1
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Carswell C, Brown JVE, Lister J, Ajjan RA, Alderson SL, Balogun-Katung A, Bellass S, Double K, Gilbody S, Hewitt CE, Holt RIG, Jacobs R, Kellar I, Peckham E, Shiers D, Taylor J, Siddiqi N, Coventry P. The lived experience of severe mental illness and long-term conditions: a qualitative exploration of service user, carer, and healthcare professional perspectives on self-managing co-existing mental and physical conditions. BMC Psychiatry 2022; 22:479. [PMID: 35850709 PMCID: PMC9295434 DOI: 10.1186/s12888-022-04117-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND People with severe mental illness (SMI), such as schizophrenia, have higher rates of physical long-term conditions (LTCs), poorer health outcomes, and shorter life expectancy compared with the general population. Previous research exploring SMI and diabetes highlights that people with SMI experience barriers to self-management, a key component of care in long-term conditions; however, this has not been investigated in the context of other LTCs. The aim of this study was to explore the lived experience of co-existing SMI and LTCs for service users, carers, and healthcare professionals. METHODS A qualitative study with people with SMI and LTCs, their carers, and healthcare professionals, using semi-structured interviews, focused observations, and focus groups across the UK. Forty-one interviews and five focus groups were conducted between December 2018 and April 2019. Transcripts were coded by two authors and analysed thematically. RESULTS Three themes were identified, 1) the precarious nature of living with SMI, 2) the circularity of life with SMI and LTCs, and 3) the constellation of support for self-management. People with co-existing SMI and LTCs often experience substantial difficulties with self-management of their health due to the competing demands of their psychiatric symptoms and treatment, social circumstances, and access to support. Multiple long-term conditions add to the burden of self-management. Social support, alongside person-centred professional care, is a key facilitator for managing health. An integrated approach to both mental and physical healthcare was suggested to meet service user and carer needs. CONCLUSION The demands of living with SMI present a substantial barrier to self-management for multiple co-existing LTCs. It is important that people with SMI can access person-centred, tailored support for their LTCs that takes into consideration individual circumstances and priorities.
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Affiliation(s)
- C. Carswell
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - J. V. E. Brown
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - J. Lister
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - R. A. Ajjan
- grid.9909.90000 0004 1936 8403Clinical and Population Sciences Department, Leeds institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - S. L. Alderson
- grid.9909.90000 0004 1936 8403Leeds Institute of Health, University of Leeds, Leeds, UK
| | - A. Balogun-Katung
- grid.1006.70000 0001 0462 7212Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - S. Bellass
- grid.25627.340000 0001 0790 5329Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - K. Double
- grid.498142.2Bradford District Care NHS Foundation Trust, Bradford, UK
| | - S. Gilbody
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.413631.20000 0000 9468 0801Hull York Medical School, York, UK
| | - C. E. Hewitt
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - R. I. G. Holt
- grid.5491.90000 0004 1936 9297Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK ,grid.430506.40000 0004 0465 4079National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R. Jacobs
- grid.5685.e0000 0004 1936 9668Centre for Health Economics, University of York, York, UK
| | - I. Kellar
- grid.9909.90000 0004 1936 8403School of Psychology, University of Leeds, Leeds, UK
| | - E. Peckham
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - D. Shiers
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK ,grid.5379.80000000121662407Division of Psychology and Mental Health, University of Manchester, Manchester, UK ,grid.9757.c0000 0004 0415 6205School of Medicine, Keele University, Staffordshire, UK
| | - J. Taylor
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK
| | - N. Siddiqi
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.498142.2Bradford District Care NHS Foundation Trust, Bradford, UK ,grid.413631.20000 0000 9468 0801Hull York Medical School, York, UK
| | - P. Coventry
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, University of York, York, UK ,grid.5685.e0000 0004 1936 9668York Environmental Sustainability Institute, University of York, York, UK
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Siddiqi K, Stubbs B, Lin Y, Elsey H, Siddiqi N. TB multimorbidity: a global health challenge demanding urgent attention. Int J Tuberc Lung Dis 2021; 25:87-90. [PMID: 33656417 DOI: 10.5588/ijtld.20.0751] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Siddiqi
- Department of Health Sciences, The University of York and Hull York Medical School, University of York, York, UK
| | - B Stubbs
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Y Lin
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - H Elsey
- Department of Health Sciences, The University of York and Hull York Medical School, University of York, York, UK
| | - N Siddiqi
- Department of Health Sciences, The University of York and Hull York Medical School, University of York, York, UK
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3
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Martinot AJ, Blass E, Yu J, Aid M, Mahrokhian SH, Cohen SB, Plumlee CR, Larocca RA, Siddiqi N, Wakabayashi S, Gardner M, Audette R, Devorak A, Urdahl KB, Rubin EJ, Barouch DH. Protective efficacy of an attenuated Mtb ΔLprG vaccine in mice. PLoS Pathog 2020; 16:e1009096. [PMID: 33315936 PMCID: PMC7769599 DOI: 10.1371/journal.ppat.1009096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/07/2020] [Revised: 12/28/2020] [Accepted: 10/26/2020] [Indexed: 01/14/2023] Open
Abstract
Bacille Calmette-Guerin (BCG), an attenuated whole cell vaccine based on Mycobacterium bovis, is the only licensed vaccine against Mycobacterium tuberculosis (Mtb), but its efficacy is suboptimal and it fails to protect against pulmonary tuberculosis. We previously reported that Mtb lacking the virulence genes lprG and rv1410c (ΔLprG) was highly attenuated in immune deficient mice. In this study, we show that attenuated ΔLprG Mtb protects C57BL/6J, Balb/cJ, and C3HeB/FeJ mice against Mtb challenge and is as attenuated as BCG in SCID mice. In C3HeB/FeJ mice, ΔLprG vaccination resulted in innate peripheral cytokine production and induced high polyclonal PPD-specific cytokine-secreting CD4+ T lymphocytes in peripheral blood. The ΔLprG vaccine afforded protective efficacy in the lungs of C3H/FeJ mice following both H37Rv and Erdman aerosolized Mtb challenges. Vaccine efficacy correlated with antigen-specific PD-1-negative CD4+ T lymphocytes as well as with serum IL-17 levels after vaccination. We hypothesize that induction of Th17 cells in lung is critical for vaccine protection, and we show a serum cytokine biomarker for IL-17 shortly after vaccination may predict protective efficacy. Many successful vaccines are based on attenuated human pathogens. The only licensed tuberculosis vaccine, BCG, is based on an attenuated version of live whole cell Mycobacterium bovis, the causative agent of tuberculosis (TB) in cattle. Advantages to using attenuated pathogens as vaccines include a broad antigen composition including proteins, lipids, carbohydrates and other molecules that can induce durable immune responses sometimes lasting decades. Here we test an attenuated Mycobacterium tuberculosis (Mtb), the causative agent of human TB, that lacks a key virulence factor as an alternative whole cell vaccine in mice. Attenuated Mtb lacking a key virulence protein, LprG, is immunogenic and protects mice against Mtb challenge. The LprG whole cell vaccine is protective in mice that develop lung pathology more similar to what is described in human TB and the LprG vaccine induces a key cytokine, IL-17, thought to be important for vaccine protection, in the peripheral blood early after vaccination. Together these data support the continued development of attenuated TB as a potential vaccine candidate. Furthermore our data suggests that serum IL-17 should be explored as a potential biomarker for vaccine efficacy in preclinical animal models.
