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Staniszewski T, Buckley N, Hanna AS. Lateral Femoral Cutaneous Nerve Transposition With Ultrasound-Guided Wire Localization: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2024; 26:104-105. [PMID: 37747349 DOI: 10.1227/ons.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 07/06/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- Thomas Staniszewski
- Department of Neurological Surgery, University of Wisconsin SMPH, Madison, Wisconsin, USA
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Cordeiro K, Kim J, Buckley N, Kraemer M, Pun C, Resnick D. Pterygoid venous plexus anastomosis in trigeminal percutaneous glycerol rhizotomy: illustrative case. J Neurosurg Case Lessons 2023; 6:CASE23173. [PMID: 37903424 PMCID: PMC10618067 DOI: 10.3171/case23173] [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] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/18/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Percutaneous glycerol rhizotomy (PGR) is a common, effective, and relatively safe treatment for trigeminal neuralgia that is refractory to medical management. Anastomotic skull base venous anatomy should be considered when delivering percutaneous agents. OBSERVATIONS The authors report an anastomotic connection, not previously described in the literature, between the bilateral pterygoid venous plexuses upon air injection during PGR with computed tomography (CT) guidance for trigeminal neuralgia. Pertinent microsurgical and skull base venous anatomy is reviewed. LESSONS Anastomoses between the pterygoid venous plexuses present a potential passage for materials used during PGR to reach unintended contralateral neurovascular structures. The use of CT guidance may identify this anastomotic connection and decrease the likelihood of an aberrant flow of materials used during the PGR.
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Affiliation(s)
| | - Jason Kim
- Departments of Neurological Surgery and
| | | | | | - Conrad Pun
- Radiology, University of Wisconsin Hospitals and Clinic, Madison, Wisconsin
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3
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Wijewickrama E, Mohamed F, Buckley N, Gawarammana I, Isbister G. POS-084 THE ROLE OF SERUM AND URINARY BIOMARKERS IN PREDICTING ACUTE KIDNEY INJURY FOLLOWING SRI LANKAN HUMP-NOSED PIT VIPER ENVENOMING. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
The p53 family transcriptional factor p73 plays a pivotal role in development. Ablation of p73 results in severe neurodevelopmental defects, chronic infections, inflammation and infertility. In addition to this, Trp73-\- mice display severe alteration in the ciliated epithelial lining and the full-length N-terminal isoform TAp73 has been implicated in the control of multiciliogenesis transcriptional program. With our recently generated Trp73Δ13/Δ13 mouse model, we interrogate the physiological role of p73 C-terminal isoforms in vivo. Trp73Δ13/Δ13 mice lack exon 13 in Trp73 gene, producing an ectopic switch from the C-terminal isoforms p73α to p73β. Trp73Δ13/Δ13 mice show a pattern of expression of TAp73 comparable to the wild-type littermates, indicating that the α to β switch does not significantly alter the expression of the gene in this cell type. Moreover, Trp73Δ13/Δ13 do not display any significant alteration in the airway ciliated epithelium, suggesting that in this context p73β can fully substitute the function of the longer isoform p73α. Similarly, Trp73Δ13/Δ13 ciliated epithelium of the brain ependyma also does appear defective. In this district however expression of TAp73 is not detectable, indicating that expression of the gene might be compensated by alternative mechanisms. Overall our work indicates that C-terminus p73 is dispensable for the multiciliogenesis program and suggests a possible tissue-specific effect of p73 alternative splicing.
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Affiliation(s)
- Niall Buckley
- Medical Research Council, Toxicology Unit, Department of Pathology, Cambridge University , Cambridge, UK
| | - Emanuele Panatta
- Medical Research Council, Toxicology Unit, Department of Pathology, Cambridge University , Cambridge, UK
| | - Nobuhiro Morone
- Medical Research Council, Toxicology Unit, Department of Pathology, Cambridge University , Cambridge, UK
| | | | - Luca Scorrano
- Department of Biology, University of Padua , Padua, Italy
| | - Richard A Knight
- Medical Research Council, Toxicology Unit, Department of Pathology, Cambridge University , Cambridge, UK
| | - Ivano Amelio
- Medical Research Council, Toxicology Unit, Department of Pathology, Cambridge University , Cambridge, UK.,Department of Experimental Medicine, TOR, University of Rome Tor Vergata , Rome, Italy.,School of Life Sciences, University of Nottingham , Nottingham, UK
| | - Gerry Melino
- Medical Research Council, Toxicology Unit, Department of Pathology, Cambridge University , Cambridge, UK.,Department of Experimental Medicine, TOR, University of Rome Tor Vergata , Rome, Italy
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Albuquerque P, Da Silva Jr. G, Meneses G, Martins A, Raubenheimer J, Shihana F, Buckley N, Daher E. SAT-158 RENAL TUBULAR DYSFUNCTION, COAGULATION DISTURBANCES AND NOVEL BIOMARKES IN ACUTE KIDNEY INJURY DUE TO SNAKEBITES. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.190] [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: 11/17/2022] Open
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6
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Beattie WS, Wijeysundera DN, Chan MTV, Peyton PJ, Leslie K, Paech MJ, Sessler DI, Wallace S, Myles PS, Galagher W, Farrington C, Ditoro A, Baulch S, Sidiropoulos S, Bulach R, Bryant D, O’Loughlin E, Mitteregger V, Bolsin S, Osborne C, McRae R, Backstrom M, Cotter R, March S, Silbert B, Said S, Halliwell R, Cope J, Fahlbusch D, Crump D, Thompson G, Jefferies A, Reeves M, Buckley N, Tidy T, Schricker T, Lattermann R, Iannuzzi D, Carroll J, Jacka M, Bryden C, Badner N, Tsang MWY, Cheng BCP, Fong ACM, Chu LCY, Koo EGY, Mohd N, Ming LE, Campbell D, McAllister D, Walker S, Olliff S, Kennedy R, Eldawlatly A, Alzahrani T, Chua N, Sneyd R, McMillan H, Parkinson I, Brennan A, Balaji P, Nightingale J, Kunst G, Dickinson M, Subramaniam B, Banner-Godspeed V, Liu J, Kurz A, Hesler B, Fu AY, Egan C, Fiffick AN, Hutcherson MT, Turan A, Naylor A, Obal D, Cooke E. Implication of Major Adverse Postoperative Events and Myocardial Injury on Disability and Survival. Anesth Analg 2018. [DOI: 10.1213/ane.0000000000003310] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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7
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Chan M, Peyton P, Myles P, Leslie K, Buckley N, Kasza J, Paech M, Beattie W, Sessler D, Forbes A, Wallace S, Chen Y, Tian Y, Wu W. Chronic postsurgical pain in the Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia (ENIGMA)-II trial. Br J Anaesth 2016; 117:801-811. [DOI: 10.1093/bja/aew338] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 12/18/2022] Open
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8
