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Redgate S, Spencer L, Adams EA, Arnott B, Brown H, Christie A, Hardy C, Harrison H, Kaner E, Mawson C, McGovern W, Phillips P, Rankin J, McGovern R. A realist approach to understanding alliancing within Local Government public health and social care service provision. Eur J Public Health 2023; 33:49-55. [PMID: 36453890 PMCID: PMC9898013 DOI: 10.1093/eurpub/ckac172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Within the current context of continued austerity and post-pandemic recovery, it remains important that Local Government services address the increasing needs of residents as cost-effectively as possible. Alliancing, whereby services work collaboratively focusing on the 'whole-system', has gained popularity as a tool with the potential to support collaborative whole systems approaches. This synthesis aims to identify how alliancing can be successfully operationalised in the commissioning of public health, wider National Health Service (NHS) and social care-related services. METHODS A realist literature synthesis was undertaken in order to identify underlying generative mechanisms associated with alliancing, the contextual conditions surrounding the implementation and operationalisation of the alliancing approach mechanisms, and the outcomes produced as a result. An iterative approach was taken, using a recent systematic review of the effectiveness of Alliancing, online database searches, and grey literature searches. RESULTS Three mechanistic components were identified within the data as being core to the successful implementation of alliances in public health and social care-related services within Local Government: (i) Achieving a system-level approach; (ii) placing local populations at the heart of the system; and (iii) creating a cultural shift. Programme theories were postulated within these components. CONCLUSIONS The alliancing approach offers an opportunity to achieve system-level change with the potential to benefit local populations. The realist synthesis approach taken within this study has provided insights into the necessary contextual and mechanistic factors of the Alliancing approach, above and beyond effectiveness outcomes typically collected through more conventional evaluation methodologies.
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Affiliation(s)
- S Redgate
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - E A Adams
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - B Arnott
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - H Brown
- Health Research, Lancaster University, Lancaster, England
| | - A Christie
- Public Health, South Tyneside Council, South Shields, England
| | - C Hardy
- Public Health, South Tyneside Council, South Shields, England
| | - H Harrison
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - C Mawson
- Public Health, South Tyneside Council, South Shields, England
| | - W McGovern
- Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, England
| | - P Phillips
- Public Health, South Tyneside Council, South Shields, England
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
| | - R McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England
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Meek T, Pandit JJ, Phillips P, Young P. Have we undone the good work of the last decade with one small slip? A reply. Anaesthesia 2022; 77:615-616. [PMID: 35201614 DOI: 10.1111/anae.15696] [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: 11/27/2022]
Affiliation(s)
- T Meek
- James Cook University Hospital, Middlesbrough, UK
| | | | - P Phillips
- Princess of Wales Hospital, Bridgend, UK
| | - P Young
- Queen Elizabeth Hospital, King's Lynn, UK
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Phillips P, MacMahon ME, Elovikova M. Counselling the “split subject”: a psychodynamic analysis of career dissatisfaction. British Journal of Guidance & Counselling 2022. [DOI: 10.1080/03069885.2021.1999389] [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: 11/02/2022]
Affiliation(s)
- P. Phillips
- Trinity Business School, Trinity College Dublin, the University of Dublin, Ireland
| | - M. E. MacMahon
- Trinity Business School, Trinity College Dublin, the University of Dublin, Ireland
| | - M. Elovikova
- Trinity Business School, Trinity College Dublin, the University of Dublin, Ireland
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Price L, Carter P, Hodzovic I, Alderman M, Hughes G, Phillips P, Varadarajan V, Wilkes A. An assessment of introducers used for airway management. Anaesthesia 2021; 77:293-300. [PMID: 34861743 DOI: 10.1111/anae.15624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/29/2022]
Abstract
Different introducers are available to assist with tracheal intubation. Subtle differences in the design of introducers can have a marked effect on safety and performance. The Difficult Airway Society's Airway Device Evaluation Project Team proposal states that devices should only be purchased for which there is at least a case-control study on patients assessing airway devices. However, resources are not currently available to carry out a case-control study on all introducers available on the market. This study comprised a laboratory and manikin-based investigation to identify introducers that could be suitable for clinical investigation. We included six different introducers in laboratory-based assessments (design characteristics) and manikin-based assessments involving the participation of 30 anaesthetists. Each anaesthetist attempted placement in the manikin's trachea with each of the six introducers in a random order. Outcomes included first-time insertion success rate; insertion success rate; number of attempts; time to placement; and distance placed. Each anaesthetist also completed a questionnaire. First-time insertion success rate depended significantly on the introducer used (p = 0.0016) and varied from 47% (Armstrong and P3) to 77% (Intersurgical and Frova). Median time to placement (including oesophageal placement) varied from 10 s (Eschmann and Frova) to 20 s (P3) (p = 0.0025). Median time to successful placement in the trachea varied from 9 s (Frova) to 22 s (Armstrong) (p = 0.037). We found that the Armstrong and P3 devices were not as acceptable as other introducers and, without significant improvements to their design and characteristics, the use of these devices in studies on patients is questionable. The study protocol is suitable for differentiating between different introducers and could be used as a basis for assessing other types of devices.
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Affiliation(s)
- L Price
- Department of Anaesthetics, Princess of Wales Hospital, Bridgend, UK
| | - P Carter
- Department of Anaesthetics, University Hospital of Wales, Cardiff, UK
| | - I Hodzovic
- Department of Anaesthetics, Royal Gwent Hospital, Newport, UK
| | - M Alderman
- Department of Anaesthetics, Princess of Wales Hospital, Bridgend, UK
| | - G Hughes
- Department of Anaesthetics, Princess of Wales Hospital, Bridgend, UK
| | - P Phillips
- Surgical Materials Testing Laboratory, Princess of Wales Hospital, Bridgend, UK
| | - V Varadarajan
- Department of Anaesthetics, Princess of Wales Hospital, Bridgend, UK
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Spira A, Lisberg A, Sands J, Greenberg J, Phillips P, Guevara F, Tajima N, Kawasaki Y, Gu J, Kobayashi F, Yamamoto N, Johnson M, Meric-Bernstam F, Yoh K, Garon E, Heist R, Shimizu T. OA03.03 Datopotamab Deruxtecan (Dato-DXd; DS-1062), a TROP2 ADC, in Patients With Advanced NSCLC: Updated Results of TROPION-PanTumor01 Phase 1 Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.280] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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6
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Aber A, Phillips P, Hughes J, Keetharuth AD, Rooney G, Radley S, Walters S, Nawaz S, Jones G, Michaels J. Electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS): development and validity. Br J Surg 2020; 107:1004-1012. [DOI: 10.1002/bjs.11531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/25/2019] [Accepted: 01/15/2020] [Indexed: 11/06/2022]
Abstract
Abstract
Background
This paper describes the development and validation of an electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS) that captures the symptomatology, quality of life and clinically relevant data of patients presenting to vascular services.
Methods
A two-stage survey was conducted in patients attending a tertiary vascular department. Patients completed the ePAQ-VAS remotely online, or on site using an electronic tablet. In the first stage of the survey, the responses were used to perform confirmatory factor analysis to assess the construct validity and remove redundant items. The internal reliability of disease-specific scales was investigated. In the second stage of the survey, the acceptability, known-group validity, test–retest reliability, and responsiveness of ePAQ-VAS was assessed.
Results
In total, 721 patients completed ePAQ-VAS. Their mean(s.d.) age was 63·5(15·7) years and 468 (64·9 per cent) were men. Some 553 patients (76·7 per cent) completed the questionnaire in clinic and the remainder completed the questionnaire online. The results of the confirmatory factor analysis confirmed the conceptual model for ePAQ-VAS structure and eliminated six items. Internal reliability was acceptable for all the scales (Cronbach's α greater than 0·7). The test–retest reliability measured by the intraclass correlation coefficient ranged from 0·65 to 0·99. The results showed that the instrument was responsive over time with the standardized response mean ranging from 0·69 to 1·60.
Conclusion
ePAQ-VAS is a holistic data-collection process that is relevant to vascular service users and has potential to contribute to patient-focused care and the collection of aggregate data for service evaluation. A demonstration version of the final version of ePAQ can be viewed at http://demo-questionnaire.epaq.co.uk/home/project?id=VASC_1.7&page=1.
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Affiliation(s)
- A Aber
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - P Phillips
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - J Hughes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - A D Keetharuth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - G Rooney
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - S Walters
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - S Nawaz
- Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - G Jones
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- Sheffield Vascular Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - J Michaels
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Marrouche N, Joseph M, Godfrey J, Phillips P, Piazza D, Macnamara F, Harari D. P2866Automated ultrasound ablation parameters predict lesion depth in a perfused thigh model. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The accuracy and safety of lesions created during catheter ablation of cardiac tissue rely on the user's ability to predict the size of lesions that form under variable conditions during treatment. A user-directed robotic system was developed that uses Low-Intensity Collimated Ultrasound (LICU) for cardiac imaging and to produce linear lesions without tissue contact. Molecular absorption of mechanical energy induced in the tissue by LICU causes a temperature rise resulting in thermal tissue necrosis.
