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Conduit C, Hutchinson AD, Leonard M, O 'Haire S, Moody M, Thomas B, Sim I, Hong W, Ahmad G, Lawrentschuk N, Lewin J, Tran B, Dhillon HM. An exploration of testicular cancer survivors' experience of ejaculatory dysfunction following retroperitoneal lymph node dissection-a sub-study of the PREPARE clinical trial. J Cancer Surviv 2023:10.1007/s11764-023-01489-9. [PMID: 37981616 DOI: 10.1007/s11764-023-01489-9] [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: 08/29/2023] [Accepted: 10/20/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE Ejaculatory dysfunction secondary to retrograde ejaculation or anejaculation is a complication of retroperitoneal lymph node dissection (RPLND) for survivors of testicular cancer. We explored survivors' experiences of ejaculatory dysfunction following RPLND. METHODS In a sub-study of a single-arm phase 2 clinical trial (ACTRN12622000537752/12622000542796), participants reporting ejaculatory dysfunction ≥ 6 months following RPLND were invited to complete semi-structured interviews. Purposive sampling was used. Interviews continued until thematic saturation occurred, and codebook thematic analysis of interviews was performed. RESULTS Of 58 individuals recruited to the trial, 33 (57%) reported ejaculatory dysfunction. Of these, 32 (97%) agreed to interview and 15 participated. Participants interviewed had median age 34 years (range 24-66), 12 (80%) in a long-term relationship with median time from surgery 36 months (range 11-112). Three overarching themes were identified. The first reflected the value of RPLND despite ejaculatory dysfunction. The second illuminated the impact(s) of ejaculatory dysfunction closely mapped to life stage, with flow-on impacts to fertility, sex, psychological wellbeing and communication. The third reflected information needs. Fertility was a substantial source of concern for some participants. Ejaculatory dysfunction had no effect on sex for some, whilst for others, sex was less pleasurable. Some reported benefits. Few reported ejaculatory dysfunction challenged masculinity, confidence, or self-esteem. CONCLUSIONS Future research should examine interventions to reduce distress related to fertility, challenged masculinity and body image. IMPLICATIONS FOR CANCER SURVIVORS Whilst most participants considered ejaculatory dysfunction to have little impact on their sexual function and relationships, some reported significant difficulties varying by life stage and relationship status.
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Affiliation(s)
- C Conduit
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Medical Oncology, University of Melbourne, 305 Grattan St., Melbourne, VIC, Australia
- Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - A D Hutchinson
- Justice & Society, Behaviour-Brain-Body Research Centre, University of South Australia, Magill, Australia
| | - M Leonard
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, Australia
| | - S O 'Haire
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - M Moody
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - B Thomas
- Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - I Sim
- Endocrinology, Monash Health and Eastern Health, Clayton, VIC, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - W Hong
- Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - G Ahmad
- Andrology, Royal Children's Hospital, Melbourne, VIC, Australia
| | - N Lawrentschuk
- Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Urology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Lewin
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Medical Oncology, University of Melbourne, 305 Grattan St., Melbourne, VIC, Australia
- ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Melbourne, VIC, Australia
| | - B Tran
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- Sir Peter MacCallum Department of Medical Oncology, University of Melbourne, 305 Grattan St., Melbourne, VIC, Australia.
- Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
| | - H M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Meijer T, Raad F, Leonard M, Meier F, Jennings P, Wilmes A. P11-14 Characterisation of transport capacity of human iPSC-derived proximal tubular-like cells. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.464] [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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Kabacik S, Lowe D, Fransen L, Leonard M, Ang SL, Whiteman C, Corsi S, Cohen H, Felton S, Bali R, Horvath S, Raj K. The relationship between epigenetic age and the hallmarks of aging in human cells. Nat Aging 2022; 2:484-493. [PMID: 37034474 PMCID: PMC10077971 DOI: 10.1038/s43587-022-00220-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/04/2022] [Indexed: 12/11/2022]
Abstract
Epigenetic clocks are mathematically derived age estimators that are based on combinations of methylation values that change with age at specific CpGs in the genome. These clocks are widely used to measure the age of tissues and cells1,2. The discrepancy between epigenetic age (EpiAge), as estimated by these clocks, and chronological age is referred to as EpiAge acceleration. Epidemiological studies have linked EpiAge acceleration to a wide variety of pathologies, health states, lifestyle, mental state and environmental factors2, indicating that epigenetic clocks tap into critical biological processes that are involved in aging. Despite the importance of this inference, the mechanisms underpinning these clocks remained largely uncharacterized and unelucidated. Here, using primary human cells, we set out to investigate whether epigenetic aging is the manifestation of one or more of the aging hallmarks previously identified3. We show that although epigenetic aging is distinct from cellular senescence, telomere attrition and genomic instability, it is associated with nutrient sensing, mitochondrial activity and stem cell composition.
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Affiliation(s)
- Sylwia Kabacik
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
- Present address: Altos Labs, Cambridge Institute of Science, Cambridge, UK
- These authors contributed equally: Sylwia Kabacik, Donna Lowe
| | - Donna Lowe
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
- Present address: Altos Labs, Cambridge Institute of Science, Cambridge, UK
- These authors contributed equally: Sylwia Kabacik, Donna Lowe
| | - Leonie Fransen
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
| | - Martin Leonard
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
| | | | - Christopher Whiteman
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
- Present address: Altos Labs, Cambridge Institute of Science, Cambridge, UK
| | - Sarah Corsi
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
- Present address: Altos Labs, Cambridge Institute of Science, Cambridge, UK
| | | | - Sarah Felton
- Department of Dermatology, Churchill Hospital, Oxford, UK
| | - Radhika Bali
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
- Department of Dermatology, Churchill Hospital, Oxford, UK
- Present address: Altos Labs, Cambridge Institute of Science, Cambridge, UK
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Altos Labs, Cambridge Institute of Science, Cambridge, UK
- These authors jointly supervised this work: Steve Horvath, Ken Raj
| | - Ken Raj
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, UK
- Present address: Altos Labs, Cambridge Institute of Science, Cambridge, UK
- These authors jointly supervised this work: Steve Horvath, Ken Raj
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Wineski RE, Panico E, Karas A, Rosen P, Van Diver B, Norwood TG, Grayson JW, Beltran-Ale G, Dimmitt R, Kassel R, Rogers A, Leonard M, Chapman A, Boehm L, Wiatrak B, Harris WT, Smith N. Optimal timing and technique for endoscopic management of dysphagia in pediatric aerodigestive patients. Int J Pediatr Otorhinolaryngol 2021; 150:110874. [PMID: 34392101 DOI: 10.1016/j.ijporl.2021.110874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/06/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The best strategy to manage an interarytenoid defect [Type 1 laryngeal cleft (LC-1) or deep interarytenoid groove (DIG)] in pediatric aerodigestive patients with dysphagia remains uncertain. This study compared benefit of interarytenoid augmentation (IAA) to suture repair or clinical observation alone in pediatric patients. METHODS A 3-year retrospective, single-center analysis of children with dysphagia undergoing endoscopic airway evaluation was performed. Physician preference guided treatment plan: suture repair with CO2 laser, IAA (carboxy methylcellulose or calcium hydroxyapatite), or observation. Primary outcome was improved post-operative diet. Significance was assumed at p < 0.05. RESULTS 449 patients underwent diagnostic endoscopy. Mean age (±SD) at procedure was 21 ± 13 months, with nearly one fourth (28 %) of children ≤ 12 months. Eighty (18 %) had either an LC-1 (n = 55) or DIG (n = 25). Of these, 35 (42 %) underwent suture repair, 22 (28 %) IAA, and 23 (30 %) observation only. Aspiration improved overall in the interventional groups compared to observational controls (58 % vs. 9 %, p < 0.05), with no change in benefit observed by age of intervention. IAA was as effective as suture repair (59 % vs 55 %, p = 0.46). In patients with only a DIG, IAA intervention alone significantly improved swallow function (66.6 % vs. 0 %, p < 0.05). CONCLUSION In pediatric aerodigestive patients with dysphagia, 18 % of children have an addressable lesion. IAA or suture repair similarly improves dietary advancement. IAA improves swallow function in patients with DIG. These findings support a novel protocol to intervene in dysphagia patients with LC-1 or DIG via IAA at the initial operative evaluation.
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Affiliation(s)
- R E Wineski
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
| | - E Panico
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - A Karas
- Department of Otorhinolaryngology- Head and Neck Surgery, Rush University School of Medicine, Chicago, IL, USA
| | - P Rosen
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - B Van Diver
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - T G Norwood
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - J W Grayson
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - G Beltran-Ale
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - R Dimmitt
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - R Kassel
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - A Rogers
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; The Charity League Hearing and Speech Center, Children's of Alabama, Birmingham, AL, USA
| | - M Leonard
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; The Charity League Hearing and Speech Center, Children's of Alabama, Birmingham, AL, USA
| | - A Chapman
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - L Boehm
- Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - B Wiatrak
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Pediatric ENT Associates, Birmingham, AL, USA
| | - W T Harris
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA
| | - N Smith
- Department of Otolaryngology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Children's of Alabama Aerodigestive Program, Birmingham, AL, USA; Pediatric ENT Associates, Birmingham, AL, USA
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Francis AO, McCabe F, McCabe P, O'Daly BJ, Leonard M. Pelvic and acetabular trauma in amateur equestrian enthusiasts - A retrospective review. Surgeon 2021; 20:164-168. [PMID: 33975806 DOI: 10.1016/j.surge.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/05/2020] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Horse riding related accidents can present with devastating pelvic and acetabular fractures. This study examines the nature, management and treatment outcomes of severe pelvic and acetabular trauma in amateur horse riders presenting to a national tertiary referral centre. We also aim to define certain at-risk groups. METHODS This was a retrospective descriptive cohort of all patients who were referred to the National Centre for Pelvic and Acetabular trauma resulting from horse riding accidents. All patients who were referred to the National Centre for Pelvic and Acetabular Trauma between January 2018 and July 2020 were included. Professional horse riders were excluded. Clinical and treatment outcome measures were stratified to four different mechanisms of injury: fall from horse (FFH), horse crush (HC), Horse Kick (HK) and Saddle Injury (SI). RESULTS There were 31 equestrian related injuries referred to our centre between January 2018 and July 2020. One patient was a professional jockey and was thus excluded from the study. Eighteen were female and the mean age at referral was 37 years old. The majority of these were pelvic ring injuries (73%). Fifty per cent of patients required surgical intervention and the majority of these were male. CONCLUSION Horse riding is a potentially dangerous recreational pursuit with significant risk of devastating injury. Pelvic and acetabular fractures secondary to horse riding are frequently associated with other injuries and the need operative intervention is common in this group. Young women and older men are higher risk groups.
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Affiliation(s)
- A O Francis
- National Centre for Pelvic and Acetabular Trauma, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland.
| | - F McCabe
- National Centre for Pelvic and Acetabular Trauma, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland
| | - P McCabe
- National Centre for Pelvic and Acetabular Trauma, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland
| | - B J O'Daly
- National Centre for Pelvic and Acetabular Trauma, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland
| | - M Leonard
- National Centre for Pelvic and Acetabular Trauma, Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, Ireland
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Hehn T, Leonard M, Thaon I. Description de l’organisation, des motivations et des conséquences du télétravail pour les salariés dans trois grandes entreprises de Lorraine : approche qualitative. ARCH MAL PROF ENVIRO 2021. [DOI: 10.1016/j.admp.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vukanic D, Murphy D, Juhdi A, Leonard M. A Big HIIT: A Fracture Dislocation of the Hip in a Young Man Participating in Extreme Conditioning Exercise: A Case Report. JBJS Case Connect 2020; 10:e1900516. [PMID: 32910585 DOI: 10.2106/jbjs.cc.19.00516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
CASE Hip dislocations with associated acetabular fracture are rare events usually associated with high-energy trauma. We describe an unusual case of low-energy acetabular fracture dislocation sustained by a 30-year-old athletic male athlete during a high-intensity training program. CONCLUSION Correct execution of training programs is important. Healthcare professionals as well as participants and instructors of extreme conditioning programs should be aware of this serious complication. Avoidance of this injury may be possible with increased interval recovery and improved technique.
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Affiliation(s)
- D Vukanic
- 1The National Centre for Pelvic and Acetabular Trauma, Tallaght University Hospital, Dublin, Ireland
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Popivanov P, Irwin R, Walsh M, Leonard M, Tan T. Gastric emptying of carbohydrate drinks in term parturients before elective caesarean delivery: an observational study. Int J Obstet Anesth 2020; 41:29-34. [DOI: 10.1016/j.ijoa.2019.07.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/26/2019] [Accepted: 07/31/2019] [Indexed: 11/30/2022]
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Leonard M, Dain E, Pelc K, Dan B, De Laet C. Nutritional status of neurologically impaired children: Impact on comorbidity. Arch Pediatr 2019; 27:95-103. [PMID: 31791829 DOI: 10.1016/j.arcped.2019.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/24/2019] [Accepted: 11/11/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Malnutrition is common in neurologically impaired (NI) children. It is, however, ill-defined and under-diagnosed. If not recognized and treated, it increases the burden of comorbidities and affects the quality of life of these children. The aim of this study was to characterize the nutritional status of a cohort of children followed up at a reference center for cerebral palsy (CP) in Brussels, Belgium, and to investigate possible links with the occurrence of comorbidities. MATERIAL AND METHODS We conducted a single-center retrospective study including all the children followed up at the Inter-university Reference Center for Cerebral Palsy ULB-VUB-ULg. The data were obtained by reviewing medical files. Anthropometric measurements as well as the etiology of neurological impairment, comorbidities, feeding patterns, and laboratory test results were collected. The children were assigned a nutritional diagnosis according to the World Health Organization and Waterlow definitions. RESULTS A total of 260 children with cerebral palsy were included, 148 males and 112 females. Their mean age was 10.9±4.3 years. The gross motor function classification system (GMFCS) level was I for 79 children, II for 63 children, III for 35 children, IV for 33 children, and V for 50 children. Of the children, 54% had a normal nutritional status, 34% showed malnutrition, and 8% were obese; 38% had oropharyngeal dysphagia. The sensitivity of mean upper arm circumference of<p10 to detect severe malnutrition was 95%. Specific growth charts for CP were neither sensitive nor specific for predicting the risk of comorbidities. Malnutrition was associated with an increased risk of comorbidities (relative risk of 2.4 [1.7; 3.4]). It was also associated with the occurrence of pneumonia, pressure ulcers, and pathological bone fracture. DISCUSSION AND CONCLUSION Children who are NI should be systematically and thoroughly screened for malnutrition, in the hope of offering early nutritional support and reduce comorbidities.
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Affiliation(s)
- M Leonard
- Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; Service de maladies métaboliques et nutrition, Hôpital des Enfants Reine Fabiola, 1020 Brussels, Belgium.
| | - E Dain
- Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; Service de maladies métaboliques et nutrition, Hôpital des Enfants Reine Fabiola, 1020 Brussels, Belgium
| | - K Pelc
- Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; Inkendaal Revalidatieziekenhuis, 1602 Sint-Pieters-Leeuw, Belgium
| | - B Dan
- Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; Inkendaal Revalidatieziekenhuis, 1602 Sint-Pieters-Leeuw, Belgium
| | - C De Laet
- Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium; Service de maladies métaboliques et nutrition, Hôpital des Enfants Reine Fabiola, 1020 Brussels, Belgium
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Fenelon C, Murphy EP, O’Daly BJ, Leonard M. Where does Pelvic and Acetabular Fracture Treatment fit into the Newly Proposed Major Trauma Model in Ireland? Ir Med J 2019; 112:915. [PMID: 31243944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aim To provide the most up to date reference of referral patterns for pelvis and acetabular (PA) fractures in Ireland and discuss where services should ideally be located. Methods A retrospective review was conducted of all referrals to the national referral centre for PA fractures in Ireland for 2016 and 2017. Results Over the two-year study period 456 referrals were made. Mean age of patients was 53 years, 62.9% were male. Management was conservative in 60.7%, operative in 38.2% while 1.1% died prior to transfer. Nearly half of fractures (47.8%) were due to falls with 38.6% due to road trauma. Referrals from the proposed central trauma network accounted for 76.1% of referrals. Median length of stay was 7 days. Average cost of operative treatment was €11,774. Conclusions PA trauma is associated with significant morbidity and costs to both patients and society. Consideration needs to be given to where best to place PA services to ensure the highest quality care in this cohort of patients
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Affiliation(s)
- C Fenelon
- National Centre for Pelvic & Acetabular Surgery, Tallaght University Hospital, Dublin
| | - E P Murphy
- National Centre for Pelvic & Acetabular Surgery, Tallaght University Hospital, Dublin
| | - B J O’Daly
- National Centre for Pelvic & Acetabular Surgery, Tallaght University Hospital, Dublin
| | - M Leonard
- National Centre for Pelvic & Acetabular Surgery, Tallaght University Hospital, Dublin
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Rapacz-Leonard A, Leonard M, Chmielewska-Krzesińska M, Paździor-Czapula K, Janowski T. Major histocompatibility complex class I in the horse (Equus caballus) placenta during pregnancy and parturition. Placenta 2018; 74:36-46. [PMID: 30638631 DOI: 10.1016/j.placenta.2018.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/07/2018] [Accepted: 12/15/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Major histocompatibility protein class I (MHC-I) is believed to be expressed in the horse allantochorion only in limited areas at limited times. However, its expression has only been investigated in early pregnancy with non-quantitative techniques that cannot reliably detect small amounts of protein. OBJECTIVE To quantify the relative expression of MHC-I in the allantochorion and endometrium during days 90-240 of pregnancy (PREG), parturition with physiological delivery of fetal membranes (PHYS), and parturition with retention of these membranes (FMR). Also, to visualize protein expression and determine whether classical or non-classical MHC-I mRNA is expressed. ANIMALS Heavy draft horses. SETTING PREG horses (n = 12) were sampled postmortem at a slaughterhouse. PHYS (n = 6) and FMR (n = 5) horses were sampled at farms in the vicinity of Olsztyn, Poland. METHODS For relative quantification of MHC-I, western blotting with densitometry was used. To visualize MHC-I, immunohistochemistry was used. For mRNA identification, RT-PCR was performed. RESULTS Although the quantity of MHC-I was lower during PREG than parturition, it was present in the allantochorion and endometrium during PREG. During parturition, MHC-I expression was upregulated in the allantochorion (PHYS vs. PREG: 2.7-times higher, 95% confidence interval, 1.3- to 5.7-times higher; FMR vs. PREG: 3.2-times higher, 95% confidence interval, 1.5- to 6.7-times higher). At parturition, staining for MHC-I was detected in the microcotyledons. Classical and non-classical MHC-I were expressed in both tissues during PREG, PHYS, and FMR. CONCLUSION MHC-I protein is present in the horse allantochorion and endometrium for at least the first two-thirds of pregnancy and at parturition.
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Affiliation(s)
- A Rapacz-Leonard
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Poland.
| | - M Leonard
- University of Warmia and Mazury, Olsztyn, Poland
| | - M Chmielewska-Krzesińska
- Department of Pathophysiology, Forensic Veterinary and Administration, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Poland
| | - K Paździor-Czapula
- Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Poland
| | - T Janowski
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Poland
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Wahl T, Ward P, Winsemius H, AghaKouchak A, Bender J, Haigh I, Jain S, Leonard M, Veldkamp T, Westra S. When Environmental Forces Collide. ACTA ACUST UNITED AC 2018. [DOI: 10.1029/2018eo099745] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multiple factors often interact to amplify the effects of severe storms, droughts, and other extreme water-related events.
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Labrude P, Mouelle P, Menu P, Vigneron C, Dellacherie E, Leonard M, Tayots J. Hemoglobin Solutions Coupled with Polyethylene Glycol 1900: Preparation, Purification, Quality Control and Pharmacological Trials by Hemorrhagic Shock. Int J Artif Organs 2018. [DOI: 10.1177/039139888801100515] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The usefulness of hemoglobin solutions as oxygen transporters is limited by their high affinity for oxygen and rapid elimination from the circulation. Various chemical modifications of hemoglobin aimed at overcoming these two handicaps have been suggested. We have developed a conjugate of pyridoxylated human hemoglobin with monomethoxypolyoxyethylene 1900, whose preparation and properties are described. We present comparative results on short-term or definitive survival of Wistar rats which, during hemorrhagic shock due to the loss of 60 or 80% of their blood mass, were given a solution of native or modified hemoglobin, in some cases purified by ion-exchange chromatography to remove non-heme proteins, lipids, and some endotoxins. The more complex the treatment used to improve the properties and the purity of the hemoglobin solutions, the longer the animals survived. The loss of hemoglobin in the urine was greatly reduced after conjugation: after 20 h, less than 6% of the total infused.
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Affiliation(s)
- P. Labrude
- Faculté des Sciences pharmaceutiques et biologiques, Nancy - France
- Centre régional de Transfusion sanguine et d'Hématologie, Vandoeuvre les Nancy - France
| | - P. Mouelle
- Faculté des Sciences pharmaceutiques et biologiques, Nancy - France
- Centre régional de Transfusion sanguine et d'Hématologie, Vandoeuvre les Nancy - France
| | - P. Menu
- Faculté des Sciences pharmaceutiques et biologiques, Nancy - France
- Centre régional de Transfusion sanguine et d'Hématologie, Vandoeuvre les Nancy - France
| | - C. Vigneron
- Faculté des Sciences pharmaceutiques et biologiques, Nancy - France
- Centre régional de Transfusion sanguine et d'Hématologie, Vandoeuvre les Nancy - France
| | - E. Dellacherie
- Unite assucieé n. 494 du Centre national de la Recherche scientifique, Ecole nationale supérieure des Industries chimiques, Nancy - France
| | - M. Leonard
- Unite assucieé n. 494 du Centre national de la Recherche scientifique, Ecole nationale supérieure des Industries chimiques, Nancy - France
| | - J.L. Tayots
- Institut Mérieux, Marcy l'Etoile, Charbonnieres les Bains - France
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O'Kelly F, Nason GJ, Manecksha RP, Cascio S, Quinn FJ, Leonard M, Koyle MA, Farhat W, Leveridge MJ. The effect of social media (#SoMe) on journal impact factor and parental awareness in paediatric urology. J Pediatr Urol 2017; 13:513.e1-513.e7. [PMID: 28483467 DOI: 10.1016/j.jpurol.2017.03.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 10/24/2016] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Social media (SoMe) comprises a number of internet-based applications that have the capability to disseminate multimodal media and allow for unprecedented inter-user connectivity. The role of Twitter has been studied in conferences and education; moreover, there is increasing evidence that patients are more likely to use social media for their own health education. OBJECTIVE The aim of this study was to assess the impact of social media platforms on the impact factor of both urological and paediatric journals that publish on paediatric urology, and to assess parental awareness of social media in paediatric urology. STUDY DESIGN A filtered Journal of Citation Reports (JCR) search was performed for the period 2012-16 for journals that published articles on paediatric urology. Journals were ranked according to impact factor, and each individual journal website was accessed to assess for the presence of social media. Parents in paediatric urology clinics and non-paediatric urology patients also filled out a questionnaire to assess for awareness and attitudes to social media. All statistical analysis was performed using Prism 6 software (Prism 6, GraphPad Software, California, USA). RESULTS Overall, there were 50 urological journals and 39 paediatric journals with a mean impact factor of 2.303 and 1.766, respectively. There was an overall average increase in impact factor across all urological journals between 2012 and 16. The presence of a Twitter feed was statistically significant for a rise in impact factor over the 4 years (P = 0.017). The cohort of parents was statistically more likely to have completed post-secondary education, to have and access to a social media profile, use it for health education, and use it to access journal/physician/hospital social media accounts. DISCUSSION This study examined, for the first time, the role of social media in paediatric urology, and demonstrated that SoMe use is associated with a positive influence in impact factor, but also a parental appetite for it. Limitations included a non-externally validated questionnaire. There may also have been bias in larger journals that generate and maintain social media platforms such as Twitter, which may then in turn have an influence on impact factor. CONCLUSIONS Social media use within paediatric urology was associated with a higher impact factor, which remained significant after 4 years of analysis. Parents were more likely to use a wide variety of social media to search for conditions and physicians/healthcare providers; therefore, journals and institutions need to embrace and endorse SoMe as a potential source of important clinical information.
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Affiliation(s)
- F O'Kelly
- Department of Paediatric Urology, Our Lady's Children' Hospital, Dublin, Ireland.
| | - G J Nason
- Department of Paediatric Urology, Our Lady's Children' Hospital, Dublin, Ireland
| | - R P Manecksha
- Department of Urological Surgery, Tallaght Hospital (AMNCH), Dublin, Ireland
| | - S Cascio
- Department of Paediatric Urology, Our Lady's Children' Hospital, Dublin, Ireland
| | - F J Quinn
- Department of Paediatric Urology, Our Lady's Children' Hospital, Dublin, Ireland
| | - M Leonard
- Division of Paediatric Urology, Childrens' Hospital of Eastern Ontario, Ottawa, Canada
| | - M A Koyle
- Department of Paediatric Urology, The Hospital for Sick Children, Toronto, Canada
| | - W Farhat
- Department of Paediatric Urology, The Hospital for Sick Children, Toronto, Canada
| | - M J Leveridge
- Department of Urological Surgery, Kingston General Hospital, Ontario, Canada
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15
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Queally JM, O'Daly B, Leonard M, McElwain JP. Pelvic and acetabular trauma care in Ireland: the past, present and future. Ir Med J 2017; 110:607. [PMID: 29341519] [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: 06/07/2023]
Affiliation(s)
- J M Queally
- Adelaide and the Meath, incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland
| | - B O'Daly
- Adelaide and the Meath, incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland
| | - M Leonard
- Adelaide and the Meath, incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland
| | - J P McElwain
- Adelaide and the Meath, incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland
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16
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Sullivan KJ, Hunter Z, Andrioli V, Guerra L, Leonard M, Klassen A, Keays MA. Assessing quality of life of patients with hypospadias: A systematic review of validated patient-reported outcome instruments. J Pediatr Urol 2017; 13:19-27. [PMID: 28089292 DOI: 10.1016/j.jpurol.2016.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/08/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient-reported outcomes have the potential to provide invaluable information for evaluation of hypospadias patients, aid in decision-making, performance assessment, and improvement in quality of care. To appropriately measure patient-relevant outcomes, well-developed and validated patient-reported outcome (PRO) instruments are essential. OBJECTIVE To identify and evaluate existing PRO instruments designed to measure quality of life and/or satisfaction of individuals with hypospadias that have been developed and validated in a hypospadias population. METHODS A systematic search of MEDLINE, EMBASE, PsycINFO, CINAHL and Health and Psychosocial Instruments was conducted in April 2016. Two reviewers independently assessed studies and identified PRO instruments for inclusion. Data were extracted on study characteristics, instrument development and validation, and content domains. RESULTS A total of 32 studies were included that used or described five PRO instruments: Hypospadias Objective Scoring Evaluation (HOSE), Pediatric Penile Perception Score (PPPS), Penile Perception Score (PPS), Genital Perception Scale (GPS) for adults, and GPS for children/adolescents. Instrument development and validation was limited. The majority of identified instruments focused on postoperative cosmetic satisfaction, with only one instrument considering urinary function, and no instruments evaluating sexual function and psychosocial sequelae. CONCLUSIONS While many hypospadias studies have acknowledged the necessity of a patient-reported element, few have used validated PRO instruments developed in a hypospadias population. Existing instruments to measure patient-reported outcomes in hypospadias require improvement in both the breadth of content and in their development and validation methodology.
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Affiliation(s)
- K J Sullivan
- Department of Pediatric Surgery, Division of Urology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada
| | - Z Hunter
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, Canada
| | - V Andrioli
- Department of Pediatric Surgery, Division of Urology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada
| | - L Guerra
- Department of Pediatric Surgery, Division of Urology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, Canada
| | - M Leonard
- Department of Pediatric Surgery, Division of Urology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, Canada
| | - A Klassen
- Department of Pediatrics, McMaster University, 3N27, 1280 Main Street West, Hamilton, ON, Canada; Department of Clinical Epidemiology & Biostatistics, McMaster University, 3N27, 1280 Main Street West, Hamilton, ON, Canada
| | - M A Keays
- Department of Pediatric Surgery, Division of Urology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, Canada.
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Raza H, Bowe A, Davarinos N, Leonard M. Bowel preparation prior to percutaneous ilio-sacral screw insertion: is it necessary? Eur J Trauma Emerg Surg 2016; 44:211-214. [PMID: 27377371 DOI: 10.1007/s00068-016-0704-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/18/2016] [Accepted: 06/24/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this study was to compare the outcomes of ilio-sacral (IS) screw fixation with and without the use of bowel preparation, in terms of obtaining adequate visualisation, malpositioning of screw requiring revision surgery and neurovascular injury. METHODS A retrospective case control study was performed. We reviewed 74 consecutive cases of IS screw fixation performed at our institution within the last 5 years. We included all patients who had undergone percutaneous IS screw fixation. Two groups, one consisting of patients who underwent bowel preparation prior to surgery (Group 1) and one consisting of patients who had no bowel preparation (Group 2), were compared in terms of the above outcomes. There were 37 patients in each group. The mean age in Group 1 was 41 years (17-63) and in Group 2 was 47 years (12-89). RESULTS In Group 1 there were two procedures abandoned due to poor visualisation. In Group 2 there were no cases abandoned for poor visualisation. There were two nerve injuries in Group 1 and no nerve injuries in Group 2. Revision surgery was performed in four patients in Group 1-for malposition, persistent buttock pain, sciatic nerve palsy and inadequate fixation while one revision performed in Group 2 for persistent buttock pain. CONCLUSION Based on these results, we conclude that bowel preparation is not necessary to obtain adequate visualisation for safe and accurate percutaneous IS screw insertion. In fact, in Group 1 two procedures were abandoned and there was higher incidence of complications. Therefore, it would appear that this treatment arm should be abandoned all together. Further studies to prove it conclusively and explain the reasons are required.
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Affiliation(s)
- H Raza
- Department of Trauma Orthopaedics, Tallaght Hospital, Dublin 24, Ireland
| | - A Bowe
- Department of Trauma Orthopaedics, Tallaght Hospital, Dublin 24, Ireland
| | - N Davarinos
- Department of Trauma Orthopaedics, Tallaght Hospital, Dublin 24, Ireland.
| | - M Leonard
- Department of Trauma Orthopaedics, Tallaght Hospital, Dublin 24, Ireland
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Abstract
Objective: Depression has been reported to occur frequently after stroke. The aim of the study was to assess the validity of questionnaire measures for screening for depression after stroke. Design: Cross-sectional correlational study between questionnaire measures of mood and psychiatric interview. Setting: Hospital and community. Participants: Stroke patients were recruited from hospital wards and from a randomized controlled trial of cognitive behavioural therapy. Main measures: Beck Depression Inventory, Wakefield Depression Inventory, General Health Questionnaire 28 and Schedules for Clinical Assessment in Neuropsychiatry. Results: Poor agreement was found between psychiatric diagnosis and questionnaire measures of mood. The sensitivity of the questionnaire measures was high, but specificity was low. No cut-off points with satisfactory sensitivity and specificity could be identified from ROC curves. Conclusions: Although questionnaire assessments of depression provide a satisfactory screening method, specificity values are too low to provide a basis for the diagnosis of depression. Measures need to be developed with higher specificity to facilitate screening for depression after stroke.
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Affiliation(s)
- N B Lincoln
- School of Psychology, University of Nottingham, Nottingham, UK.
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19
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Devarapalli M, Leonard M, Briyal S, Stefanov G, Puppala BL, Schweig L, Gulati A. Prenatal Oxycodone Exposure Alters CNS Endothelin Receptor Expression in Neonatal Rats. Drug Res (Stuttg) 2015; 66:246-50. [PMID: 26676852 DOI: 10.1055/s-0035-1569279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Prenatal opioid exposure such as oxycodone is linked to significant adverse effects on the developing brain. Endothelin (ET) and its receptors are involved in normal development of the central nervous system. Opioid tolerance and withdrawal are mediated through ET receptors. It is possible that adverse effect of oxycodone on the developing brain is mediated through ET receptors. We evaluated brain ETA and ETB receptor expression during postnatal development in rats with prenatal oxycodone exposure. Timed pregnant Sprague-Dawley rats received either oxycodone or placebo throughout gestation. After birth, male rat pups were sacrificed on postnatal day (PND) 1, 7, 14 or 28. Brain ETA and ETB receptor expression was determined by Western blot analysis. Oxycodone pups compared to placebo demonstrated congenital malformations of the face, mouth, and vertebrae at the time of birth [4/69 (5.7%) vs. 0/60 (0%); respectively] and intrauterine growth retardation [10/69 (15%) vs. 2/60 (3.3%); respectively]. On PND 28, oxycodone pups compared to placebo had lower body and kidney weight. ETA receptor expression in the oxycodone group was significantly higher compared to placebo on PND 1 (p=0.035), but was similar on PND 7, 14, or 28. ETB receptor expression decreased in oxycodone compared to placebo on PND 1 and 7 (p=0.001); and increased on PND 28 (p=0.002), but was similar on PND 14. Oxycodone-exposed rat pups had lower birth weight and postnatal weight gain and greater congenital malformations. ETB receptor expression is altered in the brain of oxycodone-treated rat pups indicating a possible delay in CNS development.
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Affiliation(s)
- M Devarapalli
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
| | - M Leonard
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
| | - S Briyal
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
| | - G Stefanov
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
| | - B L Puppala
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
| | - L Schweig
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
| | - A Gulati
- Department of Pediatrics, Divisions of Neonatology and Research, Advocate Children's Hospital and Department of Pharmaceutical Sciences, Chicago College of Pharmacy, Midwestern University, Downers Grove, USA
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20
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Abstract
BACKGROUND Pelvic and acetabular fractures are rare, complex injuries associated with significant morbidity. Fixation of these injuries requires major orthopaedic surgery which in itself is associated with substantial blood loss owing to the extensile operative approach and prolonged operating time required to address the complex fracture anatomy. In order to reduce morbidity, a multifactor approach to blood conservation must be adopted. CURRENT ROLE OF ANTIFIBRINOLYTICS IN ORTHOPAEDIC SURGERY The use of antifibrinolytics to reduce operative blood loss is well documented in many surgical specialties, including orthopaedic surgery. Elective spinal surgery and joint arthroplasty have benefited from the introduction of antifibrinolytics; however, their role in trauma and fracture surgery is not fully defined. Pelvic and acetabular fracture surgery would benefit from further investigation on the benefit and safety of these agents. CONCLUSION Routine use cannot be recommended at this time but agents may be considered on a case-specific basis.
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Affiliation(s)
- R P Piggott
- Department of Trauma and Orthopaedics, The National Centre for the Treatment of Pelvic and Acetabular Fractures, The Adelaide and Meath Hospital Dublin, Incorporating The National Children's Hospital (AMNCH), Tallaght, Dublin 24, Ireland.
| | - M Leonard
- Department of Trauma and Orthopaedics, The National Centre for the Treatment of Pelvic and Acetabular Fractures, The Adelaide and Meath Hospital Dublin, Incorporating The National Children's Hospital (AMNCH), Tallaght, Dublin 24, Ireland
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21
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Macchiarulo S, Gant T, Leonard M. Transcriptome profiling reveals allergy associated gene expression in human bronchial epithelial cells and dendritic cells exposed to diesel exhaust particulate chemicals. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rapacz-Leonard A, Kankofer M, Leonard M, Wawrzykowski J, Dąbrowska M, Raś A, Paździor-Czapula K, Janowski T. Differences in extracellular matrix remodeling in the placenta of mares that retain fetal membranes and mares that deliver fetal membranes physiologically. Placenta 2015; 36:1167-77. [PMID: 26297153 DOI: 10.1016/j.placenta.2015.07.126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 07/18/2015] [Accepted: 07/21/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION In mammals, placenta separation at term may involve degradation of the extracellular matrix by matrix metalloproteinases (MMPs). The activity of MMPs is modulated by TIMPs. We hypothesized that the placentas of mares that deliver fetal membranes physiologically and those that retain fetal membranes (FMR) differ in terms of histology; mRNA expression of MMP-2 and MMP-9; protein expression of MMP-2, MMP-9, and TIMP-2; and the potential activity of both MMPs. METHODS Placenta biopsies were taken from mares (n = 9; 4 FMR, 5 controls) immediately after foal expulsion. Retention was defined as failure to expel all fetal membranes within 3 h of expulsion. All mares were monitored for time of expulsion. The degree of allantochorial/endometrial adhesion was determined in FMR mares, and biopsies from all mares were histologically examined. mRNA expression, protein immunolocalization, protein amount and potential enzyme activity were determined with RT-PCR, immunohistochemistry, Western Blotting and zymography, respectively. RESULTS FMR mares had strong to extremely strong allantochorial/endometrial adhesion, and significantly more connective tissue in the allantochorial villi than controls. The range of MMP-2 mRNA expression levels was more than 13 times greater in FMR mares than in controls. Protein content of both MMPs and TIMP-2 differed significantly between groups. The range of potential MMP-2 and MMP-9 activity was larger in FMR mares, and MMP-2 potential activity was 1.4 times higher in controls (P = 0.02). DISCUSSION These results indicate differences in extracellular matrix remodeling in FMR mares and controls, and suggest dysregulation of MMP expression and activation in FMR mares.
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Affiliation(s)
- A Rapacz-Leonard
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, ul. Oczapowskiego 14, 10-719 Olsztyn, Poland.
| | - M Kankofer
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Life Sciences, ul. Akademicka 12, 20-033 Lublin, Poland
| | - M Leonard
- University of Warmia and Mazury, Oczapowskiego 14, 10719 Olsztyn, Poland
| | - J Wawrzykowski
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Life Sciences, ul. Akademicka 12, 20-033 Lublin, Poland
| | - M Dąbrowska
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, ul. Oczapowskiego 14, 10-719 Olsztyn, Poland
| | - A Raś
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, ul. Oczapowskiego 14, 10-719 Olsztyn, Poland
| | - K Paździor-Czapula
- Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Warmia and Mazury, ul. Oczapowskiego 13, 10-719 Olsztyn, Poland
| | - T Janowski
- Department of Animal Reproduction with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury, ul. Oczapowskiego 14, 10-719 Olsztyn, Poland
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23
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Briyal S, Nguyen C, Leonard M, Gulati A. Stimulation of endothelin B receptors by IRL-1620 decreases the progression of Alzheimer's disease. Neuroscience 2015; 301:1-11. [PMID: 26022359 DOI: 10.1016/j.neuroscience.2015.05.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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: 02/21/2015] [Revised: 05/08/2015] [Accepted: 05/18/2015] [Indexed: 11/17/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by severe cognitive impairment that ultimately leads to death. Endothelin (ET) and its receptors have been considered as therapeutic targets for AD. Recent studies in our lab have shown that stimulation of ETB receptors provide significant neuroprotection following Aβ1-40 administration. It is possible that IRL-1620 may be neuroprotective due to angiogenesis. However, the effect of IRL-1620 on neurovascular remodeling following Aβ1-40 administration has not been established. The purpose of this study was to determine the effect of stimulation of ETB receptors by IRL-1620 on vascular and neuronal growth factors after Aβ1-40 administration. Rats were treated with Aβ1-40 (day 1, 7 and 14) in the lateral cerebral ventricles using stereotaxically implanted cannula and received three intravenous injections of IRL-1620 (an ETB agonist), and/or BQ788 (an ETB antagonist) at 2-h interval on day 8; experiments were performed on day 15. Rats were sacrificed for estimation of brain ETB receptors, vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) expression using immunofluorescence and Western blot. In the Morris swim task, amyloid-β (Aβ)-treated rats showed a significant (p<0.0001) impairment in spatial memory. Rats treated with IRL-1620 significantly (p<0.001) reduced the cognitive impairment induced by Aβ. BQ788 treatment completely blocked IRL-1620-induced improvement in cognitive impairment. IRL-1620 treatment enhanced the number of blood vessels labeled with VEGF compared to vehicle treatment. Additionally, cells showed increased (p<0.001) positive staining for NGF in IRL-1620-treated animals. ETB, VEGF and NGF protein expression significantly (p<0.001) increased in the brain of IRL-1620-treated rats as compared to vehicle. Pretreatment with BQ788 blocked the effects of IRL-1620, thus confirming the role of ETB receptors in the neurovascular remodeling actions of IRL-1620. Results of the present study demonstrate that IRL-1620 improves both acquisition (learning) and retention (memory) on the water maze task and enhances angiogenic and neurogenic remodeling. These findings indicate that the ETB receptor may be a novel therapeutic target for AD and other neurovascular degenerative disorders.
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Affiliation(s)
- S Briyal
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL 60515, USA
| | - C Nguyen
- Chicago College of Health Sciences, Midwestern University, Downers Grove, IL 60515, USA
| | - M Leonard
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL 60515, USA
| | - A Gulati
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL 60515, USA.
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Meagher D, O'Regan N, Ryan D, Connolly W, Boland E, O'Caoimhe R, Clare J, Mcfarland J, Tighe S, Leonard M, Adamis D, Trzepacz PT, Timmons S. Frequency of delirium and subsyndromal delirium in an adult acute hospital population. Br J Psychiatry 2014; 205:478-85. [PMID: 25359923 DOI: 10.1192/bjp.bp.113.139865] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [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: 11/23/2022]
Abstract
Background The frequency of full syndromal and subsyndromal delirium is understudied. Aims We conducted a point prevalence study in a general hospital. Method Possible delirium identified by testing for inattention was evaluated regarding delirium status (full/subsyndromal delirium) using categorical (Confusion Assessment Method (CAM), DSM-IV) and dimensional (Delirium Rating Scale-Revised-98 (DRS-R98) scores) methods. Results In total 162 of 311 patients (52%) screened positive for inattention. Delirium was diagnosed in 55 patients (17.7%) using DSM-IV, 52 (16.7%) using CAM and 58 (18.6%) using DRS-R98⩾12 with concordance for 38 (12.2%) individuals. Subsyndromal delirium was identified in 24 patients (7.7%) using a DRS-R98 score of 7-11 and 41 (13.2%) using 2/4 CAM criteria. Subsyndromal delirium with inattention (v. without) had greater disturbance of multiple delirium symptoms. Conclusions The point prevalence of delirium and subsyndromal delirium was 25%. There was modest concordance between DRS-R98, DSM-IV and CAM delirium diagnoses. Inattention should be central to subsyndromal delirium definitions.
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Affiliation(s)
- D Meagher
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - N O'Regan
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - D Ryan
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - W Connolly
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - E Boland
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - R O'Caoimhe
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - J Clare
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - J Mcfarland
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - S Tighe
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - M Leonard
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - D Adamis
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - P T Trzepacz
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
| | - S Timmons
- D. Meagher, MD, PhD, MRCPsych, Foundation Chair of Psychiatry, Head of Teaching and Research in Psychiatry, University of Limerick Medical School, Limerick, Director of the Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick and Department of Psychiatry, University Hospital Limerick, Ireland; N. O'Regan, MRCPI, D. Ryan, MRCPI, W. Connolly, MB, E. Boland, MB, R. O'Caoimhe, MB, J. Clare, MRCP, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland; J. Mcfarland, MD, MRCPsych, S. Tighe, MRCPsych, University of Limerick Medical School, Limerick and Clare-Limerick Mental Health Services, HSE-West, Mental Health Services, Ireland; M. Leonard, MD, MRCPsych, University of Limerick Medical School, Limerick and Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland; D. Adamis, MD, MRCPsych, University of Limerick Medical School, Limerick, Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Ireland, Sligo-Leitrim Mental Health Services, Sligo, Ireland, and Research and Academic Institute of Athens, Athens, Greece; P. T. Trzepacz, MD, Lilly Research Laboratories, Indianapolis, Indiana, University of Mississippi Medical School, Jackson, Tufts University School of Medicine, Massachusetts and Indiana University School of Medicine, Indiana, USA; S. Timmons, MD, MRCPI, Centre for Gerontology and Rehabilitation, St Finbarr's Hospital, Cork, Ireland
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Leonard M, Macchiarulo S, Gant T. Diesel exhaust particulate associated chemicals elicit a pattern of asthma associated gene expression in human primary bronchial epithelial cells. Toxicol Lett 2014. [DOI: 10.1016/j.toxlet.2014.06.694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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O'Neill F, Nassiri M, Lui D, Leonard M, McElwain J, Morris S. Creation of an electronic referral pathway for pelvic and acetabular fractures in times of austerity. Ir Med J 2014; 107:221-222. [PMID: 25226724] [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: 06/03/2023]
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Kelly ME, Leonard M, Green C, Beggs R, Cheung C, McElwain J, Morris S. Should money follow the patient: Financial implication for being the National Centre for the Treatment and Management of Pelvic and Acetabular Fractures in Ireland. Injury 2013; 44:1816-9. [PMID: 23490321 DOI: 10.1016/j.injury.2013.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 12/04/2012] [Accepted: 02/09/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pelvic and acetabular fractures are complex injuries requiring specialist treatment. Our institution is the National Centre for Treatment and Management of these injuries. AIM To audit all referrals to our institution over a 6-month period and calculate the cost incurred by being the national referral centre. METHODS Retrospective review of database, and subsequent allocation of Casemix points to assess total cost of treatment for each patient referred to our institution. RESULTS 103 patients referred with pelvic or acetabular fracture for operative management. The furthest referral distance was 181miles. Over-all, the length of stay was 15.4 days. The average inclusive cost for a referral to our unit for operative management was €16,302. CONCLUSION Pelvic and acetabular fractures are complex injuries that require specialist referral unit management. However for these units to remain sustainable money needs to "follow the patient".
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Affiliation(s)
- M E Kelly
- National Centre for Pelvic & Acetabular Surgery, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Dublin, Ireland.
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Leonard M, Tait C, Gillan A, Rai B, Byrne D, Nabi G. Impact of multiple deprivations on detection, progression and interventions in small renal masses (less than 4 cm) in a population based study. Eur J Surg Oncol 2013; 39:1157-63. [DOI: 10.1016/j.ejso.2013.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022] Open
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Wolf A, Müller SO, Hewitt P, Pfaller W, Jennings P, Testai E, Bois F, Prieto P, Price A, Lukas A, Richert L, Guillouzo A, Leonard M, Blaauboer BJ, Rostami A, Reinert K, Honegger P, Cechelli R, Kopp-Schneider A, Weiss DG, Schröder O, Huber C, Dekant W. Predict-IV project overview (EU grant 202222): non animal-based toxicity profiling by integrating toxico dynamics and biokinetics. Toxicol Lett 2013. [DOI: 10.1016/j.toxlet.2013.06.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chanson C, Leonard M, Thaon I, Penven E, Speyer E, Paris C. Reconnaissance des psychopathologies par les comités régionaux de reconnaissance des maladies professionnelles de Lorraine entre 2005 et 2011. ARCH MAL PROF ENVIRO 2013. [DOI: 10.1016/j.admp.2012.11.004] [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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O'Neill F, Leonard M, Lui D, McElwain J, Morris S. Pelvic and acetabular fractures. Ir Med J 2012; 105:306. [PMID: 23240284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Patients that sustain pelvic and/or acetabular trauma in Ireland and require surgical intervention are treated at the Adelaide and Meath National Children's Hospital (AMNCH). For this study an audit was conducted of all pelvic and acetabular fractures referred to the AMNCH over a 12 month period from July 2010 to June 2011. This study was conducted with the purpose of recording the different fracture patterns, methods of injury and surgical procedures performed over this time frame. The results demonstrate that 109 patients were referred to the AMNCH with the majority of these fractures being sustained as the result of an RTA (43) or a fall from a height (45). Seventy one patients suffered an acetabular fracture while 43 patients suffered a fracture of their pelvic ring with some patients suffering both. There were 129 surgical procedures performed with 25 patients having more than one surgical procedure.
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Abstract
A case is presented of a healthy 57 year old female who slipped and fell awkwardly into what is known in athletic terms as the front splits. As a result of her fall she sustained bilateral crescent and superior and inferior rami pelvic fractures. Successful operative fixation was undertaken by a combination of open and percutaneous techniques. To our knowledge this is the first reported case of bilateral crescent fractures, and of a pelvic fracture as a result of this mechanism of injury.
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Affiliation(s)
- F O'Neill
- The National Centre for Pelvic and Acetabula Taruma Adelaide and Meath Hospital, Dublin, Ireland
| | - M Leonard
- The National Centre for Pelvic and Acetabula Taruma Adelaide and Meath Hospital, Dublin, Ireland
| | - S Morris
- The National Centre for Pelvic and Acetabula Taruma Adelaide and Meath Hospital, Dublin, Ireland
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Affiliation(s)
- M. Leonard
- Department of Orthopaedic Surgery, Beaumont Hospital, Dublin, Ireland
| | - H. Mullett
- Department of Orthopaedic Surgery, Beaumont Hospital, Dublin, Ireland
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Camargo JA, Sapin A, Nouvel C, Daloz D, Leonard M, Bonneaux F, Six JL, Maincent P. Injectable PLA-based in situ forming implants for controlled release of Ivermectin a BCS Class II drug: solvent selection based on physico-chemical characterization. Drug Dev Ind Pharm 2012; 39:146-55. [PMID: 22397675 DOI: 10.3109/03639045.2012.660952] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In situ forming implants (ISI) prepared from biodegradable polymers such as poly(D,L-lactide) (PLA) and biocompatible solvents can be used to obtain sustained drug release after parenteral administration. The aim of this work was to study the effect of several biocompatible solvents with different physico-chemical properties on the release of ivermectin (IVM), an antiparasitic BCS II drug, from in situ forming PLA-based implants. The solvents evaluated were N-methyl-2-pyrrolidone (NMP), 2-pyrrolidone (2P), triacetine (TA) and benzyl benzoate (BB). Hansen's solubility parameters of solvents were used to explain polymer/solvent interactions leading to different rheological behaviours. The stability of the polymer and drug in the solvents were also evaluated by size exclusion and high performance liquid chromatography, respectively. The two major factors determining the rate of IVM release from ISI were miscibility of the solvent with water and the viscosity of the polymer solutions. In general, the release rate increased with increasing water miscibility of the solvent and decreasing viscosity in the following order NMP>2P>TA>BB. Scanning electron microscopy revealed a relationship between the rate of IVM release and the surface porosity of the implants, release being higher as implant porosity increased. Finally, drug and polymer stability in the solvents followed the same trends, increasing when polymer-solvent affinities and water content in solvents decreased. IVM degradation was accelerated by the acid environment generated by the degradation of the polymer but the drug did not affect PLA stability.
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Affiliation(s)
- J A Camargo
- Faculty of Pharmacy, Laboratory of Pharmaceutical Technology, Nancy University, EA 3452 Nancy Cedex, France
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Elyas R, Guerra LA, Pike J, DeCarli C, Betolli M, Bass J, Chou S, Sweeney B, Rubin S, Barrowman N, Moher D, Leonard M. Is staging beneficial for Fowler-Stephens orchiopexy? A systematic review. J Urol 2010; 183:2012-8. [PMID: 20303527 DOI: 10.1016/j.juro.2010.01.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Fowler and Stephens showed that by dividing the spermatic vessels a high intra-abdominal testis could be placed in the scrotum. Testicular atrophy is a potential complication of this technique. We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability. MATERIALS AND METHODS We searched electronic databases, clinical trial registries and gray literature. We included reports describing boys younger than 18 years with a primary outcome of "testicular viability and position." We performed a meta-analysis using random effects models. Heterogeneity was assessed using forest plot and I(2) statistic. RESULTS We identified 1,807 citations and included 61 articles. Single stage Fowler-Stephens orchiopexy was discussed in 9 articles, a 2-stage procedure in 36 and both approaches in 16. There were no randomized controlled trials, and most studies were cohort or case series. The pooled estimate of success rates was 80% for single stage Fowler-Stephens orchiopexy (95% CI 75 to 86) and 85% for 2-stage Fowler-Stephens orchiopexy (95% CI 81 to 90). The pooled odds ratio of single stage vs 2-stage Fowler-Stephens orchiopexy was 2.0 (95% CI 1.1 to 3.9) favoring the 2-stage procedure. There was no difference in the success rate between laparoscopic and open techniques in either single or 2-stage Fowler-Stephens orchiopexy. There was no evidence of asymmetry on the funnel plot. There were no complications reported with single stage, while ileus, hematoma and infection were the most common complications with 2-stage Fowler-Stephens orchiopexy. CONCLUSIONS Both techniques have a fairly high success rate but 2-stage Fowler-Stephens orchiopexy appears to carry a higher rate of success than the single stage approach (85% vs 80%, OR 2 in favor of 2-stage). Laparoscopic and open techniques had the same success rate. However, the level of evidence of the studies was low, and a study of a more robust design, such as a randomized controlled trial, should be performed.
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Affiliation(s)
- R Elyas
- Queens University, Kingston, Ontario, Canada
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Signorelli S, Jennings P, Leonard M, Pfaller W. Differential Effects of Hypoxic Stress in Alveolar Epithelial Cells and Microvascular Endothelial Cells. Cell Physiol Biochem 2010; 25:135-44. [DOI: 10.1159/000272066] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2009] [Indexed: 11/19/2022] Open
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Abstract
The objective of this paper is to highlight the potential role of eye tracking technology (ETT) in the assessment of delirious patients. Delirium occurs in one in five general hospital admissions (Siddiqi, 2006) and its frequency will increase as society gets older. Despite its frequency and significant independent impact upon morbidity and mortality, delirium remains under studied and is frequently missed, detected late, or misdiagnosed (Farrell & Ganzani, 1995; Inouye, 2001; Kakuma, 2003). Detection is a key target for both clinical and research efforts. Assessment of attention is key to diagnosing delirium, yet nurses and non-research medical staff often fail to correctly identify inattention (Inouye et al., 2001; Lemiengre et al., 2006; Ryan et al., 2008). Eye tracking measures have been used in a plethora of key areas of psychiatric research (Crawford et al., 2005; Corden, Chilvers, & Skuse, 2008; Hardin, Schroth, Pine, & Ernst, 2007; Holzman, Leonard, Proctor, & Hughes, 1973), and provide an accurate and non-invasive method in the assessment of cognitive function. The potential of ETT for direct clinical applications in the assessment of attention and comprehension, key cognitive symptoms of delirium, are promising. This paper considers potential new approaches which recent advancements in non-invasive ETT may bring to the examination and understanding of delirium.
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Affiliation(s)
- C Exton
- Department of Computer Science, University of Limerick, Limerick, Ireland.
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Abstract
The Confusion Assessment Method (CAM) is widely used in the palliative care setting despite the fact that its performance in this population has not been validated. The aim of the study was to determine the sensitivity and specificity of the CAM when used by Non-Consultant Hospital Doctors (NCHDs) working in a specialist palliative care unit. A pilot phase was performed in which NCHDs received a 1-hour training session based on the original CAM training manual. 32 patients underwent 33 assessments in the pilot phase but the sensitivity of the CAM was only 0.5 (0.22-0.78) and specificity was 1.0 (0.81-1.0). An 'enhanced' training programme was devised that took place over two 1-hour sessions and involved case-based learning focused on the areas where the NCHDs were experiencing difficulty. 52 patients underwent 54 assessments in the main phase of the study and the performance of the CAM improved significantly. Sensitivity was 0.88 (0.62-0.98) and specificity was 1.0 (0.88-1.0). The results suggest that the CAM is a valid screening tool for delirium in the palliative care setting but its performance is dependent on the skill of the operator. NCHDs require a certain standard of training before becoming proficient in its use.
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Affiliation(s)
- K Ryan
- Department of Palliative Medicine, Mater Misericordiae University Hospital, Connolly Hospital Blanchardstown and St Francis Hospice, Raheny, Dublin.
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Leonard M, Raju B, Conroy M, Donnelly S, Trzepacz PT, Saunders J, Meagher D. Reversibility of delirium in terminally ill patients and predictors of mortality. Palliat Med 2008; 22:848-54. [PMID: 18755829 DOI: 10.1177/0269216308094520] [Citation(s) in RCA: 62] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In this study, factors related to reversibility and mortality in consecutive cases of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) delirium [n = 121] occurring in palliative care patients were evaluated. Delirium was assessed with the revised Delirium Rating Scale (DRS-R98) and Cognitive Test for Delirium (CTD). Patients were followed until recovery from delirium or death. In all, 33 patients (27%) recovered from delirium before death. Mean time until death was 39.7 +/- 69.8 days in patients with reversible delirium [n = 33] versus 16.8 +/- 10.0 days in those with irreversible delirium [n = 88; P < 0.01]. DRS-R98 and CTD scores were higher in irreversible delirium (P < 0.001) with greater disturbances of sleep, language, long-term memory, attention, vigilance and visuospatial ability. Irreversible delirium was associated with greater disturbance of CTD attention and higher DRS-R98 visuospatial function. Survival time was predicted by CTD score (P < 0.001), age (P = 0.01) and organ failure (P = 0.01). Delirium was not necessarily a harbinger of imminent death. Less reversible delirium involved greater impairment of attention, vigilance and visuospatial function. Survival time is related to age, severity of cognitive impairment and evidence of organ failure.
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Affiliation(s)
- M Leonard
- Department of Adult Psychiatry, Midwestern Regional Hospital, Limerick, Ireland
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Abstract
Bird song is used to defend territories and attract mates and tends to make the singer conspicuous. Singing on the nest (SOTN) has been mentioned since 1904 but has remained largely unexplored. This behavior occurs in 10.1% of breeding birds of North America. Factors that predict the likelihood of SOTN for any species include colonial nesting, incubation sharing and feeding, and taxonomic family. If SOTN is as conspicuous as other forms of singing, this behavior may incur significant costs, such as increased nest predation and parasitism. Data collected from the literature regarding nest vocalizations of adult birds (calls and songs) showed those costs were not significantly different between vocalizing and silent birds. There was greater variance in the rates of nest predation and parasitism for vocalizing birds, which may suggest greater risk. The function(s) of SOTN are not well understood and are mostly untested. Several hypotheses are presented to explain this behavior. This is the first attempt to examine this behavior in any depth and demonstrates the need for further research to explore its function(s) and consequences.
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Affiliation(s)
- M. Leonard
- Department of Biology, University of New Mexico, Albuquerque, NM 87131, USA (e-mail: )
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Leonard M, Magill P, Khayyat G. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia. Int Orthop 2008; 33:1149-53. [PMID: 18654775 DOI: 10.1007/s00264-008-0629-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 05/10/2008] [Accepted: 06/02/2008] [Indexed: 11/25/2022]
Abstract
The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.
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Affiliation(s)
- M Leonard
- Our Lady Of Lourdes Hospital, Drogheda, Co. Louth, Ireland.
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Aumelas A, Serrero A, Durand A, Dellacherie E, Leonard M. Nanoparticles of hydrophobically modified dextrans as potential drug carrier systems. Colloids Surf B Biointerfaces 2007; 59:74-80. [PMID: 17560095 DOI: 10.1016/j.colsurfb.2007.04.021] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Revised: 04/24/2007] [Accepted: 04/24/2007] [Indexed: 10/23/2022]
Abstract
Nanoparticles combining a hydrophobically modified dextran core and a polysaccharide surface coverage were elaborated. Their suitability for applications like drug delivery was evaluated. The selected polysaccharide, dextran, was chemically modified by the covalent attachment of hydrocarbon groups (aliphatic or aromatic) via the formation of ether links. According to the extent of modification, either water-soluble or water-insoluble dextran derivatives were obtained. The latter exhibited solubility in organic solvents like tetrahydrofuran or dichloromethane saturated with water. Water-soluble dextran derivatives were used as polymeric surfactants for the control of nanoparticles surface characteristics. Nanoparticles were prepared either by o/w emulsion or solvent-diffusion methods. The size and surface properties of dextran nanoparticles were correlated to processing conditions. The stability of colloidal suspensions was examined as a function of ionic strength and related to the particle surface characteristics. The redispersability of freeze-dried suspensions without the addition of cryoprotectant was demonstrated. Finally, the degradability of modified dextrans was compared to that of starting dextran, after enzymatic hydrolysis in the presence of dextranase.
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Affiliation(s)
- A Aumelas
- Laboratoire de Chimie Physique Macromoléculaire, UMR 7568 CNRS-Nancy University, ENSIC, BP 20451, 54001 Nancy Cedex, France
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Keays M, Guerra L, Mihill J, Raju G, Al-Asheeri N, Geier P, Gaboury I, Matzinger M, Pike J, Leonard M. MP-02.02: Reliability and validity assessment of society for fetal urology ultrasound grading system for hydronephrosis. Urology 2007. [DOI: 10.1016/j.urology.2007.06.185] [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: 10/22/2022]
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Guerra L, Moher D, Barrowman N, Sampson M, Pike J, Leonard M. POS-02.119: Intravesical oxybutynin for children with poorly compliant neurogenic bladders: a Systematic Review. Urology 2007. [DOI: 10.1016/j.urology.2007.06.1055] [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: 10/22/2022]
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Baumann B, McCans K, Stahmer S, Leonard M, Shults J, Holmes W. Bladder Ultrasound Increases Catheterization Success in Pediatric Patients. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1173] [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: 11/10/2022]
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Leonard M, Jones A, Hernandez-Nino J, Kline J. Determination of the Effect of In-vitro Time, Temperature and Tourniquet Use on Whole Blood Venous Point-of-care Lactate Concentrations. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1233] [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: 11/10/2022]
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Baumann B, McCans K, Stahmer S, Leonard M, Shults J, Holmes W. Caregiver and Healthcare Provider Satisfaction with Ultrasound-Guided Pediatric Bladder Catheterization. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.971] [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: 11/10/2022]
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Abstract
Paediatric spinal injuries, although rare (1-2% of all paediatric fractures) are associated with the highest mortality rate of all orthopaedic injuries in children. The low incidence is due, not only to the plasticity of the paediatric spine, but also the difficulty of diagnosis and the usually severe if not fatal associated injuries. A 10-year (1995-2004) retrospective study was undertaken of all patients treated for a spinal injury at our institute, which functions as both an acute care centre and a tertiary referral centre for seriously injured children. The study was performed in order to highlight the unique features of spinal injuries in children, and to assess the incidence and pattern of associated injuries. A total of 40 patients had a documented diagnosis of spinal injury. The charts and radiographs of all patients were retrieved and reviewed. The median age was 10 years (range 2-15) and 25 were male. The causative factors were motor vehicle accidents in 16, falls in 14, sport injuries in 7 and assaults in 3. Over 65% of the children sustained one or more associated injuries, the mean injury severity score was 18.95. There were two deaths, both in patients with severe multiple trauma and associated spinal fracture. Treatment included closed reduction in two patients and posterior open reduction and stabilisation in two patients, with one of these also requiring decompression. Spinal injuries in children differ from adults due primarily to the biomechanical and anatomical features of the developing musculoskeletal system. When a spinal injury is identified on initial radiographic or clinical evaluation of an injured child, one should have a high index of suspicion that concurrent, potentially life-threatening injuries may be present.
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Affiliation(s)
- M Leonard
- Department of Orthopaedics, The Children's University Hospital, Temple Street, Dublin 1, Ireland.
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Gaire B, Sayler AM, Wang PQ, Johnson NG, Leonard M, Parke E, Carnes KD, Ben-Itzhak I. Determining the absolute efficiency of a delay line microchannel-plate detector using molecular dissociation. Rev Sci Instrum 2007; 78:024503. [PMID: 17578132 DOI: 10.1063/1.2671497] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We present a method to measure the absolute detection efficiency of a delay-line microchannel-plate detector using the breakup of diatomic molecular ions. This method provides the absolute total detection efficiency, as well as the individual efficiency for each signal of the detector. The method is based on the fact that molecular breakup always yields two hits on the detector, but due to finite detection efficiency some of these events are recorded as single particles while others are detected in pairs. We demonstrate the method by evaluating the detection efficiency for both timing and position signals of a delay-line detector using laser-induced dissociation of molecular ions. In addition, the detection efficiency as a function of position has been determined by dividing the detector into sectors.
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Affiliation(s)
- B Gaire
- J. R. Macdonald Laboratory, Department of Physics, Kansas State University, Manhattan, Kansas 66506, USA
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Leonard M, Metcalfe A, Lambert M, Kuczera G. Implementing a space-time rainfall model for the Sydney region. Water Sci Technol 2007; 55:39-47. [PMID: 17425070 DOI: 10.2166/wst.2007.093] [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: 05/14/2023]
Abstract
This paper investigates a Spatial Neyman-Scott Rectangular Pulse (SNSRP) model, which is one of only a few models capable of continuous simulation of rainfall in both space and time. The SNSRP is a spatial extension of the Neyman-Scott Rectangular Pulse model at a single point. The model is highly idealized having six parameters: storm arrival, cell arrival, cell radius, cell lifetime and two cell intensity parameters. A spatial interpolation of the scale parameter is used so that the model can be simulated continuously in space, rather than as a multi-site model. The parameters are calibrated using least-squares fits to statistical moments based on data aggregated to hourly and daily totals. The SNSRP model is calibrated to a very large network of 85 gauges over metropolitan Sydney and shows a good agreement to calibrated statistics. A simulation of 50 replicates over the region compares favourably to several observed temporal statistics, with an example given for one site. A qualitative discussion of the simulated spatial images demonstrates the underlying structure of non-advecting cylindrical cells.
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Affiliation(s)
- M Leonard
- School of Civil and Environmental Engineering, University of Adelaide, Adelaide, Australia
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