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Coldwell M, Morrison N, Nichols C, Sutherland S, Chiasson M. 236 Screening for celiac disease in people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00926-2] [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: 11/05/2022]
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2
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Foss L, Brown SA, Sutherland S, Miller CJ, Philliber S. A randomized controlled trial of the impact of the Teen Council peer education program on youth development. Health Educ Res 2022; 37:36-47. [PMID: 35134906 DOI: 10.1093/her/cyac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
This paper presents results of an impact evaluation of Teen Council, a program that trains youth as peer educators. Teen Council is designed to help peer educators make healthy sexual and reproductive decisions, increase their confidence and abilities to educate their peers and inspire them to advocate for just sexual policies. The program's impact on these educators was evaluated using a randomized controlled trial. Over 5 years, interested high school students in seven states were randomly assigned to a study condition. An intent-to-treat framework using ordinary least square (OLS) regression was employed to measure program effects. Relative to control, Teen Council youth showed enhanced comfort with their own sexuality, greater comfort with and more frequent communication with parents about sexuality and more positive sexual health behaviors, including accessing reproductive health care and adopting more effective means of contraception. Teen Council youth also reported greater confidence in talking with peers about sexuality and more confidence in their civic engagement skills.
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Affiliation(s)
- L Foss
- Philliber Research & Evaluation, 16 Main Street, Accord, NY 12404, USA
| | - S A Brown
- Philliber Research & Evaluation, 16 Main Street, Accord, NY 12404, USA
| | - S Sutherland
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, 2001 E. Madison, Seattle, WA 98122, USA
| | - C J Miller
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, 2001 E. Madison, Seattle, WA 98122, USA
| | - S Philliber
- Philliber Research & Evaluation, 16 Main Street, Accord, NY 12404, USA
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Martens F, De Wachter S, Van Breda J, Witte L, Brits T, Smits M, Padron O, Sutherland S, Toozs-Hobson P, Digesu A, Cline K, Dmochowski R, Heesakkers J. OASIS pivotal trial to evaluate the safety and efficacy of the RENOVA iStim System™ for the treatment of women with overactive bladder. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00530-9] [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: 11/16/2022]
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El-Rabbany M, Blanas N, Sutherland S, Shah PS, Lam DK, Azarpazhooh A. Development and evaluation of the clinimetric properties of the Medication-Related Osteonecrosis of the Jaw Quality of Life Questionnaire (MRONJ-QoL). Int J Oral Maxillofac Surg 2021; 51:768-775. [PMID: 34924268 DOI: 10.1016/j.ijom.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/10/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to develop a self-administered questionnaire (MRONJ-QoL) to assess the quality of life (QoL) of patients with medication-related osteonecrosis of the jaw (MRONJ). A prospective study was performed to develop and evaluate the questionnaire. The MRONJ-QoL was formulated through a review of the literature and interviews of experts and patients. Following development, it was administered to 60 patients with a diagnosis of MRONJ. The sensibility of the questionnaire was assessed by evaluating feasibility (via interviews of patients), face validity (via interviews of patients and experts), and content validity (via evaluation of internal consistency, floor/ceiling effects, and factor analysis). Reliability was evaluated by measuring intra-rater reliability. Construct validity of the questionnaire was evaluated by both cross-sectional and longitudinal comparisons, including comparing scores of the MRONJ-QoL to disease resolution at 6 months. The final MRONJ-QoL questionnaire consisted of 14 questions, demonstrating high internal consistency (Cronbach's alpha of 0.85) and good reliability (weighted kappa score of 0.65). At the 6-month follow-up, disease resolution was found to be significantly associated with improved MRONJ-QoL scores, suggesting validity of the questionnaire (P < 0.01). Therefore, this is a sensible, reliable, and valid questionnaire for evaluating the QoL of patients with MRONJ.