Purpose
By varying the speed of the LICU beam as it traces the desired lesion path, while considering the beam intensity, distance from catheter tip to tissue, and relative motion of the target tissue, we demonstrate the capability to deposit lesions of known depth according to a predictive model.
Methods
The LICU catheter was mounted in a servo-controlled, 3 axis stage suspended above a perfused porcine thigh that simulates the thermodynamic properties of the myocardium such as acoustic attenuation, thermal conduction, and specific heat capacity. Therapy was delivered along a linear path while varying the distance to tissue, speed of the beam, and motion of the catheter relative to the tissue in 3 dimensions. Programmed relative motion was representative of typical and extreme motion in humans. Pathological analysis after necropsy was used to quantify lesion depth which was then compared to lesion depth as predicted by a mathematical model from approx. 4–12 mm.
Results
Data from 66 samples were categorized according to typical and extreme motion at 4 different distances (3, 8, 9 and 13 mm). Measured vs predicted lesion depth was well correlated (R = 0.898) with 98.5% of the samples within ±2 mm.
Assessment of LICU lesion depth
Conclusion
Lesion depth using LICU is well controlled in an animal model for the range of distances and relative motion typically encountered in a human subject. The range of acoustic beam speeds and acoustic power density with LICU predictably produces lesions up to 12 mm deep. The LICU thermal model may be useful to create lesions of known depth thus ensuring transmurality of lesions while potentially avoiding unintended extra-cardiac injury.
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Affiliation(s)
- N Marrouche
- University of Utah, Comprehensive Arrhythmia and Research Management Center, University of Utah, Salt Lake City, Salt Lake City, United States of America
| | - M Joseph
- Vytronus, Inc., Sunnyvale, CA, United States of America
| | - J Godfrey
- Vytronus, Inc., Sunnyvale, CA, United States of America
| | - P Phillips
- Vytronus, Inc., Sunnyvale, CA, United States of America
| | - D Piazza
- Vytronus, Inc., Sunnyvale, CA, United States of America
| | - F Macnamara
- Vytronus, Inc., Sunnyvale, CA, United States of America
| | - D Harari
- Vytronus, Inc., Sunnyvale, CA, United States of America
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Schindler A, Meabon J, Baskin B, Cooper E, Yagi M, Simon B, Peskind E, Phillips P, Cook D. Non-invasive vagus nerve stimulation for the prevention/treatment of comorbid mild traumatic brain injury and PTSD. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.356] [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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9
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Cook TM, Wilkes A, Bickford Smith P, Dorn L, Stacey M, Kinsella SM, Sharpe P, Phillips P. Multicentre clinical simulation evaluation of the
ISO
80369‐6 neuraxial non‐Luer connector. Anaesthesia 2019; 74:619-629. [DOI: 10.1111/anae.14585] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 11/28/2022]
Affiliation(s)
- T. M. Cook
- Department of Anaesthesia and Intensive Care Medicine Royal United Hospitals Bath NHS Foundation Trust BathUK
- School of Medicine University of Bristol Bristol UK
| | - A. Wilkes
- Independent Medical Device Consultant Edinburgh UK
| | | | - L. Dorn
- Associate Director Clinical Development Baxter Healthcare Chicago IllinoisUSA
| | - M. Stacey
- Cardiff & Vale University Hospitals Board Cardiff UK
| | - S. M. Kinsella
- University Hospitals Bristol NHS Foundation Trust BristolUK
| | - P. Sharpe
- University Hospitals of Leicester NHS Trust LeicesterUK
| | - P. Phillips
- Surgical Materials Testing Laboratory Princess of Wales Hospital Bridgend UK
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Phillips P, Lithgow GJ, Driscoll M. REPRODUCIBILITY & ROBUSTNESS IN PURSUING LIFE-EXTENDING COMPOUNDS: CAENORHABDITIS INTERVENTION TESTING PROGRAM. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Phillips
- Department of Biology, University of Oregon, Eugene, Oregon, United States
| | - G J Lithgow
- Buck Institute for Aging Research, Novato, California 94945, USA
| | - M Driscoll
- Rutgers University, Piscataway, New Jersey 08854, USA
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Phillips P, Poku E, Essat M, Woods H, Goka E, Kaltenthaler E. Systematic Review of Carotid Artery Procedures and the Volume-Outcome Relationship in Europe. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.02.014] [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: 10/17/2022]
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12
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Hawryluk R, Barnes CW, Batha S, Beer M, Bell M, Bell R, Berk H, Bitter M, Bretz N, Budny R, Bush C, Cauffman S, Chang CS, Chang Z, Cheng C, Darrow D, Dendy R, Dorland W, Dudek L, Duong H, Durst R, Efthimion P, Evenson H, Fisch N, Fisher R, Fonck R, Forrest C, Fredrickson E, Fu G, Furth H, Gorelenkov N, Grek B, Grisham L, Hammett G, Heidbrink W, Herrmann H, Herrmann M, Hill K, Hooper B, Hosea J, Houlberg W, Hughes M, Jassby D, Jobes F, Johnson D, Kaita R, Kamperschroer J, Kesner J, Krazilniknov A, Kugel H, Kumar A, LaMarche P, LeBlanc B, Levine J, Levinton F, Lin Z, Machuzak J, Majeski R, Mansfield D, Mazzucato E, Mauel M, McChesney J, McGuire K, McKee G, Meade D, Medley S, Mikkelsen D, Mimov S, Mueller D, Navratil G, Nazikian R, Nevins B, Okabayashi M, Osakabe M, Owens D, Park H, Park W, Paul S, Petrov M, Phillips C, Phillips M, Phillips P, Ramsey A, Redi M, Rewoldt G, Rice B, Rogers J, Roquemore A, Ruskov E, Sabbagh S, Sasao M, Schilling G, Schmidt G, Scott S, Semenov I, Skinner C, Spong D, Strachan J, Strait E, Stratton B, Synakowski E, Takahashi H, Tang W, Taylor G, Goeler SV, Halle AV, White R, Williams M, Wilson J, Wong K, Wurden G, Young K, Zarnstorff M, Zweben S. Review of D-T Results from TFTR. ACTA ACUST UNITED AC 2018. [DOI: 10.13182/fst96-a11963011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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13
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Aber A, Poku E, Phillips P, Essat M, Buckley Woods H, Palfreyman S. Systematic Review of Patient-Reported Outcome Measures in Patients With Varicose Veins. J Vasc Surg Venous Lymphat Disord 2018. [DOI: 10.1016/j.jvsv.2017.10.007] [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: 10/18/2022]
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Poku E, Aber A, Phillips P, Essat M, Buckley Woods H, Palfreyman S, Kaltenthaler E, Jones G, Michaels J. Systematic review assessing the measurement properties of patient-reported outcomes for venous leg ulcers. BJS Open 2017; 1:138-147. [PMID: 29951616 PMCID: PMC5989950 DOI: 10.1002/bjs5.25] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/14/2017] [Indexed: 12/21/2022] Open
Abstract
Background A variety of instruments have been used to assess outcomes for patients with venous leg ulcers. This study sought to identify, evaluate and recommend the most appropriate patient‐reported outcome measures (PROMs) for English‐speaking patients with venous leg ulcers. Methods This systematic review used a two‐stage search approach. Electronic searches of major databases including MEDLINE were completed in October 2015, and then updated in July 2016. Additional studies were identified from citation checking. Study selection, data extraction and quality assessment were undertaken independently by at least two reviewers. Evaluation and summary of measurement properties of identified PROMs were done using standard and adapted study‐relevant criteria. Results Ten studies with data for four generic PROMS and six condition‐specific measures were identified. No generic PROM showed adequate content and criterion validity; however, the EuroQoL Five Dimensions (EQ‐5D™), Nottingham Health Profile (NHP) and 12‐item Short‐Form Health Survey (SF‐12®) had good acceptability. In general, the EQ‐5D™ showed poor responsiveness in patients with venous leg ulcers. Most condition‐specific PROMs demonstrated poor criterion and construct validity. Overall, there was some evidence of internal consistency for the Venous Leg Ulcer Quality of Life (VLU‐QoL) and the Sheffield Preference‐based Venous Ulcer questionnaire (SPVU‐5D). Test–retest reliability was satisfactory for the Venous Leg Ulcer Self‐Efficacy Tool (VeLUSET). Conclusion The NHP and VLU‐QoL questionnaire seemed the most suitable PROMs for use by clinicians. However, a valid condition‐specific PROM is still required.
