganna G. Application of process capability indices to quality control in a clinical chemistry laboratory. Clin Chem 1996; 42:2035-7. [PMID: 8969646] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- L Burnett
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
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Burnett L, Hegedus G, Chesher D, Burnett J, Costaganna G. Application of process capability indices to quality control in a clinical chemistry laboratory. Clin Chem 1996. [DOI: 10.1093/clinchem/42.12.2035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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]
Affiliation(s)
- L Burnett
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - G Hegedus
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - D Chesher
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - J Burnett
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - G Costaganna
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
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Gross BA, Smith HC, Burnett L, Thompson W, Jonasson DA, Tamsen L, Wolter-Svennsonn LO. F229 Continuous premarin and medroxyprogesterone acetate vs tibolone (livial): A comparative study of effects on carbohydrate metabolism, safety, and acceptability-an interim report. Maturitas 1996. [DOI: 10.1016/s0378-5122(97)81191-7] [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: 10/18/2022]
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Abstract
Many Australians are being advised to apply microfine titanium dioxide sunscreen daily from the cradle to the grave. However, there is a surprising lack of data on the percutaneous absorption of microfine titanium dioxide. A prospective pilot study was conducted to analyse the percutaneous absorption of microfine titanium dioxide from sunscreens. Selected patients scheduled to have skin surgery, applied titanium dioxide sunscreen to the skin daily for 2-6 weeks prior to their operation. After excision, the stratum corneum of the sample was stripped and the titanium concentration of the remaining epidermis and dermis was measured by inductively coupled plasma-mass spectrometry. The results from this pilot study showed that levels of titanium in the epidermis and dermis of subjects who applied microfine titanium dioxide to their skin were higher than the levels of titanium found in controls. Studies with larger cohorts are necessary to establish if this absorption is statistically significant.
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Affiliation(s)
- M H Tan
- Department of Dermatology, Westmead Hospital, New South Wales, Australia
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30
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Chesher D, Burnett L. Using Shewhart p control charts of external quality-assurance program data to monitor analytical performance of a clinical chemistry laboratory. Clin Chem 1996; 42:1478-82. [PMID: 8787708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We have investigated the application of Shewhart's p control charts in our external quality-assurance program to monitor the long-term performance of our laboratory's analytical quality. The p control charts have been able to detect long-term changes in our laboratory's analytical performance that would have been difficult to detect by more-conventional techniques. We have explored methods for interpreting these charts as well as some of their limitations, which include minimum subgroup size and dependence on constant specification limits. These charts may be not only a simple method for the long-term monitoring of analytical performance of a laboratory, but also of use to the organizers of external quality-assurance programs.
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Affiliation(s)
- D Chesher
- Department of Clinical Chemistry, Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW, Australia
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31
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Chesher D, Burnett L. Using Shewhart p control charts of external quality-assurance program data to monitor analytical performance of a clinical chemistry laboratory. Clin Chem 1996. [DOI: 10.1093/clinchem/42.9.1478] [Citation(s) in RCA: 6] [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: 11/14/2022]
Abstract
Abstract
We have investigated the application of Shewhart's p control charts in our external quality-assurance program to monitor the long-term performance of our laboratory's analytical quality. The p control charts have been able to detect long-term changes in our laboratory's analytical performance that would have been difficult to detect by more-conventional techniques. We have explored methods for interpreting these charts as well as some of their limitations, which include minimum subgroup size and dependence on constant specification limits. These charts may be not only a simple method for the long-term monitoring of analytical performance of a laboratory, but also of use to the organizers of external quality-assurance programs.
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Affiliation(s)
- D Chesher
- Department of Clinical Chemistry, Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW, Australia
| | - L Burnett
- Department of Clinical Chemistry, Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW, Australia
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Khoury M, Burnett L, Mackay MA. Error rates in Australian chemical pathology laboratories. Med J Aust 1996; 165:128-30. [PMID: 8709873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To measure transcription and analytical errors made by Australian chemical pathology laboratories. DESIGN Retrospective data collection covering the period 1 November 1993 to 1 April 1994. SETTING AND PARTICIPANTS Fourteen pathology laboratories in five Australian States (seven in the public sector, and seven in the private sector). MAIN OUTCOME MEASURES Error rates in transcribing information from request forms to computer record systems, and laboratory performance on chemical analysis. RESULTS Pathology laboratories had a transcription-error rate of up to 39% and an error rate of up to 26% for analytical results. The worst-performing laboratory had errors (of patient identification or results of analysis) in 46% of requests. The three best-performing laboratories achieved 85% error-free reporting, with one achieving 95%. CONCLUSIONS Error rates in Australian pathology laboratories vary widely, but may be as high as 46% for all specimens in some laboratories. The types of errors reported were under the control of the laboratory, and would affect the accuracy of reported pathology test results, with potential adverse outcomes for patient care and inefficient use of health-care resources. There is a need to establish broader quality assurance programs and performance requirements to reduce these types of error.
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Affiliation(s)
- M Khoury
- Faculty of Clinical Chemistry, School of Life Sciences, University of Technology (Gore Hill Campus), Sydney, NSW
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33
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Howell VM, Burnett L. Genetic testing. Lancet 1996; 347:685-6. [PMID: 8596394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Burnett L, Proos AL, Chesher D, Howell VM, Longo L, Tedeschi V, Yang VA, Siafakas N, Turner G. The Tay-Sachs disease prevention program in Australia: Sydney pilot study. Med J Aust 1995; 163:298-300. [PMID: 7565235 DOI: 10.5694/j.1326-5377.1995.tb124595.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To determine the frequency of heterozygous carriers of the Tay-Sachs disease gene in an asymptomatic Ashkenazi Jewish population and to compare the acceptability of different community testing strategies. DESIGN Pilot survey of carrier rates and community attitudes. SETTING Sydney, February 1993 to November 1994. PARTICIPANTS 147 self- or medically referred people of Ashkenazi Jewish origin were tested. Jewish religious, medical and community organisations and leaders were consulted. OUTCOMES Prevalence of HEXA mutations, client and community preference for different testing and reporting strategies. RESULTS Frequency of heterozygous carriers was 1 in 18, with a relative frequency of the three major allelic variants similar to that in overseas studies. Most subjects were medically referred and preferred individual reporting of their carrier status. Community representatives had serious reservations about this strategy and few orthodox Jews participated in the study. An alternative strategy was developed for future testing. CONCLUSIONS Frequency of heterozygous carriers of the Tay-Sachs disease gene was higher than found among Ashkenazi Jews in other countries, possibly because of ascertainment bias. A testing strategy with medical referral and individual reporting of carrier status may not be appropriate for all the community at risk and a modified strategy is necessary.
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Affiliation(s)
- L Burnett
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, NSW
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35
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Abstract
OBJECTIVE To reduce the risk of needlestick injuries to laboratory workers. DESIGN Continuous Quality Improvement (CQI) tools were applied to data collected on the number of blood gas syringes that arrived in the laboratory with needles still attached and to the reasons for these occurrences. SETTING A clinical chemistry department within a 900-bed tertiary referral university teaching hospital. PARTICIPANTS Clinical chemistry laboratory staff and medical staff responsible for sending syringes with needles still attached. INTERVENTIONS Changing to a preheparinized blood gas syringe that included a syringe cap within the packaging. RESULTS Fivefold reduction in the number of syringes arriving in the laboratory with needles still attached. CONCLUSION The risk of needlestick injury to laboratory workers can be reduced by provision to clinical staff of preheparinized blood gas syringes that include a syringe cap within the packaging. The techniques to CQI provide powerful tools for the identification, solving, and monitoring of safety-related issues within the healthcare environment.
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Affiliation(s)
- L Burnett
- Department of Clinical Chemistry, Westmead Hospital, NSW, Australia
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36
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Affiliation(s)
- N Siafakas
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - L Burnett
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - B Bennetts
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
| | - A Proos
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
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37
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Siafakas N, Burnett L, Bennetts B, Proos A. Nonenzymatic extraction of DNA from blood collected into serum separator tubes. Clin Chem 1995; 41:1045-6. [PMID: 7600688] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- N Siafakas
- Dept. of Clin. Chem., Westmead Hosp., NSW, Australia
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38
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Burnett L, Barger D. Nurse executives online: connecting to health care-related services. Bulletin boards and the Internet--Part II. Aspens Advis Nurse Exec 1995; 10:6-8. [PMID: 7766462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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39
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Chesher D, Burnett L. Simple computer spreadsheet for standardized interpretation of oral glucose tolerance tests. Pathology 1995; 27:140-1. [PMID: 7567141 DOI: 10.1080/00313029500169752] [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: 01/26/2023]
Affiliation(s)
- D Chesher
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW
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40
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Burnett L, Barger D. Nurse executives on-line: connecting to on-line services. Bulletin boards and the Internet--Part I. Aspens Advis Nurse Exec 1995; 10:7-8. [PMID: 7794664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Burnett L. Applying the Australian Quality Awards criteria to a clinical chemistry department. Qual Manag Health Care 1995; 3:1-15. [PMID: 10139244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
National quality award schemes can provide a detailed self-assessment process enabling an organization to assess its current position and to highlight opportunities for further improvement along the road to implementing best practice. This article describes how the Australian Quality Awards were used to guide the intermediate stages of implementation and to integrate some advanced stages of implementation of total quality management within a clinical chemistry department.