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Affiliation(s)
- M El-Rabbany
- Florida Craniofacial Institute, Tampa, Florida, USA
| | - N Blanas
- Department of Dentistry, Sunnybrook Hospital, Toronto, Ontario, Canada; Department of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - S Sutherland
- Department of Dentistry, Sunnybrook Hospital, Toronto, Ontario, Canada; Department of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - P S Shah
- Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada; Institute of Health, Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - D K Lam
- Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York, USA; Department of Surgery, Stony Brook School of Medicine, Stony Brook, New York, USA; Stony Brook Cancer Center, Stony Brook, New York, USA
| | - A Azarpazhooh
- Department of Dentistry, University of Toronto, Toronto, Ontario, Canada; Divisions of Endodontics and Research, Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
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Liedl B, Grigoryan N, Witczak M, Sutherland S, Tuchenhagen K, Roovers JP. Symptome von über-, unteraktiver Blase, Stuhlinkontinenz, Stuhlentleerungsstörung und Schmerzen treten häufig koexistierend bei Frauen mit vaginalem Prolaps auf und können durch vaginale ligamentäre Prolapskorrektur geheilt werden. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- B Liedl
- Urologische Klinik Planegg, Beckenbodenzentrum Planegg
| | - N Grigoryan
- Urologische Klinik Planegg, Beckenbodenzentrum Planegg
| | - M Witczak
- Urologische Klinik Planegg, Beckenbodenzentrum Planegg
| | - S Sutherland
- The Pelvic Health Center, University of Washington, Urology
| | - K Tuchenhagen
- Urologische Klinik Planegg, Beckenbodenzentrum München
| | - J.-P Roovers
- University of Amsterdam, Academic Medical Centre, Gynecology
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Golea DM, Jarvis P, Jefferson B, Moore G, Sutherland S, Parsons SA, Judd SJ. Influence of granular activated carbon media properties on natural organic matter and disinfection by-product precursor removal from drinking water. Water Res 2020; 174:115613. [PMID: 32092546 DOI: 10.1016/j.watres.2020.115613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/05/2020] [Accepted: 02/10/2020] [Indexed: 06/10/2023]
Abstract
Operational and financial constraints challenge effective removal of natural organic matter (NOM), and specifically disinfection by-product (DBP) precursors, at remote and/or small sites. Granular activated carbon (GAC) is a widely used treatment option for such locations, due to its relatively low maintenance and process operational simplicity. However, its efficacy is highly dependent on the media capacity for the organic matter, which in turn depends on the media characteristics. The influence of GAC media properties on NOM/DBP precursor removal has been studied using a range of established and emerging media using both batch adsorption tests and rapid small-scale column tests. DBP formation propensity (DBPFP) was measured with reference to trihalomethanes (THMs) and haloacetic acids (HAAs). All GAC media showed no selectivity for specific removal of precursors of regulated DBPs; DBP formation was a simple function of residual dissolved organic carbon (DOC) levels. UV254 was found to be a good surrogate measurement of DBPFP for an untreated water source having a high DOC. Due to the much-reduced concentration of DBP precursors, the correlation was significantly poorer for the coagulation/flocculation-pretreateed water source. Breakthrough curves generated from the microcolumn trials revealed DOC removal and consequent DBP reduction to correlate reasonably well with the prevalence pores in the 5-10 nm range. A 3-6 fold increase in capacity was recorded for a 0.005-0.045 cm3/g change in 5-10 nm-sized pore volume density. No corresponding correlation was evident with other media pore size ranges.
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Affiliation(s)
- D M Golea
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | - P Jarvis
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | - B Jefferson
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | - G Moore
- Scottish Water, Edinburgh, Scotland, UK
| | | | | | - S J Judd
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK.
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Kosmin M, Padhani A, Gogbashian A, Woolf D, Ah-See ML, Ostler P, Sutherland S, Miles D, Noble J, Marshall A, Dunn J, Makris A. Response evaluation of cancer therapeutics in metastatic breast cancer to the bone: A single arm phase II study of whole-body magnetic resonance imaging. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.311] [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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Ray-Chaudhuri N, Voros GM, Sutherland S, Figueiredo FC. Comparison of the Effect of Sodium Hyaluronate (Ophthalin®) and Hydroxypropylmethylcellulose (HPMC-Ophtal®) on Corneal Endothelium, Central Corneal Thickness, and Intraocular Pressure after Phacoemulsification. Eur J Ophthalmol 2018; 16:239-46. [PMID: 16703541 DOI: 10.1177/112067210601600208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To prospectively evaluate the effects of 2% hydroxypropyl-methylcellulose (HPMC-Ophtal) and sodium hyaluronate 1% (Ophthalin) on intraocular pressure, corneal thickness, and endothelial cell loss in small incision cataract surgery with implant. METHODS A total of 110 patients undergoing routine phacoemulsification with implant received either 2% hydroxypropyl methylcellulose or sodium hyaluronate 1% as ophthalmic viscosurgical device. Pre- and postoperative slitlamp examination, intraocular pressure measurement (preoperatively and at 1-4 hours, 1 day, and 7 days postoperatively), ultrasonic pachymetry (preoperatively and at 1 week, 4-6 weeks, and 12 weeks post operatively), and corneal endothelial cell count (preoperatively and 12 weeks postoperatively) were performed. Data were analyzed using two-way analysis of variance. RESULTS All measurements were comparable between the two groups preoperatively. Intraocular pressure was significantly lower in the Ophthalin group at 1 day post operatively, while no significant difference was found between the two groups on the 1-4 hours and 7 days examination. The central corneal thickness was not significantly different between the two groups at any postoperative visit . However, the mean cell density demonstrated a significant fall of 11.76% for Ophthalin and 4.27% for HPMC-Ophtal at 12 weeks post-operatively, the difference between the two being significant (p=0.009). CONCLUSIONS 2% Hydroxypropyl methylcellulose, compared with sodium hyaluronate 1%, is superior in protecting the corneal endothelial cells, has the same effect on central corneal thickness, and is associated with slightly higher intraocular pressure 1 day post operatively. It compares favorably with sodium hyaluronate 1% and can be used as an effective and cheaper alternative in routine small incision cataract surgery with implant.
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Affiliation(s)
- N Ray-Chaudhuri
- Department of Ophthalmology, Royal Victoria Infirmary, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
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Crolley V, Marashi H, Rawther S, Parton M, