1
|
Collins L, Boehm E, Luxford C, Clifton‐Bligh R, Grill V. Hypervitaminosis D Secondary to a CYP24A1 Loss-of-Function Mutation: An Unusual Cause of Hypercalcemia in Two Siblings. JBMR Plus 2023; 7:e10788. [PMID: 37701149 PMCID: PMC10494500 DOI: 10.1002/jbm4.10788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/15/2023] [Accepted: 06/06/2023] [Indexed: 09/14/2023] Open
Abstract
Hypervitaminosis D as a cause of hypercalcemia may be due to vitamin D intoxication, granulomatous diseases, or abnormalities of vitamin D metabolism. The CYP24A1 gene encodes for the 24-hydroxylase enzyme, which is responsible for the catabolism of 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D). Mutations in CYP24A1 can result in elevated 1,25(OH)2D causing parathyroid hormone (PTH)-independent hypercalcemia, hypercalciuria, nephrolithiasis, and nephrocalcinosis. We present the cases of two siblings exhibiting hypercalcemia secondary to a CYP24A1 loss-of-function mutation. Case 1 presented initially with PTH-dependent hypercalcemia, with localization of a left upper parathyroid adenoma on parathyroid technetium sestamibi (99mTc-MIBI) uptake study. Despite parathyroidectomy (180 mg adenoma), hypercalcemia, hypercalciuria, and low normal PTH levels persisted. A repeat parathyroid 99mTc-MIBI uptake study localized a second adenoma and a right inferior parathyroidectomy was performed (170 mg adenoma). PTH subsequently became undetectable, however hypercalcemia and hypercalciuria persisted. A new presentation of PTH-independent hypercalcemia found to be secondary to a CYP24A1 loss-of-function mutation in his sibling, Case 2, signaled the underlying cause. Cascade testing confirmed both siblings were homozygous for the pathogenic variant c.1186C>T, p.Arg396Trp (R396W) of CYP24A1 (NM_000782.5). In clinical practice CYP24A1 loss-of-function mutations should be considered in patients presenting with PTH-independent hypercalcemia, hypercalciuria, and 1,25(OH)2D levels in the upper normal or elevated range. Although in our case assays of 24,25(OH)2D were not available, calculation of the 25(OH)D:24,25(OH)2D ratio can assist in the diagnostic process. Possible treatments to manage the risk of hypercalcemia in patients with a CYP24A1 loss-of-function mutation include avoidance of vitamin D oversupplementation and excessive sun exposure. Hydration and bisphosphonate therapy can be useful in managing the hypercalcemia. Although not utilized in our cases, treatment with ketoconazole, fluconazole, and rifampicin have been described as potential therapeutic options. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Lucy Collins
- Department of Endocrinology and DiabetesWestern HealthMelbourneVictoriaAustralia
| | - Emma Boehm
- Department of Endocrinology and DiabetesWestern HealthMelbourneVictoriaAustralia
- University of MelbourneMelbourneVictoriaAustralia
| | - Catherine Luxford
- Royal North Shore HospitalKolling InstituteSt LeonardsNew South WalesAustralia
| | - Roderick Clifton‐Bligh
- Royal North Shore HospitalKolling InstituteSt LeonardsNew South WalesAustralia
- Department of EndocrinologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Vivian Grill
- Department of Endocrinology and DiabetesWestern HealthMelbourneVictoriaAustralia
- University of MelbourneMelbourneVictoriaAustralia
| |
Collapse
|
2
|
Monks T, Harper A, Allen M, Collins L, Mayne A. Forecasting the daily demand for emergency medical ambulances in England and Wales: a benchmark model and external validation. BMC Med Inform Decis Mak 2023; 23:117. [PMID: 37434185 DOI: 10.1186/s12911-023-02218-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND We aimed to select and externally validate a benchmark method for emergency ambulance services to use to forecast the daily number of calls that result in the dispatch of one or more ambulances. METHODS The study was conducted using standard methods known to the UK's NHS to aid implementation in practice. We selected our benchmark model from a naive benchmark and 14 standard forecasting methods. Mean absolute scaled error and 80 and 95% prediction interval coverage over a 84 day horizon were evaluated using time series cross validation across eight time series from the South West of England. External validation was conducted by time series cross validation across 13 time series from London, Yorkshire and Welsh Ambulance Services. RESULTS A model combining a simple average of Facebook's prophet and regression with ARIMA errors (1, 1, 3)(1, 0, 1, 7) was selected. Benchmark MASE, 80 and 95% prediction intervals were 0.68 (95% CI 0.67 - 0.69), 0.847 (95% CI 0.843 - 0.851), and 0.965 (95% CI 0.949 - 0.977), respectively. Performance in the validation set was within expected ranges for MASE, 0.73 (95% CI 0.72 - 0.74) 80% coverage (0.833; 95% CI 0.828-0.838), and 95% coverage (0.965; 95% CI 0.963-0.967). CONCLUSIONS We provide a robust externally validated benchmark for future ambulance demand forecasting studies to improve on. Our benchmark forecasting model is high quality and usable by ambulance services. We provide a simple python framework to aid its implementation in practice. The results of this study were implemented in the South West of England.
Collapse
Affiliation(s)
- Thomas Monks
- University of Exeter Medical School, University of Exeter, Heavitree Road, Devon, EX1 2LU, Exeter, UK.
- NIHR Applied Research Collaboration Wessex, University of Exeter, Heavitree Road, Exeter, EX1 2LU, Devon, UK.
| | - Alison Harper
- University of Exeter Medical School, University of Exeter, Heavitree Road, Devon, EX1 2LU, Exeter, UK
- NIHR Applied Research Collaboration Wessex, University of Exeter, Heavitree Road, Exeter, EX1 2LU, Devon, UK
| | - Michael Allen
- University of Exeter Medical School, University of Exeter, Heavitree Road, Devon, EX1 2LU, Exeter, UK
- NIHR Applied Research Collaboration Wessex, University of Exeter, Heavitree Road, Exeter, EX1 2LU, Devon, UK
| | - Lucy Collins
- Data Science Team, South Western Ambulance Service NHS Foundation Trust, Eagle Way, Exeter, EX2 7HY, Devon, UK
| | - Andrew Mayne
- Service Evaluation & Improvement Team, Somerset NHS Foundation Trust, Musgrove Park Hospital, Taunton, TA1 5DA, Somerset, UK
| |
Collapse
|
3
|
Collins L, Trouvé R, Baker PJ, Cirulus B, Nitschke CR, Nolan RH, Smith L, Penman TD. Fuel reduction burning reduces wildfire severity during extreme fire events in south-eastern Australia. J Environ Manage 2023; 343:118171. [PMID: 37245307 DOI: 10.1016/j.jenvman.2023.118171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
Extreme fire events have increased across south-eastern Australia owing to warmer and drier conditions driven by anthropogenic climate change. Fuel reduction burning is widely applied to reduce the occurrence and severity of wildfires; however, targeted assessment of the effectiveness of this practice is limited, especially under extreme climatic conditions. Our study utilises fire severity atlases for fuel reduction burns and wildfires to examine: (i) patterns in the extent of fuel treatment within planned burns (i.e., burn coverage) across different fire management zones, and; (ii) the effect of fuel reduction burning on the severity of wildfires under extreme climatic conditions. We assessed the effect of fuel reduction burning on wildfire severity across temporal and spatial scales (i.e., point and local landscape), while accounting for burn coverage and fire weather. Fuel reduction burn coverage was substantially lower (∼20-30%) than desired targets in fuel management zones focused on asset protection, but within the desired range in zones that focus on ecological objectives. At the point scale, wildfire severity was moderated in treated areas for at least 2-3 years after fuel treatment in shrubland and 3-5 years in forests, relative to areas that did not receive fuel reduction treatments (i.e., unburnt patches). Fuel availability strongly limited fire occurrence and severity within the first 18 months of fuel reduction burning, irrespective of fire weather. Fire weather was the dominant driver of high severity canopy defoliating fire by ∼3-5 years after fuel treatment. At the local landscape scale (i.e., 250 ha), the extent of high canopy scorch decreased marginally as the extent of recently (<5 years) treated fuels increased, though there was a high level of uncertainty around the effect of recent fuel treatment. Our findings demonstrate that during extreme fire events, very recent (i.e., <3 years) fuel reduction burning can aid wildfire suppression locally (i.e., near assets) but will have a highly variable effect on the extent and severity of wildfires at larger scales. The patchy coverage of fuel reduction burns in the wildland-urban interface indicates that considerable residual fuel hazard will often be present within the bounds of fuel reduction burns.
Collapse
Affiliation(s)
- L Collins
- Pacific Forestry Centre, Canadian Forest Service, Natural Resources Canada, 506 Burnside Road West, Victoria, BC, V8Z 1M5, Canada; Department of Environment and Genetics, La Trobe University, Bundoora, Victoria, 3086, Australia.
| | - R Trouvé
- School of Ecosystem and Forest Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - P J Baker
- School of Ecosystem and Forest Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - B Cirulus
- School of Ecosystem and Forest Sciences, University of Melbourne, Creswick, Victoria, 3363, Australia
| | - C R Nitschke
- School of Ecosystem and Forest Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - R H Nolan
- Hawkesbury Institute for the Environment, Western Sydney University, Penrith, New South Wales, 2751, Australia; NSW Bushfire Risk Management Research Hub, Wollongong, New South Wales, Australia
| | - L Smith
- Forest Fire and Regions, Department of Energy, Environment and Climate Action, 1 Licola Rd, Heyfield, Victoria, 3858, Australia
| | - T D Penman
- School of Ecosystem and Forest Sciences, University of Melbourne, Creswick, Victoria, 3363, Australia
| |
Collapse
|
4
|
Sweis R, Garralda E, Saavedra Santa Gadea O, Moore K, Davar D, Hamid O, Segal N, Evans T, Dar M, Yuan Y, Collins L, Kirk P, Karakuzu O, Lopez J, Melero I. 157P Phase I expansion of IMC-C103C, a MAGE-A4×CD3 ImmTAC bispecific protein, in ovarian carcinoma. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
5
|
Siracusa C, Saulitis A, Collins L, Mirus K, Patel N, George C, Sabadosa K, Riekert K. 304 Using network learning models to facilitate best practices for successful conversations prompted from the daily care check-in. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00994-8] [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: 11/05/2022]
|
6
|
Hamid O, Sato T, Davar D, Callahan M, Thistlethwaite F, Aljumaily R, Johnson M, Arkenau HT, Ileana Dumbrava E, Izar B, Chen H, Marshall S, Yuan Y, Deo M, Stanhope S, Collins L, Mundy R, Abdullah S, Lopez J. 728O Results from phase I dose escalation of IMC-F106C, the first PRAME × CD3 ImmTAC bispecific protein in solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.854] [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: 11/01/2022] Open
|
7
|
Tierney A, Curran M, Collins L, Kennedy L, McDonnell C, Jurascheck A, Sheikhi A, Walsh C, Button B, Casserly B, Cahalan R. P231 Steps Ahead: optimising physical activity in adults with cystic fibrosis - a pilot randomised trial using wearable technology, goal setting and text message feedback. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00560-4] [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]
|
8
|
Sugahara O, Danilenko U, Poynter K, Collins L, Khoshnam N, Coffman C, Buchannan T, Ribera A, Laughlin B, Dahya K, Smith B, Arndt A, Pokuah F, Wirtz D, Ulmer C, Zhou H, Vesper H. M258 Improving the diagnosis, treatment, and prevention of diseases through accurate and reliable laboratory measurements with CDC clinical standardization programs (CDC CSP). Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.477] [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]
|
9
|
Bendall ER, Bedward M, Boer M, Clarke H, Collins L, Leigh A, Bradstock RA. Growth enhancements of elevated atmospheric [CO
2
] are reduced under drought‐like conditions in temperate eucalypts. Funct Ecol 2022. [DOI: 10.1111/1365-2435.14046] [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: 11/27/2022]
Affiliation(s)
- E. R. Bendall
- University of Wollongong Centre for Environmental Risk Management of Bushfires Northfields Avenue Wollongong New South Wales Australia 2522
| | - M. Bedward
- University of Wollongong Centre for Environmental Risk Management of Bushfires Northfields Avenue Wollongong New South Wales Australia 2522
| | - M. Boer
- Hawkesbury Institute for the Environment Western Sydney University Richmond New South Wales Australia
| | - H. Clarke
- University of Wollongong Centre for Environmental Risk Management of Bushfires Northfields Avenue Wollongong New South Wales Australia 2522
- Hawkesbury Institute for the Environment Western Sydney University Richmond New South Wales Australia
| | - L. Collins
- La Trobe University Department of Ecology Environment & Evolution Bundoora Victoria 3086 Australia
- Arthur Rylah Institute for Environmental Research Department of Environment, Land, Water and Planning Heidelberg Victoria 3084 Australia
- Pacific Forestry Centre Canadian Forest Service Natural Resources Canada 506 Burnside Road West Victoria BC V8Z 1M5 Canada
| | - A. Leigh
- University of Technology Sydney School of Life Sciences Broadway New South Wales Australia
| | - R. A. Bradstock
- University of Wollongong Centre for Environmental Risk Management of Bushfires Northfields Avenue Wollongong New South Wales Australia 2522
| |
Collapse
|
10
|
Binder P, Nguyen B, Collins L, Zi M, Liu W, Christou F, Luo X, Hille SS, Frey N, Cartwright EJ, Chernoff J, Müller OJ, Guan K, Wang X. Pak2 Regulation of Nrf2 Serves as a Novel Signaling Nexus Linking ER Stress Response and Oxidative Stress in the Heart. Front Cardiovasc Med 2022; 9:851419. [PMID: 35350536 PMCID: PMC8957820 DOI: 10.3389/fcvm.2022.851419] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/11/2022] [Indexed: 12/20/2022] Open
Abstract
Endoplasmic Reticulum (ER) stress and oxidative stress have been highly implicated in the pathogenesis of cardiac hypertrophy and heart failure (HF). However, the mechanisms involved in the interplay between these processes in the heart are not fully understood. The present study sought to determine a causative link between Pak2-dependent UPR activation and oxidative stress via Nrf2 regulation under pathological ER stress. We report that sustained ER stress and Pak2 deletion in cardiomyocytes enhance Nrf2 expression. Conversely, AAV9 mediated Pak2 delivery in the heart leads to a significant decrease in Nrf2 levels. Pak2 overexpression enhances the XBP1-Hrd1 UPR axis and ameliorates tunicamycin induced cardiac apoptosis and dysfunction in mice. We found that Pak2 deletion and altered proteostasis render Nrf2 detrimental by switching from its antioxidant role to renin-angiotensin aldosterone system (RAAS) gene regulator. Mechanistically, Pak2 mediated Hrd1 expression targets Nrf2 for ubiquitination and degradation thus preventing its aberrant activation. Moreover, we find a significant increase in Nrf2 with a decrease in Pak2 in human myocardium of dilated heart disease. Using human-induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs), we find that Pak2 is able to ameliorate Nrf2 induced RAAS activation under ER stress. These findings demonstrate that Pak2 is a novel Nrf2 regulator in the stressed heart. Activation of XBP1-Hrd1 is attributed to prevent ER stress-induced Nrf2 RAAS component upregulation. This mechanism explains the functional dichotomy of Nrf2 in the stressed heart. Thus, Pak2 regulation of Nrf2 homeostasis may present as a potential therapeutic route to alleviate detrimental ER stress and heart failure.
Collapse
Affiliation(s)
- Pablo Binder
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Binh Nguyen
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Lucy Collins
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Min Zi
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Wei Liu
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Foteini Christou
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Xiaojing Luo
- Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Susanne S Hille
- Department of Internal Medicine III, University of Kiel, Kiel, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Norbert Frey
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Elizabeth J Cartwright
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Jonathan Chernoff
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Oliver J Müller
- Department of Internal Medicine III, University of Kiel, Kiel, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - Kaomei Guan
- Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Xin Wang
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
11
|
Magner S, Collins L, Quaid S, Burke P, Lynch A, Horan E. 131 A REVIEW OF FRAILTY AND PATIENT DISCHARGE OUTCOMES IN A NEWLY FORMED PHYSIOTHERAPY TEAM IN A LEVEL 4 TEACHING HOSPITAL. Age Ageing 2021. [PMCID: PMC8690004 DOI: 10.1093/ageing/afab219.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion
Collapse
Affiliation(s)
- S Magner
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - L Collins
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Quaid
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - P Burke
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Lynch
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - E Horan
- Mater Misericordiae University Hospital, Dublin, Ireland
| |
Collapse
|
12
|
Curran M, Tierney AC, Button B, Collins L, Kennedy L, McDonnell C, Casserly B, Cahalan R. The effectiveness of exercise interventions to increase physical activity in Cystic Fibrosis: A systematic review. J Cyst Fibros 2021; 21:272-281. [PMID: 34753671 DOI: 10.1016/j.jcf.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/10/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
Physical activity (PA) and exercise have numerous benefits in Cystic Fibrosis (CF) including improved lung function, exercise capacity and quality of life. Despite these benefits, the effectiveness of interventions to promote PA in this population are still largely unknown. The objective of this review was to synthesise existing research and determine whether exercise interventions are effective in promoting PA in people with CF. Using the PRISMA guidelines, a comprehensive search was conducted. Fifteen studies (463 participants) met the inclusion criteria. Eleven studies demonstrated improvements in PA in both short- and long-term interventions. However, the interventions were variable across the included studies, with a large inconsistency in PA assessment tools used. Aerobic training and activity counselling were the two elements identified in this review which most consistently improved PA. Future research should consider larger sample sizes and the use of accurate instruments to assess and track PA levels longitudinally.
Collapse
Affiliation(s)
- M Curran
- School of Allied Health, University of Limerick, Limerick, Ireland; University Hospital Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
| | - A C Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, Australia; Health Implementation Science and Technology Research Group, Health Research Institute, University of Limerick, Limerick, Ireland
| | - B Button
- Departments of Respiratory Medicine and Physiotherapy, The Alfred, Melbourne, Australia; Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - L Collins
- University Hospital Limerick, Limerick, Ireland
| | - L Kennedy
- University Hospital Limerick, Limerick, Ireland
| | - C McDonnell
- University Hospital Limerick, Limerick, Ireland
| | - B Casserly
- University Hospital Limerick, Limerick, Ireland
| | - R Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
13
|
Stäger R, Stanhope S, Greenshields-Watson A, Collins L, Ramelyte E, Kolm I, Dummer R, Meier-Schiesser B. 1772P Demonstration of T cell redirection and immune activation in skin rash following tebentafusp treatment. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
14
|
Merino LDLC, Eroglu Z, Collins L, Greenshields-Watson A, Stanhope S, Abdullah S, Ranade K, Sacco J. 1770P Genomic correlates of clinical outcomes in patients with metastatic uveal melanoma (mUM) treated with tebentafusp (tebe). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
15
|
Piulats J, Sato T, Luke J, Collins L, Edukulla R, Abdullah S, Leyvraz S. 1013P Similar overall survival in tebentafusp-treated 2L+ metastatic uveal melanoma regardless of prior immunotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1397] [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] Open
|
16
|
Shoushtari A, Collins L, Espinosa E, Sethi H, Stanhope S, Abdullah S, Ikeguchi A, Ranade K, Hamid O. 1757O Early reduction in ctDNA, regardless of best RECIST response, is associated with overall survival (OS) on tebentafusp in previously treated metastatic uveal melanoma (mUM) patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
17
|
Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Jurascheck A, Sheikhi A, Button B, Casserly B, Cahalan R. P198 Physical activity is associated with aerobic capacity and lung function in adults with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01223-6] [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]
|
18
|
Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Button B, Casserly B, Cahalan R. P201 The effectiveness of exercise interventions to increase physical activity in cystic fibrosis: a systematic review. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01226-1] [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]
|
19
|
Collins L, Binder P, Chen H, Wang X. Regulation of Long Non-coding RNAs and MicroRNAs in Heart Disease: Insight Into Mechanisms and Therapeutic Approaches. Front Physiol 2020; 11:798. [PMID: 32754048 PMCID: PMC7365882 DOI: 10.3389/fphys.2020.00798] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular disease is the leading cause of mortality worldwide and there is an increasing need to identify new therapeutic targets that could be used to prevent or treat these diseases. Due to recent scientific advances, non-coding RNAs are widely accepted as important regulators of cellular processes, and the identification of an axis of interaction between long non-coding RNAs (lncRNAs) and micro RNAs (miRNAs) has provided another platform through which cardiovascular disease could be targeted therapeutically. Increasing evidence has detailed the importance of these non-coding RNAs, both individually and in an axis of regulation, in the processes and diseases involving the heart. However, further investigation into the consequences of targeting this mechanism, as well as refinement of how the system is targeted, are required before a treatment can be provided in clinic. This level of genomic regulation provides an exciting potential novel therapeutic strategy for the treatment of cardiovascular disease.
Collapse
Affiliation(s)
- Lucy Collins
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Pablo Binder
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Hongshan Chen
- Key Laboratory of Cardiovascular and Cerebrovascular Medicine, Nanjing Medical University, Nanjing, China
| | - Xin Wang
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
20
|
Pastor A, Conn J, O'Brien CL, Teng J, Loh M, Collins L, MacIsaac RJ, Bonomo Y. Clinicians feel comfortable discussing alcohol but not illicit drug use with young adults with Type 1 diabetes: a survey of clinicians. Diabet Med 2020; 37:1076-1078. [PMID: 31529510 DOI: 10.1111/dme.14136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- A Pastor
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - J Conn
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - C L O'Brien
- Mental Health Services, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - J Teng
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - M Loh
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - L Collins
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - R J MacIsaac
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - Y Bonomo
- Department of Addiction Medicine, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
21
|
Ruiz-Velasco A, Zi M, Hille SS, Azam T, Kaur N, Jiang J, Nguyen B, Sekeres K, Binder P, Collins L, Pu F, Xiao H, Guan K, Frey N, Cartwright EJ, Müller OJ, Wang X, Liu W. Targeting mir128-3p alleviates myocardial insulin resistance and prevents ischemia-induced heart failure. eLife 2020; 9:54298. [PMID: 32223896 PMCID: PMC7124275 DOI: 10.7554/elife.54298] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/27/2020] [Indexed: 01/02/2023] Open
Abstract
Myocardial insulin resistance contributes to heart failure in response to pathological stresses, therefore, a therapeutic strategy to maintain cardiac insulin pathways requires further investigation. We demonstrated that insulin receptor substrate 1 (IRS1) was reduced in failing mouse hearts post-myocardial infarction (MI) and failing human hearts. The mice manifesting severe cardiac dysfunction post-MI displayed elevated mir128-3p in the myocardium. Ischemia-upregulated mir128-3p promoted Irs1 degradation. Using rat cardiomyocytes and human-induced pluripotent stem cell-derived cardiomyocytes, we elucidated that mitogen-activated protein kinase 7 (MAPK7, also known as ERK5)-mediated CCAAT/enhancer-binding protein beta (CEBPβ) transcriptionally represses mir128-3p under hypoxia. Therapeutically, functional studies demonstrated gene therapy-delivered cardiac-specific MAPK7 restoration or overexpression of CEBPβ impeded cardiac injury after MI, at least partly due to normalization of mir128-3p. Furthermore, inhibition of mir128-3p preserved Irs1 and ameliorated cardiac dysfunction post-MI. In conclusion, we reveal that targeting mir128-3p mitigates myocardial insulin resistance, thereafter slowing down the progression of heart failure post-ischemia.
Collapse
Affiliation(s)
- Andrea Ruiz-Velasco
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Min Zi
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Susanne S Hille
- Department of Internal Medicine III, University of KielKielGermany,DZHK, German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/LübeckKielGermany
| | - Tayyiba Azam
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Namrita Kaur
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Juwei Jiang
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Binh Nguyen
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Karolina Sekeres
- Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universitaet DresdenDresdenGermany
| | - Pablo Binder
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Lucy Collins
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Fay Pu
- Edinburgh University Medical SchoolEdinburghUnited Kingdom
| | - Han Xiao
- Institute of Vascular Medicine, Peking UniversityBeijingChina
| | - Kaomei Guan
- Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universitaet DresdenDresdenGermany
| | - Norbert Frey
- Department of Internal Medicine III, University of KielKielGermany,DZHK, German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/LübeckKielGermany
| | - Elizabeth J Cartwright
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Oliver J Müller
- Department of Internal Medicine III, University of KielKielGermany,DZHK, German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/LübeckKielGermany
| | - Xin Wang
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| | - Wei Liu
- Faculty of Biology, Medicine, and Health, the University of ManchesterManchesterUnited Kingdom
| |
Collapse
|
22
|
Binder P, Wang S, Radu M, Zin M, Collins L, Khan S, Li Y, Sekeres K, Humphreys N, Swanton E, Reid A, Pu F, Oceandy D, Guan K, Hille SS, Frey N, Müller OJ, Cartwright EJ, Chernoff J, Wang X, Liu W. Pak2 as a Novel Therapeutic Target for Cardioprotective Endoplasmic Reticulum Stress Response. Circ Res 2019; 124:696-711. [PMID: 30620686 PMCID: PMC6407830 DOI: 10.1161/circresaha.118.312829] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Supplemental Digital Content is available in the text. Rationale: Secreted and membrane-bound proteins, which account for 1/3 of all proteins, play critical roles in heart health and disease. The endoplasmic reticulum (ER) is the site for synthesis, folding, and quality control of these proteins. Loss of ER homeostasis and function underlies the pathogenesis of many forms of heart disease. Objective: To investigate mechanisms responsible for regulating cardiac ER function, and to explore therapeutic potentials of strengthening ER function to treat heart disease. Methods and Results: Screening a range of signaling molecules led to the discovery that Pak (p21-activated kinase)2 is a stress-responsive kinase localized in close proximity to the ER membrane in cardiomyocytes. We found that Pak2 cardiac deleted mice (Pak2-CKO) under tunicamycin stress or pressure overload manifested a defective ER response, cardiac dysfunction, and profound cell death. Small chemical chaperone tauroursodeoxycholic acid treatment of Pak2-CKO mice substantiated that Pak2 loss-induced cardiac damage is an ER-dependent pathology. Gene array analysis prompted a detailed mechanistic study, which revealed that Pak2 regulation of protective ER function was via the IRE (inositol-requiring enzyme)-1/XBP (X-box–binding protein)-1–dependent pathway. We further discovered that this regulation was conferred by Pak2 inhibition of PP2A (protein phosphatase 2A) activity. Moreover, IRE-1 activator, Quercetin, and adeno-associated virus serotype-9–delivered XBP-1s were able to relieve ER dysfunction in Pak2-CKO hearts. This provides functional evidence, which supports the mechanism underlying Pak2 regulation of IRE-1/XBP-1s signaling. Therapeutically, inducing Pak2 activation by genetic overexpression or adeno-associated virus serotype-9–based gene delivery was capable of strengthening ER function, improving cardiac performance, and diminishing apoptosis, thus protecting the heart from failure. Conclusions: Our findings uncover a new cardioprotective mechanism, which promotes a protective ER stress response via the modulation of Pak2. This novel therapeutic strategy may present as a promising option for treating cardiac disease and heart failure.
Collapse
Affiliation(s)
- Pablo Binder
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Shunyao Wang
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Maria Radu
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA (M.R., J.C.)
| | - Min Zin
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Lucy Collins
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Saba Khan
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Yatong Li
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Karolina Sekeres
- Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universitaet Dresden, Germany (K.S., K.G.)
| | - Neil Humphreys
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Eileithyia Swanton
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Adam Reid
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Fay Pu
- Edinburgh University Medical School, United Kingdom (F.P.)
| | - Delvac Oceandy
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Kaomei Guan
- Institute of Pharmacology and Toxicology, Faculty of Medicine Carl Gustav Carus, Technische Universitaet Dresden, Germany (K.S., K.G.)
| | - Susanne S Hille
- Department of Internal Medicine III, University of Kiel, Germany (S.S.H., N.F., O.J.M.)
| | - Norbert Frey
- Department of Internal Medicine III, University of Kiel, Germany (S.S.H., N.F., O.J.M.)
| | - Oliver J Müller
- Department of Internal Medicine III, University of Kiel, Germany (S.S.H., N.F., O.J.M.).,DZHK, German Centre for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Germany (O.J.M.)
| | - Elizabeth J Cartwright
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Jonathan Chernoff
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA (M.R., J.C.)
| | - Xin Wang
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| | - Wei Liu
- From the Faculty of Biology, Medicine and Health, The University of Manchester, United Kingdom (P.B., S.W., M.Z., L.C., S.K., Y.L., N.H., E.S., A.R., D.O., E.J.C., X.W., W.L.)
| |
Collapse
|
23
|
Nguyen BY, Ruiz‐Velasco A, Bui T, Collins L, Wang X, Liu W. Mitochondrial function in the heart: the insight into mechanisms and therapeutic potentials. Br J Pharmacol 2019; 176:4302-4318. [PMID: 29968316 PMCID: PMC6887906 DOI: 10.1111/bph.14431] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/08/2018] [Accepted: 06/20/2018] [Indexed: 12/19/2022] Open
Abstract
Mitochondrial dysfunction is considered as a crucial contributory factor in cardiac pathology. This has highlighted the therapeutic potential of targeting mitochondria to prevent or treat cardiac disease. Mitochondrial dysfunction is associated with aberrant electron transport chain activity, reduced ATP production, an abnormal shift in metabolic substrates, ROS overproduction and impaired mitochondrial dynamics. This review will cover the mitochondrial functions and how they are altered in various disease conditions. Furthermore, the mechanisms that lead to mitochondrial defects and the protective mechanisms that prevent mitochondrial damage will be discussed. Finally, potential mitochondrial targets for novel therapeutic intervention will be explored. We will highlight the development of small molecules that target mitochondria from different perspectives and their current progress in clinical trials. LINKED ARTICLES: This article is part of a themed section on Mitochondrial Pharmacology: Featured Mechanisms and Approaches for Therapy Translation. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.22/issuetoc.
Collapse
Affiliation(s)
- Binh Yen Nguyen
- Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Andrea Ruiz‐Velasco
- Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Thuy Bui
- Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Lucy Collins
- Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Xin Wang
- Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| | - Wei Liu
- Faculty of Biology, Medicine and HealthThe University of ManchesterManchesterUK
| |
Collapse
|
24
|
Levin JH, Collins L, Adekunle O, Jackson HT, Vaziri K, Schroeder M, Davison D. Blood product wastage reduction by utilising low-cost, low-impact multimodal physician-to-physician communication initiatives. Transfus Med 2019; 29:389-393. [PMID: 31663197 DOI: 10.1111/tme.12640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess a multimodal physician-to-physician communication initiative that is low in cost and impact to daily workflow to reduce blood product wastage. BACKGROUND Blood product stewardship is an important issue in all hospital systems. Previous studies have proposed low-cost interventions to reduce blood product wastage, but few have evaluated improvements in communication between the blood bank and providers. We undertook a prospective quality improvement project focusing on improving communication to reduce blood product wastage. METHODS We conducted a prospective quality improvement project over the first quarter of 2017, identifying patients with issued but unused blood products. Each service overseeing the care of patients identified on the unit status report was contacted through two possible methods: (i) phone or (ii) proprietary Health Insurance Portability and Accountability Act of 1996 compliant digital messaging application. Collected variables included reserved blood product type and participant time spent. Outcomes included the rate of blood product release and changes in wastage compared with historical data tracked by the blood bank. RESULTS Eight hundred and forty products were reserved during the study period, of which 436 (52%) were released. Average participant times ranged from 2 ± 1 min to 15 ± 4 min with no significant differences in time spent between participants (P = 0·194). Compared with the average product wastage 10 months prior to project initiation, there were significant reductions in the average wastage for platelets (5·3 ± 2·5 units vs 2·5 ± 1·5 units, P = 0·05), RBCs (6·1 ± 3·7 units vs 0 ± 0 units, P = 0·01) and overall wastage (58·3 ± 14·9 units vs 40 ± 15·7 units, P = 0·05). CONCLUSION Efforts focusing on improving provider-to-provider communication can reduce blood product wastage.
Collapse
Affiliation(s)
- J H Levin
- Department of Surgery, George Washington University, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| | - L Collins
- Department of Nursing, George Washington University Hospital, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| | - O Adekunle
- Department of Critical Care, George Washington University Hospital, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| | - H T Jackson
- Department of Surgery, George Washington University, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| | - K Vaziri
- Department of Surgery, George Washington University, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| | - M Schroeder
- Department of Surgery, George Washington University, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| | - D Davison
- Department of Critical Care, George Washington University Hospital, Pennsylvania Avenue NW, Suite 6B, Washington, DC, USA
| |
Collapse
|
25
|
Ding H, Gonzalez-Garcia M, Varnfield M, Krumins A, Martin Y, Bourke F, Gilroy L, Collins L, Karunanithi M. P6215Limited functional capacity and physical activity associated with patient withdrawals from cardiac rehabilitation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0820] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac rehabilitation (CR) assists patients with cardiovascular disease (CVD) in improving physical activity and effectively managing their health conditions. With numerous clinical benefits including reduced risks of mortality (by 25%) and all-cause hospitalizations (by 18% - 25%), CR has been strongly recommended by evidence-based clinical guidelines for secondary prevention of CVD. However, many CR participant withdraw and hence fail to fully benefit from their CR programme. To address this issue, knowledge on risk stratification of patients' characteristics to appropriate CR care pathways is important.
Purpose
The purpose of this study is to identify clinical baseline characteristics associated with patients who withdraw from a CR programme.
Methods
We retrospectively analysed patients who participated in the centre-based CR programmes of a research study in Queensland, Australia. The CR programmes provided structured sessions (training and education) once or twice a week for six weeks in community care centres. We compared the patients who withdrew from their CR programme (Group-W) with those who did not withdraw (or simply completion) (Group-C). Withdrawal was defined as discontinuing within the first four weeks of the CR programme. In the comparison, the one-way analysis of variance (ANOVA) and Fisher's exact test were used for analysing age and sex respectively. The analysis of covariance (ANCOVA) with an adjustment for age and sex was used for the body mass index (BMI), six-minute walk test (6WMT), and health-related quality of life (HeartQoL, ESC 2012), comprising physical (HeartQoL-Phy), emotional (HeartQoL-Emo), and global (HeartQoL-Glo) subscales. The study was approved by the Human Research Ethics Committee (Reference: HREC/16/QPAH/636).
Results
From Dec 2016 to Dec 2017, 600 outpatients with CVD were consented, and enrolled in the study. Seventy participants withdrew. Between the two groups (Group-W vs Group-C), no significant differences were found in age (64±12 years vs 65±10 years; p=0.4221), sex (Female, 31% vs 25%; p=0.2461) and BMI (30.5±6.2 vs 30.1±11.2; p=0.8211). The 6MWT distance was significantly lower in Group-W than Group-C (346±103 m vs 394±92 m; p=0.001). Significantly lower scores of HeartQoL-Phy (1.66±0.86 vs 1.93±0.74; p=0.0072) and HeartQoL-Glo scores (1.80±0.78 vs 2.02±0.67; p=0.0205) were found in Group-W. HeartQoL-Emo scores were lower in Group-W but the difference was not significant (2.19±0.73 vs 2.28±0.72; p=0.4550).
Conclusions
The levels of functional capacity measured by 6MWT and physical activity related quality of life were found to be significantly lower in withdrawal patients than those who completed their CR programme. The finding indicates that new care strategies, especially for patients with limited functional capacity and physical activity, are needed to improve the adherence and effectiveness of CR intervention in future studies.
Acknowledgement/Funding
CSIRO and Metro South Health
Collapse
Affiliation(s)
- H Ding
- The Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| | | | - M Varnfield
- The Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| | - A Krumins
- Medicine and Chronic Disease, Metro South Health, Brisbane, Australia
| | - Y Martin
- Medicine and Chronic Disease, Metro South Health, Brisbane, Australia
| | - F Bourke
- Medicine and Chronic Disease, Metro South Health, Brisbane, Australia
| | - L Gilroy
- Medicine and Chronic Disease, Metro South Health, Brisbane, Australia
| | - L Collins
- Medicine and Chronic Disease, Metro South Health, Brisbane, Australia
| | - M Karunanithi
- The Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| |
Collapse
|
26
|
Curran M, Tierney A, Collins L, Kennedy L, McDonnell C, Sheikhi A, Walsh C, Casserly B, Cahalan R. ePS3.10 Reliability and validity of the ActivPAL and Fitbit Charge 2 as a measure of step count in cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30268-1] [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]
|
27
|
Harriman K, Collins L. P333 The development of a nutrition education and social session for families with children with cystic fibrosis: “work in progress”. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30625-3] [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]
|
28
|
Graham-Wisener L, Collins L, Hanna J, Dempster M. The need for enhanced psychological support in esophageal cancer-an exploratory study of the perception of HCPs, patients, and carers. Dis Esophagus 2019; 32:5075410. [PMID: 30124801 DOI: 10.1093/dote/doy076] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal cancer patients and carers report significant levels of psychological distress. Despite this, only a small number of patients and carers engage with existing psychological services. This study aims to explore the perception of esophageal cancer patients, carers, and healthcare professionals (HCPs) of psychological distress and current provision of support, the need for and format of tailored support and barriers to patient/carer engagement. Semistructured interviews were undertaken with n = 14 esophageal cancer patients, carers, and HCPs. Directed content analysis was utilized to code the transcripts according to the preconceived categories as defined by study aim. Participants reported key periods for heightened distress around diagnosis and postsurgery on discharge from hospital. Provision of existing support was not felt to be adequate. A number of patient/carer barriers to engaging with support were identified in addition to HCP barriers. Participants perceived enhanced psychological support as a priority supportive care need with a number of recommendations for tailoring existing support services more adequately to the clinical population. With reports of heightened psychological morbidity yet with few esophageal cancer patients engaging with psychological services, there is an impetus to develop detailed care pathways to facilitate meeting this prioritized support need.
Collapse
Affiliation(s)
- L Graham-Wisener
- Marie Curie Hospice Belfast, Marie Curie.,School of Psychology, Queen's University Belfast
| | - L Collins
- Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - J Hanna
- Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - M Dempster
- School of Psychology, Queen's University Belfast
| |
Collapse
|
29
|
Kim HJ, Dominici L, Rosenberg S, Pak LM, Poorvu PD, Ruddy K, Tamimi R, Schapira L, Come S, Peppercorn J, Borges V, Warner E, Vardeh H, Collins L, King T, Partridge A. Abstract GS6-01: Surgical treatment after neoadjuvant systemic therapy in young women with breast cancer: Results from a prospective cohort study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs6-01] [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: 11/16/2022]
Abstract
Abstract
Background
Young women are more likely than older women to present with higher stage breast cancer (BC) and may benefit to a greater extent from downstaging with neoadjuvant systemic treatment (NST). Young age is also associated with greater likelihood of pathologic complete response (pCR). Using a large prospective cohort of young women with BC, we investigated response to neoadjuvant therapy, eligibility for breast conserving surgery (BCS) pre- and post-NST, and surgical treatment.
Methods
The Young Women's Breast Cancer Study (YWS) is a multi-center cohort of women diagnosed with BC at age ≤40, that enrolled 1302 patients from 2006 to 2016. Disease characteristics and treatment information were obtained through medical record and central pathology review. Surgical recommendation before and after NST, conversion from BCS borderline/ineligible to BCS eligible, surgery, documented reasons for choosing mastectomy (MTX) among BCS eligible women, and final pathologic response were independently reviewed.
Results
Among 1302 women enrolled in YWS, 801 (62%) presented with unilateral stage I-III breast cancer and 317(40%) received NST. Median age was 36 years old (22-40). Pre-NST, 85/317 (27%) were BCS eligible, 49 (15%) were borderline, and 169 (53%) were not eligible (16 inflammatory breast cancer (IBC), 88 large tumor size /cosmetic, 48 diffuse calcifications, and 83 multicentricity). Among the 218 patients who were BCS ineligible/borderline pre-NST, 82 (38%) became eligible for BCS after NST. 4 patients who were BCS eligible pre-NST became ineligible. Of all patients eligible for BCS post-NST (n=163), 80 (49%) attempted BCS, 74 (93%) of whom were successful, and 83 (51%) chose MTX. Reasons for choosing MTX included: patient preference (38/83 (46%)), BRCA or TP53 mutation (31 (37%)), family history (3 (4%)), unknown (11 (13%)). On final pathology, 75 (24%) patients had pCR. Among patients who achieved a pCR, 48 (64%) underwent MTX, fewer than half (21/48 (44%)) were for anatomic indications (IBC, large tumor at diagnosis, diffuse calcifications, multicentric disease).
Conclusion
While NST doubled the proportion of young women eligible for BCS, nearly half chose MTX regardless of response to NST, mostly for personal preference or high-risk preventative reasons. These data highlight that surgical decision making among young women with breast cancer is often driven by factors beyond extent of disease and clinical response to therapy.
Table 1.Clinical-pathologic characteristicsCharacteristicsNumber%Pre NST surgical recommendation BCS eligible8526.8Borderline4915.5BCS ineligible16953.3Unknown144.4Clinical Response Complete20263.7Partial9229.0Stable30.9Progressing72.2Unknown134.1Pathologic Response pCR (No invasive or DCIS)7524No pCR24276Post NST Surgical recommendation BCS eligible16351.4BCS ineligible14445.4Unknown103.2Attempted surgery BCS8025.2MTX23674.1Unknown20.6Final Surgery BCS7423.3MTX24176unknown20.6
Citation Format: Kim HJ, Dominici L, Rosenberg S, Pak LM, Poorvu PD, Ruddy K, Tamimi R, Schapira L, Come S, Peppercorn J, Borges V, Warner E, Vardeh H, Collins L, King T, Partridge A. Surgical treatment after neoadjuvant systemic therapy in young women with breast cancer: Results from a prospective cohort study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS6-01.
Collapse
Affiliation(s)
- HJ Kim
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - L Dominici
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - S Rosenberg
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - LM Pak
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - PD Poorvu
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - K Ruddy
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - R Tamimi
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - L Schapira
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - S Come
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - J Peppercorn
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - V Borges
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - E Warner
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - H Vardeh
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - L Collins
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - T King
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| | - A Partridge
- Dana-Farber Cancer Institute, Boston, MA; Brigham and Women's Hospital, Boston, MA; Mayo Clinic, Rochester, MN; Stanford University, Palo Alto, CA; Beth Israel Deaconess Medical Center, Boston, MA; Massachusetts General Hospital, Boston; University of Colorado Cancer Center, Aurora, CO; Sunnybrook Health Science Center, Toronto, Canada
| |
Collapse
|
30
|
Pak LM, Rosenberg SM, Ruddy KJ, Tamimi RM, Peppercorn J, Schapira L, Borges VF, Come SE, Warner E, Snow C, Collins L, King TA, Partridge AH. Abstract P6-22-03: Tumor phenotype and concordance in synchronous bilateral breast cancer in young women. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-22-03] [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: 11/16/2022]
Abstract
Abstract
Background: Synchronous bilateral breast cancer is rare, with reported incidence from 0.3-12%; the incidence and pattern of bilateral breast cancer among younger women is unknown. Here we report the incidence and phenotypes of bilateral breast cancer in women ≤40 years of age enrolled in the Young Women's Study (YWS) cohort.
Methods: The YWS is a multi-center, prospective cohort study that enrolled women with newly diagnosed breast cancer at age ≤40 years from 2006-2016. Those with synchronous bilateral breast cancer (in-situ and/or invasive) formed our study cohort. Disease characteristics and treatment were obtained by medical record review. Central pathology review was performed to capture histologic features and categorize the tumor phenotype as either luminal A (hormone receptor (HR)+, HER2-, grade 1 or 2), luminal B (HR+, HER2+, or HER2- and grade 3), HER2-type (HR-, HER2+), or triple negative (TNC; HR/HER2-). Tumor phenotypes of bilateral breast cancers were compared and evaluated for concordance.
Results: Among 1302 patients enrolled in the YWS, 20 (1.5%) patients presented with bilateral disease, with median age of diagnosis of 38 years (range 18-40). The majority of patients (13 (65%)) presented with unilateral symptoms and contralateral disease was identified on subsequent imaging. 12 (60%) reported a positive family history of breast cancer and 17 (85%) underwent genetic testing; resulting in the identification of 6 mutation carriers (2 BRCA1, 3 BRCA2, 1 TP53). The majority of patients (15 (75%)) underwent bilateral mastectomy, 1 underwent unilateral mastectomy with contralateral lumpectomy, and 4 underwent bilateral lumpectomy. On pathology, 2 patients had bilateral in-situ disease, 5 had unilateral invasive and contralateral in-situ disease, and 13 had bilateral invasive disease. Of those with bilateral invasive disease, all had concordant tumor histology (92% ductal, 8% ductal and lobular), 10 (77%) patients had bilateral luminal tumors and when fully characterized 6 were of the same luminal type. Only one patient had bilateral basal-like breast cancer.
Patient ID ERPRHer2 amplifiedGradePhenotype1Left++-2Luminal A Right++-3Luminal B3Left++-3Luminal B Right++-3Luminal B6Left++-3Luminal B Right++-3Luminal B9Left++-2Luminal A Right++-2Luminal A10Left+++3Luminal B Right++-2Luminal A12Left+--3Luminal B Right+--2Luminal A13Left---NABasal-like Right++-NALuminal A or B14Left+++2Luminal B Right++-3Luminal B15Left++-3Luminal B Right+++3Luminal B16Left+++3Luminal B Right--+NAHEr2-type17Left---3Basal-like Right---3Basal-like19Left++-2Luminal A Right++-3Luminal B20Left++-1Luminal A Right++-2Luminal A
Conclusions: Among a large cohort of young women, only 20 (1.5%) had bilateral disease, and the majority of the invasive tumors were of the luminal phenotype, yet frequently differed by grade or HER2 status; supporting the need for thorough pathologic evaluation of bilateral disease to determine risk and tailor treatment. Overall the low incidence of bilateral disease and preponderance of the luminal phenotype in this population is reassuring.
Citation Format: Pak LM, Rosenberg SM, Ruddy KJ, Tamimi RM, Peppercorn J, Schapira L, Borges VF, Come SE, Warner E, Snow C, Collins L, King TA, Partridge AH. Tumor phenotype and concordance in synchronous bilateral breast cancer in young women [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-22-03.
Collapse
Affiliation(s)
- LM Pak
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - SM Rosenberg
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - KJ Ruddy
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - RM Tamimi
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - J Peppercorn
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - L Schapira
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - VF Borges
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - SE Come
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - E Warner
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - C Snow
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - L Collins
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - TA King
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| | - AH Partridge
- Brigham and Women's Hospital, Boston; Dana-Farber Cancer Institute, Boston; Mayo Clinic, Rochester; Massachusetts General Hospital, Boston; Stanford University, Palo Alto; University of Colorado Cancer Center, Aurora; Beth Israel Deaconess Medical Center, Boston; Sunnybrook Hospital, Toronto, Canada
| |
Collapse
|
31
|
Sood S, Lim R, Collins L, Trajanovska M, Hutson JM, Teague WJ, King SK. The long-term quality of life outcomes in adolescents with Hirschsprung disease. J Pediatr Surg 2018; 53:2430-2434. [PMID: 30244941 DOI: 10.1016/j.jpedsurg.2018.08.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/25/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Postoperative outcomes for Hirschsprung disease (HD) remain variable, with many patients affected by constipation and/or fecal incontinence. The long-term impact upon quality of life (QoL) for HD patients is unclear. We measured long-term QoL outcomes in adolescents with HD using validated questionnaires. METHODS Patients with HD, managed at a large tertiary pediatric institution between 1997 and 2004, were identified. Patients and/or their proxy completed validated questionnaires. Results were compared with published healthy population controls. Two questionnaires assessed QoL: Pediatric Quality of Life Inventory (PedsQL) and Fecal Incontinence and Constipation Quality of Life (FICQOL). Three measures assessed functional outcomes: Baylor Continence Scale, Cleveland Clinic Constipation Scoring System, and Vancouver Dysfunctional Elimination Symptom Survey. RESULTS Interviews were completed for 58 (70% response rate) patients [M:F, 49:9; median age, 14.5 years (11.1-18.7)]. No significant differences were found in general QoL scores between patients and healthy controls (84.84 versus 81.49, p = 0.28). Disease-specific questionnaires revealed reduced QoL in patients and families, with 17% of parents reporting the bowel dysfunction stopped their child from socializing and 47% of parents experiencing some degree of anxiety/depression regarding their child's bowel condition. Fecal incontinence (r = -0.59, p < 0.01), constipation (r = -0.36, p = 0.01), and dysfunctional elimination (r = -0.59, p < 0.01) all negatively correlated with QoL scores. CONCLUSIONS In this study, generic QoL in the adolescent HD population was comparable to healthy populations. However, children with HD have ongoing bowel dysfunction which negatively impacts upon their QoL. LEVEL OF EVIDENCE Prognosis study:- level II (prospective cohort study).
Collapse
Affiliation(s)
- Shreya Sood
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne; Department of Paediatrics, University of Melbourne; Surgical Research, Murdoch Children's Research Institute, Melbourne
| | - Reuben Lim
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne; Department of Paediatrics, University of Melbourne; Surgical Research, Murdoch Children's Research Institute, Melbourne
| | - Lucy Collins
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne; Department of Paediatrics, University of Melbourne; Surgical Research, Murdoch Children's Research Institute, Melbourne
| | - Misel Trajanovska
- Centre for Community and Child Health, The Royal Children's Hospital, Melbourne
| | - John M Hutson
- Department of Paediatrics, University of Melbourne; Surgical Research, Murdoch Children's Research Institute, Melbourne; Department of Urology, The Royal Children's Hospital, Melbourne
| | - Warwick J Teague
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne; Department of Paediatrics, University of Melbourne; Surgical Research, Murdoch Children's Research Institute, Melbourne
| | - Sebastian K King
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne; Department of Paediatrics, University of Melbourne; Surgical Research, Murdoch Children's Research Institute, Melbourne; Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne.
| |
Collapse
|
32
|
Papac N, Collins L. The female pioneers in Mohs micrographic surgery. Int J Womens Dermatol 2018; 5:18-20. [PMID: 30809574 PMCID: PMC6374705 DOI: 10.1016/j.ijwd.2018.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/12/2018] [Accepted: 08/13/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- N. Papac
- The University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - L. Collins
- Department of Dermatology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Corresponding author. The University of Oklahoma Health Sciences Center, 619 NE 13 Street, Oklahoma City, OK 73104.
| |
Collapse
|
33
|
Buck ZN, Torres J, Miskowiec A, Mamontov E, Kaiser H, Hansen FY, Taub H, Tyagi M, Collins L, Herwig KW. Effect of melittin on water diffusion and membrane structure in DMPC lipid bilayers. ACTA ACUST UNITED AC 2018. [DOI: 10.1209/0295-5075/123/18002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
34
|
Collins L, Collis B, Trajanovska M, Khanal R, Hutson JM, Teague WJ, King S. Reply to letter to the Editor. J Pediatr Surg 2018; 53:1447-1448. [PMID: 29685488 DOI: 10.1016/j.jpedsurg.2018.02.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Lucy Collins
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Brennan Collis
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Misel Trajanovska
- Centre for Community and Child Health, The Royal Children's Hospital, Melbourne, Australia
| | - Rija Khanal
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - John M Hutson
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Urology, The Royal Children's Hospital, Melbourne, Australia
| | - Warwick J Teague
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Sebastian King
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Australia.
| |
Collapse
|
35
|
Murphy N, Collins L, Tierney A, Linnane B, Casserly B. WS12.2 Supporting cystic fibrosis care at University Hospital Limerick (UHL) through eHealth. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30185-1] [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: 11/25/2022]
|
36
|
Collins L, Boer MM, de Dios VR, Power SA, Bendall ER, Hasegawa S, Hueso RO, Nevado JP, Bradstock RA. Effects of competition and herbivory over woody seedling growth in a temperate woodland trump the effects of elevated CO 2. Oecologia 2018; 187:811-823. [PMID: 29704063 DOI: 10.1007/s00442-018-4143-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 04/11/2018] [Indexed: 12/01/2022]
Abstract
A trend of increasing woody plant density, or woody thickening, has been observed across grassland and woodland ecosystems globally. It has been proposed that increasing atmospheric [CO2] is a major driver of broad scale woody thickening, though few field-based experiments have tested this hypothesis. Our study utilises a Free Air CO2 Enrichment experiment to examine the effect of elevated [CO2] (eCO2) on three mechanisms that can cause woody thickening, namely (i) woody plant recruitment, (ii) seedling growth, and (iii) post-disturbance resprouting. The study took place in a eucalypt-dominated temperate grassy woodland. Annual assessments show that juvenile woody plant recruitment occurred over the first 3 years of CO2 fumigation, though eCO2 did not affect rates of recruitment. Manipulative experiments were established to examine the effect of eCO2 on above-ground seedling growth using transplanted Eucalyptus tereticornis (Myrtaceae) and Hakea sericea (Proteaceae) seedlings. There was no positive effect of eCO2 on biomass of either species following 12 months of exposure to treatments. Lignotubers (i.e., resprouting organs) of harvested E. tereticornis seedlings that were retained in situ for an additional year were used to examine resprouting response. The likelihood of resprouting and biomass of resprouts increased with lignotuber volume, which was not itself affected by eCO2. The presence of herbaceous competitors and defoliation by invertebrates and pathogens were found to greatly reduce growth and/or resprouting response of seedlings. Our findings do not support the hypothesis that future increases in atmospheric [CO2] will, by itself, promote woody plant recruitment in eucalypt-dominated temperate grassy woodlands.
Collapse
Affiliation(s)
- L Collins
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Department of Ecology, Environment & Evolution, La Trobe University, Bundoora, VIC, 3086, Australia. .,Department of Environment, Land, Water and Planning, Arthur Rylah Institute for Environmental Research, PO Box 137, Heidelberg, VIC, 3084, Australia. .,Research Centre for Future Landscapes, La Trobe University, Bundoora, VIC, 3086, Australia.
| | - M M Boer
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - V Resco de Dios
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Life Science and Engineering, Southwest University of Science and Technology, Mianyang, China.,Department of Crop and Forest Sciences and Agrotecnio Center, Universitat de Lleida, 25198, Lleida, Spain
| | - S A Power
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - E R Bendall
- Centre for Environmental Risk Management of Bushfires, University of Wollongong, Wollongong, NSW, 2500, Australia
| | - S Hasegawa
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Center for Regional Environmental Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - R Ochoa Hueso
- Department of Ecology, Autonomous University of Madrid, 28049, Madrid, Spain
| | - J Piñeiro Nevado
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - R A Bradstock
- Centre for Environmental Risk Management of Bushfires, University of Wollongong, Wollongong, NSW, 2500, Australia
| |
Collapse
|
37
|
Binder P, Wang S, Zi M, Collins L, Liu W, Wang X. Pak2 promotes ER‐dependent cardioprotection. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.287.1] [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)
- Pablo Binder
- Faculty of BiologyMedicine and Health ‐ Division of Cardiovascular SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Shunyao Wang
- Faculty of BiologyMedicine and Health ‐ Division of Cardiovascular SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Min Zi
- Faculty of BiologyMedicine and Health ‐ Division of Cardiovascular SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Lucy Collins
- Faculty of BiologyMedicine and Health ‐ Division of Cardiovascular SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Wei Liu
- Faculty of BiologyMedicine and Health ‐ Division of Cardiovascular SciencesUniversity of ManchesterManchesterUnited Kingdom
| | - Xin Wang
- Faculty of BiologyMedicine and Health ‐ Division of Cardiovascular SciencesUniversity of ManchesterManchesterUnited Kingdom
| |
Collapse
|
38
|
Carroll GA, Boyle LA, Hanlon A, Palmer MA, Collins L, Griffin K, Armstrong D, O’Connell NE. Identifying physiological measures of lifetime welfare status in pigs: exploring the usefulness of haptoglobin, C- reactive protein and hair cortisol sampled at the time of slaughter. Ir Vet J 2018; 71:8. [PMID: 29507716 PMCID: PMC5833096 DOI: 10.1186/s13620-018-0118-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/26/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Physiological measures indicative of the welfare status of animals during rearing could form part of an abattoir-based animal health and welfare assessment tool. A total of 66 pigs were used in this study, the aim of which was to assess how serum concentrations of haptoglobin (Hp) and C-reactive protein (CRP) (assessed in 51 pigs), and hair concentrations of cortisol (assessed in 65 pigs), measured at or close to slaughter, reflected welfare-related indicators recorded from the animal during its lifetime. These indicators were recorded at intervals between 7 and 21 weeks of age and included assigning scores for levels of tail and skin lesions, recording the presence or absence of certain health issues, and conducting qualitative behavioural assessments (QBA). RESULTS Pigs recorded as having tail lesions during their lifetime had higher hair cortisol levels than those with no tail lesions (tail lesions: 47.87 ± 3.34 pg/mg, no tail lesions: 42.20 ± 3.29 pg/mg, P = 0.023), and pigs recorded as having moderate or severe tail lesions had higher Hp levels than those with no or mild tail lesions (moderate/severe: 1.711 mg/ml ± 0.74, none/mild: 0.731 mg/ml ±0.10, P = 0.010). Pigs recorded as being lame during their lifetime tended to have higher hair cortisol levels than non-lame pigs (lame: 52.72 pg/mg ± 3.83, not lame: 43.07 pg/mg ± 2.69, P = 0.062). QBA scores were not associated with any of the physiological measures (P > 0.05). Receiver Operator Curve (ROC) analysis was also carried out to get a better understanding of the usefulness of the physiological measures in discriminating animals that had had welfare-related issues recorded during their lifetime from those that had not. Hair cortisol was determined as having 'moderate' accuracy in discriminating pigs that were tail bitten on-farm from unbitten pigs (AUC: 0.748) while Hp and CRP were determined to have no meaningful discriminatory ability (AUC < 0.600). CONCLUSION This research should be repeated on a larger scale, but the results suggest that hair cortisol measured at slaughter could provide insight into the welfare status of pigs during their lifetime. Hp may be a useful indicator of tail lesions in pigs. However, further research utilising a greater proportion of severely bitten pigs is required before conclusions can be drawn.
Collapse
Affiliation(s)
- G. A. Carroll
- Institute for Global Food Security, Queens University Belfast, Northern Ireland Technology Centre, Malone Road, Belfast, BT9 5HN UK
| | - L. A. Boyle
- Animal & Grassland Research & Innovation Centre, Teagasc Moorepark, Fermoy, Co Cork Republic of Ireland
| | - A. Hanlon
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4 Republic of Ireland
| | - M. A. Palmer
- Institute for Global Food Security, Queens University Belfast, Northern Ireland Technology Centre, Malone Road, Belfast, BT9 5HN UK
| | - L. Collins
- Life Sciences, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TS UK
| | - K. Griffin
- School of Biological Sciences, Queens University Belfast, 97 Lisburn Road, Belfast, BT9 7BL UK
| | - D. Armstrong
- Agri-food and Biosciences Institute Pig Unit, Large Park, Hillsborough, Lisburn, County Down BT26 6DR UK
| | - N. E. O’Connell
- School of Biological Sciences, Queens University Belfast, 97 Lisburn Road, Belfast, BT9 7BL UK
| |
Collapse
|
39
|
Abstract
A single group of pigeons received two different training conditions presented on different response keys. Responding during the first component of each condition was reinforced, according to a fixed interval schedule, by gaining access to the second component. In the uninformative condition the second component consisted on every trial of the illumination of the response key for 10 sec, the key was then darkened and food presented with a probability of 0.5. In the informative condition half of the trials at the conclusion of the first component resulted in the key being darkened and no additional events were presented. On the remaining trials the second component was similar to that for the uninformative condition. The results from the first two stages revealed that responding during the first component was faster in the informative than uninformative condition when trials were presented separately. In the final stage, when the trials were presented simultaneously, the rate of responding during the first component was eventually similar in the two conditions, but subjects preferred the second component of the informative condition. These results suggest that events which are informative, or perhaps unpredictable, can support a higher response rate than those which are uninformative, or predictable.
Collapse
|
40
|
Mulligan M, Collins L, Dunne CP, Keane L, Linnane B. Determination of the Lung Clearance Index (LCI) in a Paediatric Cystic Fibrosis Cohort. Ir Med J 2017; 110:629. [PMID: 29372944] [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: 06/07/2023]
Abstract
The pathogenesis of CF lung disease may start in infancy. Therefore, it is important to monitor the early stages of its progress. The Exhalyzer D is the first commercially available device designed to measure lung ventilation inhomogeneity at any age. This study was conducted to assess the performance and feasibility of using the Exhalyzer D in a paediatric CF clinic. A total of 91 subjects were recruited (23 controls, and 68 patients with CF). The majority of CF patients (79%) and controls (78%) completed at least two successful washouts. A strong linear correlation was noted between LCI and FEV1. Children with CF under six years of age struggled to perform the washout in a technically correct manner. A clear learning effect was observed, with improved technique and shorter testing times on repeated visits.
Collapse
Affiliation(s)
- M Mulligan
- Paediatric Department, University Hospital Limerick (UHL), Limerick, Ireland
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - L Collins
- Paediatric Department, University Hospital Limerick (UHL), Limerick, Ireland
| | - C P Dunne
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - L Keane
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - B Linnane
- Paediatric Department, University Hospital Limerick (UHL), Limerick, Ireland
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
- National Children's Research Centre, Crumlin, Dublin, Ireland
| |
Collapse
|
41
|
Linnane B, Collins L, Bussmann N, O'Connell NH, Dunne CP. Medical devices for cystic fibrosis care may be portable reservoirs of potential pathogens. J Hosp Infect 2017; 96:397-398. [PMID: 28535966 DOI: 10.1016/j.jhin.2017.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/19/2017] [Indexed: 01/09/2023]
Affiliation(s)
- B Linnane
- University Hospital Limerick, Dooradoyle, Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - L Collins
- University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - N Bussmann
- University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - N H O'Connell
- University Hospital Limerick, Dooradoyle, Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - C P Dunne
- Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland.
| |
Collapse
|
42
|
Corn K, Imms C, Timewell G, Carter C, Collins L, Dubbeld S, Schubiger S, Froude E. Impact of Second Skin Lycra Splinting on the Quality of Upper Limb Movement in Children. Br J Occup Ther 2016. [DOI: 10.1177/030802260306601005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
43
|
Abstract
Multicentric Castleman's disease (MCD) was originally described in non-HIV patients. It is a rare lymphoproliferative disorder, which is more commonly seen in HIV-positive patients and is associated with human herpes virus-8 (HHV-8). We describe a patient with advanced HIV who responded well to conventional highly active antiretroviral treatment. She was diagnosed with MCD soon after her diagnosis of HIV. She presented with multiple flares of her MCD. The case illustrates the difficulty of differentiating between episodes of septicaemia and a flare of MCD. The patient was treated with various chemotherapy regimens, which included several cycles of liposomal doxyrubicin and etoposide. There is currently no consensus on the treatment of MCD and various therapies are described in the literature, which include chemotherapy. Chemotherapy must be chosen with the immunosuppressive effects of the treatment being considered with caution. Both doxyrubicin and etoposide are well tolerated and successfully controlled the symptoms of MCD in our patient.
Collapse
Affiliation(s)
- A Fowler
- Department of Genito-urinary Medicine, Guy's and St Thomas' NHS Foundation Trust, London SE7 7EH, UK.
| | | | | | | | | | | |
Collapse
|
44
|
Richards T, Collins L, Schwarz E. The real cost of core training. Assoc Med J 2016. [DOI: 10.1136/bmj.i2051] [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]
|
45
|
Albright AL, Collins L, Li J, Harris B, White JM. Crystal Structures of the Amide and Iminol Tautomers O-(3,5-dinitrobenzoyloxy)benzohydroxamate. A Case of a Disappearing Solvate? Aust J Chem 2016. [DOI: 10.1071/ch16369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The O-(3,5-dinitrobenzoyl) derivative of benzohydroxamic acid 1 crystallizes in its iminol tautomeric form, hydrogen bonded to a molecule of dimethyl sulfoxide (DMSO) when crystallized from methanol in the presence of DMSO. In contrast, in the absence of DMSO, 1 crystallizes in its amide tautomeric form. Computations suggest that in the absence of DMSO, the amide tautomer of 1 is significantly more stable than the iminol form. Conversely, in the presence of DMSO, the two forms have comparable stabilities. Solution infrared spectra of 1 run in dichloromethane are consistent with the amide tautomeric form predominating; however, titration of aliquots of DMSO results in the formation of a second species with spectral characteristics consistent with the iminol tautomer.
Collapse
|
46
|
Motzer RJ, Alyasova A, Ye D, Karpenko A, Li H, Alekseev B, Xie L, Kurteva G, Kowalyszyn R, Karyakin O, Neron Y, Cosgriff T, Collins L, Brechenmacher T, Lin C, Morgan L, Yang L. Phase II trial of second-line everolimus in patients with metastatic renal cell carcinoma (RECORD-4). Ann Oncol 2015; 27:441-8. [PMID: 26681676 DOI: 10.1093/annonc/mdv612] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/05/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND RECORD-1 demonstrated clinical benefit of everolimus in patients with metastatic renal cell carcinoma (mRCC) previously treated with sunitinib, sorafenib, or both; prior treatment with cytokines, bevacizumab, and chemotherapy was also permitted. RECORD-4 prospectively assessed everolimus in a purely second-line setting. METHODS Patients with clear-cell mRCC were enrolled into one of three cohorts based on first-line therapy with sunitinib, other anti-VEGF agents, or cytokines. Patients were treated with everolimus 10 mg/day until progression (RECIST, v1.0) or intolerance. The primary end point was progression-free survival (PFS) per investigator review. Data cutoff was 1 September 2014, for the primary analysis and 26 June 2015, for the final overall survival (OS) analysis. RESULTS Enrolled patients (N = 134) previously received sunitinib (n = 58), other anti-VEGF therapy (n = 62; sorafenib, 23; bevacizumab, 16; pazopanib, 13; tivozanib, 5; and axitinib, 3), or cytokines (n = 14). Overall median age was 59 years, and most patients were men (68%) and of favorable/intermediate MSKCC risk (52/37%). Overall median PFS was 7.8 months [95% confidence interval (CI) 5.7-11.0]; in the cohorts, it was 5.7 months (95% CI 3.7-11.3) with previous sunitinib, 7.8 months (95% CI 5.7-11.0) with other previous anti-VEGF therapy, and 12.9 months [95% CI 2.6-not estimable (NE)] with previous cytokines. Overall, 67% of patients achieved stable disease as their best objective response. At final OS analysis, total median OS was 23.8 months (95% CI 17.0-NE) and, in the cohorts, it was 23.8 months (95% CI 13.7-NE) with previous sunitinib, 17.2 months (95% CI 11.9-NE) with other previous anti-VEGF therapy, and NE (95% CI 15.9-NE) with previous cytokine-based therapy. Overall, 56% of patients experienced grade 3 or 4 adverse events (regardless of relationship to study drug). CONCLUSIONS These results confirm the PFS benefit of second-line everolimus after first-line sunitinib or other anti-VEGF therapies. The safety profile of everolimus was consistent with previous experience. CLINICAL TRIAL NAME AND IDENTIFIER Everolimus as Second-line Therapy in Metastatic Renal Cell Carcinoma (RECORD-4), ClinicalTrials.gov identifier, NCT01491672.
Collapse
Affiliation(s)
- R J Motzer
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Alyasova
- Prevoljskiy Region Medical Centre, Novgorod, Russia
| | - D Ye
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - A Karpenko
- Leningrad Regional Oncologic Dispensary, Saint-Petersburg, Russia
| | - H Li
- Peking Union Medical College Hospital, Beijing, China
| | - B Alekseev
- Moscow Hertzen Oncology Institute, Moscow, Russia
| | - L Xie
- First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, China
| | | | - R Kowalyszyn
- Centro de Investigaciones Clinicas Clinica Viedma, Viedma, Argentina
| | - O Karyakin
- Department of Oncology, Medical Radiological Research Center, Obninsk, Russia
| | - Y Neron
- Centro de Pesquisas Oncológicas-CEPON, Florianopolis-SC, Brazil
| | - T Cosgriff
- Crescent City Research Consortium, Marrero, Louisiana
| | - L Collins
- Novartis Oncology, East Hanover, USA
| | | | - C Lin
- Novartis Oncology, East Hanover, USA
| | - L Morgan
- Novartis Oncology, East Hanover, USA
| | - L Yang
- Chinese Academy of Medical Science, Cancer Institute and Hospital, Beijing, China
| |
Collapse
|
47
|
Yang L, Alyasova A, Ye D, Karpenko A, Li H, Alekseev B, Xie L, Kurteva G, Kowalyszyn R, Karyakin O, Nerón Y, Cosgriff T, Collins L, Brechenmacher T, Lin J, Morgan L, Motzer R. 239O RECORD-4: Multicenter phase 2 trial of second-line everolimus (EVE) in patients (pts) with metastatic renal cell carcinoma (mRCC): Asian versus non-Asian population subanalysis. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv524.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
48
|
Collins L. Radiography special issue – Issues in breast imaging. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2015.09.003] [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]
|
49
|
Markocic S, Humphries M, Tarne K, Watts M, Collins L. What are the risks and knowledge deficits for prescribing and administering opioids in the ward environment? A quality project on assessing and improving knowledge. Nurse Educ Pract 2015; 17:182-7. [PMID: 26589096 DOI: 10.1016/j.nepr.2015.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/09/2015] [Accepted: 10/21/2015] [Indexed: 11/27/2022]
Abstract
Investigations into Medical Emergency Team (MET) calls and related clinical incident reviews at a large district teaching hospital provided evidence that over sedation can be a significant issue post opioid administration and that safe and effective pain management requires accurate opioid knowledge and patient assessment skills. The aim of the study was to develop education that was directed at identified knowledge deficits, and to evaluate the impact of this tailored education program on knowledge of safe prescribing and administration of opioids. Knowledge levels were explored using a structured questionnaire in a pre and post-test design. A convenience sample of 34 nurses and 5 junior medical officers across three surgical wards in a tertiary referral hospital had their knowledge assessed. Results showed significant improvement when repeat questionnaires were given two weeks post-delivery of education. Mean scores were 68% at baseline and 89% two weeks post completion of the education program. The greatest improvement in scores was recorded for drug knowledge including dose, half-life and administration. The findings from this study suggest that the opioid education program is effective in improving the knowledge of safe prescribing and administration of opioids, however further studies are required.
Collapse
Affiliation(s)
- S Markocic
- Department of Nursing, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, NSW, Australia.
| | - M Humphries
- Department of Pharmacy, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, NSW, Australia.
| | - K Tarne
- Department of Nursing, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, NSW, Australia.
| | - M Watts
- Department of Nursing, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, NSW, Australia.
| | - L Collins
- Department of Nursing, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, NSW, Australia.
| |
Collapse
|
50
|
Dunseth C, Collins L, Reddy S, Schlueter AJ. Use of a simple, inexpensive device for collection of blood during acute normovolaemic haemodilution in a Jehovah's Witness patient. Vox Sang 2015; 110:202-5. [DOI: 10.1111/vox.12350] [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] [Received: 04/30/2015] [Revised: 08/19/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022]
Affiliation(s)
- C. Dunseth
- Department of Pathology; University of Iowa Carver College of Medicine; Iowa City IA USA
| | - L. Collins
- Department of Pathology; University of Iowa Carver College of Medicine; Iowa City IA USA
| | - S. Reddy
- Department of Anesthesiology; University of Iowa Carver College of Medicine; Iowa City IA USA
| | - A. J. Schlueter
- Department of Pathology; University of Iowa Carver College of Medicine; Iowa City IA USA
| |
Collapse
|