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Affiliation(s)
- E Poku
- School of Health and Related Research University of Sheffield Sheffield UK
| | - A Aber
- School of Health and Related Research University of Sheffield Sheffield UK
| | - P Phillips
- School of Health and Related Research University of Sheffield Sheffield UK
| | - M Essat
- School of Health and Related Research University of Sheffield Sheffield UK
| | - H Buckley Woods
- School of Health and Related Research University of Sheffield Sheffield UK
| | - S Palfreyman
- Edmonton Clinic Health Academy, University of Alberta Edmonton, Alberta Canada
| | - E Kaltenthaler
- School of Health and Related Research University of Sheffield Sheffield UK
| | - G Jones
- School of Social Sciences Leeds Beckett University Leeds UK
| | - J Michaels
- School of Health and Related Research University of Sheffield Sheffield UK
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Aber A, Poku E, Phillips P, Essat M, Buckley Woods H, Palfreyman S, Kaltenthaler E, Jones G, Michaels J. Systematic review of patient-reported outcome measures in patients with varicose veins. Br J Surg 2017; 104:1424-1432. [DOI: 10.1002/bjs.10639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/20/2017] [Accepted: 06/04/2017] [Indexed: 02/04/2023]
Abstract
Abstract
Background
Varicose veins can affect quality of life. Patient-reported outcome measures (PROMs) provide a direct report from the patient about the impact of the disease without interpretation from clinicians or anyone else. The aim of this study was to examine the quality of the psychometric evidence for PROMs used in patients with varicose veins.
Methods
A systematic review was undertaken to identify studies that reported the psychometric properties of generic and disease-specific PROMs in patients with varicose veins. Literature searches were conducted in databases including MEDLINE, up to July 2016. The psychometric criteria used to assess these studies were adapted from published recommendations in accordance with US Food and Drug Administration guidance.
Results
Nine studies were included which reported on aspects of the development and/or validation of one generic (36-Item Short Form Health Survey, SF-36®) and three disease-specific (Aberdeen Varicose Vein Questionnaire, AVVQ; Varicose Veins Symptoms Questionnaire, VVSymQ®; Specific Quality-of-life and Outcome Response – Venous, SQOR-V) PROMs. The evidence from included studies provided data to support the construct validity, test–retest reliability and responsiveness of the AVVQ. However, its content validity, including weighting of the AVVQ questions, was biased and based on the opinion of clinicians, and the instrument had poor acceptability. VVSymQ® displayed good responsiveness and acceptability rates. SF-36® was considered to have satisfactory responsiveness and internal consistency.
Conclusion
There is a scarcity of psychometric evidence for PROMs used in patients with varicose veins. These data suggest that AVVQ and SF-36® are the most rigorously evaluated PROMs in patients with varicose veins.
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Affiliation(s)
- A Aber
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E Poku
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - P Phillips
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - M Essat
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - H Buckley Woods
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - S Palfreyman
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - E Kaltenthaler
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - G Jones
- Department of Psychology, School of Social Sciences, Leeds Beckett University, Leeds, UK
| | - J Michaels
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Booth L, Kada S, Satinovic M, Phillips P, Miller P. Student radiographers' attitudes towards the older patient – A longitudinal study. Radiography (Lond) 2017; 23:229-234. [DOI: 10.1016/j.radi.2017.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/22/2017] [Accepted: 03/26/2017] [Indexed: 11/15/2022]
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17
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Lucanic M, Guo M, Lithgow G, Driscoll M, Phillips P. CITP: SCREENING CHEMICALS FOR REPRODUCIBLE AND ROBUST EFFECTS ACROSS DIVERSE GENETIC BACKGROUNDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4490] [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: 11/15/2022] Open
Affiliation(s)
- M. Lucanic
- Buck Institute for Research on Aging, Novato, California,
| | - M. Guo
- Division of Aging Biology, National Institute on Aging, Bethesda, Maryland,
| | - G.J. Lithgow
- Buck Institute for Research on Aging, Novato, California,
| | - M. Driscoll
- Rutgers University, Dept. of Molecular Biology and Biochemistry, Nelson Biological Laboratories, Piscataway, New Jersey,
| | - P. Phillips
- Institute of Ecology and Evolution, University of Oregon, Eugene, Oregon
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18
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Phillips P, Poku E, Essat M, Woods HB, Goka EA, Kaltenthaler EC, Shackley P, Walters S, Michaels JA. Systematic review of carotid artery procedures and the volume-outcome relationship in Europe. Br J Surg 2017. [PMID: 28632941 DOI: 10.1002/bjs.10593] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hospitals that conduct more procedures on the carotid arteries may achieve better outcomes. In the context of ongoing reconfiguration of UK vascular services, this systematic review was conducted to evaluate the relationship between the volume of carotid procedures and outcomes, including mortality and stroke. METHODS Searches of electronic databases identified studies that reported the effect of hospital or clinician volume on outcomes. Reference and citation searches were also performed. Inclusion was restricted to European populations on the basis that the model of healthcare delivery is similar across Europe, but differs from that in the USA and elsewhere. Analyses of hospital and clinician volume, and carotid endarterectomy (CEA) and carotid artery stenting (CAS) were conducted separately. RESULTS Eleven eligible studies were identified (233 411 participants), five from the UK, two from Sweden, one each from Germany, Finland and Italy, and a combined German, Austrian and Swiss population. All studies were observational. Two large studies (179 736 patients) suggested an inverse relationship between hospital volume and mortality (number needed to treat (NNT) as low as 165), and combined mortality and stroke (NNT as low as 93), following CEA. The evidence was less clear for CAS; multiple analyses in three studies did not identify convincing evidence of an association. Limited data are available on the relationship between clinician volume and outcome in CAS; in CEA, an inverse relationship was identified by two of three small studies. CONCLUSION The evidence from the largest and highest-quality studies included in this review support the centralization of CEA.
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Affiliation(s)
- P Phillips
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - E Poku
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - M Essat
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - H B Woods
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E A Goka
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E C Kaltenthaler
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - P Shackley
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - S Walters
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - J A Michaels
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Ouroua A, Beno J, Bryant A, Weeks D, Phillips P, Rowan W. Design, Analysis, and Testing of a Hot Calibration Source for the ITER-ECE Diagnostic System. Fusion Science and Technology 2017. [DOI: 10.1080/15361055.2017.1330640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A. Ouroua
- University of Texas at Austin, Center for Electromechanics, Austin, Texas
| | - J.H. Beno
- University of Texas at Austin, Center for Electromechanics, Austin, Texas
| | - A. Bryant
- University of Texas at Austin, Center for Electromechanics, Austin, Texas
| | - D. Weeks
- University of Texas at Austin, Center for Electromechanics, Austin, Texas
| | - P. Phillips
- University of Texas at Austin, Institute for Fusion Studies, Austin, Texas
| | - W.L. Rowan
- University of Texas at Austin, Institute for Fusion Studies, Austin, Texas
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20
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Reddy V, Harari D, Eggert C, Walczak S, Phillips P, Piazza D, Neuzil P. P372Automated low intensity collimated ultrasound 3D anatomic mapping and ablation system minimizes need for continuous operator engagement. Europace 2017. [DOI: 10.1093/ehjci/eux141.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Greenwald M, Basse N, Bonoli P, Bravenec R, Edlund E, Ernst D, Fiore C, Granetz R, Hubbard A, Hughes J, Hutchinson I, Irby J, LaBombard B, Lin L, Lin Y, Lipschultz B, Marmar E, Mikkelsen D, Mossessian D, Phillips P, Porkolab M, Rice J, Rowan W, Scott S, Snipes J, Terry J, Wolfe S, Wukitch S, Zhurovich K. Confinement and Transport Research in Alcator C-Mod. Fusion Science and Technology 2017. [DOI: 10.13182/fst07-a1422] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Greenwald
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - N. Basse
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - P. Bonoli
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | | | - E. Edlund
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - D. Ernst
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - C. Fiore
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - R. Granetz
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - A. Hubbard
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - J. Hughes
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - I. Hutchinson
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - J. Irby
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - B. LaBombard
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - L. Lin
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - Y. Lin
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - B. Lipschultz
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - E. Marmar
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - D. Mikkelsen
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - D. Mossessian
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | | | - M. Porkolab
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - J. Rice
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - W. Rowan
- University of Texas, Austin, Texas
| | - S. Scott
- Princeton Plasma Physics Laboratory, Princeton, New Jersey
| | - J. Snipes
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - J. Terry
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - S. Wolfe
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - S. Wukitch
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
| | - K. Zhurovich
- Massachusetts Institute of Technology, Plasma Science and Fusion Center, Cambridge, Massachusetts 02138
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22
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Furin J, Alirol E, Allen E, Fielding K, Merle C, Abubakar I, Andersen J, Davies G, Dheda K, Diacon A, Dooley KE, Dravnice G, Eisenach K, Everitt D, Ferstenberg D, Goolam-Mahomed A, Grobusch MP, Gupta R, Harausz E, Harrington M, Horsburgh CR, Lienhardt C, McNeeley D, Mitnick CD, Nachman S, Nahid P, Nunn AJ, Phillips P, Rodriguez C, Shah S, Wells C, Thomas-Nyang'wa B, du Cros P. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults. Int J Tuberc Lung Dis 2017; 20:290-4. [PMID: 27046707 DOI: 10.5588/ijtld.15.0490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.
