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Roy SM, Rafferty D, Trejo A, Hamilton L, Bohonowych JE, Strong TV, Ambartsumyan L, Cantu S, Scheimann A, Duis J. Feeding tube use and complications in Prader-Willi syndrome: Data from the Global Prader-Willi Syndrome Registry. Am J Med Genet A 2024; 194:e63546. [PMID: 38303141 DOI: 10.1002/ajmg.a.63546] [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: 09/29/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
Guidance on indications for, and types of, feeding tubes recommended in Prader-Willi syndrome (PWS) is needed. A Global PWS Registry survey was developed to investigate nasogastric (NG) and gastrostomy (G) tube use and associated complications. Of 346 participants, 242 (69.9%) had NG-tubes, 17 (4.9%) had G-tubes, and 87 (25.1%) had both NG- and G-tubes. Primary indication for placement was "feeding difficulties and/or poor weight gain" for both NG- (90.2%) and G-tubes (71.2%), while "aspiration/breathing difficulties" was the procedural indication for 6.4% of NG-tubes and 23.1% of G-tubes. NG-tubes were generally removed by age 6 months (NG Only: 82.9%; NG/G: 98.8%), while G-tubes were often removed by age 2 years (G Only: 85.7%; NG/G: 70.5%). The severe complication rate from G-tubes was 31.7% and from NG-tubes was 1.2%. Overall, caregivers indicated the presence of an NG- or G-tube had a positive effect on quality of life. Feeding difficulties in PWS are largely managed by NG-tube alone. The severe complication rate from G-tubes was about 25 times higher than from NG-tubes; yet, G-tube placement rates have generally increased. G-tube placement puts individuals with PWS at risk for anesthesia and surgery-related complications and should be considered judiciously by a multidisciplinary team.
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Affiliation(s)
- Sani M Roy
- Cook Children's Medical Center, Fort Worth, Texas, USA
| | | | - Amy Trejo
- Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Luke Hamilton
- Cook Children's Medical Center, Fort Worth, Texas, USA
| | | | | | | | - Samson Cantu
- Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Ann Scheimann
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Jessica Duis
- Children's Hospital Colorado, Aurora, Colorado, USA
- SequenceMD, Denver, Colorado, USA
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Hagemeister M, Hamilton L, Wandrey N, Hill M, Mounce E, Mosel N, Lytle K, Redinger M, Boley J, Fancher N, Haynes A, Fill I, Cole PA, Hill E, Moxley MA, Thomas AA. Evaluation of Rhodanine Indolinones as AANAT Inhibitors. ChemMedChem 2024; 19:e202300567. [PMID: 37984928 PMCID: PMC10843758 DOI: 10.1002/cmdc.202300567] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/18/2023] [Accepted: 11/19/2023] [Indexed: 11/22/2023]
Abstract
Circadian rhythm (CR) dysregulation negatively impacts health and contributes to mental disorders. The role of melatonin, a hormone intricately linked to CR, is still a subject of active study. The enzyme arylalkylamine N-acetyltransferase (AANAT) is responsible for melatonin synthesis, and it is a potential target for disorders that involve abnormally high melatonin levels, such as seasonal affective disorder (SAD). Current AANAT inhibitors suffer from poor cell permeability, selectivity, and/or potency. To address the latter, we have employed an X-ray crystal-based model to guide the modification of a previously described AANAT inhibitor, containing a rhodanine-indolinone core. We made various structural modifications to the core structure, including testing the importance of a carboxylic acid group thought to bind in the CoA site, and we evaluated these changes using MD simulations in conjunction with enzymatic assay data. Additionally, we tested three AANAT inhibitors in a zebrafish locomotion model to determine their effects in vivo. Key discoveries were that potency could be modestly improved by replacing a 5-carbon alkyl chain with rings and that the central rhodanine ring could be replaced by other heterocycles and maintain potency.
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Affiliation(s)
- Mackenzie Hagemeister
- Department of Psychology, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Luke Hamilton
- Department of Biology, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Nicole Wandrey
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Mackinzi Hill
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Emery Mounce
- Department of Psychology, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Noah Mosel
- Department of Psychology, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Katie Lytle
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Makenna Redinger
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Jake Boley
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Nathan Fancher
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Alexis Haynes
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Ianna Fill
- Department of Psychology, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Philip A Cole
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Evan Hill
- Department of Psychology, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Michael A Moxley
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
| | - Allen A Thomas
- Department of Chemistry, University of Nebraska at Kearney, Kearney, NE, 69949, USA
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Yiannakis C, Hamilton L, Slim M, Kontorinis G. A systematic review and meta-analysis of prophylactic medication of vestibular migraine. J Laryngol Otol 2023; 137:953-961. [PMID: 36200521 DOI: 10.1017/s0022215122001979] [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] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Vestibular migraine is in the process of recognition as an individual clinical entity. At present, no guidelines exist for its management. This study aimed to conduct a systematic review and meta-analysis to determine the effectiveness of available prophylactic medication. METHOD A literature search was performed using PubMed, Ovid and Embase databases. Qualitative and quantitative analysis were performed as well as risk of bias analysis. Meta-analysis for the mean differences for pre- and post-treatment impact based on Dizziness Handicap Inventory and Vertigo Symptom Scale were performed. Proportionate transformation meta-analysis for the successful event rate based on complete symptoms control was explored. RESULTS Thirteen publications were identified: 3 were randomised, controlled trials and 10 were non-randomised, controlled trials. Propranolol and venlafaxine improved the Vertigo Symptom Scale score by -13.31 points and -4.16 points, respectively, and the Dizziness Handicap Inventory score by -32.24 and -21.24, respectively. Only propranolol achieved statistically significant impact with 60 per cent of patients achieving complete symptom control. CONCLUSION Propranolol should be offered as the first-line treatment for vestibular migraine followed by venlafaxine. Amitriptyline, flunarizine and cinnarizine showed a trend for symptom improvement, but this was not statistically significant.