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Affiliation(s)
- Amanda J. Martinot
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Infectious Diseases and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts, United States of America
| | - Eryn Blass
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Malika Aid
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Shant H. Mahrokhian
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sara B. Cohen
- Department of Immunology, Seattle Children’s Research Institute, Seattle, Washington, United States of America
| | - Courtney R. Plumlee
- Department of Immunology, Seattle Children’s Research Institute, Seattle, Washington, United States of America
| | - Rafael A. Larocca
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Noman Siddiqi
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Shoko Wakabayashi
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Michelle Gardner
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Rebecca Audette
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Anne Devorak
- Department of Infectious Diseases and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts, United States of America
| | - Kevin B. Urdahl
- Department of Immunology, Seattle Children’s Research Institute, Seattle, Washington, United States of America
- Departments of Pediatrics and Immunology, University of Washington, Seattle, Washington, United States of America
| | - Eric J. Rubin
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Dan H. Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, United States of America
- * E-mail:
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4
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Booth R, Aliozo C, Mureb A, Ahmad M, Clarke A, Nash G, Qureshi T, Siddiqi N, Parvaiz A. Minimally invasive surgery in the COVID-19 pandemic: An early single centre experience. Br J Surg 2020; 107:e516-e517. [PMID: 32822507 PMCID: PMC7461392 DOI: 10.1002/bjs.11986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 11/09/2022]
Affiliation(s)
- R Booth
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - C Aliozo
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - A Mureb
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - M Ahmad
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - A Clarke
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - G Nash
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - T Qureshi
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - N Siddiqi
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
| | - A Parvaiz
- Department of Colorectal Surgery, Poole Hospital NHS Trust, Poole, United Kingdom
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5
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Mykoniatis I, Siddiqi N, Khan J. Robotic multivisceral resection for a locally advanced rectosigmoid cancer - a video vignette. Colorectal Dis 2020; 22:726. [PMID: 31965699 DOI: 10.1111/codi.14972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/20/2019] [Indexed: 02/08/2023]
Affiliation(s)
- I Mykoniatis
- Colorectal Surgery Department, Queen Alexandra Hospital, Portsmouth, UK
| | - N Siddiqi
- Colorectal Surgery Department, Queen Alexandra Hospital, Portsmouth, UK
| | - J Khan
- Colorectal Surgery Department, Queen Alexandra Hospital, Portsmouth, UK
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6
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Shenkin SD, Fox C, Goodacre S, Weir CJ, Godfrey M, Siddiqi N, Young J, Anand A, Gray A, Hanley J, MacRaild A, Steven J, Black PL, Boyd J, Tieges Z, Stephen J, MacLullich AM. 131UTILITY OF THE 4AT RAPID ASSESSMENT INSTRUMENT IN ASSESSMENT OF DELIRIUM AND COGNITIVE IMPAIRMENT IN ACUTE CARE. Age Ageing 2019. [DOI: 10.1093/ageing/afy207.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - C Fox
- University of East Anglia
| | | | | | | | - N Siddiqi
- University of York, Edinburgh Napier University
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7
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Bush SH, Lawlor PG, Ryan K, Centeno C, Lucchesi M, Kanji S, Siddiqi N, Morandi A, Davis DHJ, Laurent M, Schofield N, Barallat E, Ripamonti CI. Delirium in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 2018; 29:iv143-iv165. [PMID: 29992308 DOI: 10.1093/annonc/mdy147] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- S H Bush
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa
- Ottawa Hospital Research Institute, Ottawa
- Bruyère Research Institute, Ottawa
- Bruyère Continuing Care, Ottawa, Canada
| | - P G Lawlor
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa
- Ottawa Hospital Research Institute, Ottawa
- Bruyère Research Institute, Ottawa
- Bruyère Continuing Care, Ottawa, Canada
| | - K Ryan
- Department of Palliative Medicine, Mater Misericordiae University Hospital, Dublin
- St Francis Hospice, Dublin
- School of Medicine, University College, Dublin, Ireland
| | - C Centeno
- Department of Palliative Medicine, University of Navarra Hospital, Pamplona
- Palliative Medicine Group, Oncology Area, Navarra Institute for Health Research IdiSNA, Pamplona
- ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - M Lucchesi
- Division of Thoracic Oncology, Cardio-Thoracic Department, University Hospital of Pisa, Pisa, Italy
| | - S Kanji
- Ottawa Hospital Research Institute, Ottawa
- Department of Pharmacy, The Ottawa Hospital, Ottawa, Canada
| | - N Siddiqi
- Department of Health Sciences, Hull York Medical School, University of York, York
- Bradford District Care NHS Foundation Trust, Bradford, UK
| | - A Morandi
- Department of Rehabilitation, Aged Care Unit, Ancelle Hospital, Cremona, Italy
| | - D H J Davis
- MRC Unit for Lifelong Health and Ageing at University College London, London, UK
| | - M Laurent
- Internal Medicine and Geriatric Department, APHP, Henri-Mondor Hospital, Créteil
- University Paris Est (UPE), UPEC A-TVB DHU, CEpiA (Clinical Epidemiology and Aging) Unit EA 7376, Créteil, France
| | | | - E Barallat
- Faculty of Nursing, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - C I Ripamonti
- Department of Onco-Haematology Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
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8
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Shah A, Sims D, Madan S, Siddiqi N, Luke A, Saeed O, Patel S, Murthy S, Shin J, Watts S, Jakobleff W, Forest S, Vukelic S, Belov D, Puius Y, Minamoto G, Muggia V, Carlese A, Leung S, Rahmanian M, Leff J, Goldstein D, Jorde U. A Multidisciplinary Continuous Support Heart Team Approach Improves Survival in Continuous Flow LVAD Recipients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.194] [Citation(s) in RCA: 1] [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: 11/30/2022] Open
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9
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Teale EA, Munyombwe T, Schuurmans M, Siddiqi N, Young J. A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents. Age Ageing 2018; 47:56-61. [PMID: 29036302 DOI: 10.1093/ageing/afx155] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Indexed: 11/14/2022] Open
Abstract
Background care home residents are particularly at risk of delirium due to high prevalence of dementia. The Delirium Observation Screening Scale (DOSS) identifies behavioural changes associated delirium onset that nursing staff are uniquely placed to recognise. We tested the psychometric properties of the DOSS in UK care homes compared with the Confusion Assessment Method (CAM). Design prospective observational cohort study performed between 1 March 2015 and 30 June 2016. Setting nine UK residential and nursing care homes. Subjects residents over 65 years except those approaching end of life or unable to complete delirium assessments. Methods the 25-item DOSS was completed daily by care home staff and compared with the temporally closest CAM performed twice per week by trained researchers. Sensitivity, specificity, positive and negative predictive values, diagnostic odds and likelihood ratios were calculated. Results 216 residents participated; mean age 84.9 (SD 7.9); 50% had cognitive impairment (median AMTS 7 (IQR 3-9)). Half of all expected DOSS assessments occurred (30,201); of these, 11,659 (39%) were complete. 78 positive CAM measurements were made during 71 delirium episodes in 45 residents over 70 weeks. Sensitivity and specificity for delirium detection were optimised at a DOSS cut point of ≥5 (sensitivity 0.61 (95% CI: 0.39-0.80) and specificity (0.71 95% CI: 0.70-0.73)). Positive and negative predictive values were 1.6 and 99.5%, respectively. Conclusions the low sensitivity of the DOSS limits clinical utility for detection of delirium as part of routine care for care home residents, although a negative DOSS affords confidence that delirium is not present.
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Affiliation(s)
- E A Teale
- Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, University of Leeds, Bradford, UK
| | - T Munyombwe
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, West Yorkshire, UK
| | - M Schuurmans
- Department of Health Science, University Medical Center, Utrecht, The Netherlands
| | - N Siddiqi
- Department of Health Sciences, University of York and Hull York Medical School, Bradford District Care NHS Foundation Trust, York, UK
| | - J Young
- Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, University of Leeds, Bradford, UK
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10
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Siddiqi N, Panteleimonits S, Ahmed J, Kuzu A, Parvaiz A. Role of laparoscopy in multivisceral resection for colorectal cancer - a video vignette. Colorectal Dis 2017; 19:693-694. [PMID: 28544431 DOI: 10.1111/codi.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/12/2017] [Indexed: 02/08/2023]
Affiliation(s)
- N Siddiqi
- Wessex Deanery, Hampshire, UK.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
| | - S Panteleimonits
- Wessex Deanery, Hampshire, UK.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
| | - J Ahmed
- Wessex Deanery, Hampshire, UK
| | - A Kuzu
- Department of Surgery, Ankara University Medical School, Ankara, Turkey
| | - A Parvaiz
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,Poole Hospitals NHS Foundation Trust, Poole, UK.,Champaulimaud Clinical Foundation, Lisbon, Portugal
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Panteleimonitis S, Siddiqi N, Nasir T, Ahmed J, Figueiredo N, Parvaiz A. Robotic lower anterior resection for a regrowth following complete clinical response - a video vignette. Colorectal Dis 2017; 19:694-695. [PMID: 28518478 DOI: 10.1111/codi.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/28/2017] [Indexed: 02/08/2023]
Affiliation(s)
- S Panteleimonitis
- Department of Colorectal Surgery, Poole Hospital NHS Foundation Trust, Poole, UK
| | - N Siddiqi
- Department of Colorectal Surgery, Poole Hospital NHS Foundation Trust, Poole, UK
| | - T Nasir
- Department of Colorectal Surgery, Poole Hospital NHS Foundation Trust, Poole, UK
| | - J Ahmed
- Department of Colorectal Surgery, Poole Hospital NHS Foundation Trust, Poole, UK
| | | | - A Parvaiz
- Department of Colorectal Surgery, Poole Hospital NHS Foundation Trust, Poole, UK.,Fundação Champalimaud, Lisbon, Portugal
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12
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Panteleimonitis S, Siddiqi N, Amjad T, Figueiredo N, Parvaiz A. Laparoscopic en bloc total mesorectal excision post chemoradiotherapy - a video vignette. Colorectal Dis 2017; 19:697-698. [PMID: 28510316 DOI: 10.1111/codi.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/28/2017] [Indexed: 02/08/2023]
Affiliation(s)
- S Panteleimonitis
- Poole Hospital NHS Trust, Poole, UK.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
| | - N Siddiqi
- Poole Hospital NHS Trust, Poole, UK.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK
| | - T Amjad
- Champalimaud Foundation, Lisbon, Portugal
| | | | - A Parvaiz
- Poole Hospital NHS Trust, Poole, UK.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,Champalimaud Foundation, Lisbon, Portugal
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13
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Siddiqi N, Luke A, Watts S, Jorde U, Saeed O, Sims D, Shin J, Patel S, Murthy S, Forest S, Goldstein D. Utilization of a Multidisciplinary Approach for Inpatient Anticoagulation Management in Left Ventricular Assist Device Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1043] [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: 11/26/2022] Open
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14
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Vohra RS, Pasquali S, Kirkham AJ, Marriott P, Johnstone M, Spreadborough P, Alderson D, Griffiths EA, Fenwick S, Elmasry M, Nunes Q, Kennedy D, Basit Khan R, Khan MAS, Magee CJ, Jones SM, Mason D, Parappally CP, Mathur P, Saunders M, Jamel S, Ul Haque S, Zafar S, Shiwani MH, Samuel N, Dar F, Jackson A, Lovett B, Dindyal S, Winter H, Fletcher T, Rahman S, Wheatley K, Nieto T, Ayaani S, Youssef H, Nijjar RS, Watkin H, Naumann D, Emeshi S, Sarmah PB, Lee K, Joji N, Heath J, Teasdale RL, Weerasinghe C, Needham PJ, Welbourn H, Forster L, Finch D, Blazeby JM, Robb W, McNair AGK, Hrycaiczuk A, Charalabopoulos A, Kadirkamanathan S, Tang CB, Jayanthi NVG, Noor N, Dobbins B, Cockbain AJ, Nilsen-Nunn A, Siqueira J, Pellen M, Cowley JB, Ho WM, Miu V, White TJ, Hodgkins KA, Kinghorn A, Tutton MG, Al-Abed YA, Menzies D, Ahmad A, Reed J, Khan S, Monk D, Vitone LJ, Murtaza G, Joel A, Brennan S, Shier D, Zhang C, Yoganathan T, Robinson SJ, McCallum IJD, Jones MJ, Elsayed M, Tuck L, Wayman J, Carney K, Aroori S, Hosie KB, Kimble A, Bunting DM, Fawole AS, Basheer M, Dave RV, Sarveswaran J, Jones E, Kendal C, Tilston MP, Gough M, Wallace T, Singh S, Downing J, Mockford KA, Issa E, Shah N, Chauhan N, Wilson TR, Forouzanfar A, Wild JRL, Nofal E, Bunnell C, Madbak K, Rao STV, Devoto L, Siddiqi N, Khawaja Z, Hewes JC, Gould L, Chambers A, Urriza Rodriguez D, Sen G, Robinson S, Carney K, Bartlett F, Rae DM, Stevenson TEJ, Sarvananthan K, Dwerryhouse SJ, Higgs SM, Old OJ, Hardy TJ, Shah R, Hornby ST, Keogh K, Frank L, Al-Akash M, Upchurch EA, Frame RJ, Hughes M, Jelley C, Weaver S, Roy S, Sillo TO, Galanopoulos G, Cuming T, Cunha P, Tayeh S, Kaptanis S, Heshaishi M, Eisawi A, Abayomi M, Ngu WS, Fleming K, Singh Bajwa D, Chitre V, Aryal K, Ferris P, Silva M, Lammy S, Mohamed S, Khawaja A, Hussain A, Ghazanfar MA, Bellini MI, Ebdewi H, Elshaer M, Gravante G, Drake B, Ogedegbe A, Mukherjee D, Arhi C, Giwa Nusrat Iqbal L, Watson NF, Kumar Aggarwal S, Orchard P, Villatoro E, Willson PD, Wa K, Mok 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S, Sinha S, Khan S, El-Hasani SS, Hussain AA, Bhattacharya V, Kansal N, Fasih T, Jackson C, Siddiqui MN, Chishti IA, Fordham IJ, Siddiqui Z, Bausbacher H, Geogloma I, Gurung K, Tsavellas G, Basynat P, Kiran Shrestha A, Basu S, Chhabra Mohan Harilingam A, Rabie M, Akhtar M, Kumar P, Jafferbhoy SF, Hussain N, Raza S, Haque M, Alam I, Aseem R, Patel S, Asad M, Booth MI, Ball WR, Wood CPJ, Pinho-Gomes AC, Kausar A, Rami Obeidallah M, Varghase J, Lodhia J, Bradley D, Rengifo C, Lindsay D, Gopalswamy S, Finlay I, Wardle S, Bullen N, Iftikhar SY, Awan A, Ahmed J, Leeder P, Fusai G, Bond-Smith G, Psica A, Puri Y, Hou D, Noble F, Szentpali K, Broadhurst J, Date R, Hossack MR, Li Goh Y, Turner P, Shetty V, Riera M, Macano CAW, Sukha A, Preston SR, Hoban JR, Puntis DJ, Williams SV, Krysztopik R, Kynaston J, Batt J, Doe M, Goscimski A, Jones GH, Smith SR, Hall C, Carty N, Ahmed J, Panteleimonitis S, Gunasekera RT, Sheel ARG, Lennon H, Hindley C, Reddy M, Kenny R, Elkheir N, McGlone ER, 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Shahin Y, Ali A, Luther A, Nicholson JA, Rajendran I, Boal M, Ritchie J. Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases. Br J Surg 2016; 103:1716-1726. [PMID: 27748962 DOI: 10.1002/bjs.10288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 01/05/2023]
Abstract
Abstract
Background
The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.
Methods
Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).
Results
Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.
Conclusion
Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.
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Affiliation(s)
| | - R S Vohra
- Trent Oesophago-Gastric Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Pasquali
- Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - A J Kirkham
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - P Marriott
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - M Johnstone
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - P Spreadborough
- West Midlands Research Collaborative, Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - D Alderson
- Academic Department of Surgery, University of Birmingham, Birmingham, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Fenwick
- Aintree University Hospital NHS Foundation Trust
| | - M Elmasry
- Aintree University Hospital NHS Foundation Trust
| | - Q Nunes
- Aintree University Hospital NHS Foundation Trust
| | - D Kennedy
- Aintree University Hospital NHS Foundation Trust
| | | | | | | | | | - D Mason
- Wirral University Teaching Hospital
| | | | | | | | - S Jamel
- Barnet and Chase Farm Hospital
| | | | - S Zafar
- Barnet and Chase Farm Hospital
| | | | - N Samuel
- Barnsley District General Hospital
| | - F Dar
- Barnsley District General Hospital
| | | | | | | | | | | | | | - K Wheatley
- Sandwell and West Birmingham Hospitals NHS Trust
| | - T Nieto
- Sandwell and West Birmingham Hospitals NHS Trust
| | - S Ayaani
- Sandwell and West Birmingham Hospitals NHS Trust
| | - H Youssef
- Heart of England Foundation NHS Trust
| | | | - H Watkin
- Heart of England Foundation NHS Trust
| | - D Naumann
- Heart of England Foundation NHS Trust
| | - S Emeshi
- Heart of England Foundation NHS Trust
| | | | - K Lee
- Heart of England Foundation NHS Trust
| | - N Joji
- Heart of England Foundation NHS Trust
| | - J Heath
- Blackpool Teaching Hospitals NHS Foundation Trust
| | - R L Teasdale
- Blackpool Teaching Hospitals NHS Foundation Trust
| | | | - P J Needham
- Bradford Teaching Hospitals NHS Foundation Trust
| | - H Welbourn
- Bradford Teaching Hospitals NHS Foundation Trust
| | - L Forster
- Bradford Teaching Hospitals NHS Foundation Trust
| | - D Finch
- Bradford Teaching Hospitals NHS Foundation Trust
| | | | - W Robb
- University Hospitals Bristol NHS Trust
| | | | | | | | | | | | | | | | - B Dobbins
- Calderdale and Huddersfield NHS Trust
| | | | | | | | - M Pellen
- Hull and East Yorkshire NHS Trust
| | | | - W-M Ho
- Hull and East Yorkshire NHS Trust
| | - V Miu
- Hull and East Yorkshire NHS Trust
| | - T J White
- Chesterfield Royal Hospital NHS Foundation Trust
| | - K A Hodgkins
- Chesterfield Royal Hospital NHS Foundation Trust
| | - A Kinghorn
- Chesterfield Royal Hospital NHS Foundation Trust
| | - M G Tutton
- Colchester Hospital University NHS Foundation Trust
| | - Y A Al-Abed
- Colchester Hospital University NHS Foundation Trust
| | - D Menzies
- Colchester Hospital University NHS Foundation Trust
| | - A Ahmad
- Colchester Hospital University NHS Foundation Trust
| | - J Reed
- Colchester Hospital University NHS Foundation Trust
| | - S Khan
- Colchester Hospital University NHS Foundation Trust
| | - D Monk
- Countess of Chester NHS Foundation Trust
| | - L J Vitone
- Countess of Chester NHS Foundation Trust
| | - G Murtaza
- Countess of Chester NHS Foundation Trust
| | - A Joel
- Countess of Chester NHS Foundation Trust
| | | | - D Shier
- Croydon Health Services NHS Trust
| | - C Zhang
- Croydon Health Services NHS Trust
| | | | | | | | - M J Jones
- North Cumbria University Hospitals Trust
| | - M Elsayed
- North Cumbria University Hospitals Trust
| | - L Tuck
- North Cumbria University Hospitals Trust
| | - J Wayman
- North Cumbria University Hospitals Trust
| | - K Carney
- North Cumbria University Hospitals Trust
| | | | | | | | | | | | | | | | | | | | | | - M P Tilston
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - M Gough
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T Wallace
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - S Singh
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - J Downing
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - K A Mockford
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - E Issa
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Shah
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - N Chauhan
- Northern Lincolnshire and Goole NHS Foundation Trust
| | - T R Wilson
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - A Forouzanfar
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - C Bunnell
- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
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- Doncaster and Bassetlaw Hospitals NHS Foundation Trust
| | - S T V Rao
- Dorset County Hospital NHS Foundation Trust
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- Dorset County Hospital NHS Foundation Trust
| | - N Siddiqi
- Dorset County Hospital NHS Foundation Trust
| | - Z Khawaja
- Dorset County Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | - D M Rae
- Frimley Park Hospital NHS Trust
| | | | | | | | | | - O J Old
- Gloucestershire Hospitals NHS Trust
| | | | - R Shah
- Gloucestershire Hospitals NHS Trust
| | | | - K Keogh
- Gloucestershire Hospitals NHS Trust
| | - L Frank
- Gloucestershire Hospitals NHS Trust
| | - M Al-Akash
- Great Western Hospitals NHS Foundation Trust
| | | | - R J Frame
- Harrogate and District NHS Foundation Trust
| | - M Hughes
- Harrogate and District NHS Foundation Trust
| | - C Jelley
- Harrogate and District NHS Foundation Trust
| | | | | | | | | | - T Cuming
- Homerton University Hospital NHS Trust
| | - P Cunha
- Homerton University Hospital NHS Trust
| | - S Tayeh
- Homerton University Hospital NHS Trust
| | | | | | - A Eisawi
- Tees Hospitals NHS Foundation Trust
| | | | - W S Ngu
- Tees Hospitals NHS Foundation Trust
| | | | | | - V Chitre
- Paget University Hospitals NHS Foundation Trust
| | - K Aryal
- Paget University Hospitals NHS Foundation Trust
| | - P Ferris
- Paget University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | - H Ebdewi
- Kettering General Hospital NHS Foundation Trust
| | - M Elshaer
- Kettering General Hospital NHS Foundation Trust
| | - G Gravante
- Kettering General Hospital NHS Foundation Trust
| | - B Drake
- Kettering General Hospital NHS Foundation Trust
| | - A Ogedegbe
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - D Mukherjee
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | - C Arhi
- Barking, Havering and Redbridge University Hospitals NHS Trust
| | | | | | | | | | | | | | - K Wa
- Kingston Hospital NHS Foundation Trust
| | - J Mok
- Kingston Hospital NHS Foundation Trust
| | - T Woodman
- Kingston Hospital NHS Foundation Trust
| | - J Deguara
- Kingston Hospital NHS Foundation Trust
| | - G Garcea
- University Hospitals of Leicester NHS Trust
| | - B I Babu
- University Hospitals of Leicester NHS Trust
| | | | - D Malde
- University Hospitals of Leicester NHS Trust
| | - D Lloyd
- University Hospitals of Leicester NHS Trust
| | | | - O Al-Taan
- University Hospitals of Leicester NHS Trust
| | - A Boddy
- University Hospitals of Leicester NHS Trust
| | - J P Slavin
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - R P Jones
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - L Ballance
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - S Gerakopoulos
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
| | - P Jambulingam
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - S Mansour
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - N Sakai
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - V Acharya
- Luton and Dunstable University Hospital NHS Foundation Trust
| | - M M Sadat
- Macclesfield District General Hospital
| | - L Karim
- Macclesfield District General Hospital
| | - D Larkin
- Macclesfield District General Hospital
| | - K Amin
- Macclesfield District General Hospital
| | - A Khan
- Central Manchester NHS Foundation Trust
| | - J Law
- Central Manchester NHS Foundation Trust
| | - S Jamdar
- Central Manchester NHS Foundation Trust
| | - S R Smith
- Central Manchester NHS Foundation Trust
| | - K Sampat
- Central Manchester NHS Foundation Trust
| | | | - M Manu
- Royal Wolverhampton Hospitals NHS Trust
| | | | - N S Malik
- Royal Wolverhampton Hospitals NHS Trust
| | - J Chang
- Royal Wolverhampton Hospitals NHS Trust
| | | | - M Lewis
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - G P Roberts
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Karavadra
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - E Photi
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Hornsby
- North Tees and Hartlepool NHS Foundation Trust
| | | | | | - K Seymour
- Northumbria Healthcare NHS Foundation Trust
| | - S Robinson
- Northumbria Healthcare NHS Foundation Trust
| | - H Hawkins
- Northumbria Healthcare NHS Foundation Trust
| | - S Bawa
- Northumbria Healthcare NHS Foundation Trust
| | | | - A Reid
- Northumbria Healthcare NHS Foundation Trust
| | - P Wood
- Northumbria Healthcare NHS Foundation Trust
| | - J G Finch
- Northampton General Hospital NHS Trust
| | - J Parmar
- Northampton General Hospital NHS Trust
| | | | | | - A Al-Muhktar
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - M Peterson
- Sheffield Teaching Hospitals NHS Foundation Trust
| | - A Majeed
- Sheffield Teaching Hospitals NHS Foundation Trust
| | | | | | - A Choy
- Peterborough City Hospital
| | | | - N Pore
- United Lincolnshire Hospitals NHS Trust
| | | | | | - C Taylor
- United Lincolnshire Hospitals NHS Trust
| | | | | | | | | | | | | | | | - S Tate
- Portsmouth Hospitals NHS Trust
| | | | | | - V Vijay
- The Princess Alexandra Hospital NHS Trust
| | | | - S Sinha
- The Princess Alexandra Hospital NHS Trust
| | - S Khan
- The Princess Alexandra Hospital NHS Trust
| | | | - A A Hussain
- King's College Hospital NHS Foundation Trust
| | | | - N Kansal
- Gateshead Health NHS Foundation Trust
| | - T Fasih
- Gateshead Health NHS Foundation Trust
| | - C Jackson
- Gateshead Health NHS Foundation Trust
| | | | | | | | | | | | | | - K Gurung
- Queen Elizabeth Hospital NHS Trust
| | - G Tsavellas
- East Kent Hospitals University NHS Foundation Trust
| | - P Basynat
- East Kent Hospitals University NHS Foundation Trust
| | | | - S Basu
- East Kent Hospitals University NHS Foundation Trust
| | | | - M Rabie
- East Kent Hospitals University NHS Foundation Trust
| | - M Akhtar
- East Kent Hospitals University NHS Foundation Trust
| | - P Kumar
- Burton Hospitals NHS Foundation Trust
| | | | - N Hussain
- Burton Hospitals NHS Foundation Trust
| | - S Raza
- Burton Hospitals NHS Foundation Trust
| | - M Haque
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - I Alam
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - R Aseem
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - S Patel
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M Asad
- Royal Albert Edward Infirmary, Wigan Wrightington and Leigh NHS Trust
| | - M I Booth
- Royal Berkshire NHS Foundation Trust
| | - W R Ball
- Royal Berkshire NHS Foundation Trust
| | | | | | | | | | - J Varghase
- Royal Bolton Hospital NHS Foundation Trust
| | - J Lodhia
- Royal Bolton Hospital NHS Foundation Trust
| | - D Bradley
- Royal Bolton Hospital NHS Foundation Trust
| | - C Rengifo
- Royal Bolton Hospital NHS Foundation Trust
| | - D Lindsay
- Royal Bolton Hospital NHS Foundation Trust
| | | | | | | | | | | | - A Awan
- Royal Derby NHS Foundation Trust
| | - J Ahmed
- Royal Derby NHS Foundation Trust
| | - P Leeder
- Royal Derby NHS Foundation Trust
| | | | | | | | | | - D Hou
- Hampshire Hospital NHS Foundation Trust
| | - F Noble
- Hampshire Hospital NHS Foundation Trust
| | | | | | - R Date
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - M R Hossack
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - Y Li Goh
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - P Turner
- Lancashire Teaching Hospitals NHS Foundation Trust
| | - V Shetty
- Lancashire Teaching Hospitals NHS Foundation Trust
| | | | | | | | - S R Preston
- Royal Surrey County Hospital NHS Foundation Trust
| | - J R Hoban
- Royal Surrey County Hospital NHS Foundation Trust
| | - D J Puntis
- Royal Surrey County Hospital NHS Foundation Trust
| | - S V Williams
- Royal Surrey County Hospital NHS Foundation Trust
| | | | | | - J Batt
- Royal United Hospital Bath NHS Trust
| | - M Doe
- Royal United Hospital Bath NHS Trust
| | | | | | | | - C Hall
- Salford Royal NHS Foundation Trust
| | - N Carty
- Salisbury Hospital Foundation Trust
| | - J Ahmed
- Salisbury Hospital Foundation Trust
| | | | | | | | - H Lennon
- Southport and Ormskirk Hospital NHS Trust
| | - C Hindley
- Southport and Ormskirk Hospital NHS Trust
| | - M Reddy
- St George's Healthcare NHS Trust
| | - R Kenny
- St George's Healthcare NHS Trust
| | | | | | | | - K Hancorn
- St Helens and Knowsley Teaching Hospitals NHS Trust
| | - A Hargreaves
- St Helens and Knowsley Teaching Hospitals NHS Trust
| | | | | | | | | | - P Ziprin
- Imperial College Healthcare NHS Trust
| | | | - G Yeldham
- Imperial College Healthcare NHS Trust
| | - E Read
- Imperial College Healthcare NHS Trust
| | | | | | | | | | - M A Khan
- Mid Staffordshire NHS Foundation Trust
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- Mid Staffordshire NHS Foundation Trust
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- City Hospitals Sunderland NHS Foundation Trust
| | - V Kanakala
- City Hospitals Sunderland NHS Foundation Trust
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- Tunbridge Wells and Maidstone NHS Trust
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- Tunbridge Wells and Maidstone NHS Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Birmingham NHS Foundation Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- University Hospital Coventry and Warwickshire NHS Trust
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- University Hospital of North Staffordshire NHS Trust
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- University Hospital of North Staffordshire NHS Trust
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- University Hospital of North Staffordshire NHS Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital Southampton NHS Foundation Trust
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- University Hospital South Manchester NHS Foundation Trust
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- University Hospital South Manchester NHS Foundation Trust
| | - K Newton
- University Hospital South Manchester NHS Foundation Trust
| | - J Mbuvi
- University Hospital South Manchester NHS Foundation Trust
| | - A Farooq
- Warrington and Halton Hospitals NHS Trust
| | | | - Z Zafrani
- Warrington and Halton Hospitals NHS Trust
| | - D Brett
- Warrington and Halton Hospitals NHS Trust
| | | | | | - J Barnes
- South Warwickshire NHS Foundation Trust
| | - M Cheung
- South Warwickshire NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - M Wadley
- Worcestershire Acute Hospitals NHS Trust
| | - E Hamilton
- Worcestershire Acute Hospitals NHS Trust
| | - S Jaunoo
- Worcestershire Acute Hospitals NHS Trust
| | - R Padwick
- Worcestershire Acute Hospitals NHS Trust
| | - M Sayegh
- Western Sussex Hospitals NHS Foundation Trust
| | - R C Newton
- Western Sussex Hospitals NHS Foundation Trust
| | - M Hebbar
- Western Sussex Hospitals NHS Foundation Trust
| | - S F Farag
- Western Sussex Hospitals NHS Foundation Trust
| | | | | | | | - C Blane
- Yeovil District Hospital NHS Trust
| | - M Giles
- York Teaching Hospital NHS Foundation Trust
| | - M B Peter
- York Teaching Hospital NHS Foundation Trust
| | - N A Hirst
- York Teaching Hospital NHS Foundation Trust
| | - T Hossain
- York Teaching Hospital NHS Foundation Trust
| | - A Pannu
- York Teaching Hospital NHS Foundation Trust
| | | | | | - G W Taylor
- York Teaching Hospital NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | - T Diamond
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - P Davey
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - C Jones
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - J M Clements
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - R Digney
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - W M Chan
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S McCain
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Gull
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Janeczko
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - E Dorrian
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - A Harris
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - S Dawson
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - D Johnston
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | - B McAree
- Belfast City Hospital, Mater Infirmorum Hospital Belfast and Royal Victoria Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | - P Burke
- University Hospital Limerick
| | | | - A D K Hill
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Khogali
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - W Shabo
- Louth County Hospital and Our Lady of Lourdes Hospital
| | - E Iskandar
- Louth County Hospital and Our Lady of Lourdes Hospital
| | | | | | | | | | | | | | | | | | - P Balfe
- St Luke's General Hospital Kilkenny
| | - M Lee
- St Luke's General Hospital Kilkenny
| | - D C Winter
- St Vincent's University and Private Hospitals, Dublin
| | - M E Kelly
- St Vincent's University and Private Hospitals, Dublin
| | - E Hoti
- St Vincent's University and Private Hospitals, Dublin
| | - D Maguire
- St Vincent's University and Private Hospitals, Dublin
| | - P Karunakaran
- St Vincent's University and Private Hospitals, Dublin
| | - J G Geoghegan
- St Vincent's University and Private Hospitals, Dublin
| | - S T Martin
- St Vincent's University and Private Hospitals, Dublin
| | - F McDermott
- St Vincent's University and Private Hospitals, Dublin
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Gibson
- Crosshouse Hospital, Ayrshire and Arran
| | | | - D G Vass
- Crosshouse Hospital, Ayrshire and Arran
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - H C C Lim
- Glangwili General and Prince Philip Hospital
| | - D Duke
- Glangwili General and Prince Philip Hospital
| | - T Ahmed
- Glangwili General and Prince Philip Hospital
| | - W D Beasley
- Glangwili General and Prince Philip Hospital
| | | | - G Maharaj
- Glangwili General and Prince Philip Hospital
| | - C Malcolm
- Glangwili General and Prince Philip Hospital
| | | | | | | | - R Radwan
- Morriston and Singleton Hospitals
| | | | - S Wood
- Princess of Wales Hospital
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Ahmed J, Siddiqi N, Khan L, Kuzu A, Parvaiz A. Standardized technique for single-docking robotic rectal surgery. Colorectal Dis 2016; 18:O380-O384. [PMID: 27440280 DOI: 10.1111/codi.13466] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/29/2016] [Indexed: 12/19/2022]
Abstract
AIM The aim of this technical note is to describe our standardized technique for rectal surgery using a single-docking totally robotic approach. METHOD The data related to patients who underwent single-docking robotic rectal surgery were analysed for the feasibility of this approach. RESULTS This technique was used in 124 consecutive patients who underwent rectal resection since July 2013. Male to female ratio of patients was 2:1 while median age was 67 years (range 24-92). The median operating time was 240 min (range 105-456), whilst blood loss was 10 ml (range 0-200). There was no evidence of intra-operative complications or conversions to either a laparoscopic or an open procedure. The median length of stay was 7 days (range 3-48). CONCLUSION A single-docking technique for robotic rectal surgery is safe and feasible. It can be considered as standard approach for pelvic robotic surgery.
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Affiliation(s)
- J Ahmed
- Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.
