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Sud S, Kanchi K, Hayward M, Wijetunga A, Corcoran D, Weiner AA. Genomic Characterization of Low and High Grade Cervical Intraepithelial Neoplasia in Comparison to Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e547. [PMID: 37785684 DOI: 10.1016/j.ijrobp.2023.06.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Screening reduces incidence of cervical cancer (CC) through identification and treatment of cervical intraepithelial neoplasia (CIN). Triage of CIN must balance between overtreatment versus progression as invasive therapies increase the risk of side effects including obstetric complications. The majority of CIN 1-2 lesions regress and a subset of CIN 3 lesions progress, however, due to inability to differentiate lesions likely to progress, the majority of CIN 2-3 lesions are treated with resection. Improved genomic and molecular identifiers of disease represent an urgent unmet clinical need. MATERIALS/METHODS Using next generation sequencing of a targeted exome panel of 1109 genes (previously validated), we characterized somatic mutations in 36 CIN (14 CIN 1, 11 CIN 2, 11 CIN 3) and 13 CC samples. Sequencing of CIN samples was performed on exfoliated cervical cells. CIN diagnosis and grade was confirmed on biopsy. Mutation profiles between CIN grades and CC were compared to identify genomic patterns that distinguish these groups. RESULTS Across the 49 samples sequenced, we identified a total of 5142 somatic mutations, including 2178 missense, 2522 synonymous, 171 nonsense, 62 splice site, 135 inframe indels, and 74 frameshift mutations. The mutation frequency was significantly higher in CC vs CIN1-3 (Table), p<0.01 (Wilcoxon signed-rank test). The difference in mutation frequency and type (Table) was not significant between CIN grades 1, 2 and 3 (p = 0.07, Kruskal-Wallis test). Cancer related pathway signatures were analyzed for the percentage of CC vs CIN samples with at least one altered variant as follows: RTK-RAS (92% vs 31%), PI3K (92% vs 17%), NOTCH (100% vs 39%), WNT (85% vs 14%) and cell cycle (53% vs 3%). Ninety percent of CC samples versus only 30% of CINs had nonsynonymous variants in the RTK-RAS and NOTCH pathways as well as the PI3K pathway which is implicated as a late event in cervical carcinogenesis. We observed recurrent missense variants in ABL1, IGF1R, TSC2 in the CIN2, CIN3 and CC samples, particularly in genes that belong to the RTK-RAS, PI3K, NOTCH pathway signatures. Potential driver mutations in EGFR, PIK3CA, ERBB4, MTOR, CSF1R genes were exclusive to CC samples. CONCLUSION Our results show that there is a clear distinction of mutational burden and type between cervical cancer and CIN1-3. However, the pathologic grading of CIN is not consistently associated with dynamic changes in overall mutation burden, type, or specific genes with escalating CIN grade. This data supports the hypothesis that late genetic events in CIN accompany a transition to invasive cervical cancer.
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Affiliation(s)
- S Sud
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - K Kanchi
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - M Hayward
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A Wijetunga
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - D Corcoran
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A A Weiner
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
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Phyu EE, Than HP, Hayward M. 512 A CASE OF AN IDIOPATHIC ACQUIRED HEMOPHILIA A IN AN ELDERLY WOMAN. Age Ageing 2021. [DOI: 10.1093/ageing/afab119.13] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Acquired Hemophilia is a bleeding diathesis caused by autoantibodies that interfere with factor VIII (FVIII). Reasons for autoantibodies production are not clear but may be related to gene polymorphisms and/or CD4+ T lymphocytes. 1.3 to 1.5 cases per million population per year are reported in the UK. Half of the cases are secondary to malignancy, pregnancy related conditions, connective tissue disorders or drug reactions while the rest are idiopathic.
Case Report
We report a case of an acquired hemophilia A in an 86-year-old lady with underlying type 2 diabetes, hypertension, and cognitive impairment, being treated as the left lower limb cellulitis with antibiotics. She was found to have a sudden hemoglobin drop and her CT (Abdomen) confirmed a spontaneous intra-abdominal hematoma. Clotting profile showed prolonged APTT to 168.5 seconds, being not corrected at mixing study, with normal PT and INR. The FVIII assay was reduced to 18.4 iU/dL with FVIII inhibitor concentration of 0.7 Bu. Viral and autoimmune screenings were negative. The idiopathic acquired hemophilia A was diagnosed. Red blood cell transfusions, bypassing agents (FEIBA) and oral tranexamic acid were given for acute bleeding episode. Concomitantly, oral prednisolone was used to reduce the inhibitor levels. Repeated FVIII assay showed 121 iU/dL and 199iU/dL on day 6 and 12, respectively. Steroid was continued for the next 4 weeks and then gradually tapered. No further bleeding episode was noted.
Conclusion
The diagnosis of acquired hemophilia should be considered in any elderly patient with prolonged APTT. Mixing study is to measure the presence of inhibitors of coagulation or to detect coagulation factor deficiency. Quantitative coagulation factor assays and Bethesda Assays are performed for definitive diagnosis. Immunosuppressive regimens are the mainstay treatment. However, premorbid conditions and co-morbidities should be taken into consideration before initiating the aggressive immunosuppressive therapy in the elderly patients.