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Affiliation(s)
- J Furin
- TB Research Unit, Case Western Reserve University School of Medicine, Room E-202, 2210 Circle Dr, Cleveland, OH 44149, USA.
| | - E Alirol
- Manson Unit Médicins Sans Frontières, London, UK
| | - E Allen
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - K Fielding
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - C Merle
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - I Abubakar
- Department of Infection and Population Health, University College of London, London, UK
| | - J Andersen
- Statistical and Data Analysis Center, Harvard School of Public Health, Boston, Massachusetts, USA
| | - G Davies
- Institutes of Infection and Global Health and of Translational Medicine, University of Liverpool, Liverpool, UK
| | - K Dheda
- Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - A Diacon
- Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | - K E Dooley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - G Dravnice
- Tuberculosis Foundation, KNCV, Amsterdam, The Netherlands
| | - K Eisenach
- Pathology and Microbiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - D Everitt
- Global Alliance for TB Drug Development, New York, New York, USA
| | | | | | - M P Grobusch
- Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Gupta
- Otsuka USA, Rockville, Maryland, USA
| | - E Harausz
- TB Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - M Harrington
- Treatment Action Group, New York City, New York, USA
| | - C R Horsburgh
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - C Lienhardt
- Stop TB Partnership & Stop TB Department, World Health Organization, Geneva, Switzerland
| | - D McNeeley
- Medical Service Corp International, Arlington, Virginia, USA
| | - C D Mitnick
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - S Nachman
- Department of Pediatrics, Stony Brook School of Medicine, Stony Brook, New York, USA
| | - P Nahid
- Curry International Tuberculosis Center, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - A J Nunn
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - P Phillips
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - C Rodriguez
- Department of Respiratory Medicine, P D Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - S Shah
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - C Wells
- Otsuka USA, Rockville, Maryland, USA
| | | | - P du Cros
- Manson Unit Médicins Sans Frontières, London, UK
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23
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Phillips P, Poku E, Essat M, Woods H, Goka E, Kaltenthaler E, Walters S, Shackley P, Michaels J. Procedure Volume and the Association with Short-term Mortality Following Abdominal Aortic Aneurysm Repair in European Populations: A Systematic Review. Eur J Vasc Endovasc Surg 2017; 53:77-88. [DOI: 10.1016/j.ejvs.2016.10.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/10/2016] [Indexed: 01/03/2023]
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24
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Chu QC, Markman B, Leighl N, Krug L, Rudin C, Lathers D, Basciano P, Fracasso P, Kollia G, Phillips P, Kolaitis G, Williams D, Jackson J, Ready N. A phase 1/2 trial of a monoclonal antibody targeting fucosyl GM1 in relapsed/refractory small cell lung cancer (SCLC): Safety and preliminary efficacy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw389.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Papineni P, Phillips P, Lu Q, Cheung Y, Nunn A, Paton N. TRUNCATE-TB: an innovative trial design for drug-sensitive tuberculosis. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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26
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Murthy S, Chatterjee F, Phillips P, Murray S, McHugh T, Gillespie S. S77 Pre-treatment Chest X-ray Severity And Its Relation To Bacterial Burden In Pulmonary Tuberculosis. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Hawthorne W, Hawkes J, Salvaris E, Liuwantara D, Barlow H, Phillips P, Robson S, Brady J, Lew A, Mark N, OʼConnell P, Cowan P. Survival of Genetically Modified Porcine Neonatal Islet Xenografts in Baboons. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Hawthorne WJ, Salvaris EJ, Phillips P, Hawkes J, Liuwantara D, Burns H, Barlow H, Stewart AB, Peirce SB, Hu M, Lew AM, Robson SC, Nottle MB, D'Apice AJF, O'Connell PJ, Cowan PJ. Control of IBMIR in neonatal porcine islet xenotransplantation in baboons. Am J Transplant 2014; 14:1300-9. [PMID: 24842781 PMCID: PMC4204157 DOI: 10.1111/ajt.12722] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 01/20/2014] [Accepted: 01/23/2014] [Indexed: 01/25/2023]
Abstract
The instant blood-mediated inflammatory reaction (IBMIR) is a major obstacle to the engraftment of intraportal pig islet xenografts in primates. Higher expression of the galactose-α1,3-galactose (αGal) xenoantigen on neonatal islet cell clusters (NICC) than on adult pig islets may provoke a stronger reaction, but this has not been tested in the baboon model. Here, we report that WT pig NICC xenografts triggered profound IBMIR in baboons, with intravascular clotting and graft destruction occurring within hours, which was not prevented by anti-thrombin treatment. In contrast, IBMIR was minimal when recipients were immunosuppressed with a clinically relevant protocol and transplanted with NICC from αGal-deficient pigs transgenic for the human complement regulators CD55 and CD59. These genetically modified (GM) NICC were less susceptible to humoral injury in vitro than WT NICC, inducing significantly less complement activation and thrombin generation when incubated with baboon platelet-poor plasma. Recipients of GM NICC developed a variable anti-pig antibody response, and examination of the grafts 1 month after transplant revealed significant cell-mediated rejection, although scattered insulin-positive cells were still present. Our results indicate that IBMIR can be attenuated in this model, but long-term graft survival may require more effective immunosuppression or further donor genetic modification.
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Affiliation(s)
- W J Hawthorne
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia,University of Sydney at Westmead HospitalWestmead, NSW, Australia,*Corresponding author: Wayne J. Hawthorne,
| | - E J Salvaris
- Immunology Research Centre, St. Vincent's HospitalMelbourne, VIC, Australia
| | - P Phillips
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia
| | - J Hawkes
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia
| | - D Liuwantara
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia
| | - H Burns
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia
| | - H Barlow
- Immunology Research Centre, St. Vincent's HospitalMelbourne, VIC, Australia
| | - A B Stewart
- Department of Anaesthesia, St. Vincent's HospitalMelbourne, VIC, Australia
| | - S B Peirce
- Experimental Medical Surgical Unit, St. Vincent's HospitalMelbourne, VIC, Australia
| | - M Hu
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia
| | - A M Lew
- Walter and Eliza Hall InstituteMelbourne, VIC, Australia
| | - S C Robson
- Beth Israel Deaconess Medical Center, Harvard Medical SchoolBoston, MA
| | - M B Nottle
- Department of Obstetrics and Gynaecology, University of AdelaideAdelaide, SA, Australia
| | - A J F D'Apice
- Immunology Research Centre, St. Vincent's HospitalMelbourne, VIC, Australia
| | - P J O'Connell
- The Centre for Transplant and Renal Research, Westmead Millennium InstituteWestmead, NSW, Australia,University of Sydney at Westmead HospitalWestmead, NSW, Australia
| | - P J Cowan
- Immunology Research Centre, St. Vincent's HospitalMelbourne, VIC, Australia,Department of Medicine, University of MelbourneMelbourne, VIC, Australia
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Helbren E, Halligan S, Phillips P, Boone D, Fanshawe TR, Taylor SA, Manning D, Gale A, Altman DG, Mallett S. Towards a framework for analysis of eye-tracking studies in the three dimensional environment: a study of visual search by experienced readers of endoluminal CT colonography. Br J Radiol 2014; 87:20130614. [PMID: 24689842 PMCID: PMC4075527 DOI: 10.1259/bjr.20130614] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/16/2014] [Accepted: 02/17/2014] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Eye tracking in three dimensions is novel, but established descriptors derived from two-dimensional (2D) studies are not transferable. We aimed to develop metrics suitable for statistical comparison of eye-tracking data obtained from readers of three-dimensional (3D) "virtual" medical imaging, using CT colonography (CTC) as a typical example. METHODS Ten experienced radiologists were eye tracked while observing eight 3D endoluminal CTC videos. Subsequently, we developed metrics that described their visual search patterns based on concepts derived from 2D gaze studies. Statistical methods were developed to allow analysis of the metrics. RESULTS Eye tracking was possible for all readers. Visual dwell on the moving region of interest (ROI) was defined as pursuit of the moving object across multiple frames. Using this concept of pursuit, five categories of metrics were defined that allowed characterization of reader gaze behaviour. These were time to first pursuit, identification and assessment time, pursuit duration, ROI size and pursuit frequency. Additional subcategories allowed us to further characterize visual search between readers in the test population. CONCLUSION We propose metrics for the characterization of visual search of 3D moving medical images. These metrics can be used to compare readers' visual search patterns and provide a reproducible framework for the analysis of gaze tracking in the 3D environment. ADVANCES IN KNOWLEDGE This article describes a novel set of metrics that can be used to describe gaze behaviour when eye tracking readers during interpretation of 3D medical images. These metrics build on those established for 2D eye tracking and are applicable to increasingly common 3D medical image displays.