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Oliveira Filho AMP, Daher EF, Albuquerque PLM, Silva Júnior G, Lopes IS, Veras MSB, Meneses GC, Buckley N. SP192ACUTE KIDNEY INJURY CAUSED BY SNAKEBITES IN PATIENTS ADMITTED TO A REFERENCE TOXICOLOGICAL ASSISTANCE CENTER IN NORTHEAST BRAZIL. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw162.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Oliveira Filho AMP, Daher EF, Albuqurque P, Menezes FH, Tessarolo LD, Santiago VR, Silva Júnior GB, Buckley N. SP219ACUTE KIDNEY INJURY AND OTHER COMPLICATIONS OF LOXOSCELISM - A CROSS-SECTIONAL STUDY IN NORTHEAST BRAZIL. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw162.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Buckley N, Huber A, Lo Y, Castle PE, Kemal K, Burk RD, Strickler HD, Einstein MH, Young M, Anastos K, Herold BC. Association of High-Risk Human Papillomavirus with Genital Tract Mucosal Immune Factors in HIV-Infected Women. Am J Reprod Immunol 2015; 75:146-54. [PMID: 26685115 DOI: 10.1111/aji.12461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/18/2015] [Indexed: 01/12/2023] Open
Abstract
PROBLEM High-risk human papillomavirus (HR-HPV) is prevalent in HIV-infected women and may be associated with mucosal changes that promote HIV replication. METHOD OF STUDY Innate immune molecules, antimicrobial activity, HIV RNA, and HPV DNA genotypes were measured in a cross-sectional study of 128 HIV-infected women categorized into HPV-16 (n = 8), other HR-HPV (n = 41), and non-HR-HPV controls (n = 79). RESULTS Compared to controls, HR-HPV groups had higher plasma viral loads (P = 0.004), lower CD4 cells (P = 0.02), more genital tract HIV RNA (P = 0.03), greater number of different HPV types (P < 0.001), higher cervicovaginal lavage (CVL) IL-1α (P = 0.03) and human beta-defensin 2 (HBD2) (P = 0.049), and less anti-HIVB al activity (P = 0.03). HPV-16 remained significantly associated with higher HBD2 (P = 0.03), higher IL-1α (P = 0.009), and lower anti-HIVB aL activity (P = 0.03) compared to controls after adjusting for plasma viral load and CD4 T cell count. CONCLUSION HR-HPV is associated with mucosal changes in HIV-infected women that could adversely impact genital tract health.
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Affiliation(s)
- Niall Buckley
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ashley Huber
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yungtai Lo
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Philip E Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kimdar Kemal
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert D Burk
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Howard D Strickler
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mark H Einstein
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mary Young
- Department of Medicine, Georgetown University, Washington, DC, USA
| | - Kathryn Anastos
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Betsy C Herold
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
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11
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Nakra NA, Madan RP, Buckley N, Huber AM, Freiermuth JL, Espinoza L, Walsh J, Parikh UM, Penrose KJ, Keller MJ, Herold BC. Loss of Innate Host Defense Following Unprotected Vaginal Sex. J Infect Dis 2015; 213:840-7. [PMID: 26464206 DOI: 10.1093/infdis/jiv488] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/06/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Multiple host defense mechanisms protect the female genital tract from pathogens, but the impact of sexual intercourse on defense is unknown. METHODS As part of a hypothesis-generating study, 17 women provided cervicovaginal lavage (CVL) specimens at baseline (all had abstained from sexual intercourse, masturbation, and vaginal product use for 72 hours prior to screening), 2-6 hours and 10-14 hours after vaginal intercourse with a male condom, and 2-6 hours and 10-14 hours after vaginal intercourse without a male condom (5 visits total, including the baseline visit). Vaginal pH, concentrations of immune molecules, and antimicrobial activity at postcoital visits were compared to baseline values. RESULTS Vaginal pH and the transforming growth factor β1 level increased, but human beta-defensin 2 (HBD-2), HBD-3, and interleukin 8 levels decreased after unprotected sex. Median Escherichia coli inhibitory activity in CVL specimens decreased significantly from baseline at the visit 2-6 hours after unprotected sex (63% [range, -34% to 99%] vs 5% [range, -51% to 100%]; P = .02) and remained low at the visit 10-14 hours after unprotected sex (6% [range, -19% to 92%]; P = .02). Pooled human seminal plasma enhanced E. coli growth in vitro in a dose-dependent manner and, when added to CVL samples with high anti-E. coli activity, reversed the inhibition. CONCLUSIONS Unprotected vaginal sex results in a reduction in endogenous anti-E. coli activity, which may reflect, in part, enhancement of bacterial growth by seminal plasma. This finding may contribute to the risk of E. coli vaginal colonization following sexual intercourse.
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Affiliation(s)
| | | | | | | | | | - Lilia Espinoza
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Jennifer Walsh
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Urvi M Parikh
- Department of Medicine, University of Pittsburgh, Pennsylvania
| | - Kerri J Penrose
- Department of Medicine, University of Pittsburgh, Pennsylvania
| | - Marla J Keller
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
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12
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Agarwal N, Buckley N, Nakra N, Gialanella P, Yuan W, Ghartey JP. Activity of Genital Tract Secretions and Synthetic Antimicrobial Peptides against Group B Streptococcus. Am J Reprod Immunol 2015; 74:499-507. [PMID: 26395128 DOI: 10.1111/aji.12427] [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: 04/02/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022] Open
Abstract
PROBLEM Genital tract secretions inhibit Escherichia coli (E. coli) through antimicrobial peptides (AMP) secreted by the host and vaginal microbiota. However, there are limited data against group B Streptococcus (GBS). METHOD OF STUDY Group B Streptococcus were incubated with cervico-vaginal lavage (CVL) samples from healthy non-pregnant women (n = 12) or synthetic AMP and monitored for bacterial growth using a turbidimetric approach. E. coli inhibitory activity was determined by a colony-forming unit assay. RESULTS None of the CVL samples inhibited GBS. The human neutrophil peptide-1 and human defensin 5 inhibited GBS growth by ≥80% at concentrations ≥20 μg/mL and ≥50 μg/mL, respectively, while human beta-defensin 2 and LL-37 did not inhibit at highest concentration tested (100 μg/mL). In contrast, all AMP inhibited E. coli. CONCLUSIONS Antimicrobial peptides may protect against E. coli colonization but have more limited activity against GBS. Future studies will focus on augmenting host defense with specific AMP to prevent genitourinary infection with these pathogenic organisms.
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Affiliation(s)
- Nidhi Agarwal
- Division of Neonatology, Department of Pediatrics, Children's Hospital At Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Niall Buckley
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Natasha Nakra
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Philip Gialanella
- Department of Pathology, Division of Microbiology, Montefiore Medical Center, Bronx, NY, USA
| | - Weirong Yuan
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jeny P Ghartey
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
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13
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Anandasabapathy N, Breton G, Hurley A, Caskey M, Trumpfheller C, Sarma P, Pring J, Pack M, Buckley N, Matei I, Lyden D, Green J, Hawthorne T, Marsh HC, Yellin M, Davis T, Keler T, Schlesinger SJ. Efficacy and safety of CDX-301, recombinant human Flt3L, at expanding dendritic cells and hematopoietic stem cells in healthy human volunteers. Bone Marrow Transplant 2015; 50:924-30. [PMID: 25915810 DOI: 10.1038/bmt.2015.74] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 02/05/2015] [Accepted: 02/19/2015] [Indexed: 12/22/2022]
Abstract
Fms-like tyrosine kinase-3 ligand (Flt3L) uniquely binds the Flt3 (CD135) receptor expressed on hematopoietic stem cells (HSCs), early progenitor cells, immature thymocytes and steady-state dendritic cells (DCs) and induces their proliferation, differentiation, development and mobilization in the bone marrow, peripheral blood and lymphoid organs. CDX-301 has an identical amino-acid sequence and comparable biological activity to the previously tested rhuFlt3L, which ceased clinical development over a decade ago. This Phase 1 trial assessed the safety, pharmacokinetic, pharmacodynamic and immunologic profile of CDX-301, explored alternate dosing regimens and examined the impact of rhuFlt3L on key immune cell subsets. Thirty healthy volunteers received CDX-301 (1-75 μg/kg/day) over 5-10 days. One event of Grade 3 community-acquired pneumonia occurred. There were no other infections, dose-limiting toxicities or serious adverse events. CDX-301 resulted in effective peripheral expansion of monocytes, hematopoietic stem and progenitor cells and key subsets of myeloid DCs and plasmacytoid DCs, with no clear effect on regulatory T cells. These data from healthy volunteers support the potential for CDX-301, as monotherapy or in combination with other agents, in various indications including allogeneic HSC transplantation and immunotherapy, but the effects of CDX-301 will need to be investigated in each of these patient populations.
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Affiliation(s)
- N Anandasabapathy
- 1] The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA [2] Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - G Breton
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - A Hurley
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - M Caskey
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - C Trumpfheller
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - P Sarma
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - J Pring
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - M Pack
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - N Buckley
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
| | - I Matei
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - D Lyden
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - J Green
- Celldex Therapeutics, Inc., Needham, MA, USA
| | - T Hawthorne
- Celldex Therapeutics, Inc., Needham, MA, USA
| | - H C Marsh
- Celldex Therapeutics, Inc., Needham, MA, USA
| | - M Yellin
- Celldex Therapeutics, Inc., Needham, MA, USA
| | - T Davis
- Celldex Therapeutics, Inc., Needham, MA, USA
| | - T Keler
- Celldex Therapeutics, Inc., Needham, MA, USA
| | - S J Schlesinger
- The Laboratory of Cellular Physiology and Immunology, The Rockefeller University, New York, NY, USA
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Ghartey JP, Smith BC, Chen Z, Buckley N, Lo Y, Ratner AJ, Herold BC, Burk RD. Lactobacillus crispatus dominant vaginal microbiome is associated with inhibitory activity of female genital tract secretions against Escherichia coli. PLoS One 2014; 9:e96659. [PMID: 24805362 PMCID: PMC4013016 DOI: 10.1371/journal.pone.0096659] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 04/10/2014] [Indexed: 01/08/2023] Open
Abstract
Objective Female genital tract secretions inhibit E. coli ex vivo and the activity may prevent colonization and provide a biomarker of a healthy microbiome. We hypothesized that high E. coli inhibitory activity would be associated with a Lactobacillus crispatus and/or jensenii dominant microbiome and differ from that of women with low inhibitory activity. Study Design Vaginal swab cell pellets from 20 samples previously obtained in a cross-sectional study of near-term pregnant and non-pregnant healthy women were selected based on having high (>90% inhibition) or low (<20% inhibition) anti-E. coli activity. The V6 region of the 16S ribosomal RNA gene was amplified and sequenced using the Illumina HiSeq 2000 platform. Filtered culture supernatants from Lactobacillus crispatus, Lactobacillus iners, and Gardnerella vaginalis were also assayed for E. coli inhibitory activity. Results Sixteen samples (10 with high and 6 with low activity) yielded evaluable microbiome data. There was no difference in the predominant microbiome species in pregnant compared to non-pregnant women (n = 8 each). However, there were significant differences between women with high compared to low E. coli inhibitory activity. High activity was associated with a predominance of L. crispatus (p<0.007) and culture supernatants from L. crispatus exhibited greater E. coli inhibitory activity compared to supernatants obtained from L. iners or G. vaginalis. Notably, the E. coli inhibitory activity varied among different strains of L. crispatus. Conclusion Microbiome communities with abundant L. crispatus likely contribute to the E. coli inhibitory activity of vaginal secretions and efforts to promote this environment may prevent E. coli colonization and related sequelae including preterm birth.
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Affiliation(s)
- Jeny P. Ghartey
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- * E-mail:
| | - Benjamin C. Smith
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Zigui Chen
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Niall Buckley
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Yungtai Lo
- Departments of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Adam J. Ratner
- Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York, United States of America
| | - Betsy C. Herold
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Microbiology-Immunology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Robert D. Burk
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Departments of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Microbiology-Immunology, Albert Einstein College of Medicine, Bronx, New York, United States of America
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Buckley N. Clement Edwards. Assoc Med J 2013. [DOI: 10.1136/bmj.f3003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cheshenko N, Trepanier JB, Stefanidou M, Buckley N, Gonzalez P, Jacobs W, Herold BC. HSV activates Akt to trigger calcium release and promote viral entry: novel candidate target for treatment and suppression. FASEB J 2013; 27:2584-99. [PMID: 23507869 DOI: 10.1096/fj.12-220285] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
HSV triggers intracellular calcium release to promote viral entry. We hypothesized that Akt signaling induces the calcium responses and contributes to HSV entry. Exposure of human cervical and primary genital tract epithelial, neuronal, or keratinocyte cells to HSV serotype 2 resulted in rapid phosphorylation of Akt. Silencing of Akt with small interfering RNA prevented the calcium responses, blocked viral entry, and inhibited plaque formation by 90% compared to control siRNA. Susceptibility to infection was partially restored if Akt was reintroduced into silenced cells with an Akt-expressing plasmid. HSV-2 variants deleted in glycoproteins B or D failed to induce Akt phosphorylation, and coimmunoprecipitation studies indicated that Akt interacts with glycoprotein B. Cell-surface expression of Akt was rapidly induced in response to HSV exposure. Miltefosine (50 μM), a licensed drug that blocks Akt phosphorylation, inhibited HSV-induced calcium release, viral entry, and plaque formation following infection with acyclovir-sensitive and resistant clinical isolates. Miltefosine blocked amplification of HSV from explanted ganglia to epithelial cells; viral yields were significantly less in miltefosine compared to control-treated cocultures (P<0.01). Together, these findings identify a novel role for Akt in viral entry, link Akt and calcium signaling, and suggest a new target for HSV treatment and suppression.
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Affiliation(s)
- Natalia Cheshenko
- Department of Pediatrics, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, USA
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Stavrou EP, Lu CY, Buckley N, Pearson S. The role of comorbidities on the uptake of systemic treatment and 3-year survival in older cancer patients. Ann Oncol 2012; 23:2422-2428. [PMID: 22351742 DOI: 10.1093/annonc/mdr618] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Older patients are notably absent from clinical trials. Thus, observational studies are the primary avenue for understanding the role of comorbidity in cancer care and survival. We examined the impact of comorbidity on systemic treatment initiation and 3-year survival in a cohort of older cancer patients. PATIENTS AND METHODS Our cohort comprised 2753 Australian veterans aged ≥65 years with full health coverage and a cancer registry notification for colorectal (CRC), breast, prostate or non-small-cell lung cancer (NSCLC). We established comorbidities based on drugs prescribed in the 6 months prior to cancer diagnosis. RESULTS Patients with higher comorbidity burden were more likely to receive systemic treatment for prostate cancer [adjusted odds ratio 1.21, 95% confidence interval (CI) 1.05-1.39] but less likely for NSCLC (0.63, 95% CI 0.45-0.86). After adjusting for receipt of treatment, increased comorbidity resulted in shorter survival for CRC [adjusted hazard ratio (aHR) 1.16, 95% CI 1.07-1.26] and breast cancer (aHR 1.23, 95% CI 1.02-1.48). However, we did not demonstrate significant improvements in 3-year survival for patients receiving systemic treatment. CONCLUSION Comorbidity influences systemic treatment uptake and adversely affects survival, with impact dependent upon comorbidity and cancer type. Clinical trials should be undertaken in older patients to better understand the risks and benefits of cancer treatments.
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Affiliation(s)
- E P Stavrou
- Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - C Y Lu
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - N Buckley
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - S Pearson
- Adult Cancer Program, Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
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Kassam S, Lu C, Buckley N, Gao Y, Lee R. Modulation of thiopental-induced vascular relaxation and contraction by perivascular adipose tissue and endothelium. Br J Anaesth 2012; 109:177-84. [DOI: 10.1093/bja/aes127] [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: 11/12/2022] Open
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Castro D, Martynoga B, Parras C, Johnston C, Buckley N, Guillemot F. [P1.62]: Transcriptional control of proliferation and differentiation of neural progenitors by the proneural factor Mash1. Int J Dev Neurosci 2010. [DOI: 10.1016/j.ijdevneu.2010.07.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
| | | | - C.M. Parras
- CRICM UPMC, Inserm UMR‐S 975/CNRS UMR 7225France
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Wilks M, Fernando R, Ariyananda P, Berry D, Tomenson J, Buckley N, Gawarammana I, Jayamanne S, Gunnell D, Dawson A. Time trends and factors influencing survival following paraquat ingestion in Sri Lanka. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.1024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anderson J, Rajapakse B, Buckley N. Secondary (nosocomial) poisoning from organophosphates in health workers, fact or fiction? Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Murray MM, Buckley N, Harkin DP. Activin B functions downstream of BRCA1 in stem cell maintenance. Breast Cancer Res 2010. [PMCID: PMC2875563 DOI: 10.1186/bcr2498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Crawford N, Buckley N, Nic An tSaoir C, Tkocz D, D'Costa Z, Oram L, Mullan P. Identification of signalling pathways downstream of BRCA1 and p63. Breast Cancer Res 2010. [PMCID: PMC2875569 DOI: 10.1186/bcr2504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Koontz BF, Chino J, Lee WR, Hahn CA, Buckley N, Huang S, Kim J, Reagan R, Joyner R, Anscher MS. Morbidity and prostate-specific antigen control of external beam radiation therapy plus low-dose-rate brachytherapy boost for low, intermediate, and high-risk prostate cancer. Brachytherapy 2009; 8:191-196. [DOI: 10.1016/j.brachy.2009.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 01/28/2009] [Accepted: 01/30/2009] [Indexed: 10/20/2022]
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Abstract
BACKGROUND Poisoning with paracetamol (acetaminophen) is a common cause of hepatotoxicity in the Western World. Inhibition of absorption, removal from the vascular system, antidotes, and liver transplantation are interventions for paracetamol poisoning. OBJECTIVES To assess the benefits and harms of interventions for paracetamol overdose. SEARCH STRATEGY We identified trials through electronic databases, manual searches of bibliographies and journals, authors of trials, and pharmaceutical companies until December 2005. SELECTION CRITERIA Randomised clinical trials and observational studies were included. DATA COLLECTION AND ANALYSIS The primary outcome measure was all-cause mortality plus liver transplantation. Secondary outcome measures were clinical symptoms, (eg, hepatic encephalopathy, fulminant hepatic failure), hepatotoxicity, adverse events, and plasma paracetamol concentration. We used Peto odds ratios and odds ratios with 95% confidence intervals (CI) for analysis of outcomes. Random- and fixed-effects meta-analyses were performed. MAIN RESULTS Ten small and low-methodological quality randomised trials, one quasi-randomised study, and 48 observational studies were identified. It was not possible to perform relevant meta-analyses of randomised trials that have addressed our outcome measures. Activated charcoal, gastric lavage, and ipecacuanha are able to reduce the absorption of paracetamol, but the clinical benefit is unclear. Of these, activated charcoal seems to have the best risk-benefit ratio. N-acetylcysteine seems preferable to placebo/supportive treatment, dimercaprol, and cysteamine, but N-acetylcysteine's superiority to methionine is unproven. It is not clear which N-acetylcysteine treatment protocol offers the best efficacy. No strong evidence supports other interventions for paracetamol overdose. N-acetylcysteine may reduce mortality in patients with fulminant hepatic failure (Peto OR 0.26, 95% CI 0.09 to 0.94, one trial). Liver transplantation has the potential to be life saving in fulminant hepatic failure, but refinement of selection criteria for transplantation and long-term outcome reporting are required. AUTHORS' CONCLUSIONS Our results highlight a paucity of randomised trials on interventions for paracetamol overdose. Activated charcoal seems the best choice to reduce absorption. N-acetylcysteine should be given to patients with overdose but the selection criteria are not clear. No N-acetylcysteine regime has been shown to be more effective than any other. It is a delicate balance when to proceed to liver transplantation, which may be life-saving for patients with poor prognosis.
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Affiliation(s)
- J Brok
- Copenhagen University Hospital, Copenhagen Trial Unit, Dept. 7102, H:S Rigshospitalet, Blegdamsvej 9, Copenhagen Ø, Denmark, 2100 KBH Ø.
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Gillman K, Prior F, Hall M, Buckley N. Serotonin syndrome. Aust Prescr 2003. [DOI: 10.18773/austprescr.2003.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
BACKGROUND Acute organophosphorus (OP) pesticide poisoning is widespread in the developing world. Standard treatment involves the administration of intravenous atropine and an oxime to counter acetylcholinesterase inhibition at the synapse, but the usefulness of oximes is uncertain. AIM To assess the evidence on the use of oximes in OP poisoning. DESIGN Systematic review. METHODS We searched Medline, Embase, and Cochrane databases (last check 01/02/02) for 'organophosphate' or 'oxime' together with 'poisoning' or 'overdose'. We cross-referenced from other articles, and contacted experts to identify unpublished studies. A Web search engine [www.google.com] was also used, with the keywords 'organophosphate', 'oxime', and 'trial' (last check 01/02/02). RESULTS We found two randomized controlled trials (RCTs) involving 182 patients treated with pralidoxime. The RCTs found no benefit with pralidoxime, and have been used to argue that pralidoxime should not be used in OP poisoning. DISCUSSION The RCT authors must be congratulated for attempting important studies in a difficult environment. However, their studies did not take into account recently clarified issues regarding outcome, and their methodology is unclear. A generalized statement that pralidoxime should not be used in OP poisoning is not supported by the published results. Oximes may well be irrelevant in the overwhelming self-poisoning typical of the tropics, but a large RCT comparing the current WHO-recommended pralidoxime regimen (>30 mg/kg bolus followed by >8 mg/kg/h infusion) with placebo is needed for a definitive answer. Such a study should be designed to identify any patient subgroups that might benefit from oximes.
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Affiliation(s)
- M Eddleston
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, UK.
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Abstract
BACKGROUND Self-poisoning with paracetamol (acetaminophen) is a common cause of hepatotoxicity in the Western World. Interventions for paracetamol poisoning encompass inhibition of absorption, removal from the vascular system, antidotes, and liver transplantation. OBJECTIVES The objective was to assess the beneficial and harmful effects of interventions or combination of interventions for paracetamol overdose. SEARCH STRATEGY The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Library, MEDLINE, EMBASE, and text searches were combined (until July 2001). SELECTION CRITERIA Randomised clinical trials (RCTs) and observational studies as well as human volunteer randomised trials were included. The studies could be unpublished or published as an article, an abstract, or a letter and no language limitations were applied. DATA COLLECTION AND ANALYSIS All the analyses were performed according to the intention to treat. The methodological quality of the included trials was evaluated by components of methodological quality. MAIN RESULTS Nine RCTs (all small and of low methodological quality), one quasi-randomised trials, 37 observational studies, and nine randomised trials including human volunteers were identified. It was impossible to perform meta-analyses including more than two RCTs. Activated charcoal, gastric lavage, and ipecacuanha are able to reduce the absorption of paracetamol but the clinical benefit is unclear. Of these, activated charcoal seems to have the best risk-benefit ratio. N-acetylcysteine seems preferable to placebo/supportive treatment (relative risk of mortality in patients with fulminant hepatic failure = 0.65; 95% confidence interval 0.43 to 0.99), dimercaprol, and cysteamine, but N-acetylcysteine's superiority to methionine is unproven. It is not clear which N-acetylcysteine treatment protocol offers the best efficacy. No evidence supports haemoperfusion or cimetidine for paracetamol overdose. Liver transplantation has the potential to be life saving in fulminant hepatic failure, but further refinement of selection criteria for liver transplantation and evaluation of the long-term outcome are required. REVIEWER'S CONCLUSIONS This systematic Review has highlighted a paucity of RCTs on interventions for paracetamol overdose. Activated charcoal seems the best choice to reduce paracetamol absorption. N-acetylcysteine should be given to patients with paracetamol overdose. No N-acetylcysteine regime has been shown to be more effective than any other. It is a delicate balance when to proceed to liver transplantation, which may be life saving in patients with a poor prognosis. Interventions for paracetamol overdose need assessment in high-quality, multi-centre RCTs.
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Affiliation(s)
- J Brok
- Centre for Clinical Intervention Research, Copenhagen University Hospital, Department 71-02, H:S Rigshospitalet, Copenhagen Ø, Denmark, DK 2100.
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Leary AC, Grealy G, Higgins TM, Buckley N, Barry DG, Ferriss JB. Premature hair greying may predict reduced bone mineral density in Graves' disease. Ir J Med Sci 2001; 170:117-9. [PMID: 11491046 DOI: 10.1007/bf03168823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Premature hair greying has been associated with low bone mineral density (BMD), and it may be more frequent in Graves' disease. AIMS To determine whether premature greying is associated with reduced BMD in women with Graves' disease and in control women, and to examine whether premature greying is more common in Graves' disease. METHODS Premature greying (> 50% grey by 40 years) and BMD were determined in 44 women with a history of Graves' disease and 133 female controls referred for routine BMD measurement. Exclusion criteria included diseases or drugs known to affect BMD. RESULTS Mean Z and T scores at the lumbar spine were significantly lower (P < 0.04) in subjects with premature greying than in those not prematurely grey among women with Graves' disease, but not among control women. Multiple regression confirmed this difference between Graves' and control women (P = 0.041). There were no differences at other measurement sites. Of Graves' patients, 36% were prematurely grey compared with 25% of control women (P = 0.14). CONCLUSION Premature greying may be a weak marker for reduced BMD in women with a history of Graves' disease, but it is not a marker in normal women.