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Affiliation(s)
- R Brillante
- School of Med., Repatriation General Hosp., Concord NSW, Australia
| | - V Yang
- School of Med., Repatriation General Hosp., Concord NSW, Australia
| | - A Proos
- School of Med., Repatriation General Hosp., Concord NSW, Australia
| | - L Burnett
- School of Med., Repatriation General Hosp., Concord NSW, Australia
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Brillante R, Yang V, Proos A, Burnett L. PCR analysis of hair root specimens to detect Tay-Sachs disease carriers in Ashkenazi Jews. Clin Chem 1995; 41:321-2. [PMID: 7874790] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- R Brillante
- School of Med., Repatriation General Hosp., Concord NSW, Australia
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Abstract
Dieting and body dissatisfaction are highly prevalent amongst young women. In this study, dietary restraint, disinhibited eating, eating attitudes and body satisfaction were compared in elderly (ES) and young (YS) normal weight women. Dietary restraint and eating attitudes were similar across age groups. Differences between current body weight and desired body weight were equivalent for both age groups (ES, M = 10.8, SEM = 1.8 lb; YS, M = 11.3, SEM = 1.2 lb), although young women (Body Shape Questionnaire, BSQ, M = 78.5, SEM = 5.8) reported significantly greater dissatisfaction with their bodies than the elderly (BSQ, M = 61.7, SEM = 2.9). Of the elderly who had dieted, the majority had dieted five times or less, had started dieting between the ages of 40 and 50 years, and very few had dieted in their teens or twenties (< 8 per cent). Despite normal weight status, desire to lose weight and attempts to achieve this are experienced by young and old alike.
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Proos A, Sutton D, Burnett L, Shaw W. Taming the supplies and inventory process at Westmead Hospital. Qual Lett Healthc Lead 1994; 6:83-6. [PMID: 10136752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
UNLABELLED In July 1991, a team within the Clinical Chemistry Department at Westmead Hospital used control charts and other statistical tools to analyze the supplies and inventory process. No single major problem was discovered. Instead, the team found many small problems causing delays and inefficiencies in the process. By developing and implementing multiple solutions, the team was able to streamline the process and reduce the number of principal suppliers. RESULTS The number of principal suppliers was reduced by two-thirds. The average number of "urgent" orders, which add extra steps to the purchasing process, was reduced by three-quarters. The mean turnaround time for common clinical chemistry laboratory tests improved by 8%.
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Abstract
The ovarian remnant syndrome represents the development of symptoms due to residual ovarian tissue after bilateral salpingo-oophorectomy. Treatment generally consists of surgical resection but recurrence after resection is common. A case is reported in which a postoperative recurrent ovarian remnant was successfully managed by using a luteinizing hormone-releasing hormone agonist. In addition, this report includes a survey of gynecologists to determine the frequency of this syndrome and of ureteral involvement.
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Affiliation(s)
- M O Koch
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765
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Abstract
Repetitive nerve stimulation (RNS) of the trapezius muscle at slow rates was performed on 192 patients with amyotrophic lateral sclerosis (ALS). Fifty-six patients (29%) showed classical neuromuscular decrement of 10-43% (mean 16.8%) while 44 patients (23%) had a borderline decrement of 5-9%. The trapezius was significantly more sensitive in revealing the defect than the distal hypothenar muscles. In 30 patients followed serially, the decremental response remained constant or increased with time. However, 25% of patients continued to show no decrement in spite of progression of disease. No statistical correlation was found between decrement and clinical severity, disease staging, or disease progression. The finding that at least 50% of ALS patients show some degree of decrement on RNS of the trapezius muscle suggests that functional alterations of the neuromuscular junction accompany this disease.
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Affiliation(s)
- J M Killian
- Department of Neurology, Baylor College of Medicine, Houston, Texas
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48
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Banning J, Brown J, Hooper L, Hamilton J, Burnett J, Burnett L. Reduction of errors in laboratory test reports using continuous quality improvement techniques. Clin Lab Manage Rev 1993; 7:424-6, 428-30, 432-6. [PMID: 10128847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The techniques of continuous quality improvement have been applied to the problem of wrongly addressed clinical laboratory test reports. Over a 6-month period, flow charts of the process of producing test reports were created, the error rates of incorrectly addressed test reports were established, and the root causes of these errors were identified and progressively removed. A 17-fold sustained reduction in the rate of incorrectly addressed test reports was achieved with faster turnaround time, no significant expenditure of funds, and no changes in staff, equipment, or the laboratory information system.
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Abstract
OBJECTIVE To report a case of familial hypobetalipoproteinaemia in a woman who presented after the incidental finding of marked hypocholesterolaemia during laboratory tests. CLINICAL FEATURES An asymptomatic 37-year-old Lebanese woman presented to the lipid clinic with a serum total cholesterol concentration of 1.1 mmol/L, high density lipoprotein (HDL) cholesterol of 1.0 mmol/L, and triglycerides of 0.28 mmol/L. No secondary cause for the hypocholesterolaemia was established. INVESTIGATION AND OUTCOME: Her serum apolipoprotein B (apo B) levels were markedly reduced at 0.07 g/L. Except for one daughter (IV-4), all other family members including her husband (her first cousin) had apo B levels about 25% of normal. Daughter IV-4 had undetectable apo B levels. Family studies confirmed an autosomal dominant pattern of inheritance consistent with familial hypobetalipoproteinaemia. CONCLUSION Familial hypobetalipoproteinaemia is a rare condition that should be considered in the differential diagnosis of hypocholesterolaemia. Absence of clinical features, autosomal dominant pattern of inheritance, and reduced apo B levels suggest the diagnosis.
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Affiliation(s)
- J R Burnett
- Department of Clinical Chemistry, Westmead Hospital, NSW
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50
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