| | - N Siddiqi
- Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK
| | - L Khan
- Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK
| | - A Kuzu
- Department of Surgery, Ankara University Medical School, Ankara, Turkey
| | - A Parvaiz
- Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.,Head of Laparoscopic & RoboticProgramme, Colorectal Cancer Unit, Champalimaud Clinical Foundation, Lisbon, Portugal
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Taylor J, Mahmoodi N, Stubbs B, Lewis H, Hosali P, Hewitt C, Smith R, Wright J, McDermid K, Kayalackakom T, Keller I, Ajjan R, Alderson S, Hughes T, Holt R, Siddiqi N. P15 Improving diabetes outcomes in severe mental illness: A systematic review and meta-analysis of pharmacological and non-pharmacological interventions. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Taylor J, Siddiqi N. Improving health outcomes for adults with severe mental illness and comorbid diabetes: is supporting diabetes self-management the right approach? J Psychiatr Ment Health Nurs 2016; 23:322-30. [PMID: 27307263 DOI: 10.1111/jpm.12307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 01/02/2023]
Affiliation(s)
- J Taylor
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
| | - N Siddiqi
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK.,Bradford District Care NHS Foundation Trust, York, UK
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Passi N, Snead J, Goldstein D, Murthy S, Patel S, Saeed O, Shin J, Sims D, Jorde U, Siddiqi N. Mycophenolate Mofetil in Adult Orthotopic Heart Transplant Recipients: How Much Is Too Much? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1229] [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: 11/24/2022] Open
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19
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Khattak H, Siddiqi N, Parvaiz A, George S, Flashman K. A comparative study assessing the quality of life and bowel function in patients following laparoscopic and open anterior resection for rectal cancer. Ann Med Surg (Lond) 2014. [DOI: 10.1016/j.amsu.2014.02.004] [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: 10/25/2022] Open
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20
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Stanley SA, Barczak AK, Silvis MR, Luo SS, Sogi K, Vokes M, Bray MA, Carpenter AE, Moore CB, Siddiqi N, Rubin EJ, Hung DT. Identification of host-targeted small molecules that restrict intracellular Mycobacterium tuberculosis growth. PLoS Pathog 2014; 10:e1003946. [PMID: 24586159 PMCID: PMC3930586 DOI: 10.1371/journal.ppat.1003946] [Citation(s) in RCA: 193] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 01/01/2014] [Indexed: 02/05/2023] Open
Abstract
Mycobacterium tuberculosis remains a significant threat to global health. Macrophages are the host cell for M. tuberculosis infection, and although bacteria are able to replicate intracellularly under certain conditions, it is also clear that macrophages are capable of killing M. tuberculosis if appropriately activated. The outcome of infection is determined at least in part by the host-pathogen interaction within the macrophage; however, we lack a complete understanding of which host pathways are critical for bacterial survival and replication. To add to our understanding of the molecular processes involved in intracellular infection, we performed a chemical screen using a high-content microscopic assay to identify small molecules that restrict mycobacterial growth in macrophages by targeting host functions and pathways. The identified host-targeted inhibitors restrict bacterial growth exclusively in the context of macrophage infection and predominantly fall into five categories: G-protein coupled receptor modulators, ion channel inhibitors, membrane transport proteins, anti-inflammatories, and kinase modulators. We found that fluoxetine, a selective serotonin reuptake inhibitor, enhances secretion of pro-inflammatory cytokine TNF-α and induces autophagy in infected macrophages, and gefitinib, an inhibitor of the Epidermal Growth Factor Receptor (EGFR), also activates autophagy and restricts growth. We demonstrate that during infection signaling through EGFR activates a p38 MAPK signaling pathway that prevents macrophages from effectively responding to infection. Inhibition of this pathway using gefitinib during in vivo infection reduces growth of M. tuberculosis in the lungs of infected mice. Our results support the concept that screening for inhibitors using intracellular models results in the identification of tool compounds for probing pathways during in vivo infection and may also result in the identification of new anti-tuberculosis agents that work by modulating host pathways. Given the existing experience with some of our identified compounds for other therapeutic indications, further clinically-directed study of these compounds is merited. Infection with the bacterial pathogen Mycobacterium tuberculosis causes the disease tuberculosis (TB) that imposes significant worldwide morbidity and mortality. Approximately 2 billion people are infected with M. tuberculosis, and almost 1.5 million people die annually from TB. With increasing drug resistance and few novel drug candidates, our inability to effectively treat all infected individuals necessitates a deeper understanding of the host-pathogen interface to facilitate new approaches to treatment. In addition, the current anti-tuberculosis regimen requires months of strict compliance to clear infection; targeting host immune function could play a strategic role in reducing the duration and complexity of treatment while effectively treating drug-resistant strains. Here we use a microscopy-based screen to identify molecules that target host pathways and inhibit the growth of M. tuberculosis in macrophages. We identified several host pathways not previously implicated in tuberculosis. The identified inhibitors prevent growth either by blocking host pathways exploited by M. tuberculosis for virulence, or by activating immune responses that target intracellular bacteria. Fluoxetine, used clinically for treating depression, induces autophagy and enhances production of TNF-α. Similarly, gefitinib, used clinically for treating cancer, inhibits M. tuberculosis growth in macrophages. Importantly, gefitinib treatment reduces bacterial replication in the lungs of M. tuberculosis-infected mice.
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Affiliation(s)
- Sarah A Stanley
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America ; Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Amy K Barczak
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America ; Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts, United States of America ; Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Melanie R Silvis
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Samantha S Luo
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Kimberly Sogi
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Martha Vokes
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Mark-Anthony Bray
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Anne E Carpenter
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Christopher B Moore
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Noman Siddiqi
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Eric J Rubin
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Deborah T Hung
- The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America ; Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, Massachusetts, United States of America ; Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, United States of America
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Siddiqi N, Someshwar V, Roy D, Anandh U. Transjugular renal biopsy in a case of nephrotic syndrome with extrahepatic portal venous obstruction. Indian J Nephrol 2013; 23:146-8. [PMID: 23716925 PMCID: PMC3658296 DOI: 10.4103/0971-4065.109445] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Renal biopsy in patients with nephrotic syndrome helps to establish the pathological diagnosis and subsequent treatment. In certain circumstances, biopsies are difficult to obtain because of the risk of bleeding. We report a case where renal biopsy was obtained through the transjugular route in a patient who had nephrotic syndrome with extrahepatic portal venous obstruction.
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Affiliation(s)
- N Siddiqi
- Department of Nephrology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
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Rahman R, Siddiqi N, Ansari M, Hussain N. 2751 – Factors influencing the selection of antidepressant by pakistani psychiatrists. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Affiliation(s)
- K Siddique
- Wirral University Teaching Hospital NHS Foundation Trust, UK.
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Siddique K, Siddiqi N, Sedman P. Use of Johan forceps as endoloop pushers for laparoscopic appendicectomy. Ann R Coll Surg Engl 2012. [DOI: 10.1308/rcsann.2012.533a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- K Siddique
- Wirral University Teaching Hospital NHS Foundation Trust, UK
| | - N Siddiqi
- Wirral University Teaching Hospital NHS Foundation Trust, UK
| | - P Sedman
- Hull and East Yorkshire Hospitals NHS Trust, UK
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Lahoti S, Siddiqi N, Gokhale S, Chaurasia A, Hastak S. A Study of Factors Causing Delay in Hospital Arrival after Acute Stroke (P03.008). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.008] [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: 11/15/2022] Open
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26
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Gopakumar S, Kumar B, Ahmed J, Siddiqi N, Mehmood S, Moore PJ. Day case surgery training for surgical trainees: a disappearing act? Int J Surg 2009; 8:135-9. [PMID: 20005311 DOI: 10.1016/j.ijsu.2009.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 11/20/2009] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Over the past decade there has been considerable change to surgical training such as modernising medical careers which have raised concerns over exposure to operative experience. With the National Health Service (NHS) plan aiming for the majority of elective surgical cases to be performed as day cases we sought to assess the level of exposure modern day surgical trainees obtain in day case surgery. METHODS An anonymous electronic questionnaire survey was completed by 100 surgical trainees in surgical training across the United Kingdom (UK) from a variety of sub-specialities. 16 questions pertinent to day case surgery exposure were answered. RESULTS The majority of the trainees who completed the survey felt day case surgery is a vital part of their training as a surgeon. Only less than one-third of all the trainees had formal timetabled day case surgery lists. Of the 31 trainees who had scheduled day lists only 58% (n = 18) were consistently able to attend. The most common reasons for being unable to attend were rota issues and lack of encouragement from seniors. 90 trainees (90%) were not satisfied with their overall Day Case Surgery training. CONCLUSIONS The survey reveals that the modern surgical trainee is gaining a low and inconsistent level of exposure to day case surgery despite being aware of the importance of this modality of training. An urgent review is required to ensure trainees become actively involved in day case surgery and are not missing on this vital training opportunity.
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Affiliation(s)
- S Gopakumar
- Department of General Surgery, Scunthorpe General Hospital, Cliff Gardens, Scunthorpe, North Lincolnshire DN15 7BH, United Kingdom.
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Ranjbar S, Boshoff HI, Mulder A, Siddiqi N, Rubin EJ, Goldfeld AE. HIV-1 replication is differentially regulated by distinct clinical strains of Mycobacterium tuberculosis. PLoS One 2009; 4:e6116. [PMID: 19568431 PMCID: PMC2699470 DOI: 10.1371/journal.pone.0006116] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [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: 01/26/2009] [Accepted: 06/02/2009] [Indexed: 12/03/2022] Open
Abstract
Background Tuberculosis (TB) is the largest cause of death in human immunodeficiency virus type 1 (HIV-1) infection, having claimed an estimated one third to one half of the 30 million AIDS deaths that have occurred worldwide. Different strains of Mycobacterium tuberculosis (MTb), the causative agent of TB, are known to modify the host immune response in a strain-specific manner. However, a MTb strain-specific impact upon the regulation of HIV-1 replication has not previously been established. Methology/Principal Findings We isolated normal human peripheral blood mononuclear cells (PBMC) and co-infected them with HIV-1 and with either the well characterized CDC1551 or HN878 MTb clinical isolate. We show that HIV-1 co-infection with the CDC1551 MTb strain results in higher levels of virus replication relative to co-infection with the HN878 MTb strain ex vivo. Furthermore, we show that the distinct pattern of CDC1551 or HN878 induced HIV-1 replication is associated with significantly increased levels of TNF and IL-6, and of the transcription and nuclear translocation of the p65 subunit of the transcription factor NF-κB, by CDC1551 relative to HN878. Conclusions/Significance These results provide a precedent for TB strain-specific effects upon HIV-1 replication and thus for TB strain-specific pathogenesis in the outcome of HIV-1/TB co-infection. MTb strain-specific factors and mechanisms involved in the regulation of HIV-1 during co-infection will be of importance in understanding the basic pathogenesis of HIV-1/TB co-infection.
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Affiliation(s)
- Shahin Ranjbar
- Immune Disease Institute, Boston, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (SR); (AEG)
| | - Helena I. Boshoff
- The Tuberculosis Research Section, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Amara Mulder
- Immune Disease Institute, Boston, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Noman Siddiqi
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Eric J. Rubin
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Anne E. Goldfeld
- Immune Disease Institute, Boston, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail: (SR); (AEG)
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Abstract
BACKGROUND Delirium is a common mental disorder with serious adverse outcomes in hospitalised patients. It is associated with increases in mortality, physical morbidity, length of hospital stay, institutionalisation and costs to healthcare providers. A range of risk factors has been implicated in its aetiology, including aspects of the routine care and environment in hospitals. Prevention of delirium is clearly desirable from patients' and carers' perspectives, and to reduce hospital costs. Yet it is currently unclear whether interventions for prevention of delirium are effective, whether they can be successfully delivered in all environments, and whether different interventions are necessary for different groups of patients. OBJECTIVES Our primary objective was to determine the effectiveness of interventions designed to prevent delirium in hospitalised patients. We also aimed to highlight the quality and quantity of research evidence to prevent delirium in these settings. SEARCH STRATEGY We searched the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 28th September, 2005. As the searches in MEDLINE, EMBASE, CINAHL and PsycINFO for the Specialized Register would not necessarily have picked up all delirium prevention trials, these databases were searched again on 28th October, 2005. We also examined reference lists of retrieved articles, reviews and books. Experts in this field were contacted and the Internet searched for further references and to locate unpublished trials. SELECTION CRITERIA Randomised controlled trials evaluating any interventions to prevent delirium in hospitalised patients. DATA COLLECTION AND ANALYSIS Data collection and quality assessment were performed by three reviewers independently and agreement reached by consensus. MAIN RESULTS Six studies with a total of 833 participants were identified for inclusion. All were conducted in surgical settings, five in orthopaedic surgery and one in patients undergoing resection for gastric or colon cancer. Only one study of 126 hip fracture patients comparing proactive geriatric consultation with usual care was sufficiently powered to detect a difference in the primary outcome, incident delirium. Total cumulative delirium incidence during admission was reduced in the intervention group (OR 0.48 [95% CI 0.23, 0.98]; RR 0.64 [95% CI 0.37, 0.98]), suggesting a 'number needed to treat' of 5.6 patients to prevent one case. The intervention was particularly effective in preventing severe delirium. In logistic regression analyses adjusting for pre fracture dementia and Activities of Daily Living impairment, there was no reduction in effect size, OR 0.6, but this no longer remained significant [95% CI 0.3,1.3]. There was no effect on the duration of delirium episodes, length of hospital stay, and cognitive status or institutionalisation at discharge. There was also no significant difference in cumulative delirium incidence between treatment and control groups in a sub-group of 50 patients with dementia (RR 0.9 [95% CI 0.59, 1.36]). In another trial of low dose haloperidol prophylaxis, there was no difference in delirium incidence but the severity and duration of a delirium episode, and length of hospital stay were all reduced. We identified no completed studies in hospitalised medical, care of the elderly, general surgery, cancer or intensive care patients. In outcomes, no studies examined for death, use of psychotropic medication, activities of daily living, psychological morbidity, quality of life, carers or staff psychological morbidity, cost of intervention and cost to health care services. Outcomes were only reported up to discharge, with no studies reporting medium or longer-term effects. AUTHORS' CONCLUSIONS Research evidence on effectiveness of interventions to prevent delirium is sparse. Based on a single study, a programme of proactive geriatric consultation may reduce delirium incidence and severity in patients undergoing surgery for hip fracture. Prophylactic low dose haloperidol may reduce severity and duration of delirium episodes and shorten length of hospital admission in hip surgery. Further studies of delirium prevention are needed.
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Affiliation(s)
- N Siddiqi
- University of Leeds, Academic Unit Psychiatry and Behavioural Sciences, 15 Hyde Terrace, Leeds, UK, LS2 9LT.
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Diaz R, Siddiqi N, Rubin EJ. Detecting genetic variability among different Mycobacterium tuberculosis strains using DNA microarrays technology. Tuberculosis (Edinb) 2006; 86:314-8. [PMID: 16644284 DOI: 10.1016/j.tube.2006.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Accepted: 01/20/2006] [Indexed: 11/21/2022]
Abstract
Recent advances in functional and comparative genomics have improved our understanding of genetic diversity among the Mycobacterium tuberculosis complex. In this study, we investigated the genetic polymorphism of M. tuberculosis using whole-genome microarray analysis. Amplified fragments of 15 M. tuberculosis strains (from two different geographical origins) and the reference strain H37Rv were produced by random amplification of polymorphic DNA (RAPD) using three different primers. The RAPD products were labeled with fluorescent dyes (Cy3 and Cy5) and hybridized to a TB DNA microarray representing nearly all open reading frames (ORFs) of H37Rv. The final results were analyzed using bioinformatic tools. Some genetic variability was found among the 16 M. tuberculosis strains. The majority of the highly polymorphic DNA sequences were observed in ORFs representing non-essential genes of the bacterium. The future use of comparative genomics based on DNA microarray technology should prove a powerful tool for understanding phenotypic variability among M. tuberculosis isolates of similar genetic composition. It is also a promising approach to provide important insights into evolution, virulence and pathogenesis of M. tuberculosis.
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Affiliation(s)
- Raul Diaz
- National Reference Laboratory on Tuberculosis and Mycobacteria, Pedro Kouri Institute of Tropical Medicine (IPK), Autopista Novia del Mediodía Km 6, Lisa, Havana, Cuba.
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Abstract
We compared the efficacies of 17 agents against rapidly growing and starved Mycobacterium tuberculosis H37Rv. Few compounds have significant activity at attainable concentrations. However, two phenothiazine compounds at similar concentrations were bactericidal for starved and growing cells. These drugs appear to target a process important in both replicating and nonreplicating bacteria.
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Affiliation(s)
- Zhifang Xie
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, USA
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Siddiqi N, Stockdale R, Holmes J, Britton AM. Interventions for preventing delirium in hospitalised patients. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2005. [DOI: 10.1002/14651858.cd005563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Siddiqi N, Das R, Pathak N, Banerjee S, Ahmed N, Katoch VM, Hasnain SE. Mycobacterium tuberculosis isolate with a distinct genomic identity overexpresses a tap-like efflux pump. Infection 2004; 32:109-11. [PMID: 15057575 DOI: 10.1007/s15010-004-3097-x] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [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: 06/12/2003] [Accepted: 12/01/2003] [Indexed: 11/29/2022]
Abstract
BACKGROUND One mechanism proposed for drug resistance in Mycobacterium tuberculosis (MTB) is by efflux of the drugs by membrane located pumps. We report a novel and definite association between drug resistance and transcription levels of a tap-like pump (Rv1258c) in a multi-drug resistant MTB patient isolate (ICC154) which possesses a unique genotypic signature. MATERIALS AND METHODS The isolate ICC154 was tested for drug sensitivity. Over-expression of Rv1258c as a function of drug pressure was analyzed by RT-PCR and the strain was typed using fluorescent amplified fragment length polymorhism (FAFLP). RESULT In the presence of rifampicin and ofloxacin, this isolate shows increased transcription of the gene Rv1258c. Genotypic fingerprinting revealed the presence of unique FAFLP markers. CONCLUSION A clear association between drug resistance and overexpression of an efflux protein is evident from our studies. The presence of specific markers has implications in rapid identification of MDR clinical isolates and consequent disease management.
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Affiliation(s)
- N Siddiqi
- Centre for DNA Fingerprinting and Diagnostics, Nacharam, Hyderabad, India
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Siddiqi N, Shamim M, Hussain S, Choudhary RK, Ahmed N, Banerjee S, Savithri GR, Alam M, Pathak N, Amin A, Hanief M, Katoch VM, Sharma SK, Hasnain SE. Molecular characterization of multidrug-resistant isolates of Mycobacterium tuberculosis from patients in North India. Antimicrob Agents Chemother 2002; 46:443-50. [PMID: 11796356 PMCID: PMC127030 DOI: 10.1128/aac.46.2.443-450.2002] [Citation(s) in RCA: 126] [Impact Index Per Article: 5.7] [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
The World Health Organization has identified India as a major hot-spot region for Mycobacterium tuberculosis infection. We have characterized the sequences of the loci associated with multidrug resistance in 126 clinical isolates of M. tuberculosis from India to identify the respective mutations. The loci selected were rpoB (rifampin), katG and the ribosomal binding site of inhA (isoniazid), gyrA and gyrB (ofloxacin), and rpsL and rrs (streptomycin). We found known as well as novel mutations at these loci. Few of the mutations at the rpoB locus could be correlated with the drug resistance levels exhibited by the M. tuberculosis isolates and occurred with frequencies different from those reported earlier. Missense mutations at codons 526 to 531 seemed to be crucial in conferring a high degree of resistance to rifampin. We identified a common Arg463Leu substitution in the katG locus and certain novel insertions and deletions. Mutations were also mapped in the ribosomal binding site of the inhA gene. A Ser95Thr substitution in the gyrA locus was the most common mutation observed in ofloxacin-resistant isolates. A few isolates showed other mutations in this locus. Seven streptomycin-resistant isolates had a silent mutation at the lysine residue at position 121. While certain mutations are widely present, pointing to the magnitude of the polymorphisms at these loci, others are not common, suggesting diversity in the multidrug-resistant M. tuberculosis strains prevalent in this region. Our results additionally have implications for the development of methods for multidrug resistance detection and are also relevant in the shaping of future clinical treatment regimens and drug design strategies.
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Affiliation(s)
- Noman Siddiqi
- Centre for DNA Fingerprinting and Diagnostics, Hyderabad 500076 , India
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Siddiqi N, Shamim M, Amin A, Chauhan DS, Das R, Srivastava K, Singh D, Sharma VD, Katoch VM, Sharma SK, Hanief M, Hasnain SE. Typing of drug resistant isolates of Mycobacterium tuberculosis from India using the IS6110 element reveals substantive polymorphism. Infect Genet Evol 2001; 1:109-16. [PMID: 12798025 DOI: 10.1016/s1567-1348(01)00014-4] [Citation(s) in RCA: 25] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigated IS6110 polymorphism in clinical isolates of Mycobacterium tuberculosis from patients attending the outpatient department at various hospitals in northern India. DNA fingerprinting of 126 clinical isolates of M. tuberculosis was carried out using restriction fragment length polymorphism (RFLP) associated with the IS6110 element in M. tuberculosis genomes. A substantive degree of polymorphism was evident in the MDR M. tuberculosis isolates. The number of bands in the fingerprints varied from 0 to 19. However, the lack of common bands made it difficult to cluster the majority of these isolates. We were also unable to associate drug resistance with IS6110 copy number. Specific regions of the gyrA and katG genes from a representative number of these isolates were sequenced to determine the genotype. The majority of the isolates analyzed were found to belong to Group 1, indicating that these strains were evolutionarily older. We find no evidence of the W strain, prevalent in the US, in our study. The epidemiological patterns of the various strains in India seem to be very complex, as reflected by the presence of a large number of different strains (types) within north India.
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Affiliation(s)
- N Siddiqi
- National Institute of Immunology, New Delhi 110067, India
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Raman LA, Siddiqi N, Shamim M, Deb M, Mehta G, Hasnain SE. Molecular characterization of Mycobacterium abscessus strains isolated from a hospital outbreak. Emerg Infect Dis 2000; 6:561-2. [PMID: 10998394 PMCID: PMC2627957 DOI: 10.3201/eid0605.000524] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Siddiqi N, Shamim M, Jain NK, Rattan A, Amin A, Katoch VM, Sharma SK, Hasnain SE. Molecular genetic analysis of multi-drug resistance in Indian isolates of Mycobacterium tuberculosis. Mem Inst Oswaldo Cruz 1998; 93:589-94. [PMID: 9830523 DOI: 10.1590/s0074-02761998000500006] [Citation(s) in RCA: 25] [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: 11/22/2022] Open
Abstract
A total of 116 isolates from patients attending the out-patient department at the All India Institute of Medical Sciences, New Delhi and the New Delhi Tuberculosis Centre, New Delhi, India were collected. They were analyzed for resistance to drugs prescribed in the treatment for tuberculosis. The drug resistance was initially determined by microbiological techniques. The Bactec 460TB system was employed to determine the type and level of resistance in each isolate. The isolates were further characterized at molecular level. The multi-drug loci corresponding to rpo beta, gyr A, kat G were studied for mutation(s) by the polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) technique. The SSCP positive samples were sequenced to characterize the mutations in rpo beta, and gyr A loci. While previously reported mutations in the gyr A and rpo beta loci were found to be present, several novel mutations were also scored in the rpo beta locus. Interestingly, analysis of the gyr A locus showed the presence of point mutation(s) that could not be detected by PCR-SSCP. Furthermore, rifampicin resistance was found to be an important marker for checking multi-drug resistance (MDR) in clinical isolates of Mycobacterium tuberculosis. This is the first report on molecular genetic analysis of MDR tuberculosis from India, and highlights the increasing incidence of MDR in the Indian isolates of M. tuberculosis.
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Affiliation(s)
- N Siddiqi
- National Institute of Immunology, New Delhi, India
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Siddiqi N, Gazzani F, Des Jardins J, Chao EY. The use of a robotic device for gait training and rehabilitation. Stud Health Technol Inform 1996; 39:440-9. [PMID: 10168939] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
This study was aimed at investigating normal subjects walking with support using a robotic device (REHABOT) intended for gait training and rehabilitation of physically disabled individuals. Ground reaction forces, knee joint kinematics, temporal factors of gait, and oxygen cost were measured on fourteen healthy subjects. The apparatus was to support 0%, 20%, 40% and 60% of each subject's body weight through an upper torso harness connected to the robotic device. Each subject was then asked to walk on a 10 meter circular pathway. Temporal factors of gait, ground reaction forces and knee kinematic measurements showed little change from 0% to 40%, but a significant alteration in these gait parameters was noticed when 60% of the subject's body weight was supported. Oxygen cost decreased significantly (P < 0.05) from 0% to 40%, but increased at 60%. These results suggest that body weight support up to 40% reduces energy demands without significantly altering gait patterns. Consequently the REHABOT can be considered as a gait training device for patients with weight-bearing difficulties. This apparatus may also be used as an exercise machine for certain patients who cannot walk un-assisted.
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Affiliation(s)
- N Siddiqi
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore,MD 21205, USA
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Nizam R, Siddiqi N, Landas SK, Kaplan DS, Holtzapple PG. Colonic tattooing with India ink: benefits, risks, and alternatives. Am J Gastroenterol 1996; 91:1804-8. [PMID: 8792702] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To provide comprehensive information on key issues concerning colonic tattooing with India ink in reported literature. METHODS A total of 735 citations on India ink alone were present in the English literature (1966-1995), including 16 on India ink and colonic tattooing. Nine major studies were identified and reviewed for 1) preparation before tattooing (type of ink used, sterilization process, colonic preparation, and antibiotic prophylaxis), 2) the tattooing process (technique and volume injected), 3) success in localization, and 4) complications. RESULTS A'total of 447 cases of colonic tattooing with India ink have been reported. Major indication was preoperative marking of tumor site. Various India ink preparations were used. Ink was unsterilized in 57% (255/447), autoclaved in 42% (187/447), and gas sterilized in 1% (5/447) of cases. Colonic preparation varied similarly. Prophylactic antibiotics were used in 1% (5/447) of cases. Dilution of India ink varied from undiluted to 1:100 (with 0.9% saline). The volume injected ranged from 0.1 to 2 ml per site injected, commonly with tangential needle insertion and delivery of ink into the submucosa in the majority of the cases. Intraoperative localization was easier with multiple tattoo injections. Five reports of complications have been made. In only one instance did overt clinical complications develop. Risk of a clinical complication with colonic tattooing with India ink is 0.22%. CONCLUSION Marked variability in technique, as well as potential for reporting bias, limit the quantitative conclusions. In general, colonic tattooing with India ink is a safe, accurate, and inexpensive method for preoperative marking and prospective study of colonic lesions.
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Affiliation(s)
- R Nizam
- Division of Gastroenterology, S.U.N.Y. Health Science Center, Syracuse, USA
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Qureshi AW, Zulfiqar I, Raza A, Siddiqi N. Comparison of immunogenicity of combined DPT--inactivated injectable polio vaccine (DPT - IPV) and association of DPT and attenuated oral polio vaccine (DPT + OPV) in Pakistani children. J PAK MED ASSOC 1989; 39:31-5. [PMID: 2499700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two hundred children aged 2-24 months attending EPI Centre Rawalpindi General Hospital, were randomly assigned to two basic immunization schedules i.e. 3 doses of oral polio vaccine alongwith two doses of DPT (Conventional Schedule) and 2 doses of combined DPT - enhanced injectable polio vaccine (new simplified schedule). Comparison of the seroconversion results showed the presence of protective antibodies against all the 3 types of polio in 100% of the children in both the groups, but there was no statistical difference in the geometric mean antibody titre in the two immunization schedules. After two doses of DPT-IPV or DPT vaccine alone the results demonstrated antibody levels above the protective threshold in both the groups against Diphtheria, Pertussis and Tetanus.
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Hessler PC, Hill DS, Siddiqi N. Renal adenocarcinoma in an asymptomatic 19-year-old female. Urol Radiol 1981; 3:117-20. [PMID: 7314322 DOI: 10.1007/bf02927821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Renal adenocarcinoma is rare before age 20. Clinically and radiographically, it presents similarly in adults and children. Prognosis is related to the clinical stage of the tumor at surgery. Treatment methods are still under investigation.
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Siddiqi N, Ghosh S, Berry AM. The natural history of measles in a low-income urban community in South Delhi. Indian Pediatr 1974; 11:557-62. [PMID: 4443057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Gerson CD, Kent TH, Saha JR, Siddiqi N, Lindenbaum J. Recovery of small-intestinal structure and function after residence in the tropics. II. Studies in Indians and Pakistanis living in New York City. Ann Intern Med 1971; 75:41-8. [PMID: 5091566 DOI: 10.7326/0003-4819-75-1-41] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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