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Affiliation(s)
- A C Leary
- Department of Medicine, Cork University Hospital and University College Cork, Ireland
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Skehan SJ, Malone DE, Buckley N, Matsumoto S, Rawlinson J, Ting G, Graham D, Alexander J, Somers S, Stevenson GW. Sedation and analgesia in adult patients: evaluation of a staged-dose system based on body weight for use in abdominal interventional radiology. Radiology 2000; 216:653-9. [PMID: 10966691 DOI: 10.1148/radiology.216.3.r00se09653] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the safety and effectiveness of a systematic protocol for sedation and analgesia in interventional radiology. MATERIALS AND METHODS Ninety-one adult patients underwent 113 abdominal interventional procedures. Fentanyl citrate and midazolam hydrochloride were administered in one to five steps (A, B, C, D, E) until the patient was drowsy and tranquil at the effective loading dose (ELD). Doses per step were as follows: A, fentanyl 1 microg per kilogram of body weight; B, midazolam 0.010-0.035 mg/kg; C, repeat dose in A; D, repeat half the dose in B; and E, midazolam 1-2-mg boluses (maximum, 0.15 mg/kg). RESULTS The ELD was reached in no procedure after step A, in 70 after B, in 23 after C, and in 18 after D. Step E was needed in two procedures. The mean maximum pain score (scale of 0 to 10) was 3.4; pain scores in 85 (75%) procedures were 4 or less (discomforting). Severe pain occurred in seven (6%) procedures. Hypoxia (oxygen saturation < 90%) occurred in 11 (22%) procedures performed in patients breathing room air and four (6%) performed in those breathing supplemental oxygen (P: =.04). All patients responded to supplemental oxygen. CONCLUSION This stepwise "ABCDE protocol" allows safe and effective sedation of patients. It is easy to use and may be useful in training radiology residents, staff, and nurses in the techniques of sedation and analgesia. Supplemental oxygen should be used routinely.
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Affiliation(s)
- S J Skehan
- Department of Radiology, McMaster University Medical Centre, Hamilton, Ontario, Canada.
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Buckley N, Korz L. Behavioral outcomes methodology. Anesthesiology 1999; 91:1959-60. [PMID: 10598644 DOI: 10.1097/00000542-199912000-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Plamondon P, Brochu D, Thomas S, Fradette J, Gauthier L, Vaillancourt K, Buckley N, Frenette M, Vadeboncoeur C. Phenotypic consequences resulting from a methionine-to-valine substitution at position 48 in the HPr protein of Streptococcus salivarius. J Bacteriol 1999; 181:6914-21. [PMID: 10559156 PMCID: PMC94165 DOI: 10.1128/jb.181.22.6914-6921.1999] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In gram-positive bacteria, the HPr protein of the phosphoenolpyruvate:sugar phosphotransferase system (PTS) can be phosphorylated on a histidine residue at position 15 (His(15)) by enzyme I (EI) of the PTS and on a serine residue at position 46 (Ser(46)) by an ATP-dependent protein kinase (His approximately P and Ser-P, respectively). We have isolated from Streptococcus salivarius ATCC 25975, by independent selection from separate cultures, two spontaneous mutants (Ga3.78 and Ga3.14) that possess a missense mutation in ptsH (the gene encoding HPr) replacing the methionine at position 48 by a valine. The mutation did not prevent the phosphorylation of HPr at His(15) by EI nor the phosphorylation at Ser(46) by the ATP-dependent HPr kinase. The levels of HPr(Ser-P) in glucose-grown cells of the parental and mutant Ga3.78 were virtually the same. However, mutant cells growing on glucose produced two- to threefold less HPr(Ser-P)(His approximately P) than the wild-type strain, while the levels of free HPr and HPr(His approximately P) were increased 18- and 3-fold, respectively. The mutants grew as well as the wild-type strain on PTS sugars (glucose, fructose, and mannose) and on the non-PTS sugars lactose and melibiose. However, the growth rate of both mutants on galactose, also a non-PTS sugar, decreased rapidly with time. The M48V substitution had only a minor effect on the repression of alpha-galactosidase, beta-galactosidase, and galactokinase by glucose, but this mutation abolished diauxie by rendering cells unable to prevent the catabolism of a non-PTS sugar (lactose, galactose, and melibiose) when glucose was available. The results suggested that the capacity of the wild-type cells to preferentially metabolize glucose over non-PTS sugars resulted mainly from inhibition of the catabolism of these secondary energy sources via a HPr-dependent mechanism. This mechanism was activated following glucose but not lactose metabolism, and it did not involve HPr(Ser-P) as the only regulatory molecule.
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Affiliation(s)
- P Plamondon
- Groupe de Recherche en Ecologie Buccale, Département de Biochimie, Faculté des Sciences et de Génie and Faculté de Médecine Dentaire, Université Laval, Cité Universitaire, Québec, Québec, Canada G1K 7P4
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Shakib S, Clark E, Buckley N, Howe L. A COMPARISON OF THE PERFORMANCE OF DIFFERENT TECHNIQUES FOR THE DETERMINATION OF A ONCE DAILY GENTAMICIN DOSE. Ther Drug Monit 1999. [DOI: 10.1097/00007691-199908000-00106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
We investigated the long-term outcome of treatment in 159 patients with hyperthyroidism first seen between 1979 and 1992. Median duration of follow-up was 10 1/2 years. We also inquired into current practice for the follow-up of hyperthyroidism by other endocrinologists in Ireland. Seven cases of unrecognised hyperthyroidism (4 per cent) and one of unrecognised hypothyroidism were identified. Among patients with Graves' disease, of those treated with an antithyroid drug, 28 per cent were in remission, 68 per cent had relapsed and 4 per cent had become hypothyroid. Of those treated by sub-total thyroidectomy, 31 per cent were in remission, 19 per cent had relapsed, 19 per cent were hypothyroid and 31 per cent were sub-clinically hypothyroid. Among patients treated with radioiodine, 19 per cent were euthyroid, 3 per cent were still hyperthyroid and three-quarters had become hypothyroid. In contrast, after radioiodine for toxic nodular goitre, 63 per cent were euthyroid and only 32 per cent had become hypothyroid (Chi Squared v. Graves' disease, P = 0.001). Of 73 patients receiving thyroxine replacement, plasma TSH was normal in only 41 per cent, although 82 per cent of patients had been seen by the family doctor within the previous 12 months. Seven of 17 other endocrinologists undertook long-term follow-up of hyperthyroid patients in their specialist clinics but none was using a computerised system to co-ordinate this. The findings confirm that careful follow-up is required for all hyperthyroid patients. The family doctor is well positioned to undertake this, but education and auditing are required.
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Affiliation(s)
- A C Leary
- Department of Medicine, Cork University Hospital
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Gleeson A, Owens D, Collins P, Johnson A, Tomkin GH, Sexton DM, Creedon G, Ledwith M, Griffin M, O’Meara N, Collins PB, Kilbane MT, Tuite AM, Shering SG, Smith DF, McDermott FWM, O’Higgins NJ, Smyth PPA, McKenna K, Thompson CJ, Kohler WM, O’Shea D, Alaghband-Zadeh J, Latham K, Carter G, Smyth PPA, Shering SG, Kilbane MT, McDermott EWM, Smith DF, O’Higgins NJ, Lovell SL, Leslie H, Doherty C, Hadden DR, McGeown MG, Kinsley BT, McKenna TJ, Byrne PM, Gallagher C, McKennal MJ, Li Voon Chong SW, Darby C, Freyne P, Cullen MJ, McKone E, Heffernan A, Darko DA, Kyrialcides E, O’Shea D, Burr R, Carter G, Armstrong VL, Ennis CN, Hunter SJ, Sheridan B, Atkinson AB, Bell PM, Giblin L, Griffin ME, Otridge B, O’Meara NM, Kinsley BT, Weinger K, Bajaj M, Levy CJ, Waters M, Simonson DC, Cox DJ, Jacobson AM, Armstrong VL, Ennis CN, Sheridan B, Atkinson AB, Bell PM, Traub AI, Creedon G, Sexton D, Griffin M, O’Meara N, Collins P, Wiggam MI, Bell PM, Sheridan B, Walmsley AE, Atkinson AB, Leary AC, Grealy G, Higgins TM, Buckley N, Barry DG, Murphy D, Ferriss JB, McConnell EM, Bell PM, Hadden DR, McCance R, Atkinson AB, Nikookam K, Suliman ME, Carroll M, Webster J, Wilson RM, Cullen DR, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Alavi Z, O’Hare JA, McAllister AS, Atkinson AB, McCance DR, Johnston GD, McKenna MJ, Freaney R. Irish endocrine society. Ir J Med Sci 1998. [DOI: 10.1007/bf02937356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bruin G, Buckley N. Intubating conditions and correct application of cricoid pressure during rapid sequence induction: who should hold the mask? Can J Anaesth 1997; 44:900. [PMID: 9260020 DOI: 10.1007/bf03013169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Beattie WS, Warriner CB, Etches R, Badner NH, Parsons D, Buckley N, Chan V, Girard M. The addition of continuous intravenous infusion of ketorolac to a patient-controlled analgetic morphine regime reduced postoperative myocardial ischemia in patients undergoing elective total hip or knee arthroplasty. Anesth Analg 1997; 84:715-22. [PMID: 9085945 DOI: 10.1097/00000539-199704000-00003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This double-blind randomized trial assessed the effect of adding an intravenous continuous infusion of ketorolac to a patient-controlled analgesia (PCA) morphine regimen on analgesia, heart rate, arterial blood pressure, and postoperative myocardial ischemia. Patients having elective total hip or knee replacement were randomized to receive ketorolac 30 mg bolus, followed by an infusion of 5 mg/h for 24 h or placebo. All patients had access to PCA morphine (20 microg/kg bolus, with a lockout of 6 min). Patients were monitored for pain visual analog scale, blood pressure, heart rate, and ST segment depression via a continuous Holter monitor. ST depression of 1 mm 60 ms after the J point was considered significant if it lasted more than 1 min. There was no difference in demographics, risk factors, or cardiac medications between the groups. Ketorolac-treated patients had significantly better pain control at 2, 6, and 24 h. There was significant morphine sparing at all times after 3 h. There was no difference in the number of ischemic events between the groups. The ischemic episodes of the patients who received ketorolac occurred at slower heart rates (97 +/- 15 vs 114 +/- 16 bpm, P = 0.001) than those of patients in the placebo group. The duration of ST depression was shorter in ketorolac-treated patients (24 +/- 35 vs 76 +/- 95 min, P < 0.05). All ST depressions were clinically silent. Logistic regression of factors predicting ischemia included the use of calcium channel blockers and low pain score. These results suggest that analgesia with ketorolac reduces the duration of ischemic episodes in the first 24 h postoperatively.
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Affiliation(s)
- W S Beattie
- Department of Anaesthesia, McMaster University, Hamilton, Ontario, Canada
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Perrett CW, Clayton RN, Pistorello M, Boscaro M, Scanarini M, Bates AS, Buckley N, Jones P, Fryer AA, Gilford J. GSTM1 and CYP2D6 genotype frequencies in patients with pituitary tumours: effects on P53, ras and gsp. Carcinogenesis 1995; 16:1643-5. [PMID: 7614700 DOI: 10.1093/carcin/16.7.1643] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
We describe studies to determine if susceptibility to pituitary tumours is associated with the putatively high risk GSTM1 null and CYP2D6 EM genotypes. Frequency distributions of these genotypes were similar in cases and controls though the frequency of CYP2D6 PM and GSTM1 B tended to be lower (P = 0.072 and P = 0.095 respectively) in the tumour group. Immunopositivity for p53 was found in 18/97 tumours. In these samples GSTM1 null (39%) and CYP2D6 EM (56%) frequencies were not different to those in controls. The frequencies of CYP2D6 PM and GSTM1 B in the p53 immunonegative tumours tended to be lower (P = 0.055 and P = 0.1185 respectively) than in controls. Mutations in gsp and ras were studied using the polymerase chain reaction and allele specific oligonucleotide analysis. Eight of 19 somatotrophinomas demonstrated mutations in gsp; frequencies of GSTM1 null and CYP02D6 EM were similar to controls. No ras mutations were identified in 55-tumour studies. The data indicate the GSTM1 null and CYP2D6 EM genotypes are not associated with altered expression of p53 or, mutation of gsp and ras in these adenomas and, suggest the CYP2D6 PM genotype is associated with a reduced risk of pituitary adenomas and, that GSTM1*B confers greater protection than GSTM1*A.
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Affiliation(s)
- C W Perrett
- Department of Medicine, School of Postgraduate Medicine, Keele University, North Staffordshire Hospital/Stoke-on-Trent, UK
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Whyte I, Buckley N, Carter G. Antidepressants and suicide. Study analyses were flawed. BMJ 1995; 311:55; author reply 57. [PMID: 7677867 PMCID: PMC2550099 DOI: 10.1136/bmj.311.6996.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
A 30-year-old presented in 1984 with a clinically nonfunctional tumour which subsequently developed into a metastatic corticotrophinoma from which he died despite surgery in 1984, 1986 and 1991 and external radiotherapy in 1986. Molecular genetic analysis of tumour and metastatic tissue revealed loss of heterozygosity at loci on the autosomes 1p, 3p, 10q26, 11q13 and 22q12. Tissue taken at surgery in 1986 also revealed positive cytoplasmic immunostaining for p53 protein. No such staining was evident in tissue taken at first surgery in 1984. Further analysis of invasive pituitary adenomas may reveal loci associated with such behaviour, enabling better prediction of subsequent clinical outcome than is possible using standard histological techniques, and delivery of early, aggressive treatment to those tumours which show molecular markers associated with a poor prognosis.
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MESH Headings
- Adenoma/chemistry
- Adenoma/genetics
- Adult
- Base Sequence
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 10
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 3
- Cushing Syndrome/genetics
- DNA Primers/genetics
- Gene Deletion
- Heterozygote
- Humans
- Immunohistochemistry
- Male
- Molecular Sequence Data
- Pituitary Neoplasms/chemistry
- Pituitary Neoplasms/genetics
- Polymerase Chain Reaction
- Tumor Suppressor Protein p53/analysis
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Affiliation(s)
- A S Bates
- Department of Medicine, School of Postgraduate Medicine, University of Keele, Stoke-on-Trent, UK
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Buckley N, Morison DH. Parental presence at induction. Can J Anaesth 1995; 42:361. [PMID: 7646681 DOI: 10.1007/bf03010717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Buckley N, Bates AS, Broome JC, Strange RC, Perrett CW, Burke CW, Clayton RN. P53 protein accumulates in Cushings adenomas and invasive non-functional adenomas. J Clin Endocrinol Metab 1995; 80:4 p following 692. [PMID: 7852482 DOI: 10.1210/jcem.80.2.7852482] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The p53 protein, a negative regulator of cell growth, plays an important role in the pathogenesis of many human tumours following gene mutation and/or deletion. We screened a large number of sporadic pituitary tumours for p53 protein accumulation suggestive of gene mutation. Samples were divided into benign adenomas (n = 95) and invasive tumours with local or distant invasion (n = 26). All main tumour classes were represented. Putative p53 mutations were detected by immunohistochemistry on paraffin-embedded sections using polyclonal CM-1 and monoclonal DO-7 and PAb1801 antibodies. Results were compared to normal post-mortem pituitary tissue controls (n = 17). p53 protein accumulation was detected in invasive tumours (16%), but only in corticotrophinomas (2/4) and non-functional tumours (4/15). In non-invasive adenomas, protein accumulation was observed only in ACTH-secreting tumours where 50% were positive (16/32). No protein accumulation was identified in any control tissue. These results indicate that p53 protein accumulation may play a role in the development of Cushings adenomas and in the progression of non-functional tumours to the invasive state.
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Affiliation(s)
- N Buckley
- School of Postgraduate Medicine, Keele University, North Staffordshire Hospital Centre, Stoke on Trent, UK
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Buckley N, Bates AS, Broome JC, Strange RC, Perrett CW, Burke CW, Clayton RN. p53 Protein accumulates in Cushings adenomas and invasive non-functional adenomas. J Clin Endocrinol Metab 1994; 79:1513-6. [PMID: 7962351 DOI: 10.1210/jcem.79.5.7962351] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The p53 protein, a negative regulator of cell growth, plays an important role in the pathogenesis of many human tumours following gene mutation and/or deletion. We screened a large number of sporadic pituitary tumours for p53 protein accumulation suggestive of gene mutation. Samples were divided into benign adenomas (n = 95) and invasive tumours with local or distant invasion (n = 26). All main tumour classes were represented. Putative p53 mutations were detected by immunohistochemistry on paraffin-embedded sections using polyclonal CM-1 and monoclonal DO-7 and PAb1801 antibodies. Results were compared to normal post-mortem pituitary tissue controls (n = 17). p53 protein accumulation was detected in invasive tumours (16%), but only in corticotrophinomas (2/4) and non-functional tumours (4/15). In non-invasive adenomas, protein accumulation was observed only in ACTH-secreting tumours where 50% were positive (16/32). No protein accumulation was identified in any control tissue. These results indicate that p53 protein accumulation may play a role in the development of Cushings adenomas and in the progression of non-functional tumours to the invasive state.
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Affiliation(s)
- N Buckley
- School of Postgraduate Medicine, Keele University, North Staffordshire Hospital Centre, Stoke on Trent, UK
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Abstract
1. A descriptive case study of calcium channel-blocking drug (CCB) overdoses in the Hunter Region of NSW was performed to analyse the in-hospital morbidity and mortality of CCB drug overdoses in an Australian population. 2. The patients were admitted to major hospitals within the Hunter Region and treated initially with gastrointestinal decontamination, including the use of oral activated charcoal. Further management was required in most cases and included intravenous calcium, atropine and inotropic support. 3. Of the 15 CCB overdoses, four patients died. Noncardiogenic pulmonary oedema occurred in two other cases. Cardiac conduction defects occurred in 11 cases. 4. Atropine was found to be effective only after intravenous calcium had been administered. 5. Overdose with slow-release verapamil required prolonged treatment with intravenous calcium salts. 6. Overdose with verapamil or diltiazem in doses greater than 300 mg carries a significant risk of death and potentially life threatening arrhythmias occur with lower doses. 7. Recommended initial management includes early, effective gastrointestinal decontamination. High dose intravenous calcium salts should be given to reverse hypotension and bradycardia. Atropine and inotropic support are frequently required.
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Affiliation(s)
- D M Howarth
- Department of Clinical Pharmacology and Toxicology, Newcastle Mater Misericordiae Hospital, Waratah, NSW, Australia
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Buckley N, Dawson A. Whole-bowel irrigation for theophylline overdose. Ann Emerg Med 1993; 22:1774; author reply 1775-6. [PMID: 8214876 DOI: 10.1016/s0196-0644(05)81326-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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