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Affiliation(s)
- C Yiannakis
- Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - L Hamilton
- Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - M Slim
- Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - G Kontorinis
- Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
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Assumpção M, Hamilton L, Díaz Miranda E, Zigo M, Jones A, Rissman J, Taylor J, Schnabel R, Sutovsky P. 167 Role of ADGRA2/TEM5/GPR124 protein during spermatogenesis and fertilisation events. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab167] [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: 12/11/2022] Open
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Roy S, Hamilton L, Wilson D, Topham E. †Does Cholesterol Screening in Prader Willi Syndrome Represent an Opportunity to Reduce Cardiovascular Disease Risk? J Clin Lipidol 2022. [DOI: 10.1016/j.jacl.2022.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fiala MM, Pattabiraman M, Hamilton L, Chandra S. Screening of Non‐Purine Ligands Binding to Adenosine Receptors A
1
, A
2A
, A
2B
, and A
3. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4816] [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]
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Xiang L, Fong W, Low A, Leung YY, Gandhi M, Xin X, Uy E, Hamilton L, Thumboo J. POS1411 EARLY IDENTIFICATION OF AXIAL SPONDYLOARTHRITIS IN A MULTI-ETHNIC ASIAN POPULATION. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:To facilitate earlier diagnosis of spondyloarthritis (SpA), we have previously cross-culturally adapted a self-administered screening questionnaire.Objectives:We aimed to improve the sensitivity of this questionnaire as a screening tool by comparing various scoring methods.Methods:Subjects newly referred to a rheumatology clinic self-administered the questionnaire before seeing a rheumatologist. Identification of axial SpA by the questionnaire using original scoring (Method A) and scoring based on Assessment of SpondyloArthritis International Society (ASAS) inflammatory back pain (IBP) criteria (Method B), ASAS referral criteria (Method C), ASAS classification criteria (Method D) and a combination of ASAS referral and classification criteria (Method E) were compared to classification by the ASAS classification criteria and diagnosis by rheumatologist. Since Methods B-E were based on SpA features, we compared self-reported vs rheumatologist-documented features in subjects with axial SpA.Results:Of 1418 subjects (age: 54 ± 14 years, female: 73%), 39 were classified as axial SpA cases by classification criteria. Methods A-E yielded sensitivities of 39%, 72%, 67%, 49% and 85%, respectively, among patients newly referred to the rheumatology clinic (Table 1). Rheumatologist-documented clinical SpA features exceeded self-report for IBP (62 vs 44%) and uveitis (15 vs 5%). The reverse was true for arthritis (21 vs 80%), enthesitis (28 vs 33%), dactylitis (3 vs 18%), good response to NSAIDs (33 vs 41%) and family history for SpA (5 vs 10%).Table 1.Performance of the five scoring methods for the cross-culturally adapted Hamilton axial SpA questionnaire.Scoring methodSensitivity(95% confidence interval)Specificity(95% confidence interval)Positive predictive value(95% confidence interval)Negative predictive value(95% confidence interval)Method A38.5(23.4 – 55.4)93.7(92.3 – 94.9)14.7(8.5 – 23.1)98.2(97.3 – 98.8)Method B71.8(55.1 – 85.0)73.1(70.7 – 75.4)7.0(4.7 – 10.0)98.9(98.1 – 99.5)Method C66.7(49.8 – 80.9)77.8(75.5 – 80.0)7.8(5.2 – 11.3)98.8(98.0 – 99.4)Method D48.7(32.4 – 65.2)74.9(72.5 – 77.2)5.2(3.2 – 8.0)98.1(97.1 – 98.8)Method E84.6(69.5 – 94.1)37.2(34.6 – 39.8)3.7(2.5 – 5.1)98.8(97.5 – 99.6)Method A: the original scoring defined by the questionnaire developers; Method B: a scoring based on the ASAS IBP criteria; Method C: a scoring based on the ASAS referral criteria; Method D: a scoring based on the ASAS classification criteria for axial and peripheral SpA; Method E: a scoring based on a combination of the ASAS referral and classification criteria.Conclusion:A self-administered questionnaire scored based on a combination of ASAS referral and classification criteria achieved high sensitivity in identifying axial SpA in subjects referred to a rheumatology clinic. This supports its evaluation as a screening tool for axial SpA in the general population.References:[1]Xiang L, Teo EPS, Low AHL, Leung YY, Fong W, Xin X, et al. Cross-cultural adaptation of the Hamilton axial spondyloarthritis questionnaire and development of a Chinese version in a multi-ethnic Asian population. Int J Rheum Dis. 2019;22(9):1652-60.[2]Sieper J, Rudwaleit M, Baraliakos X, Brandt J, Braun J, Burgos-Vargas R, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Annals of the rheumatic diseases. 2009;68 Suppl 2:ii1-44.[3]Poddubnyy D, van Tubergen A, Landewe R, Sieper J, van der Heijde D. Development of an ASAS-endorsed recommendation for the early referral of patients with a suspicion of axial spondyloarthritis. Annals of the rheumatic diseases. 2015;74(8):1483-7.[4]Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Annals of the rheumatic diseases. 2011;70(1):25-31.Acknowledgements:This work was supported by a Health Services Research Grant (HSRG) from the Singapore Ministry of Health National Medical Research Council [grant number: NMRC/HSRG/0075/2017].Disclosure of Interests:None declared
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Lim CSE, Hamilton L, Low S, Toms A, Macgregor A, Gaffney K. POS0035 ONE IN TWENTY INFLAMMATORY BOWEL DISEASE PATIENTS WHO UNDERWENT ABDOMINOPELVIC COMPUTED TOMOGRAPHY HAVE UNDIAGNOSED AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The diagnosis of axial spondyloarthritis (axSpA) is challenging and hindered by delay. There may be an opportunity to identify sacroiliitis for further rheumatology review in inflammatory bowel disease (IBD) patients who undergo Computed Tomography (CT) for non-musculoskeletal (MSK) indications.Objectives:To identify what proportion of IBD patients who underwent abdominopelvic CT for non-MSK indications have axSpA and to explore the role of an imaging strategy for identifying axSpA.Methods:Abdominopelvic CT scans of verified IBD patients were identified retrospectively from eight years of imaging archive. Patients between 18-55 yrs. were selected as having the highest diagnostic yield for axSpA. CT review (using criteria from a validated CT screening tool developed by Chan1) was undertaken by a trained radiology team for presence of CT-defined sacroiliitis (CTSI). All CTSI patients were sent a screening questionnaire. Those with self-reported chronic back pain (CBP), duration > 3 months, onset < 45 years were invited for rheumatology review. This included a medical interview, physical examination (joint count, MASES, dactylitis count, BASMI), patient reported outcomes (BASDAI, BASFI, BASGI, Harvey-Bradshaw-Index, Partial-Mayo-Index), relevant laboratory tests (CRP, ESR, HLA-B27), axSpA protocol MRI, and remote review by a panel of experienced rheumatologists with a special interest in axSpA.Results:CTSI was identified in 60 of 301 patients. Thirty-two (53%) responded to the invitation to participate and 27 (84%) were enrolled. Of these, eight had a pre-existing axSpA diagnosis and five did not report chronic back pain. Fourteen patients underwent rheumatological assessment; three of 14 (21.4% [95% CI: 4.7%, 50.8%]) had undiagnosed axSpA. In total, 11 of 27 (40.7% [95% CI: 22.4%, 61.2%]) patients had a rheumatologist verified diagnosis of axSpA.Conclusion:One in five patients (60/301) with IBD who underwent abdominopelvic CT for non-MSK indications have CTSI and at least one in five (11/60) have axSpA. Five percent (3/60) were previously undiagnosed. This highlights a hidden disease burden and a potential strategy for identifying new cases.References:[1]Chan J, Sari I, Salonen D, Inman RD, Haroon N. Development of a Screening Tool for the Identification of Sacroiliitis in Computed Tomography Scans of the Abdomen. J Rheumatol 2016; 43(9); 1687-94.Acknowledgements:We are indebted to Baljeet Dhillon and Shin Azegami for their assistance in the scoring of the CTSI.Disclosure of Interests:Chong Seng Edwin Lim Grant/research support from: AbbVie, Louise Hamilton: None declared, Samantha Low: None declared, Andoni Toms: None declared, Alex MacGregor: None declared, Karl Gaffney Speakers bureau: AbbVie, Eli Lilly, Novartis, UCB Pharma, Consultant of: AbbVie, Eli Lilly, Novartis, UCB Pharma, Grant/research support from: AbbVie, Gilead, Eli Lilly, Novartis, UCB Pharma.
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Cox J, Hamilton L, Doucette S, Foster G, Thabane L, Parkash R, Xie F, MacKillop J, Ciaccia A, Choudhri S, Nemis-White J. The effect of computer decision support on optimizing appropriate dosing of novel oral anticoagulant therapy in the IMPACT-AF study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Guidelines favour use of the non-vitamin K oral anticoagulants (NOACs) over vitamin-K antagonists for stroke prevention in atrial fibrillation (AF). However, studies have shown these agents are being under-dosed relative to the doses recommended in the product labels.
Purpose
To assess the ability of a CDS tool, employed to support management of patients with AF in primary care, to optimize NOAC prescribing.
Methods
The Integrated Management Program Advancing Community Treatment of Atrial Fibrillation (IMPACT-AF) study was a cluster randomized controlled trial that assessed the ability of a CDS tool to optimize care of community-based AF patients. Between September 2014 and December 2016, 203 primary care providers (104 randomized to CDS use, 99 to usual care [UC]) and 1133 of their patients (n=597 CDS, n=548 UC) were enrolled. Among other functions, 9 CDS program rules provided recommendations on NOAC prescribing based upon a given patient's clinical profile, as per product labels. Appropriate NOAC prescribing within the IMPACT-AF study population was compared between patients managed with the CDS versus UC at baseline and 12-months.
Results
Of those patients prescribed a NOAC, a high proportion (approximately 70%) were managed as per NOAC prescribing recommendations at baseline (Fig. 1). At 12 months, this proportion did not appreciably change in the UC arm (Fig. 1). In the CDS arm, an 8.2% absolute/11.8% relative improvement in appropriate NOAC prescribing over baseline was seen at 12-months (Fig. 1).
A comparison of patients at baseline and 12-months within each arm revealed a non-significant decline in the level of appropriate NOAC prescribing in the UC group (p=0.53). In the CDS arm, a significant improvement was observed in appropriate NOAC prescribing over time (p<0.001).
Conclusion
Even prior to any quality improvement efforts, appropriate NOAC prescribing was higher than anticipated in this contemporary cohort of community-based AF patients. At 12-months, significant further improvements were seen in the CDS but not the UC arm. These findings suggest that physician decision support can help enhance appropriate NOAC prescribing in the primary care setting.
Figure 1. Appropriate NOAC prescribing
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Bayer Inc.
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Affiliation(s)
- J Cox
- Dalhousie University, Professor of Medicine, Halifax, Canada
| | - L Hamilton
- Nova Scotia Health Authority, Halifax, Canada
| | - S Doucette
- Nova Scotia Health Authority, Halifax, Canada
| | - G Foster
- McMaster University, Health Research Methods, Evidence and Impact, Hamilton, Canada
| | - L Thabane
- McMaster University, Health Research Methods, Evidence and Impact, Hamilton, Canada
| | - R Parkash
- Dalhousie University, Professor of Medicine, Halifax, Canada
| | - F Xie
- McMaster University, Health Research Methods, Evidence and Impact, Hamilton, Canada
| | - J MacKillop
- Nova Scotia Health Authority, Halifax, Canada
| | | | | | - J Nemis-White
- Strive Health Management Consulting Ltd., Halifax, Canada
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Hamilton L, McNeal C, Wilson D. Type 1 diabetes mellitus, familial hypercholesterolemia, and elevated lipoprotein (a). Proc (Bayl Univ Med Cent) 2020; 33:398-400. [DOI: 10.1080/08998280.2020.1759335] [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] [Received: 03/06/2020] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Luke Hamilton
- Department of Pediatric Endocrinology and Diabetes, Cook Children’s Medical Center, Fort Worth, Texas
| | - Catherine McNeal
- Division of Cardiology, Department of Internal Medicine, Baylor Scott & White Health, Temple, Texas
| | - Don Wilson
- Department of Pediatric Endocrinology and Diabetes, Cook Children’s Medical Center, Fort Worth, Texas
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Hamilton L, de la Torre A, Wilson D. Use and Variability of Lipoprotein (a) in a Pediatric Lipid Clinic. J Clin Lipidol 2020. [DOI: 10.1016/j.jacl.2020.05.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lim CSE, Tremelling M, Hamilton L, Macgregor A, Gaffney K. SAT0380 ENHANCING RHEUMATOLOGY REFERRALS AMONG INFLAMMATORY BOWEL DISEASE PATIENTS WITH SUSPECTED AXIAL SPONDYLOARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Axial spondyloarthritis (axSpA) is associated with inflammatory bowel disease (IBD). In IBD patients, the clinical probability of axSpA increases in those with chronic back pain (CBP) whose symptoms started before the age of forty-five years old. In practice, this should trigger a rheumatology review especially if accompanied by other symptoms suspicious of inflammatory disease. However, in any health system, the goal of identifying all possible cases need to be balanced with the practical realisation of the finite resources available.Objectives:The study aimed to define the clinical characteristics of a subgroup of IBD patients who are routinely managed in secondary care who have an increased clinical probability for axSpA. Identification of these characteristics may help improve the quality and specificity of referrals to Rheumatology from Gastroenterology clinics.Methods:An analytical cross-sectional study was undertaken. Consecutive IBD patients attending routine Gastroenterology clinics were sent a modified validated back pain questionnaire. The questionnaire included the presence or absence of a previous diagnosis of axSpA; components of validated inflammatory back pain criteria; diagrams to indicate the location of back pain and other musculoskeletal pain; personal and family history of known axSpA manifestations; and details of their IBD course, activity and treatment.IBD patients, with back pain duration > 3 months with onset before 45 years were considered to have a medium diagnostic probability (MDP) for axSpA. MDP-positive IBD patients were compared with MDP-negative IBD patients and logistic regression was used to model the association with clinical features.Results:Four hundred and seventy consecutive IBD patients (mean age 54 years; 46% male) were surveyed. Two hundred and nine patients (59%) replied, of whom 191 patients (69%) consented to participate. One hundred and seventy-three (91%) of those who consented had a valid completed questionnaire and were included for data analysis. Of these, 74% had Ulcerative Colitis and 26% had Crohn’s disease. Their mean age was 58 years, 39% male. Mean age at IBD diagnosis was 39 years, mean IBD disease duration 19 yrs. CBP (back pain greater than three months) was reported by 76%. Inflammatory back pain fulfilling Calin, Berlin, ASAS criteria was seen in 23%, 29%, and 15% respectively. In addition, 80% reported peripheral musculoskeletal pain. Self-reported personal history of enthesitis, reactive arthritis (ReA), acute anterior uveitis (AAU), skin psoriasis (PSO) and dactylitis were 50%, 30%, 24%, 15% and 0% respectively. Self-reported family history of IBD, ReA, PSO, axSpA and AAU were 60%, 36%, 22%, 11%, and 