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Affiliation(s)
- E Helbren
- Centre for Medical Imaging, University College London, London, UK
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Zaghloul M, Ahmed S, Eldebaway E, Mousa A, Amin A, Elkhateeb N, Sabry M, Ogiwara H, Morota N, Sufit A, Donson A, Birks D, Patel P, Foreman N, Handler M, Massimino M, Biassoni V, Gandola L, Schiavello E, Pecori E, Potepan P, Bach F, Janssens GO, Jansen MH, Lauwers SJ, Nowak PJ, Oldenburger FR, Bouffet E, Saran F, van Ulzen KK, van Lindert EJ, Schieving JH, Boterberg T, Kaspers GJ, Span PN, Kaanders JH, Gidding CE, Hargrave D, Bailey S, Howman A, Pizer B, Harris D, Jones D, Kearns P, Picton S, Saran F, Wheatley K, Gibson M, Glaser A, Connolly D, Hargrave D, Kawamura A, Nagashima T, Yamamoto K, Sakata J, Lober R, Freret M, Fisher P, Edwards M, Yeom K, Monje M, Jansen M, Aliaga ES, Van Der Hoeven E, Van Vuurden D, Heymans M, Gidding C, De Bont E, Reddingius R, Peeters-Scholte C, van Meeteren AS, Gooskens R, Granzen B, Paardekoper G, Janssens G, Noske D, Barkhof F, Vandertop WP, Kaspers G, Saratsis A, Yadavilli S, Nazarian J, Monje M, Freret M, Mitra S, Mallick S, Kim J, Beachy P, Nobre L, Vasconcelos F, Lima F, Mattos D, Kuiven N, Lima G, Silveira J, Sevilha M, Lima MA, Ferman S, Leblond P, Lansiaux A, Rialland X, Gentet JC, Geoerger B, Frappaz D, Aerts I, Bernier-Chastagner V, Shah R, Zaky W, Grimm J, Bluml S, Wong K, Dhall G, Caretti V, Schellen P, Lagerweij T, Bugiani M, Navis A, Wesseling P, Vandertop WP, Noske DP, Kaspers G, Wurdinger T, Lee H, Ziegler D, Schroeder K, Huang E, Berlow N, Patel R, Becher O, Taylor I, Mao XG, Hutt M, Weingart M, Kahlert U, Maciacyk J, Nikkhah G, Eberhart C, Raabe E, Barton K, Misuraca K, Misuraca K, Becher O, Zhou Z, Rotman L, Ho S, Souweidane M, Hutt M, Lim KJ, Warren K, Chang H, Eberhart C, Raabe E, Lightner D, Haque S, Souweidane M, Khakoo Y, Dunkel I, Gilheeney S, Kramer K, Lyden D, Wolden S, Greenfield J, De Braganca K, Ting-Rong H, Muh-Li L, Kai-Ping C, Tai-Tong W, Hsin-Hung C, Kebudi R, Cakir FB, Agaoglu FY, Gorgun O, Dizdar Y, Ayan I, Darendeliler E, Zapotocky M, Churackova M, Malinova B, Kodet R, Kyncl M, Tichy M, Stary J, Sumerauer D, Minturn J, Shu HK, Fisher M, Patti R, Janss A, Allen J, Phillips P, Belasco J, Taylor K, Baudis M, von Beuren A, Fouladi M, Jones C. DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG). Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Alberga AS, Goldfield GS, Kenny GP, Hadjiyannakis S, Phillips P, Prud'homme D, Tulloch H, Gougeon R, Wells GA, Sigal RJ. Healthy Eating, Aerobic and Resistance Training in Youth (HEARTY): study rationale, design and methods. Contemp Clin Trials 2012; 33:839-47. [PMID: 22548962 DOI: 10.1016/j.cct.2012.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/27/2012] [Accepted: 04/13/2012] [Indexed: 11/15/2022]
Abstract
PURPOSE The objective of the Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) trial (ClinicalTrials.Gov # NCT00195858) was to examine the effects of resistance training, with and without aerobic training, on percent body fat in sedentary, post-pubertal overweight or obese adolescents aged 14-18 years. This paper describes the HEARTY study rationale, design and methods. METHODS After a 4-week supervised low-intensity exercise run-in period, 304 overweight or obese adolescents with a body mass index≥85th percentile for age and sex were randomized to 4 groups for 22 weeks (5 months): diet+aerobic exercise, diet+resistance exercise, diet+combined aerobic and resistance exercise, or a diet only waiting-list control. All participants received dietary counseling designed to promote healthy eating with a maximum daily energy deficit of -250 kcal. OUTCOMES The primary outcome is percent body fat measured by Magnetic Resonance Imaging. Secondary outcomes include changes in anthropometry, regional body composition, resting energy expenditure, cardiorespiratory fitness, musculoskeletal fitness, cardiometabolic risk markers, and psychological health. SUMMARY To our knowledge, HEARTY is the largest clinical trial examining effects of aerobic training, resistance training, and combined aerobic and resistance training on changes in adiposity and cardiometabolic risk markers in overweight and obese adolescents. The findings will have important clinical implications regarding the role that resistance training should play in the management of adolescent obesity and its co-morbidities.
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Affiliation(s)
- A S Alberga
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada K1N 6N5
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SJ A, Z X, Fiala-Beer E, Phillips P, Goldstein D, Biankin A, Pirola R, Wilson JS, Apte MV. Abstract LB-395: Hepatocyte growth factor: a potential therapeutic target in pancreatic cancer. Cancer Res 2011. [DOI: 10.1158/1538-7445.am2011-lb-395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Pancreatic stellate cells (PSCs, which produce the desmoplastic reaction of pancreatic cancer) interact with pancreatic cancer (PC) cells to potentiate PC progression. A candidate factor that may mediate this interaction is the hepatocyte growth factor (HGF). High serum HGF levels in PC patients correlate with poor outcome. However, there is limited knowledge about the role of HGF in PC. Aims: To i) determine whether human PSCs and PC cell lines express HGF; and
ii) assess the effects of HGF inhibition on PC progression in an orthotopic mouse model.
Methods:
i) HGF expression in PSCs and PC cells assessed by RT-PCR, immunoblotting/immunocytochemistry.
ii) Orthotopic model: AsPC-1 (a human PC cell line) ± human PSCs implanted into the pancreas mice. One week later, mice divided into groups (n=8 mice/group) and treated with: HGF antibody AMG102 [(Amgen Inc.), 300 or 600μg IP biweekly] or isotype IgG (600 μg IP biweekly). Seven weeks later, tumour size and metastasis assessed.
Results:
i) PSCs express HGF at both mRNA and protein levels. In contrast, PC cells (MiaPaCa2, Panc-1, AsPC-1) express negligible HGF mRNA.
ii) Orthotopic model: a) IgG treated AsPC-1+PSC mice showed larger tumours than mice injected with AsPC-1 alone (Table); b) 300 and 600μg AMG102 inhibited tumour growth in AsPC-1+PSC mice compared to the IgG treated group. However, AMG102 did not reduce tumour size in mice injected with AsPC-1 alone (Table). c) 600μg AMG102 inhibited metastasis (liver, diaphragm, mediastinum) in AsPC-1+PSC mice (p<0.05) compared to IgG treated mice.
Conclusions: We have shown for the first time that i)human PSCs synthesise HGF; ii)HGF inhibition reduces tumour growth and metastasis of tumours representative of human PC i.e., exhibiting both tumour elements and a stromal reaction, but not in the clinically non-representative cancers formed by PC cells alone.
Implication: Targeting the stromal reaction with relevant specific inhibitors may represent a novel therapeutic approach in PC.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-395. doi:10.1158/1538-7445.AM2011-LB-395
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Lawton R, Gardner P, Green B, Davey C, Chamberlain P, Phillips P, Hughes G. An engineered solution to the maladministration of spinal injections. Qual Saf Health Care 2011; 18:492-5. [PMID: 19955463 DOI: 10.1136/qshc.2007.025767] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND An overview is provided of the progress made in a Department of Health (DH) initiative to implement an engineered solution to the maladministration of spinal injections. In an effort to eliminate the possibility of misconnection errors at the spinal route, the DH is investigating the potential for dedicated spinal equipment that will be incompatible with standard Luer syringes, needles and associated devices. METHOD Background information on the problem of misconnection errors is provided and a systematic approach to their eradication is detailed. Research to date has entailed extensive bench-testing of prototype non-Luer connectors, a prospective hazard analysis of spinal procedures in haematology and anaesthesia and usability evaluation of prototype non-Luer devices in simulated environments. RESULTS The prospective hazard analysis identified two potential risks which will need to be managed as part of a successful implementation programme. CONCLUSION Usability testing of two prototype connection systems concluded that one design was inadequate, as the non-Luer element was provided as a separable adapter. The second connection system was modified following the first round of testing, and achieved improved satisfaction ratings from clinicians in round two. This system was selected to proceed to a pre-implementation evaluation and the research team are currently evaluating its acceptability in clinical use.
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Affiliation(s)
- R Lawton
- Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT UK.