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Affiliation(s)
- E E Phyu
- Dept of Elderly Care, Medway Maritime Hospital
| | - H P Than
- Dept of Elderly Care, Basildon University Hospital
| | - M Hayward
- Dept of Elderly Care, Medway Maritime Hospital
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Berry C, Newcombe H, Strauss C, Rammou A, Schlier B, Lincoln T, Hayward M. Validation of the Hamilton Program for Schizophrenia Voices Questionnaire: Associations with emotional distress and wellbeing, and invariance across diagnosis and sex. Schizophr Res 2021; 228:336-343. [PMID: 33540145 DOI: 10.1016/j.schres.2020.12.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/02/2020] [Accepted: 12/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Voice-hearing is a transdiagnostic experience with evident negative effects on patients. Good quality measurement is needed to further elucidate the nature, impact and treatment of voice-hearing experiences across patient groups. The Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) is a brief self-report measure which requires further psychometric evaluation. METHODS Using data from a transdiagnostic sample of 401 adult UK patients, the fit of a conceptual HPSVQ measurement model, proposing a separation between physical and emotional voice-hearing characteristics, was tested. A structural model was examined to test associations between voice-hearing, general emotional distress (depression, anxiety, stress) and wellbeing. The invariance of model parameters was examined across diagnosis and sex. RESULTS The final measurement model comprised two factors named 'voice severity' and 'voice-related distress'. The former comprised mainly physical voice characteristics and the latter mainly distress and other negative impacts. Structural model results supported voice-related distress as mediating the associations between voice severity and emotional distress and wellbeing. Model parameters were invariant across psychosis versus non-psychosis diagnosis and partially invariant across sex. Females experienced more severe and distressing voices and a more direct association between voice severity and general anxiety was evident. CONCLUSIONS The HPSVQ is a useful self-report measure of voice-hearing with some scope for further exploration and refinement. Voice-related distress appears a key mechanism by which voice severity predicts general distress and wellbeing. Whilst our data broadly support interventions targeting voice-related distress for all patients, females may benefit especially from interventions targeting voice severity and strategies for responding.
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Affiliation(s)
- C Berry
- Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland.
| | - H Newcombe
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - C Strauss
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
| | - A Rammou
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - B Schlier
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - T Lincoln
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - M Hayward
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
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Dharmaprani D, Jenkins E, Quah J, Lahiri A, Tiver K, Mitchell L, Bradley C, Hayward M, Paterson D, Taggart P, Clayton R, Nash M, Ganesan A. A Governing Equation for Human Ventricular Fibrillation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Objectives: Tissue diagnosis prior to thoracic surgery with curative intent is vital in thoracic lesions concerning for lung cancer. Methods of obtaining tissue diagnosis are variable within the United Kingdom.Methods: We performed a model-based analysis to identify the most efficient method of diagnosis using both a health care perspective. Our analysis concerns adults in the UK presenting with a solitary pulmonary nodule suspicious for a primary lung malignancy, patients with more advanced disease (for example lymph node spread) were not considered. Model assumptions were derived from published sources and expert reviews, cost data were obtained from healthcare research group cost estimates (2016-17). Outcomes were measured in terms of costs experienced to healthcare trusts.Results: Our results show that CT guided percutaneous lung biopsy using an ambulatory approach, is the most cost-effective method of diagnosis. Indeed, using this approach, trust experience approximately half of the cost of an approach of surgical lung biopsy performed at the time of potential resection ('frozen section').Limitations and conclusions: Whilst this analysis is limited to the specific scenario of a solitary pulmonary nodule, these findings have implications for the implementation of lung cancer screening in the UK, which is likely to result in increased numbers of patients with such early disease.
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Affiliation(s)
- J Barnett
- Department of Radiology, Royal Brompton Hospital, London, UK
| | | | - A N Tavare
- Department of Radiology, Royal Free NHS Foundation Trust, London, UK
| | - A Saini
- Department of Radiology, Royal Free NHS Foundation Trust, London, UK
| | - A Patel
- Department of Respiratory Medicine, Royal Free NHS Foundation Trust, London, UK
| | - M Hayward
- Department of Surgery, University College Hospital NHS Foundation Trust, London, UK
| | - S S Hare
- Department of Radiology, Royal Free NHS Foundation Trust, London, UK
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Choksi N, Hayward M, Kwon D, Marrazzo J, Mitchell C. Genetic variation of lactobacilllus crispatus strains isolated from a woman during and after bacterial vaginosis. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2018.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mani A, Petko M, Mitsos S, Patrini D, Scarci M, Panagiotopoulos N, Lawrence D, Hayward M, George R. P-116DOES THE MODIFIED FRAILTY INDEX SCORE PREDICT OUTCOME IN PATIENTS UNDERGOING VIDEO-ASSISTED THORACIC SURGERY PLEURODESIS FOR MALIGNANT PLEURAL EFFUSION? Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.116] [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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Mitsos S, Petko M, Patrini D, Hayward M, Scarci M, Lawrence D, Panagiotopoulos N. Is pneumonectomy a justified procedure in patients with persistent N2 nonsmall cell lung cancer disease following induction therapy. Indian J Cancer 2017; 54:73-81. [DOI: 10.4103/ijc.ijc_209_17] [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: 11/04/2022]
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Champney F, Maddock L, Welford J, Kemp J, Allan V, Persidskikh Y, Orini M, Ang R, Workman A, Wong L, Honarbakhsh S, Leong K, Silberbauer J, O'Nunain S, Gomes J, McCready J, Bostock J, Shaw K, McKenna C, Bailey J, Honarbakhsh S, Casas J, Wallace J, Hunter R, Schilling R, Perel P, Morley K, Banerjee A, Hemingway H, Mrochak A, Ilyina T, Goncharik D, Chasnoits A, Plashinskaya L, Taggart P, Hayward M, Lambiase P, Hosford P, Kasparov S, Lambiase P, Tinker A, Gourine A, Kettlewell S, Dempster J, Colman M, Rankin A, Myles R, Smith G, Tester D, Jaye A, FitzPatrick D, Evans M, Fleming P, Jeffrey I, Cohen M, Simpson M, Ackerman M, Behr E, Srinivasan N, Kirkby C, Firman E, Tobin L, Murphy C, Lowe M, Hunter RJ, Finlay M, Schilling RJ, Lambiase PD, Ng F, Tomlinson L, Nuthoo S, Cajilog E, Lefroy D, Qureshi N, Koa-Wing M, Whinnett Z, Linton N, Davies D, Lim P, Peters N, Kanagaratnam P, Varnava A. ORAL ABSTRACTS (1)Allied Professionals7CRYOABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION - IS AN EP LAB REQUIRED?8A PATHWAY TO SAFETY - ANTICOAGULATION COMPLIANCE IN CIED PATIENTS WITH AF9UNDERSTANDING THE WAYS IN WHICH OCCUPATION IS AFFECTED BY POSTURAL TACHYCARDIA SYNDROME: A UK OCCUPATIONAL THERAPY PERSPECTIVE10DEVELOPMENT OF AN INTERGRATED SUPPORT PATHWAY FOR PATIENTS FULFILLING NICE CRITERIA FOR AN INTERNAL CARDIOVASCULAR DEBRIBRILLATOR (ICD) IN A DISTRICT GENERAL HOSPITAL11ARE CARDIOVASCULAR RISK FACTORS ALSO ASSOCIATED WITH THE INCIDENCE OF ATRIAL FIBRILLATION? A SYSTEMATIC REVIEW AND FIELD SYNOPSIS OF 23 FACTORS IN 32 INITIALLY HEALTHY COHORTS OF 20 MILLION PARTICIPANTS12BRAIN MRI FINDINGS IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING CARDIOVERSIONBasic Science/Sudden Cardiac Death13PRELIMINARY ASSESSMENT OF THE “RE-ENTRY VULNERABILITY INDEX” AS A MARKER OF CARDIAC INSTABILITY IN THE HUMAN HEART USING WHOLE-HEART CONTACT EPICARDIAL MAPPING14OPTOGENETIC STIMULATION OF BRAINSTEM'S VAGAL PREGANGLIONIC NEURONES IS ASSOCIATED WITH NEURONAL NITRIC OXIDE SYNTHASE-DEPENDENT PROLONGATION OF VENTRICULAR EFFECTIVE REFRACTORY PERIOD15A DYNAMIC-CLAMP STUDY OF L-TYPE Ca2+ CURRENT IN RABBIT AND HUMAN ATRIAL MYOCYTES: THE CONTRIBUTION OF WINDOW ICaL TO EARLY AFTERDEPOLARISATIONS16WHOLE EXOME SEQUENCING IN SUDDEN INFANT DEATH SYNDROME17MEDIUM TERM SURVIVAL AND FAMILY SCREENING OUTCOMES IN AN IDIOPATHIC VENTRICULAR FIBRILLATION COHORT - A MULTICENTRE EXPERIENCE18CLINICAL CHARACTERISTICS OF SCD SURVIVORS WITH BRUGADA SYNDROME:- ARE SPONSANEOUS TYPE I ECG AND PREVIOUS SYNCOPE REALLY ASSOCIATED WITH HIGH RISK? Europace 2016. [DOI: 10.1093/europace/euw270] [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: 11/14/2022] Open
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Mellor G, Orini M, Specterman M, Sawhney V, Merghani A, Claridge S, Laksman Z, Gerull B, Simpson C, Klein G, Champagne J, Talajic M, Gardner M, Steinberg C, Janzen M, Arbour L, Green M, Angaran P, Roberts J, Leather R, Sanatani S, Chauhan V, Healey J, Krahn A, Taggart P, Srinivasan N, Hayward M, Lambiase P, Aziz Q, Finlay M, Nobles M, Anderson N, Ng K, Schilling R, Tinker A, Breitenstein A, Ullah W, Honarbakhsh S, Dhinoja M, Schilling R, Providencia R, Babu G, Chow A, Lambiase P, Panikker S, Kontogeorgis A, Wong T, Hall M, Temple I, Bartoletti S, Kalla M, Cassar M, Rajappan K, Hunter R, Maestrini V, Rosmini S, Cox A, Yeo T, Dhutia H, Narain R, Malhotra A, Behr E, Tome M, Alfakih K, Moon J, Sharma S, Mennuni S, Jackson T, Behar J, Porter B, Sieniewicz B, Webb J, Bostock J, O'Neill M, Murgatroyd F, Carr-White G, Chiribiri A, Razavi R, Chen Z, Rinaldi C. YOUNG INVESTIGATORS COMPETITION1GENETIC ANALYSIS IN THE EVALUATION OF UNEXPLAINED CARDIAC ARREST: FROM THE CARDIAC ARREST SURVIVORS WITH PRESERVED EJECTION FRACTION REGISTRY (CASPER)2IN-VIVO WHOLE HEART CONTACT MAPPING DATA AND A SIMPLE MATHEMATICAL FRAMEWORK TO UNDERSTAND THE INTERACTIONS BETWEEN ACTIVATION AND REPOLARIZATION RESITUTION DYNAMICS IN THE INTACT HUMAN HEART3THE K(ATP) CHANNEL OPENER DIAZOXIDE REDUCES AUTOMATICITY IN AN IN VITRO ATRIAL CELL MODEL - POTENTIAL FOR K(ATP) CHANNELS AS A DRUG TARGET FOR ATRIAL ARRHYTHMIAS4LONG-TERM OUTCOMES AFTER CATHETER ABLATION OF VENTRICULAR TACHYCARDIA IN PATIENTS WITH STRUCTURAL HEART DISEASE: A MULTICENTRE UK STUDY5THE BURDEN OF ARRHYTHMIAS IN LIFE-LONG ENDURANCE ATHLETES6CARDIAC MAGNETIC RESONANCE IMAGING RISK STRATIFICATION USING MARKERS OF REGIONAL AND DIFFUSE FIBROSIS FOR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR THERAPY: THE VALUE OF T1 MAPPING IN NON-ISCHEMIC PATIENTS. Europace 2016. [DOI: 10.1093/europace/euw275] [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: 11/12/2022] Open
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Panagiotopoulos N, Patrini D, Cabanyes SD, Hayward M, Lawrence D. 103P: Lobectomy for non-small cell lung cancer in octogenarians: A 7-year single center experience. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Grilley-Olsen J, Keith KC, Hayward M, Dees EC, Deal A, Ivanova A, Benbow JM, Parker J, Patel NM, Eberhard D, Mieczkowski P, Weck KE, Hayes DN, Muss H, Jolly T, Reeder-Hayes K, Earp HS, Sharpless N, Carey L, Anders CK. Abstract PD6-07: Genomic sequencing in metastatic breast cancer patients to inform clinical practice at the University of North Carolina at Chapel Hill. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-pd6-07] [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: An increasing number of molecularly-targeted therapies for metastatic breast cancer (MBC) are clinically-available (approved and investigational). These anti-cancer agents target specific molecular abnormalities such as mutated, amplified, deleted, or rearranged genes. Reporting of unique tumor genetic alterations is not included in routine clinical/diagnostic panels. In MBC, knowledge of mutational status may foster efficient transitions in clinical care and trial enrollment at disease progression. We describe the development and implementation of a clinically-integrated genomic sequencing program and report how information regarding targetable genomic aberrations in MBC patients (pts) is used to improve clinical practice in an academic setting.
Methods: Genomic sequencing of investigative biomarkers was prospectively offered to pts with MBC. DNA libraries were prepared separately from a retrieved archival FFPE tumor sample and a matched normal sample from each pt. Relevant targets were enriched by custom Agilent SureSelect hybrid capture baits using standard protocols. Samples were sequenced on Illumina HiSeq 2000/2500 platforms. Mutational findings were reviewed by a molecular tumor board (MTB); variants identified to be potentially actionable underwent confirmatory testing in a CLIA-approved laboratory. Confirmed findings were inserted into the pt's EMR accessible by both the pt and the treating oncologist.
Results: Of the 725 MBC pts seen at UNC since 1/1/2012, 194 (27%) contributed samples for genomic sequencing. Of those whose tumors were sequenced, average age at MBC diagnosis was 54 (25 - 91); 73% were Caucasian, 16% African American. De novo MBC accounted for 39 (20%) sequenced pts. Of sequenced patients, sites of metastatic disease included bone only (7%), visceral only (46%), and both bone and visceral (47%). Approximately 1/3 of pts were consented for sequencing at time of initial MBC diagnosis, 1/4 after 1st line therapy for MBC, and the remaining at or beyond their 2nd line. In total, 131 (68%) pts have sequencing results available of which 43% of pts had reportable mutations deemed actionable by the MTB. Specific mutations and observed frequency by subtype are shown below. Pts (19%) whose tumors were sequenced were more commonly enrolled in a therapeutic clinical trial for MBC, a higher rate than seen in the non-sequenced group (7%) (p<0.001). To date, 27% of pts' tumors harbored an alteration that is an eligibility requirement for a molecularly-targeted therapeutic trial accruing pts at UNC.
Observed Mutation by Clinical Subype Genes Total # (56 pts)HR+/HER2- (25 pts)HER2+ (13 pts)TNBC (18pts)PIK3CA15933TP5315456CCND19531NF-14103FGFR13300PTEN3012KRAS2011MDM22110PIK3R12002ROS12011TSC12011Other*14518TOTAL73281728*Mutations observed only once
Conclusion: Preemptive genomic sequencing can be integrated into the clinical and operational practice of a comprehensive cancer center. Currently this research tool and program provides valuable information that has the potential to foster both clinical trial eligibility and/or enrollment. With longer follow-up, we hope such an approach ultimately will improve patient outcomes.
Citation Format: Grilley-Olsen J, Keith KC, Hayward M, Dees EC, Deal A, Ivanova A, Benbow JM, Parker J, Patel NM, Eberhard D, Mieczkowski P, Weck KE, Hayes DN, Muss H, Jolly T, Reeder-Hayes K, Earp HS, Sharpless N, Carey L, Anders CK. Genomic sequencing in metastatic breast cancer patients to inform clinical practice at the University of North Carolina at Chapel Hill. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD6-07.
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Affiliation(s)
- J Grilley-Olsen
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - KC Keith
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - M Hayward
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - EC Dees
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A Deal
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - A Ivanova
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - JM Benbow
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J Parker
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - NM Patel
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - D Eberhard
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - P Mieczkowski
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - KE Weck
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - DN Hayes
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - H Muss
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - T Jolly
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - K Reeder-Hayes
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - HS Earp
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - N Sharpless
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - L Carey
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - CK Anders
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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Le Page PA, Furtado R, Hayward M, Law S, Tan A, Vivian SJ, Van der Wall H, Falk GL. Durability of giant hiatus hernia repair in 455 patients over 20 years. Ann R Coll Surg Engl 2015; 97:188-93. [PMID: 26263802 DOI: 10.1308/003588414x14055925060839] [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] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The surgical management of symptomatic giant hiatus hernia (GHH) aims to improve quality of life (QoL) and reduce the risk of life threatening complications. Previous reports are predominantly those with small sample sizes and short follow-up periods. The present study sought to assess a large cohort of patients for recurrence and QoL over a longer time period. METHODS This was a follow-up study of a prospectively collected database of 455 consecutive patients. Primary repair of GHH was evaluated by endoscopy/barium meal for recurrence and a standardised symptom questionnaire for QoL. Recurrence was assessed for size, elapsed time, oesophagitis and symptoms. RESULTS Objective and subjective review was achieved in 91.9% and 68.6% of patients. The median age was 69 years (range: 15-93 years) and 64% were female. Laparoscopic repair was completed in 95% (mesh in 6% and Collis gastroplasty in 7%). The 30-day mortality rate was 0.9%. The proportion of patients alive at five and ten years were 90% and 75% respectively. Postoperative QoL scores improved from a mean of 95 to 111 (p<0.01) and were stable over time (112 at 10 years). The overall recurrence rate was 35.6% (149/418) at 42 months; this was 11.5% (48/418) for hernias >2cm and 24.2% (101/418) for <2cm. The rate of new recurrence at 0-1 years was 13.7% (>2cm = 3.4%, <2cm = 10.3%), at 1-5 years it was 30.8% (>2cm = 9.5%, <2cm = 21.3%), at 5-10 years it was 40.1% (>2cm = 13.8%, <2cm = 26.3%) and at over 10 years it was 50.0% (>2cm = 25.0%, <2cm = 25.0%). Recurrence was associated with oesophagitis but not decreased QoL. Revision surgery was required in 4.8% of cases (14.8% with recurrence). There were no interval major GHH complications. CONCLUSIONS Surgery has provided sustained QoL improvements irrespective of recurrence. Recurrence occurred progressively over ten years and may predispose to oesophagitis.
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Affiliation(s)
- P A Le Page
- 1 Concord Repatriation General Hospital, NSW , Australia
| | - R Furtado
- 1 Concord Repatriation General Hospital, NSW , Australia
| | - M Hayward
- 2 University of Sydney, NSW , Australia
| | - S Law
- 2 University of Sydney, NSW , Australia
| | - A Tan
- 2 University of Sydney, NSW , Australia
| | - S J Vivian
- 3 Sydney Heartburn Clinic, Lindfield, NSW , Australia
| | | | - G L Falk
- 1 Concord Repatriation General Hospital, NSW , Australia.,2 University of Sydney, NSW , Australia.,3 Sydney Heartburn Clinic, Lindfield, NSW , Australia
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Cunningham S, Hall A, Jackson A, Jarrett-Smith L, Rees P, Brennan C, Saeed Y, Ng F, Kirkwood G, Orini M, Lambiase P, Srinivasan N, Walker N, Wright G, Goodwin J, Reilly J, Connelly D, Mudd P, Wilson C, Rice A, Iglesias A, Taggart S, James S, Thornley A, Turley A, Linker N, Rashid-Fadel T, Bond R, Rosengarten J, Thomas G, Butcher C, Lysitsas D, Wong T, Markides V, Jones D, Hussain W, Gilmore M, Barry J, Srinivasan N, Patel K, Lowe M, Segal O, Temple I, Borbas Z, Atkinson A, Yanni J, Yanni J, Boyett M, Garratt C, Dobrzynski H, Roney C, Debney M, Eichhorn C, Nachiappan A, Qureshi N, Chowdhury R, Kanagaratnam P, Lyon A, Peters N, Lawless M, Pearman C, Radcliffe E, Caldwell J, Trafford A, Taggart P, Hanson B, Hayward M, Lambiase PD, Yanni J, Orini M, Hanson B, Hayward M, Smith A, Zhang H, Dobrzynski H, Boyett M, Taggart P, Orini M, Simon R, Providencia R, Babu G, Vyas S, Khan F, Chow T, Segal O, Lowe M, Lambiase P. Allied Professionals. Europace 2015; 17:v3-v5. [PMCID: PMC4892104 DOI: 10.1093/europace/euv325] [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: 10/20/2023] Open
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15
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Rees PSC, Babu GG, Boston-Griffiths EA, Bognolo G, Hayward M, Kolvekar S, Lawrence D, Yap J, Hausenloy DJ, Yellon DM. 014 Atorvastatin protects human myocardium from lethal ischaemia-reperfusion injury by activating the risk pathway. Heart 2015. [DOI: 10.1136/hrt.2010.195941.14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Mangini L, Dong Y, Hayward M, Forman M. Household Food Insecurity and Asthma in the 3rd Grade of the Early Childhood Longitudinal Study‐Kindergarten Cohort. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.261.1] [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)
- L Mangini
- Nutritional SciencesThe University of Texas at AustinUnited States
| | - Y Dong
- Nutritional SciencesThe University of Texas at AustinUnited States
| | - M Hayward
- Population Research Center The University of Texas at AustinUnited States
| | - M Forman
- Nutritional SciencesThe University of Texas at AustinUnited States
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Succony L, Gowers K, Hynds R, Hayward M, Lawrence D, Giangreco A, Janes S. S111 Methods To Isolate Basal Cells From The Respiratory Epithelium. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.117] [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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18
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Hayward M. Animal law in Australasia, 2nd edition by P Sankoff, S White and C Black. The Federation Press, Australia, 2013. 416 pages. Price: A$84.95. ISBN 9781862879300. Aust Vet J 2014. [DOI: 10.1111/avj.12201] [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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19
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Candilio L, Malik A, Ariti C, Barnard M, Wright S, Smith A, Giannaris S, Ashley E, Martin B, Hamilton-Davies C, Cordery R, Hurley R, Bertoja E, Burt C, Di Salvo C, Lawrence D, Hayward M, Yap J, Roberts N, McGregor C, Sheikh A, Kolvekar S, Hausenloy DJ, Yellon DM. 123 THE EFFECTS OF MULTI-LIMB REMOTE ISCHAEMIC PRECONDITIONING IN PATIENTS UNDERGOING CARDIAC BYPASS SURGERY. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Spillane J, Hayward M, Hirsch NP, Taylor C, Kullmann DM, Howard RS. Thymectomy: role in the treatment of myasthenia gravis. J Neurol 2013; 260:1798-801. [PMID: 23508539 DOI: 10.1007/s00415-013-6880-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 02/14/2013] [Accepted: 02/16/2013] [Indexed: 11/26/2022]
Abstract
Thymectomy is a frequently used treatment for myasthenia gravis (MG) and is virtually always indicated in MG patients who have a thymoma. However, the evidence for thymectomy in non-thymomatous MG remains less certain-no randomised controlled trials have been published to date, although one is currently underway. We reviewed the management and clinical outcome of patients with MG who underwent thymectomy over a 12 year period. Eighty-nine patients who underwent transsternal thymectomy were identified. A thymoma was identified on histology in 24 %, whereas 48, 9 and 19 % had hyperplastic, atrophic and normal thymic histology, respectively. One patient developed post operative myasthenic crisis but generally the procedure was well tolerated. Outcome was favourable for the majority of patients, with 34 % achieving complete stable remission (CSR) and an additional 33 % achieving pharmacological remission. Moreover, steroid requirements fell progressively during follow-up. Patients with a hyperplastic gland had a significantly greater chance of achieving CSR compared to other histological subtypes and the incidence of CSR increased with a longer duration of follow-up. Thymectomy for MG is generally safe and well tolerated and is associated with a sustained improvement of symptoms in the majority of patients.
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Affiliation(s)
- J Spillane
- UCL, Institute of Neurology, Queen Square, London, WC1N3BG, UK.
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21
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Hodges LA, Connolly SM, Winter J, Schmidt T, Stevens HNE, Hayward M, Wilson CG. Modulation of gastric pH by a buffered soluble effervescent formulation: A possible means of improving gastric tolerability of alendronate. Int J Pharm 2012; 432:57-62. [PMID: 22564778 DOI: 10.1016/j.ijpharm.2012.04.073] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 04/25/2012] [Accepted: 04/26/2012] [Indexed: 11/27/2022]
Abstract
Gastrointestinal side-effects of alendronate (ALN) are believed to be associated with oesophageal lodging of tablets and perhaps reflux of gastric contents with alendronate under strongly acidic pH conditions. This leads to unfavourable posture restrictions when dosing. This clinical study evaluated gastric emptying and gastric pH after administration of Fosamax(®) tablets and a novel effervescent ALN formulation with a high buffering capacity. This novel formulation, EX101, was developed to potentially improve gastric tolerance. Gastric pH was monitored by nasogastric probes. Gastric emptying was determined simultaneously by scintigraphic imaging of (99m)Tc-DTPA labelled formulations. Both formulations tested rapidly cleared the oesophagus and there were no statistically significant or physiologically relevant differences in gastric emptying times. Mean pH at time to 50% gastric emptying of the radiolabel was significantly higher in EX101-treated subjects compared to those treated with Fosamax(®). At time to 90% gastric emptying of the radiolabel, mean pH values were comparable. Mucosal exposure to ALN at pH less than 3 is irritating to gastro-oesophageal tissue. Ingestion of Fosamax(®) resulted in ALN being present in the stomach at a pH below 3 within minutes. EX101 minimised the possibility of exposing the oesophagus (in case of reflux) to acidified ALN.
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Affiliation(s)
- L A Hodges
- Bio-Images Research Ltd., Within Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
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22
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Diaz A, Di Salvo C, Lawrence D, Hayward M. Left atrial and right ventricular myxoma: an uncommon presentation of a rare tumour. Interact Cardiovasc Thorac Surg 2011; 12:622-3. [DOI: 10.1510/icvts.2010.255661] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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23
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Naqvi J, Navani N, Saeed S, Shastry M, Groves A, Shaw P, Lawrence D, Kolvekar S, Hayward M, Janes S. P222 A retrospective study of disease recurrence post thoracotomy for non-small cell lung cancer. Thorax 2010. [DOI: 10.1136/thx.2010.151068.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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24
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25
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Berry C, Gerry L, Hayward M, Chandler R. Expectations and illusions: a position paper on the relationship between mental health practitioners and social exclusion. J Psychiatr Ment Health Nurs 2010; 17:411-21. [PMID: 20584238 DOI: 10.1111/j.1365-2850.2009.01538.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the last 10 years, the social inclusion agenda has been gaining momentum as a policy driver in mental health services. Prior to the seminal Social Exclusion Unit (SEU) report, Mental Health and Social Exclusion, there was a lack of awareness concerning the pervasive links between social exclusion and mental health problems. In the report, the SEU suggested that mental health practitioners themselves may actually be contributing to this social exclusion. This finding has been given limited coverage in both social inclusion literature and research. The current paper is a positioned commentary further exploring the relationship between practitioners and the social exclusion of mental health service users. A literature review was conducted in order to identify themes among factors which appear to moderate and contribute to this relationship. These factors are presented and implications for inclusive practice are explored.
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Affiliation(s)
- C Berry
- Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK.
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26
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Ang M, Zhao N, Hayward M, Patel M, Yin X, Wilkerson MD, Funkhouser WK, Fritchie K, Olshan A, Hayes DN. Expression and prognostic significance of X-ray crosscomplementation group 1 (XRCC1) in head and neck squamous cell carcinoma patients undergoing concurrent chemoradiation. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5541] [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: 11/20/2022] Open
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27
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ten Tusscher KHWJ, Mourad A, Nash MP, Clayton RH, Bradley CP, Paterson DJ, Hren R, Hayward M, Panfilov AV, Taggart P. Organization of ventricular fibrillation in the human heart: experiments and models. Exp Physiol 2009; 94:553-62. [PMID: 19168541 DOI: 10.1113/expphysiol.2008.044065] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sudden cardiac death is a major health problem in the industrialized world. The lethal event is typically ventricular fibrillation (VF), during which the co-ordinated regular contraction of the heart is overthrown by a state of mechanical and electrical anarchy. Understanding the excitation patterns that sustain VF is important in order to identify potential therapeutic targets. In this paper, we studied the organization of human VF by combining clinical recordings of electrical excitation patterns on the epicardial surface during in vivo human VF with simulations of VF in an anatomically and electrophysiologically detailed computational model of the human ventricles. We find both in the computational studies and in the clinical recordings that epicardial surface excitation patterns during VF contain around six rotors. Based on results from the simulated three-dimensional excitation patterns during VF, which show that the total number of electrical sources is 1.4 +/- 0.12 times greater than the number of epicardial rotors, we estimate that the total number of sources present during clinically recorded VF is 9.0 +/- 2.6. This number is approximately fivefold fewer compared with that observed during VF in dog and pig hearts, which are of comparable size to human hearts. We explain this difference by considering differences in action potential duration dynamics across these species. The simpler spatial organization of human VF has important implications for treatment and prevention of this dangerous arrhythmia. Moreover, our findings underline the need for integrated research, in which human-based clinical and computational studies complement animal research.
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Affiliation(s)
- K H W J ten Tusscher
- Department of Scientific Computing, Simula Research Laboratory, Lysaker, Norway.
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28
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Grilley-Olson JE, Hayes DN, Miller RD, Socinski MA, Stinchcombe TE, Hayward M, Qaqish BF, Moore DT, Funkhouser WK. Inter-observer reliability for the diagnosis of lung cancer in a clinical cohort using the WHO classification system, version. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22020] [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: 11/20/2022] Open
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29
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Hayes DN, Lee CB, Hayward M, Socinski MA, Stinchcombe TE, Roberts P, Thorne L, Bernard PS, Yin X, Parsons A, Funkhouser WK. Molecular markers distinguish patients at differential risk of brain metastases in lung cancer by immunohistochemistry. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8083] [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: 11/20/2022] Open
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30
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Abstract
Alkaptonuria (endogenous ochronosis) is a rare metabolic disorder caused by a deficiency of homogentisic acid oxidase, an enzyme responsible for the metabolic degradation of tyrosine. Patients with alkaptonuria commonly present with joint pain owing to degenerative arthritis. Other affected patients may present with pigmentation of the ear cartilage and sclera. This article reports a case of aortic stenosis associated with ochronosis in a 48-year-old man who presented with severe cardiac failure. He had no previous diagnosis of alkaptonuria, which was confirmed by mass spectrometry analysis of urine. The pathogenesis of cardiovascular ochronosis is unclear, but is probably related to the extensive extracellular deposits of ochronotic pigment in the cardiac tissue.
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Affiliation(s)
- L V Ffolkes
- Department of Histopathology, University College London Hospitals NHS Trust, London, UK
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31
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Merkin SS, Karlarnangla A, Crimmins E, Hayward M, Seeman T. Education Differentials by Race in the Diagnosis. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s1-b] [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: 11/12/2022] Open
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32
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Larsen S, Chng K, Battah F, Armstrong M, Hayward M, Leung L, Thomson S, Hennessy A, Rasko J. Cytokine-induced in vivo expansion and mobilization of marrow mesenchymal stem cells in nonhuman primates. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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33
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Saunders C, Herbert P, Rowe G, Hayward M, Wilkins K, Milligan J, Stenning M, Seacombe A, Prowse C. In-vitro evaluation of the PALL Leukotrap Affinity Prion Reduction Filter as a secondary device following primary leucoreduction. Vox Sang 2005; 89:220-8. [PMID: 16262755 DOI: 10.1111/j.1423-0410.2005.00703.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES A filter (PRF1) designed to remove abnormal prion proteins from red-cell units has been developed. The purpose of this study was to evaluate the quality of red cells produced using this device. MATERIALS AND METHODS Leucocyte-depleted red-cell units (CPD, CPD-A1 and CPD/SAGM) processed according to standard UK practices were filtered using PRF1. Filtered and control units were stored and sampled on day 1, day 7 and on the date of expiry and were tested using standard measures of red-cell quality. RESULTS Filtered units were found to have significantly higher percentage haemolysis levels, lower haemoglobin levels and a smaller volume compared with controls. All results, however, were well within the permitted 0.8% haemolysis level at the end of storage and all units met the UK guidelines for haemoglobin and volume. The other test parameters measured showed no significant differences between the test and control units. CONCLUSIONS The PRF1 filter was found to be easy to use and resulted in red-cell units that met all relevant UK and European Guidelines.
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Woods DR, World M, Rayson MP, Williams AG, Jubb M, Jamshidi Y, Hayward M, Mary DASG, Humphries SE, Montgomery HE. Endurance enhancement related to the human angiotensin I-converting enzyme I-D polymorphism is not due to differences in the cardiorespiratory response to training. Eur J Appl Physiol 2002; 86:240-4. [PMID: 11990733 DOI: 10.1007/s00421-001-0545-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Human physical performance is strongly influenced by genetic factors. We have previously reported that the I variant of the human angiotensin I-converting enzyme (ACE) gene is associated with greater endurance performance in mountaineers and Olympic runners and improved performance in army recruits. In this study we examined whether this effect is mediated by improvements in cardiovascular fitness with training in 58 army recruits homozygous for the insertion (I, ACE genotype II) or deletion (D, ACE genotype DD) allele. A submaximal and maximal exercise protocol was used to calculate both the heart rate/oxygen uptake (VO2) relationship and changes in maximal oxygen uptake (VO2max), respectively. There was no significant intergroup difference in VO2max at baseline (P=0.19) or after training (P=0.22). There was no difference between genotypes with training in the heart rate/VO2 elevation (P = 0.79 for the mean difference in mean adjusted heart rates). However, VO2 at all exercise intensities in the submaximal test was lower for all subjects after training and at 80 W the reduction in VO2 was greater for the II subjects compared to DD subjects [mean(SEM)] [1.6 (0.27) and 0.68 (0.27) ml kg(-1) min(-1), respectively; P = 0.02 for mean difference]. The I/D polymorphism may play a role in enhanced endurance performance but this is not mediated by differences in VO2max or the heart rate/VO2 relationship in response to training.
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Affiliation(s)
- D R Woods
- Dept Medicine, Freeman Hospital, Newcastle upon Tyne, UK.
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36
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Clegg A, Hayward M. The extension of nurse prescribing. Prof Nurse 2001; 17:263. [PMID: 12030184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- A Clegg
- University of the West of England, Bristol
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37
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Hayward M. Disagrees with one aspect of the euthanasia panel report. J Am Vet Med Assoc 2001; 219:907. [PMID: 11601777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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38
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Kaye J, Hayward M. Paradoxical embolism: computed tomography demonstration. Australas Radiol 2001; 45:233-5. [PMID: 11380372 DOI: 10.1046/j.1440-1673.2001.00910.x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Paradoxical emboli are rare and often presumptively diagnosed. A case of paradoxical embolism, in which both the arterial and venous emboli were documented on CT, is described.
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Affiliation(s)
- J Kaye
- Women's & Children's Hospital, North Adelaide, Australia
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39
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Mcfall T, Hayward M. Should the RCN have appointed an American as general secretary? Nurs Times 2001; 97:17. [PMID: 11954209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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40
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Hayward M, Neal K, Andrews A. How do I handle claims of cruelty? Nurs Times 2000; 96:31. [PMID: 11995620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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41
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Grattan T, Hickman R, Darby-Dowman A, Hayward M, Boyce M, Warrington S. A five way crossover human volunteer study to compare the pharmacokinetics of paracetamol following oral administration of two commercially available paracetamol tablets and three development tablets containing paracetamol in combination with sodium bicarbonate or calcium carbonate. Eur J Pharm Biopharm 2000; 49:225-9. [PMID: 10799813 DOI: 10.1016/s0939-6411(00)00081-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This report concerns a single dose randomized five way crossover study to compare the pharmacokinetics of paracetamol from two commercially available paracetamol (500 mg) tablets and three different development paracetamol (500 mg) tablet formulations containing either sodium bicarbonate (400 mg), sodium bicarbonate (630 mg) or calcium carbonate (375 mg). The results demonstrated that addition of sodium bicarbonate (630 mg) to paracetamol tablets, increased the rate of absorption of paracetamol relative to conventional paracetamol tablets and soluble paracetamol tablets. Addition of sodium bicarbonate (400 mg) to paracetamol tablets increased the absorption rate of paracetamol relative to conventional paracetamol tablets, but there was no difference in the rate of absorption compared to soluble paracetamol tablets. Inclusion of calcium carbonate (375 mg) to paracetamol tablets had no effect on absorption kinetics compared to the conventional paracetamol tablet. The faster absorption observed for the sodium bicarbonate formulations may be as a result of an increase in gastric emptying rate leading to faster transport of paracetamol to the small intestine where absorption takes place.
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Affiliation(s)
- T Grattan
- SmithKline Beecham Consumer Healthcare, Weybridge, Surrey, UK.
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42
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Salvage J, Hayward M. Can nurse leaders lead if they don't nurse? Nurs Times 2000; 96:18. [PMID: 11235394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- J Salvage
- Queen Alexandra Hospital, Portsmouth
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43
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Hayward M. Accountability. Tug of war. Nurs Times 1999; 95:28-9. [PMID: 10568968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- M Hayward
- Coronary Care Unit, Queen Alexandra Hospital, Portsmouth
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45
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Sibson L, Dunn R, Evans J, Jones R, Hayward M, Wallace S. The virtual mole clinic: preliminary results from the Plymouth skin cancer screening study using telemedicine. Med Inform Internet Med 1999; 24:189-99. [PMID: 10654813 DOI: 10.1080/146392399298393] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study evaluated a skin cancer screening service between primary and secondary care in Plymouth using a store and forward telemedicine system. The primary objective was to minimize the time from a patient presenting to a GP with a suspicious lesion to the lesion being assessed and diagnosed by a plastic surgeon. This study retrospectively assessed the practical, technical and operational aspects of incorporating telemedicine into everyday practice and patient satisfaction. Both the GP practice and plastic surgeons were equipped with the appropriate technology for creating, transmitting and accessing an electronic telemedicine record (ETR) via an ISDN 2 line. Patients with suspicious lesions accessed the GP via Mole Check Clinics. The GP captured and transmitted an ETR consisting of digital images and relevant clinical data. In a virtual mole clinic, the plastic surgeon accessed and reviewed the ETR. The expert opinion was entered directly into the ETR and transmitted to the GP within 48 hours. All patients were offered a face-to-face consultation at a real mole clinic within 7 days. Outcomes demonstrated patient and clinician satisfaction and the ability to deliver high quality diagnostic images and resulting expert opinion. This study informed a larger study for future applications of telemedicine.
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Abstract
Cardiopulmonary resuscitation (CPR) is now established medical practice for all in-hospital cardiac arrests except where a specific 'do not resuscitate' (DNR) order is in place. This article explores many of the ethical and moral issues surrounding CPR and the use of DNR orders. It examines the success rate of in-hospital CPR and raises the question of what constitutes outcome success by illustrating that at best only 15% of resuscitated patients survive to hospital discharge. The article proposes that both patients and healthcare professionals grossly overestimate the success of CPR and suggests that many elderly patients might choose not to be resuscitated if they were allowed to make an informed choice. It concludes by suggesting that further work needs to be undertaken with regard to early assessment of all in-hospital patients, combined with realistic and frank communication between healthcare professionals and patients if futile, undignified and costly deaths are to be avoided.
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Affiliation(s)
- M Hayward
- Coronary Care Unit, Queen Alexandra Hospital, Portsmouth
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Hayward M, O'Neill B. Boxing should be banned. Nurs Times 1999; 95:31. [PMID: 10455751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- M Hayward
- Coronary Care Unit, Queen Alexandra Hospital, Portsmouth
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Hayward M. Time to fight. Nurs Times 1998; 94:22. [PMID: 9919269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Montgomery HE, Marshall R, Hemingway H, Myerson S, Clarkson P, Dollery C, Hayward M, Holliman DE, Jubb M, World M, Thomas EL, Brynes AE, Saeed N, Barnard M, Bell JD, Prasad K, Rayson M, Talmud PJ, Humphries SE. Human gene for physical performance. Nature 1998; 393:221-2. [PMID: 9607758 DOI: 10.1038/30374] [Citation(s) in RCA: 402] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Hayward M. As nurses considered the governments first year in power. Nurs Times 1998; 94:13. [PMID: 9625948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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