1% respectively.Ninety-one (53%) patients were MDP-positive and 82 (47%) patients were MDP-negative. The clinical characteristics associated with MDP (adjusted for age at invitation) were: the presence of inflammatory back pain using ASAS criteria [OR 8.84 (1.61,48.67); p=0.01], longer interval between symptom onset and gastroenterologist diagnosis of IBD [OR 1.09 (1.03,1.16); p=0.005], and use of rectal topical 5-aminosalicylic acid [OR 3.27 (1.11,9.68); p=0.03].Conclusion:Chronic back pain and peripheral musculoskeletal pain are common in a secondary care IBD population. In IBD patients, with back pain duration > 3 months and onset before 45 years, the presence of inflammatory back pain, longer diagnostic delay of IBD and the use of rectal topical 5-aminosalicylic acid were associated with a higher clinical probability of axSpA. The identification of these clinical features may not only improve the quality and specificity of Rheumatology referrals from Gastroenterology in this subgroup of patients but also lends real world evidence to current ASAS-endorsed recommendations for early referral of patients with a suspicion of axial spondyloarthritis.Disclosure of Interests:Chong Seng Edwin Lim Grant/research support from: AbbVie - Research support/grant but NOT for this study., Mark Tremelling: None declared, Louise Hamilton: None declared, Alexander Macgregor: None declared, Karl Gaffney Grant/research support from: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma, Consultant of: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma, Speakers bureau: AbbVie, Celgene, MSD, Novartis, Pfizer, and UCB Pharma
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Morley J, Moayyeri A, Ali L, Taylor A, Feudjo-Tepie M, Hamilton L, Bayly J. Persistence and compliance with osteoporosis therapies among postmenopausal women in the UK Clinical Practice Research Datalink. Osteoporos Int 2020; 31:533-545. [PMID: 31758206 PMCID: PMC7076063 DOI: 10.1007/s00198-019-05228-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 11/06/2019] [Indexed: 12/16/2022]
Abstract
UNLABELLED Gaining full benefits from osteoporosis medications requires long-term treatment. Investigating the real-world persistence of women receiving osteoporosis medications in the UK, we found that most patients stop treatment within a year. To prevent osteoporotic fragility fractures, long-term treatment persistence must be improved. INTRODUCTION Persistence with osteoporosis therapies has historically been poor. To treat this chronic and progressive disease, it is essential that patients receive the full benefit of these medications. We estimated persistence and compliance with osteoporosis therapies in a large sample of postmenopausal women in the UK. METHODS Data were obtained from the Clinical Practice Research Datalink for all women aged 50 years and over or women with early menopause, who received at least one prescription in primary care for any licensed osteoporosis therapy between January 1, 2010 and December 31, 2015. Persistence and compliance at 24 months (primary objective) and at 5 years (exploratory objective) were estimated in three patient cohorts: "All Patients," "Naïve Patients," and "Drug-Specific." RESULTS The All Patients cohort included 72,256 women. Persistence with any therapy was 56.1%, 43.6%, 36.4%, and 31.0% at 6, 12, 18, and 24 months, respectively, and 23.2% and 13.1% at 3 years and 5 years, respectively. Patients were generally more persistent and compliant if evaluated from their first exposure to osteoporosis therapy (Naïve Patients cohort). In the drug-specific analysis, 64% of patients receiving denosumab (administered subcutaneously every 6 months) were persistent at 24 months compared with 28% and 23% of those taking oral bisphosphonates and intravenous bisphosphonates, respectively. CONCLUSIONS Only about one in three patients who received osteoporosis therapy continued to be on treatment after 2 years. There is a need to improve persistence with osteoporosis therapy, especially for high-risk patients.
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Affiliation(s)
| | | | | | | | | | | | - J Bayly
- University of Derby, Derby, UK
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Hamilton L, Farrell M, Mielke B, Solano M, Silva S, Calvo I. The natural history of canine occult Grade II medial patellar luxation: an observational study. J Small Anim Pract 2020; 61:241-246. [PMID: 32003012 DOI: 10.1111/jsap.13093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 10/08/2019] [Accepted: 11/07/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the risk of lameness and the rate of subsequent medial patellar luxation surgery in dogs that present with occult Grade II medial patellar luxation. MATERIALS AND METHODS Retrospective owner survey and review of clinical records of adult dogs diagnosed with Grade II medial patellar luxation that were initially asymptomatic and managed non-surgically that had a minimum of 4-year follow-up. Clinical notes and owner questionnaires identified dogs that subsequently developed lameness and required surgery on the previously asymptomatic stifle. RESULTS Thirty-eight dogs were included with an average follow-up of 51 months. Seventeen dogs re-presented for unscheduled contralateral medial patellar luxation surgery at an average of 15 months after initial presentation. A further two dogs had chronic contralateral limb lameness after an average of 33 months after initial surgery and may have been potential surgical candidates. CLINICAL SIGNIFICANCE Fifty percent of adult dogs presenting with occult Grade II medial patellar luxation subsequently developed chronic lameness or required surgery.
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Affiliation(s)
- L Hamilton
- Davies Veterinary Specialists, Higham Gobion, Hertfordshire, SG53HR, UK
| | - M Farrell
- Davies Veterinary Specialists, Higham Gobion, Hertfordshire, SG53HR, UK
| | - B Mielke
- Department of Orthopaedic Surgery, Royal Veterinary College, Hertfordshire, UKAL97TA, UK
| | - M Solano
- Department of Orthopaedic Surgery, Fitzpatrick Referrals, Surrey, GU72Q, UK
| | - S Silva
- Department of Orthopaedic Surgery, Fitzpatrick Referrals, Surrey, GU72Q, UK
| | - I Calvo
- Department of Orthopaedic Surgery, Royal Veterinary College, Hertfordshire, UKAL97TA, UK
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Horner S, Hamilton L, Hamby T, Wilson DP. Severe hypercholesterolemia in a 2-year-old. J Clin Lipidol 2019; 13:393-396. [PMID: 31088731 DOI: 10.1016/j.jacl.2019.03.004] [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: 11/15/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 10/27/2022]
Abstract
Routine and selective cholesterol screening of children is an effective tool to help identify those with familial hypercholesterolemia. In children found to have elevated levels of cholesterol, secondary causes should be excluded, including hypothyroidism. Thyroid hormone has multiple effects on the regulation of lipid synthesis, absorption, and metabolism. In this case report, we described a 2-year-old with a history of congenital hypothyroidism who was found to have severe hypercholesterolemia. A detailed medical history and appropriate screening tests are important in determining the underlying cause of elevated low-density lipoprotein cholesterol to help inform clinical decision-making.
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Affiliation(s)
- Susanna Horner
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Luke Hamilton
- Department of Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX, USA.
| | - Tyler Hamby
- Department of Research Administration, Cook Children's Medical Center, Fort Worth, TX, USA
| | - Don P Wilson
- Department of Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX, USA
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Sprunger A, Hamilton L, Hamby T, Wilson D. A novel mutation of APOB in two siblings with hypercholesterolemia. J Clin Lipidol 2019. [DOI: 10.1016/j.jacl.2019.04.038] [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: 10/26/2022]
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17
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Jarvis T, Bopp B, Hamby T, Hamilton L, Wilson D. Perceived fatigue may be an overlooked barrier to successful therapeutic lifestyle change. J Clin Lipidol 2019. [DOI: 10.1016/j.jacl.2019.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Hamilton L, de la Torre A, Wilson D. Lipoprotein (a) testing in youth. J Clin Lipidol 2019. [DOI: 10.1016/j.jacl.2019.04.017] [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: 10/26/2022]
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19
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Mitts M, Gongidi P, Hamilton L, Steelman J. SUN-594 Skeletal Dysplasia and Growth Failure in Congenital Hypothyroidism Due to a Novel Form of Generalized Thyroid Hormone Resistance. J Endocr Soc 2019. [PMCID: PMC6553396 DOI: 10.1210/js.2019-sun-594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Thyroid hormone exerts systemic actions mediated by its specific receptors. These actions encompass a wide array of functions, including energy homeostasis, skeletal growth, neural development, cardiac function, and gastrointestinal function. There are two thyroid hormone receptors, thyroid hormone receptor alpha (THRA) and thyroid hormone receptor beta (THRB) which are encoded by genes on two different chromosomes and with differing tissue distributions. Only mutations in THRB were known until recently with a reported incidence of 1 in ~40,000. Mutations in thyroid receptor THRA have recently been discovered and are exceedingly rare, with 14 cases documented in the past five years. We report a case of a patient with generalized thyroid hormone resistance due to THRA mutation. Clinical Case: Patient was born to non-consanguineous parents at term and was appropriate for gestational age. Prenatal ultrasound was suspect for shortened long bones. Congenital heart disease (ASD and VSD) were detected at birth. Genetics consultation confirmed ultrasound concern with finding of mild rhizomelia. Patient had coarse facial features, macroglossia, and dysmorphic appearance. Initial genetics work-up showed normal chromosomes, normal newborn screening, and normal metabolic studies. Genetics was concerned for possible mucopolysaccharidosis, but further testing ordered did not confirm this diagnosis. Patient exhibited post-natal growth failure after birth with length well below 3rd percentile by 18 months old. Delayed developmental milestones (verbal > motor) were noted. Thyroid function tests between birth and 11 months old were normal. Thyroid function testing at 11 months old were suspect for central hypothyroidism with free T4 0.6 ng/dl (0.6-1.3) and TSH 1.07 uIU/ml (0.71-5.81). Cranial MRI scan showed no abnormalities in hypothalamic-pituitary area. Levothyroxine 37.5 mcg was started, and thyroid function tests normalized. However, little change was seen clinically in patient’s growth pattern or development. Whole exome screening performed in 2013 demonstrated a heterozygous mutation in the THRA gene consistent with generalized thyroid hormone resistance from this mutation. Liothyronine treatment was added in 2014. Growth has continued to be extremely slow with current height standard deviation score of -4.2. Patient is developmentally delayed and non-verbal. Conclusions: A constellation of findings including post-natal growth failure, skeletal findings, and prominent verbal developmental delays are seen in generalized thyroid hormone resistance due to THRA mutation. The subtle presentation of this condition is different from congenital hypothyroidism or generalized thyroid hormone resistance due to THRB mutation. Presentation of this case will hopefully help pediatric specialist to recognize and test for this condition more promptly.
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Affiliation(s)
- Matthew Mitts
- University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Preetam Gongidi
- Cook Childrens Medical Center, Fort Worth, TX, United States
| | - Luke Hamilton
- Cook Childrens Medical Center, Fort Worth, TX, United States
| | - Joel Steelman
- Cook Childrens Medical Center, Fort Worth, TX, United States
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Scovil CY, Delparte JJ, Walia S, Flett HM, Guy SD, Wallace M, Burns AS, Wolfe DL, Wolfe D, Kras-Dupuis A, Walia S, Guy S, Askes H, Casalino A, Fraser C, Paiva M, Miles S, Gagliardi J, Orenczuk S, Sommerdyk J, Genereaux M, Jarvis D, Wesenger J, Bloetjes L, Flett H, Burns A, Scovil C, Delparte J, Leber D, McMillan L, Domingo T, Wallace M, Stoesz B, Aguillon G, Koning C, Mumme L, Cwiklewich M, Bayless K, Crouse L, Crocker J, Erickson G, Mark M, Charbonneau R, Lloyd A, Van Doesburg C, Knox J, Wright P, Mouneimne M, Parmar R, Isaacs T, Reader J, Oga C, Birchall N, McKenzie N, Nicol S, Joly C, Laramée M, Robidoux I, Casimir M, Côté S, Lubin C, Lemay J, Beaulieu J, Truchon C, Noreau L, Lemay V, Vachon J, Bélanger D, Proteau F, O'Connell C, Savoie J, McCullum S, Brown J, Duda M, Bassett-Spiers K, Riopelle R, Hsieh J, Reinhart-McMillan W, Joshi P, Noonan V, Humphreys S, Hamilton L, MacIsaac G. Implementation of Pressure Injury Prevention Best Practices Across 6 Canadian Rehabilitation Sites: Results From the Spinal Cord Injury Knowledge Mobilization Network. Arch Phys Med Rehabil 2019; 100:327-335. [DOI: 10.1016/j.apmr.2018.07.444] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 07/11/2018] [Accepted: 07/20/2018] [Indexed: 12/19/2022]
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21
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Hamilton L, Allard E. INVESTIGATING HOW THE AGING BODY IMPACTS EMOTION-COGNITION ACROSS ADULTHOOD. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.413] [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: 11/13/2022] Open
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22
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Krassioukov A, Holmgren T, Lee A, Shea H, Hamilton L, Sandholdt N, Hellsing I, Elliott S, Claes H. Breastfeeding and motherhood after spinal cord injury: Barriers and challenges. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Hamilton L, Wilson D. A 10 Year Old Female with Low HDL Cholesterol. J Clin Lipidol 2018. [DOI: 10.1016/j.jacl.2018.03.019] [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: 12/01/2022]
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24
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Hamilton L, Tran-Tan K, O'Reilly C, Williams L, Aaron K, Gonzalez J, Wilson D. Do Children Who Undergo Treatment with Antipsychotic Medications Receive Adequate Screening of Cardiovascular Disease Risk Factors? J Clin Lipidol 2018. [DOI: 10.1016/j.jacl.2018.03.029] [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: 12/01/2022]
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25
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Bowden E, Hamilton L, Wilson D. VISUAL VIGNETTE. Endocr Pract 2017; 24:234. [PMID: 29106818 DOI: 10.4158/ep171948.vv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Emily Bowden
- From the 1Baylor/Texas A&M University Health Science Center, Dallas, Texas
| | - Luke Hamilton
- Department of Pediatric Endocrinology Cook Children's Medical Center, Fort Worth, Texas
| | - Don Wilson
- Department of Pediatric Endocrinology Cook Children's Medical Center, Fort Worth, Texas
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26
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Oliver-Welsh L, Hamilton L, Slater N. A novel cabling technique. Ann R Coll Surg Engl 2017; 100:417-418. [PMID: 29046097 DOI: 10.1308/rcsann.2017.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- L Oliver-Welsh
- Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells Hospital , Pembury, Tunbridge Wells , UK
| | - L Hamilton
- Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells Hospital , Pembury, Tunbridge Wells , UK
| | - N Slater
- Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells Hospital , Pembury, Tunbridge Wells , UK
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27
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Wilson DP, Hamilton L, Prakash S, Castro-Silva FJ, Friedman J. Dyslipidemia, weight gain, and decreased growth velocity in a 14-year-old male. J Clin Lipidol 2017; 11:562-566. [PMID: 28502514 DOI: 10.1016/j.jacl.2017.01.010] [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: 01/03/2017] [Accepted: 01/13/2017] [Indexed: 11/25/2022]
Abstract
A 14-year-old male was referred for dyslipidemia. His findings were consistent with metabolic syndrome. Although he lacked the typical physical appearance, his accelerated weight gain combined with a decreased linear growth velocity suggested Cushing syndrome. He was subsequently found to have adrenocorticotropic hormone-independent Cushing syndrome secondary to primary pigmented nodular adrenal disease without Carney Complex. After bilateral adrenalectomy, his lipid profile returned to normal. In this article, we discuss the role of glucocorticoids on lipid and lipoprotein metabolism.
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Affiliation(s)
- Don P Wilson
- Department of Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX, USA.
| | - Luke Hamilton
- Department of Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, TX, USA
| | - Sameer Prakash
- University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | - James Friedman
- Fort Worth Pediatrics, Cook Children's Medical Center, Fort Worth, TX, USA
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Jarvis T, Brautbar A, Hamilton L, Ahmad Z, Wilson D. Genetic Mutation of the LDL-C Receptor without Hypercholesterolemia. J Clin Lipidol 2017. [DOI: 10.1016/j.jacl.2017.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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29
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Cielonko L, Hamby T, Dallas JS, Hamilton L, Wilson DP. Provider variability in the initial diagnosis and treatment of congenital hypothyroidism. J Pediatr Endocrinol Metab 2017; 30:583-586. [PMID: 28328531 DOI: 10.1515/jpem-2016-0326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/30/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early diagnosis and expeditious treatment of newborns with congenital hypothyroidism (CH) is necessary to avoid mental retardation. METHODS A survey of 44 practitioners in the southern US was conducted to better understand common practices regarding neonatal CH and the findings were compared with current guidelines in the US and Europe. RESULTS Responses indicated some consensus that 10-15 μg of thyroid hormone/kg/day was the appropriate dosage. However, despite guidelines advocating their use, practitioners reported that they did not commonly use imaging or laboratory tests, though experienced providers apparently used them more often. CONCLUSIONS Together, these results show moderate adherence to published guidelines for treating and diagnosing CH. Further research is needed to determine why providers deviate from these guidelines and to generalize these results to other populations.
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Abstract
Abstract
Skin wounds are a common presentation in small animal practice. These wounds may be acute or chronic with a complicated healing process. An important aspect of the healing of wounds is debridement which may be carried out by surgical, autolytic, mechanical or enzymatic methods. The debridement method is chosen according to the individual skin defect and influenced by factors such as wound size and location, the age of the wound, and the presence of infection or exudate. Enzymatic debridement is a method that is not commonly used in veterinary practice, and involves the use of enzyme preparations to remove necrotic tissue from a wound. The aim of this study was to investigate the effects of the enzymatic ointment collagenase as a method of debridement, and its effect on the macroscopic appearance of chronic skin wounds in cats and dogs. We observed that the application of Iruxol Mono directly to the wound changes the progress of the healing process, with no obvious adverse effects. The time of healing of chronic wounds was decreased and healthy granulation tissue was developed within a couple of days after application of the ointment. Enzymatic debridement appears to be a promising method of debridement for use in chronic wounds, and should be considered in cases where more conventional methods of debridement are ineffective or unsuitable.
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Affiliation(s)
- L. Hamilton
- University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia
| | - M. Kožár
- University of Veterinary Medicine and Pharmacy, Komenského 73, 04181 Košice, Slovakia
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Hamilton L, Wilson DP, O'Reilly CM, Gonzalez J, de la Torre A. The Prevalence of Dyslipidemia and Other Cardiovascular Risk Factors in Youth with Diabetes. Curr Pediatr Rev 2017; 13:277-280. [PMID: 29473517 DOI: 10.2174/1573396314666180221163924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/05/2017] [Accepted: 02/14/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Individuals diagnosed with diabetes mellitus have an increased risk of cardiovascular disease, often leading to premature morbidity and mortality. As the number of youth developing T1D and T2D continues to grow, early onset predisposes patients to a longer burden of disease and earlier onset of cardiovascular complications. Early identification and effective management and treatment of risk factors can lead to decreased cardiovascular events and improved quality of life. OBJECTIVE In this study, we describe the prevalence of CVD risk factors in children with diabetes. RESULTS 274 subjects were included in this study, all > 1 year since the time of diagnosis. 134 participants were male (49%). Mean age was 13.7 years (males); 12.8 years (females). subjects averaged 4 diabetes-related visits per year. At the time of their most recent clinic visit, 33% of subjects had a HbA1c < 8%, and 29% had a HbA1c > 10%. Greater than 50% of subjects were overweight or obese. A significant number of subjects were found to have dyslipidemia, and elevated blood pressure was common. DISCUSSION CVD risk factors are common in children with diabetes mellitus. Good glycemic control, early identification, and effective life-long management of all CVD risk factors may help decrease the high rate of premature morbidity and mortality in diabetes.