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Atlantis E, Goldney R, Eckert K, Taylor A, Phillips P. FC21-07 - Trends in health-related quality of life and health service use associated with comorbid diabetes and major depression in South Australia, 1998–2008. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73637-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
PurposeTo investigate trends in health-related quality of life and health service use associated with diabetes and/or major depression in South Australia from 1998 to 2008.MethodsData analyzed were from 9,059 persons aged ≥15 years who participated in representative surveys of the South Australian population in 1998, 2004 and 2008. Major depression was determined using the mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD). Diagnosed diabetes and health service use was determined by self-report. Health-related quality of life was assessed using the 36-item Short-Form Health Survey (SF-36) and the 15-item Assessment of Quality of Life (AQoL) instruments. Weighted age-standardized and multiple-adjusted means of dependent measures were computed.ResultsThe prevalence of diabetes only, major depression only, and comorbid diabetes and major depression increased by 74%, 36% and 53% from 1998 to 2008. Mean health-related quality of life scores were 9% to 41% lower (worse), and health service use was 49% higher for persons with comorbid diabetes and major depression than for those with diabetes only (all P-values < 0.05), consistently over the 10-year period.ConclusionsIf past trends continue, our results suggest that the population health and economic burden of comorbid diabetes and major depression will grow similarly over the next decade or so. These trends have important implications for making health policy and resource allocation decisions.
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Kojonazarov B, Sydykov A, Luitel H, Kosanovic D, Pullamsetti S, Tian X, Evans S, Phillips P, Davie N, Weissmann N, Grimminger F, Seeger W, Ghofrani HA, Schermuly RT. Effects of multi-kinase inhibitors on pulmonary vascular and right ventricular remodelling. Pneumologie 2011. [DOI: 10.1055/s-0031-1272117] [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: 10/18/2022]
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Abstract
Two field studies examined the calving patterns of cows in seasonal dairy herds in the Waikato (Field Study 1) and South Taranaki regions (Field Study 2). The first study examined patterns for cows commencing their second or subsequent lactation in herds which had used an inseminating service during the previous season. The second study included first lactation heifers only in 15 herds where animals had been naturally mated, and in 15 herds in which they had been synchronised and then artificially inseminated at the synchronised oestrus. The parameters describing calving patterns were based on the date for each herd's planned start of calving (PSC), which was 282 days from the date on which breeding commenced in the preceding season. The average interval from PSC to mean calving date for the 35 herds in Field Study 1 was 22 days, with individual herds ranging from 15 to 30 days. In herds with heifers which had been naturally mated (Field Study 2), it was 17.6 days compared to 11.0 days for previously synchronised animals. Calculating the intervals from PSC to median calving date and separately for the last two quartiles more effectively described a herd's calving pattern. The duration for the last quartile of the calving pattern was influenced by the extent and timing of induced calving. In Field Study 1, 88.6% of the 35 herd owners induced premature parturition in at least one cow. In these herds, 11.3% of cows were treated and calved prematurely. Only 61.7% of heifers which had previously been naturally mated calved by 3 weeks after PSC. Their calving dates were not evenly distributed over this 3-week period, with 9.8% in the first week and 25.6% in the third week. The calving pattern for heifers which had been previously synchronised showed several distinct peaks. Calvings to the synchronised mating were completed 15 days after PSC, by which time 64.7% of animals had calved. By 3 weeks after PSC, 72.9% of these heifers had calved. The results showed that there was considerable variation in calving patterns in seasonal dairy herds. This variation would have been due to differences in conception pattern, and the way induced calving had been applied. The calving pattern in heifers which had been naturally mated was less concentrated than had been expected. Synchronisation can significantly concentrate the calving pattern of these first lactation animals. The parameters used to describe calving patterns may be less applicable in herds in which a high proportion of animals is induced to calve prematurely, or where a whole herd is synchronised. Nonetheless, they do serve as an illustrative example of the variation in calving patterns among herds.
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Affiliation(s)
- K L Macmillan
- Dairying Research Corporation, c/- Ruakura Agricultural Centre, Hamilton, New Zealand
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Wolcott RD, Rumbaugh KP, James G, Schultz G, Phillips P, Yang Q, Watters C, Stewart PS, Dowd SE. Biofilm maturity studies indicate sharp debridement opens a time- dependent therapeutic window. J Wound Care 2010; 19:320-8. [PMID: 20852503 DOI: 10.12968/jowc.2010.19.8.77709] [Citation(s) in RCA: 270] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the hypothesis that newly formed wound biofilms (or bioburdens) are more susceptible to antimicrobial treatment. METHOD Four separate and distinct models were performed by four separate biofilm research laboratories to evaluate the resistance of biofilms to antimicrobial treatments over time. These included a drip-flow biofilm model along with a hydrodebridement study, a porcine skin punch biopsy ex vivo model, a mouse chronic wound model and clinical longitudinal debridement study. RESULTS All four models showed that, within the first 24 hours, the biofilm community was more susceptible to the selected antibiotics, and after maturing for up to 48 hours became increasingly tolerant. In each model, there was at least a 24-hour period in which the biofilms were more resistant to antibiotics. Each of the models utilised showed a significant decrease in the resistance of the biofilm/ burden to gentamicin for up to 24 hours with a confidence interval of at least 95%. The resistance increased in each of the models by 48 hours and reached original resistance levels by 72 hours. CONCLUSION These data suggest the principles of biofilm-based wound care, along with the use of serial debridement to continually remove mature biofilm, followed by biofilm wound management strategies, including topical antibiotics while the bioburden is still immature and more susceptible, are valid.
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Affiliation(s)
- R D Wolcott
- Southwest Regional Wound Care Center, Lubbock, TX, USA
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Rowan W, Austin M, Beno J, Ellis R, Feder R, Ouroua A, Patel A, Phillips P. Electron cyclotron emission diagnostic for ITER. Rev Sci Instrum 2010; 81:10D935. [PMID: 21033963 DOI: 10.1063/1.3496978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Electron temperature measurements and electron thermal transport inferences will be critical to the nonactive and deuterium phases of ITER operation and will take on added importance during the alpha heating phase. The diagnostic must meet stringent criteria on spatial coverage and spatial resolution during full field operation. During the early phases of operation, it must operate equally well at half field. The key to the diagnostic is the front end design. It consists of a quasioptical antenna and a pair of calibration sources. The radial resolution of the diagnostic is less than 0.06 m. The spatial coverage extends at least from the core to the separatrix with first harmonic O-mode being used for the core and second harmonic X-mode being used for the pedestal. The instrumentation used for the core measurement at full field can be used for detection at half field by changing the detected polarization. Intermediate fields are accessible. The electron cyclotron emission systems require in situ calibration, which is provided by a novel hot calibration source. The critical component for the hot calibration source, the emissive surface, has been successfully tested. A prototype hot calibration source has been designed, making use of extensive thermal and mechanical modeling.
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Affiliation(s)
- W Rowan
- Institute for Fusion Studies, The University of Texas at Austin, Austin, Texas 78712, USA.
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Gajjar AJ, Stewart CF, Ellison DW, Curran T, Phillips P, Goldman S, Packer R, Kun LE, Boyett JM, Gilbertson RJ. A phase I pharmacokinetic trial of sonic hedgehog (SHH) antagonist GDC-0449 in pediatric patients with recurrent or refractory medulloblastoma: A Pediatric Brain Tumor Consortium study (PBTC 25). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.18_suppl.cra9501] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
CRA9501 Background:Aberrant signaling in SHH pathway is implicated in causing medulloblastoma in approximately 20% of children with this disease. GDC-0449 is an orally active agent that binds to the SMO receptor and prevents downstream signaling through GLI. Preclinical murine models predict efficacy of an SMO antagonist to treat tumors dependent on the SHH pathway. Adult studies have documented the efficacy of this compound against recurrent medulloblastoma and basal cell carcinoma. A phase I pharmacokinetic trial of GDC 0449 was conducted in children with recurrent or refractory medulloblastoma to select, based on safety and pharmacokinetics, one of two dosages to recommend for a pediatric phase II trial. We also used immunonistochemistry (IHC) and in situ hybridization (ISH) on paraffin-embedded tissue to determine which tumors belonged to the SHH subtype. Methods: GDC 0449 was administered once daily for 28 days dose levels of (1) 85 mg/m2/dose and (2) 170 mg/m2/dose. A course was defined as 28 days in duration. PK analysis was performed during the first course and steady-state concentrations were obtained prior to each subsequent course (day 21). MRI scans of the knees were obtained at baseline and 3 mos to assess abnormalities in bone development. Results: To date 11 eligible patients have been enrolled on the trial (10 males, median age 11.6 years (range 4.4–20.9). All patients were fully evaluable for toxicity. 1 DLT, grade 3 gamma-Glutamyl transpeptidase, occurred in a patient enrolled at 170 mg/m2/dose. There were no grade 4 toxicities. The median (range) steady-state day 21 concentration at 85 mg/m2 (n=5) is 10.15 μ M (9.10–18.99 μ M) and at 170 mg/m2 (n=2) is 14.50 μ M (14.43–14.57 μ M). The steady-state GDC-0449 clearance (n=7) is 0.86 (0.44 – 1.17 L/h/m2). At steady state (day 21), the ratio of GDC-0449 CSF to plasma is 1.3%, which is an estimate of the CSF penetration of GDC-0449. Conclusions: GDC 0449 is well-tolerated in children with recurrent or refractory medulloblastoma. The phase I study estimating the recommended phase II dose of GDC 0449 is ongoing; final results including medulloblastoma subgroup data will be presented. [Table: see text]
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Affiliation(s)
- A. J. Gajjar
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - C. F. Stewart
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - D. W. Ellison
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - T. Curran
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - P. Phillips
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - S. Goldman
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - R. Packer
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - L. E. Kun
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - J. M. Boyett
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
| | - R. J. Gilbertson
- St. Jude Children's Research Hospital, Memphis, TN; Children's Hospital, Philadelphia, PA; Children's Memorial Hospital, Chicago, IL; Children's National Medical Center, Washington, DC
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Reid RD, Tulloch HE, Sigal RJ, Kenny GP, Fortier M, McDonnell L, Wells GA, Boulé NG, Phillips P, Coyle D. Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial. Diabetologia 2010; 53:632-40. [PMID: 20012857 DOI: 10.1007/s00125-009-1631-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 11/23/2009] [Indexed: 01/22/2023]
Abstract
AIMS/HYPOTHESIS The Diabetes Aerobic and Resistance Exercise (DARE) study showed that aerobic and resistance exercise training each improved glycaemic control and that a combination of both was superior to either type alone in patients with type 2 diabetes mellitus. Here we report effects on patient-reported health status and well-being in the DARE Trial. METHODS We randomised 218 inactive participants with type 2 diabetes mellitus in parallel to 22 weeks of aerobic exercise (n = 51), resistance exercise (n = 58), combined aerobic and resistance exercise (n = 57) or no exercise (control; n = 52). Intervention allocation was managed by a central office. Outcomes included health status as assessed by the physical and mental component scores of the Medical Outcomes Trust Short-Form 36-item version (SF-36) and well-being as measured by the Well-Being Questionnaire 12-item version (WBQ-12); these were measured at the Ottawa Hospital. RESULTS Using a p value of 0.0125 for statistical significance due to multiple comparisons, mixed model analyses indicated that resistance exercise led to clinically but not statistically significant improvements in the SF-36 physical component score compared with aerobic exercise (Delta = 2.7 points; p = 0.048) and control (i.e. no exercise; Delta = 3.3 points; p = 0.015). For mental component scores, there were clinically important improvements favouring no (control) compared with resistance (Delta = 7.6 points; p < 0.001) and combined (Delta = 7.2 points; p < 0.001) exercise. No effects on WBQ-12 scores were noted. Overall, 59/218 (27%) of participants included in this analysis sustained an adverse event during the course of the study, including 16 participants in the combined exercise group, 19 participants in the resistance exercise group, 16 participants in the aerobic exercise group, and eight participants in the control group. All participants were included in the intent-to-treat analyses. The trial is now closed to follow-up. CONCLUSIONS/INTERPRETATION Resistance exercise was better than aerobic or no exercise for improving physical health status in these patients. No exercise was superior to resistance or combined exercise for improving mental health status. Well-being was unchanged by intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT00195884 FUNDING This study was funded by the Canadian Institutes of Health Research (grant MCT-44155) and the Canadian Diabetes Association (The Lillian Hollefriend Grant).
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Affiliation(s)
- R D Reid
- University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada.
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Seth D, D'Souza El-Guindy NB, Apte M, Mari M, Dooley S, Neuman M, Haber PS, Kundu GC, Darwanto A, de Villiers WJ, Vonlaufen A, Xu Z, Phillips P, Yang S, Goldstein D, Pirola RM, Wilson JS, Moles A, Fernández A, Colell A, García-Ruiz C, Fernández-Checa JC, Meyer C, Meindl-Beinker NM. Alcohol, signaling, and ECM turnover. Alcohol Clin Exp Res 2010; 34:4-18. [PMID: 19860812 DOI: 10.1111/j.1530-0277.2009.01060.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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] [Indexed: 11/09/2023]
Abstract
Alcohol is recognized as a direct hepatotoxin, but the precise molecular pathways that are important for the initiation and progression of alcohol-induced tissue injury are not completely understood. The current understanding of alcohol toxicity to organs suggests that alcohol initiates injury by generation of oxidative and nonoxidative ethanol metabolites and via translocation of gut-derived endotoxin. These processes lead to cellular injury and stimulation of the inflammatory responses mediated through a variety of molecules. With continuing alcohol abuse, the injury progresses through impairment of tissue regeneration and extracellular matrix (ECM) turnover, leading to fibrogenesis and cirrhosis. Several cell types are involved in this process, the predominant being stellate cells, macrophages, and parenchymal cells. In response to alcohol, growth factors and cytokines activate many signaling cascades that regulate fibrogenesis. This mini-review brings together research focusing on the underlying mechanisms of alcohol-mediated injury in a number of organs. It highlights the various processes and molecules that are likely involved in inflammation, immune modulation, susceptibility to infection, ECM turnover and fibrogenesis in the liver, pancreas, and lung triggered by alcohol abuse.
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Affiliation(s)
- Devanshi Seth
- Drug Health Services & Centenary Institute, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
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Sharif R, Dawra R, Wasiluk K, Phillips P, Dudeja V, Kurt-Jones E, Finberg R, Saluja A. Impact of toll-like receptor 4 on the severity of acute pancreatitis and pancreatitis-associated lung injury in mice. Gut 2009; 58:813-9. [PMID: 19201771 DOI: 10.1136/gut.2008.170423] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Acute pancreatitis is an inflammatory disease involving acinar cell injury, and the rapid production and release of inflammatory cytokines, which play a dominant role in local pancreatic inflammation and systemic complications. Toll-like receptor 4 (TLR4) initiates a complex signalling pathway when it interacts with lipopolysaccharide (LPS), which ultimately results in a proinflammatory response. We hypothesised that TLR4 is important in the pathophysiology of acute pancreatitis, independently of LPS. Using two different models of acute pancreatitis, we investigated how genetic deletion of TLR4 or its co-receptor CD14 effects its progression and severity. METHODS We induced acute pancreatitis by administering either caerulein or L-arginine to wild-type, TLR4(-/-), and CD14(-/-) mice. Control mice received normal saline injections. The severity of acute pancreatitis was determined by measuring serum amylase activity, quantifying myeloperoxidase (MPO) activity in the pancreatic tissue, and histologically assessing acinar cell injury. RESULTS It was found that administering caerulein and L-arginine to wild-type mice resulted in acute pancreatitis (as assessed by hyperamylasaemia, oedema, increased pancreatic MPO activity, and pancreatic necrosis) and associated lung injury. The same treatment to TLR4(-/-) or CD14(-/-) mice resulted in significantly less severe acute pancreatitis, and reduced lung injury. We found no evidence of either bacteria or LPS in the blood or in pancreatic tissue. CONCLUSIONS The severity of acute pancreatitis is ameliorated in mice that lack either TLR4 or CD14 receptors. Furthermore, these results indicate that TLR4 plays a significant pro-inflammatory role independently of LPS in the progression of acute pancreatitis.
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Affiliation(s)
- R Sharif
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Phillips P, Cortina-Borja M, Gilbert R, Millar M, Kempley S. Risk stratification by level of care for comparing bloodstream infection rates in neonatal intensive care units. J Hosp Infect 2009; 72:181-3. [DOI: 10.1016/j.jhin.2009.01.018] [Citation(s) in RCA: 3] [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] [Received: 10/03/2008] [Accepted: 01/16/2009] [Indexed: 10/21/2022]
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Bharali DJ, Yalcin M, Dier U, Mousa S, Mousa S, Hanko C, Phillips P, Mousa SA. Nanoparticle-targeted delivery of nonanticoagulant heparin and doxorubicin in doxorubicin-resistant breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e11599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e11599 Background: In comparison to low molecular weight heparin (LMWH), non-anticoagulant heparin (NACH), originally developed in our laboratory, has minimal effects on hemostasis. Encapsulation of chemotherapeutic agents and NACH in biodegradable nanoparticles has tremendous potential in improving survival among the breast cancer patients. Furthermore, custom-made nanoparticles with a targeted moiety on the surface would enable us to increase the efficacy and decrease the adverse effects of doxorubicin. Methods: PLGA-PEG nanoparticles co-encapsulating NACH and doxorubicin were synthesized by double emulsion solvent evaporation method. The in vitro efficacy of these nanoparticles was examined in MCF-7 doxorubicin resistant (MCF-7R) cells using MTT cell viability assay. Confocal microscopy was used to examine the uptake of αvβ3 antibody conjugated nanoparticles in human dermal microvascular endothelial cells (HDMEC), which are known to over express αvβ3 integrins. Results: Size measurement by DLS revealed that these nanoparticles co-encapsulating doxorubicin and heparins to be 200–300 nm in size. Data from the MTT assays in MCF-7R cells showed synergy between NACH and doxorubicin when encapsulated in PLGA-PEG nanoparticles. Confocal imaging in HDMEC cells indicates that these nanoparticles have the potential to be used for site specific delivery to the tumor neovascularization. In vivo data in nude mice xenograft (MCF-7R) are shown in the table below (doses of doxorubicin and NACH injected subcutaneously were 0.625 mg/kg and 2.5 mg/kg body weight, respectively). Significant decrease in tumor weight was observed in the mice xenograft, when treated with αvβ3 conjugated nanoparticles co-encapsulating doxorubcin or to greater extent doxorubicin and NACH compares to its non encapsulated counterparts. Conclusions: These data indicated distinct improvement in the anti-tumor efficacy using αvβ3site directed delivery doxorubicin and NACH encapsulted in PLGA-PEG nanoparticles. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- D. J. Bharali
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - M. Yalcin
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - U. Dier
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - S. Mousa
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - S. Mousa
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - C. Hanko
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - P. Phillips
- The Pharmaceutical Research Institute, Rensselaer, NY
| | - S. A. Mousa
- The Pharmaceutical Research Institute, Rensselaer, NY
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Phillips P, Yalcin M, Cui H, Abdel-Nabi HH, Sajjad M, Bernacki R, Mousa S. Effects of novel heparin-derived compounds on tumor uptake of chemotherapeutics and chemoresponse. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2537] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2537 Thrombotic complications are the second most common cause of mortality in cancer patients and fibrin deposition in the tumor microenvironment might play a key role in tumor progression and inference with tumor chemotherapeutic uptake. Treatments that target these processes may result in improved uptake of chemotherapeutic agents and subsequent inhibition of tumor growth and metastasis. Tissue Factor (TF) is frequently associated with aggressive behavior and poor outcome in tumors. We have previously demonstrated potent anti-tumor efficacy for various mechanisms that interfere with TF/VIIa. The purpose of this study was to investigate the effects of low molecular weight heparins (LMWH) and sulfated non-anticoagulant LMWH (S-NACH) on tumor chemotherapeutic uptake. Studies: (1) Nude mice xenograft A549 human lung carcinoma: LMWH or S-NACH at 10 mg/kg S.C. daily effectively limited tumor growth. (2) LCC6 human lung tumor xenograft model: Paclitaxel alone or in combination with Tinzaparin or S-NACH on tumor re-growth after discontinuation of treatment: Paclitaxel + S-NACH treatment showed significant (P<0.01) tumor growth suppression and improved survival when compared to Paclitaxel. (3) Biodistribution studies: animals were injected with LMWH S.C. daily for 5 days (10 mg/kg) then injected i.v. with [124-I]-Paclitaxel. LMWH increased [124-I]-Paclitaxel uptake into LCC6 tumors with tumor: muscle ratios several fold greater than that of [124-I]-Paclitaxel alone at 24 hrs post injection. This is a highly significant result in the light of the fact that the FDA criterion for a clinically meaningful effect is a 15% increase in uptake. (4) HPLC studies of tumor uptake of Doxorubicin (DOX in mice treated with 10 mg/kg of LMWH or S-NACH for 10 days followed by Doxorubicin (2.5 mg/kg). Both LMWH and S-NACH significantly (P<0.01) increased the uptake of chemotherapeutic agent DOX in MCF7 DOX resistant tumors by 1.5–2 folds but not in heart or lung tissues, confirming the findings obtained with another agent [124-I]-Paclitaxel. Conclusions: LMWH or S-NACH increased chemotherapeutics uptake and hence chemoresponse. Protocols utilizing adjuvant or neo-adjuvant therapy with LMWH or S-NACH could lead to increase tumor chemo responsiveness and overcoming tumor chemo resistance. No significant financial relationships to disclose.
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Affiliation(s)
- P. Phillips
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
| | - M. Yalcin
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
| | - H. Cui
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
| | - H. H. Abdel-Nabi
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
| | - M. Sajjad
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
| | - R. Bernacki
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
| | - S. Mousa
- Vascular Vision Pharmaceuticals Co., Rensselaer, NY; The Pharmaceutical Research Institute, Rensselaer, NY; University at Buffalo, Buffalo, NY; Roswell Park, Buffalo, NY; Albany College of Pharmacy, Albany, NY
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Phillips P, Lee JK, Wang C, Yoshida E, Lima VD, Montaner J. Chylous ascites: a late complication of intra-abdominal Mycobacterium avium complex immune reconstitution syndrome in HIV-infected patients. Int J STD AIDS 2009; 20:285-7. [DOI: 10.1258/ijsa.2008.008275] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chylous ascites related to Mycobacterium avium complex (MAC) in HIV-infected patients is rare, with only six cases reported in the English literature. We report a series of six cases from a single institution. During the past six years, chylous ascites was diagnosed in six (35%) of 17 AIDS patients, all of whom had previously been diagnosed with intra-abdominal MAC immune reconstitution syndrome (MAC-IRS). A review of medical records identified no other cases of chylous ascites among HIV-positive patients over the past 13 years (1994–2007), and the incidence was estimated at one in 2248 HIV-positive admissions. The ascitic fluid had a milky appearance and a median triglyceride level of 4.07 mmol/L (range 3.19–29.6 mmol/L) (360 mg/dL, range 282–2620 mg/dL). After a median follow-up of 20 months, five (83%) of six patients survived. Chylous ascites is a late complication of intra-abdominal MAC-IRS, and is usually associated with a favourable prognosis.
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Affiliation(s)
- P Phillips
- Division of Infectious Diseases
- British Columbia Center for Excellence in HIV/AIDS
- St Paul's Hospital
| | - J K Lee
- Department of Medicine, University of British Columbia
| | - C Wang
- Division of Gastroenterology, University of Toronto
| | - E Yoshida
- Division of Gastroenterology, Vancouver General Hospital
| | - V D Lima
- British Columbia Center for Excellence in HIV/AIDS
| | - J Montaner
- British Columbia Center for Excellence in HIV/AIDS
- St Paul's Hospital
- Division of AIDS, University of British Columbia, Vancouver, BC, Canada
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Schimke K, Chubb SAP, Davis WA, Phillips P, Davis TME. Antiplatelet therapy, Helicobacter pylori infection and complicated peptic ulcer disease in diabetes: the Fremantle Diabetes Study. Diabet Med 2009; 26:70-5. [PMID: 19125763 DOI: 10.1111/j.1464-5491.2008.02637.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To assess whether, based on its relationship with complications of peptic ulcer disease (PUD), directed Helicobacter pylori serological screening is justified in diabetic patients prior to commencement of antiplatelet therapy. METHODS We analysed data from the longitudinal, community-based Fremantle Diabetes Study (FDS). The present substudy included (i) 1301 patients (91.2% of the total FDS sample; mean age 62.0 +/- 13.3 years, 49.5% male) with available sera from baseline assessment between 1993 and 1996, and (ii) a subset of 40 patients admitted to hospital for complicated PUD (bleeding and/or perforation) between baseline and end of June 2006. All hospital admissions for complicated PUD in the population of Western Australia were identified over the same period. Helicobacter pylori IgG antibodies were measured in all patients at baseline and in the subset at the FDS visit prior to hospital admission. RESULTS Helicobacter pylori seropositivity was present in 60.6% of FDS patients at baseline and was independently associated with increasing age and non-Anglo-Celt/non-Asian ethnicity. There were 2.9 (95% confidence interval 2.1, 3.9) first admissions for complicated PUD per 1000 patient-years, an incidence more than seven times that in the local general population. Independent baseline predictors of hospital admission were increasing age, serum urea, non-aspirin anticoagulant therapy, sulphonylurea therapy, peripheral arterial disease and diabetic retinopathy, but not aspirin use, H. pylori seropositivity or their interaction. CONCLUSIONS There are diabetes-specific risk factors for complicated PUD, including sulphonylurea use and vascular complications. Knowledge of H. pylori serological status does not predict complicated PUD in diabetes regardless of use of antiplatelet therapy.
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Affiliation(s)
- K Schimke
- University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, Australia
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Abstract
This paper describes a pilot study undertaken in a major acute trust investigating reduction of bacterial contamination in a healthcare environment attributable to the use of silver antimicrobial (BioCote®) technology. The four month study assessed the impact of various BioCote®-treated products on the counts of viable bacteria cultured from the treated environment compared to a control. A mean reduction in bacterial counts of 95.8% was demonstrated on the BioCote®treated surfaces compared with untreated surfaces. A mean reduction of 43.5% was demonstrated on untreated products positioned in the same environment as BioCote®-treated products compared with control untreated products. This suggests decontamination is not limited to treated materials but can extend to the wider environment because of the presence of antimicrobial materials. In the light of increasing evidence implicating the role of the environment in healthcare acquired infection, the potential of BioCote®-treated products to provide an additional infection control mechanism is highlighted.
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Affiliation(s)
- L. Taylor
- Microbiologist, BioCote Ltd, Wolverhampton Science Park, Technology Centre, Glashier Drive, Wolverhampton WV10 9RU
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Baselga J, van Dam PA, Greil R, Gardner H, Bandaru R, Molloy B, Steinseifer J, Phillips P, Dixon JM, Rugo HS. Improved clinical and cell cycle response with an mTOR inhibitor, daily oral RAD001 (everolimus) plus letrozole versus placebo plus letrozole in a randomized phase II neoadjuvant trial in ER+ breast cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.530] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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