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Affiliation(s)
- Luke Hamilton
- Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, Texas, United States
| | - Don P Wilson
- Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, Texas, United States
| | - Crystal M O'Reilly
- Cook Children's Health Plan, Cook Children's Medical Center, Fort Worth, Texas, United States
| | - Jose Gonzalez
- Cook Children's Health Plan, Cook Children's Medical Center, Fort Worth, Texas, United States
| | - Alejandro de la Torre
- Pediatric Endocrinology and Diabetes, Cook Children's Medical Center, Fort Worth, Texas, United States
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Wilson DP, de la Torre A, Brautbar A, Hamilton L. Screening for genetic mutations in children and adolescents with dyslipidemia: importance of early identification and implications of missed diagnoses. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2016.1189824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Don P. Wilson
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Alejandro de la Torre
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Ariel Brautbar
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Luke Hamilton
- Cardiovascular Health and Risk Reduction Program, Cook Children’s Medical Center, Fort Worth, TX, USA
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Sykes M, Hamilton L, Jones C, Gaffney K. FRI0427 The Prevalence of Axial Spondyloarthritis in Patients Presenting with Acute Anterior Uveitis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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Hamilton L, de la Torre A, Wilson D. Lipoprotein-Derived Insulin Resistance (LP=IR) Score Vs. Standard Measures Of Insulin Resistance In Youth. J Clin Lipidol 2016. [DOI: 10.1016/j.jacl.2016.03.032] [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]
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36
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Hamilton L. Psychiatric input into the assessment and management of chronic pelvic pain. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hamilton L, Keh S, Spielmann PM, Hussain SSM. How we do it: locating the posterior semicircular canal in occlusion surgery for refractory benign paroxysmal positional vertigo: a cadaveric temporal bone study. Clin Otolaryngol 2015; 41:190-3. [PMID: 26095673 DOI: 10.1111/coa.12479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
Affiliation(s)
- L Hamilton
- Temporal Bone Laboratory, Department of Otolaryngology, University of Dundee School of Medicine & Ninewells Hospital, Dundee, UK
| | - S Keh
- Temporal Bone Laboratory, Department of Otolaryngology, University of Dundee School of Medicine & Ninewells Hospital, Dundee, UK
| | - P M Spielmann
- Temporal Bone Laboratory, Department of Otolaryngology, University of Dundee School of Medicine & Ninewells Hospital, Dundee, UK
| | - S S M Hussain
- Temporal Bone Laboratory, Department of Otolaryngology, University of Dundee School of Medicine & Ninewells Hospital, Dundee, UK
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Armstrong C, Hamilton L, Shenkin SD. 26 * FACTORS PREDICTIVE OF NURSING HOME ADMISSION DIRECTLY FROM HOSPITAL: A SYSTEMATIC REVIEW. Age Ageing 2015. [DOI: 10.1093/ageing/afv029.26] [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
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Yang JC, Simon C, Schneider A, Seritan AL, Hamilton L, Hagerman PJ, Hagerman RJ, Olichney JM. Abnormal semantic processing in females with fragile X-associated tremor/ataxia syndrome. Genes Brain Behav 2013; 13:152-62. [PMID: 24299169 DOI: 10.1111/gbb.12114] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/12/2013] [Accepted: 11/28/2013] [Indexed: 11/29/2022]
Abstract
Fragile X-associated tremor/ataxia syndrome (FXTAS), a neurodegenerative disorder, affects fragile X (FMR1) gene premutation carriers in late life. Studies have shown cognitive impairments in FXTAS including executive dysfunction, working memory and visuospatial deficits. However, less is known about cognition in females with FXTAS. Thus, we examined semantic processing and verbal memory in female FXTAS patients with event-related potentials (ERPs) and neuropsychological testing. Sixty-one females (34 FXTAS, Mage = 62.7; 27 controls, Mage = 60.4) were studied with 32-channel ERPs during a category judgment task in which semantically congruous (50%) and incongruous items were repeated approximately 10-140 seconds later. N400 and P600 amplitude data were submitted to analysis of covariance. Neuropsychological testing demonstrated lower performance in verbal learning and executive function in females with FXTAS. Event-related potential analyses showed a significant reduction of the N400 congruity effect (incongruous - congruous) in the FXTAS group. The N400 congruity effect reduction in females with FXTAS was mainly due to increased N400 amplitude to congruous new words. No significant abnormalities of the N400 repetition effect or the P600 repetition effect were found, indicating preserved implicit memory and verbal memory, respectively, in females with FXTAS. The decreased N400 congruity effect suggests abnormal semantic expectancy and/or semantic network disorganization in female FXTAS patients. The enhanced N400 amplitude to congruous new words may reflect decreased cognitive flexibility among FXTAS women, making access to less typical category exemplar words more difficult.
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Affiliation(s)
- J-C Yang
- Department of Neurology, University of California Davis School of Medicine, Sacramento; Center for Mind and Brain, University of California Davis, Davis
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Hamilton L, Macgregor A, Warmington V, Pinch E, Gaffney K. The prevalence of inflammatory back pain in a UK primary care population. Rheumatology (Oxford) 2013; 53:161-4. [DOI: 10.1093/rheumatology/ket344] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ranasinghe A, Clark S, Corris P, Fisher A, Gould K, Hamilton L, Lordan J, Meachery G, Morley K, Parry G, Perry A, Pillay T, Schueler S, Tocewicz K, Dark J. Improving Outcomes in Lung Transplantation for Cystic Fibrosis – A Unified Approach. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.542] [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: 12/01/2022] Open
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Harris C, Remedios D, Aptowitzer T, Keat A, Hamilton L, Guile G, Belkhiri A, Newman D, Toms A, Macgregor A, Gaffney K, Morton L, Jones GT, MacDonald AG, Downham C, Macfarlane GJ, Tillett W, Jadon D, Wallis D, Costa L, Waldron N, Griffith N, Cavill C, Korendowych E, de Vries C, McHugh N, Iaremenko O, Fedkov D, Emery P, Baeten D, Sieper J, Braun J, van der Heijde D, McInnes I, Van Laar J, Landewe R, Wordsworth BP, Wollenhaupt J, Kellner H, Paramarta I, Bertolino A, Wright AM, Hueber W, Sofat N, Smee C, Hermansson M, Wajed J, Sanyal K, Kiely P, Howard M, Howe FA, Barrick TR, Abraham AM, Pearce MS, Mann KD, Francis RM, Birrell F, Carr A, Macleod I, Ng WF, Kavanaugh A, van der Heijde D, Chattopadhyay C, Gladman D, Mease P, McInnes I, Krueger G, Xu W, Goldstein N, Beutler A, Van Laar J, Baraliakos X, Braun J, Laurent DD, Baeten D, van der Heijde D, Sieper J, Emery P, McInnes I, Landewe R, Wordsworth BP, Wollenhaupt J, Kellner H, Wright AM, Gsteiger S, Hueber W, Conaghan PG, Peterfy CG, DiCarlo J, Olech E, Alberts AR, Alper JA, Devenport J, Anisfeld AM, Troum OM, Cooper P, Gimpel M, Deakin G, Jameson K, Godtschailk M, Gadola S, Stokes M, Cooper C, Gordon C, Kalunian K, Petri M, Strand V, Kilgallen B, Barry A, Wallace D, Flurey CA, Morris M, Pollock J, Hughes R, Richards P, Hewlett S. Oral abstracts 1: Spondyloarthropathies * O1. Detecting axial spondyloarthritis amongst primary care back pain referrals. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes118] [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
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Gregory P, Woollard M, Lighton D, Munro G, Jenkinson E, Newcombe RG, O'Meara P, Hamilton L. Comparison of malleable stylet and reusable and disposable bougies by paramedics in a simulated difficult intubation. Anaesthesia 2012; 67:371-6. [PMID: 22288931 DOI: 10.1111/j.1365-2044.2011.06999.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In a randomised crossover study, 60 ambulance paramedics attempted tracheal intubation of a manikin model of a Cormack and Lehane grade 3/4 view using a Portex stylet, Portex and Frova single-use bougies, and a Portex reusable bougie. Tracheal intubation within 30 s was achieved by 34/60 (57%) using the stylet, 18/60 (30%) using a Portex single-use bougie, 16/60 (27%) using a Frova single-use bougie and 5/60 (8%) using a Portex reusable bougie. The proportion intubating within 30 s was significantly higher with the stylet compared with any bougie (p < 0.001), but significantly lower with a Portex reusable bougie than any other device (p < 0.004). Participants rated the Portex reusable bougie as significantly more difficult to use than the other devices (p < 0.001). There was no evidence of a relationship between previous experience and success rate for any device.
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Jeffery ND, Hamilton L, Granger N. Designing clinical trials in canine spinal cord injury as a model to translate successful laboratory interventions into clinical practice. Vet Rec 2011; 168:102-7. [PMID: 21493470 DOI: 10.1136/vr.d475] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Many interventions have been shown to improve outcome after experimental spinal cord injury in laboratory animals. The challenge now is to determine whether any of these can be translated to become an efficacious therapy for clinical lesions - a process that is often difficult and frequently fails. Here, we discuss the steps that are required to make this transition and the need for rigorous clinical trials. A key component is an outcome measure that is amenable to statistical analysis; we describe methods that we have developed to accurately measure function after spinal cord injury in dogs. The general methodology may have parallels in the development of veterinary models to test putative therapies for other diseases of humans and animals.
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Affiliation(s)
- N D Jeffery
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1600 South 16th Street, Ames, IA 50011, USA.
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Castillo-Gallego C, de Miguel Mendieta E, Garcia-Arias M, Plasencia-Rodriguez C, Lojo-Oliveira L, Martin-Mola E, Tillett W, Cavill C, Korendowych E, McHugh N, Coates L, Bhalla AK, Creamer P, Packham J, Hailwood S, Taylor G, Hamilton L, Brooksby A, Leeder J, Gaffney K, Malipeddi AS, Neame R, Francis J, Hassan W, Mease P, Olds M, Kary S, Kupper H, Bell C, Peffers G, Rees F, Lanyon P, Obrenovic K, Sandhu R, Packham J, Erb N, Coates LC, Conaghan P, Emery P, Green M, Ibrahim G, MakIver H, Helliwell P, Giles JL, McHugh K, DiGleria K, Shaw J, Kollnberger S, Maenaka K, Marroquin O, Renner C, Bowness P, Landewe R, Ritchlin C, Olds M, Guerette B, Lavie F, Kavanaugh A, McInnes I, Krueger GG, Gladman D, Zrubek J, Goldstein N, Xu S, Mudivarthy S, Mack M, Prevosto C, McDonald S, De Riva A, Goodman R, Key T, Hill Gaston JS, Deery MJ, Busch R, Fischer R, Wright C, Kessler B, Bowness P, Sheehy C, Jois RN, Leeder J, Kerrigan N, Mills KS, Somerville M, Scott DG, Gaffney K, Kavanaugh A, van der Heijde D, Chattopadhyay C, Gladman D, Mease P, McInnes I, Krueger GG, Xu W, Rahman MU, Zrubek J, Baratelle A, Beutler A, Stober CB, Benham HJ, Goodall JC, Hill Gaston JS, Sanyal K, Walker-Bone K, Coates LC, Conaghan P, Emery P, Green M, Ibrahim G, MakIver H, Helliwell PS, Vastesaeger N, Wang Y, Inman R, Deodhar A, Hsu B, Rahman MU, Dijkmans B, Braun J, Geusens P, Sieper J, van der Heijde D, El Miedany Y, Palmer D, McHugh K, Giles JL, Shaw J, Kollnberger S, Payeli S, Utriainen L, Milling S, Renner C, Bowness P. Spondylarthropathies (including psoriatic arthritis): 244. Validity of Colour Doppler and Spectral Doppler Ultrasound of Sacroilicac Joints Againts Physical Examination as Gold Standard. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rennerfelt K, Zhang Q, Hamilton L, Styf J. Patient pain drawing in diagnosing the cause of exercise-induced leg pain. Br J Sports Med 2011. [DOI: 10.1136/bjsm.2010.081554.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Van Belle S, Dalivoust P, Reinthaller A, Tzanninis D, Urbanski K, Hamilton L, Pujol B. P92 Current practice use of darbepoetin alfa in the management of chemotherapy-induced anaemia in patients < 65 and ≥65 years: interim data from CHOICE, an international, observational study. Crit Rev Oncol Hematol 2009. [DOI: 10.1016/s1040-8428(09)70130-1] [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: 10/20/2022] Open
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Woollard M, Lighton D, Gregory P, Munro G, Jenkinson E, Hamilton L, Newcombe R, O'Meara P. Malleable stylet vs re-useable and disposable bougies in a model of difficult intubation: a randomised cross-over trial. Emerg Med J 2009. [DOI: 10.1136/emj.2009.075416l] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hamilton L, Fay S, Rockwood K. Misplacing objects in mild to moderate Alzheimer's disease: a descriptive analysis from the VISTA clinical trial. J Neurol Neurosurg Psychiatry 2009; 80:960-5. [PMID: 19293172 DOI: 10.1136/jnnp.2008.166801] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Misplacing objects is a commonly reported symptom of Alzheimer's disease (AD) but it is little described systematically and conflicting characterisations (losing/forgetting the location of objects versus inappropriate placement) of this "warning sign" of dementia currently exist. Patient and carer descriptions of misplacing in clinical interviews are reported here. METHODS This was a secondary qualitative analysis of video recorded, open ended and semistructured clinical interviews with 130 community dwelling patients with mild to moderate AD (mean age 77 (7.7) years; 63% women; 67% mild AD) and their carers who participated in the Video Imaging Synthesis of Treating Alzheimer's Disease (VISTA) study, a 4 month, randomised, placebo controlled trial of galantamine. Employing a framework analysis approach, we summarised descriptive accounts of misplacing with relevant proportions. RESULTS Recurrent incidents of misplacing were described for 96/130 (74%) study patients, 45 of whom established treatment goals to track this problem. For most (78/96, 81%), misplacing was the inability to recall where an item had been set down or put away. Fewer patients (25/96, including 18 with recall misplacing) put objects in unusual or incorrect places. Patients were commonly aware of their misplacing (56/96, 58%) and were distressed by it (31/56). Patients who misplaced also displayed tendencies towards delusions/hallucinations (51/96, but only directly related to misplacing in 17 cases) and hiding items (15%) CONCLUSION Misplacing is a common phenomenon in mild to moderate AD. Here, misplacing was usually described as an inability to recall where an item was set down, more so than the inappropriate placement of items.
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Affiliation(s)
- L Hamilton
- Geriatric Medicine Research Unit, Capital District Health Authority and Dalhousie University, Halifax, Nova Scotia, Canada
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Hamilton L, Evans A, Cornford E, James J, Burrell H. Ultrasound diagnosis of fibroadenoma — is biopsy always necessary? Clin Radiol 2008; 63:1070-1. [DOI: 10.1016/j.crad.2008.05.006] [Citation(s) in RCA: 5] [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] [Received: 04/29/2008] [Accepted: 05/09/2008] [Indexed: 11/24/2022]
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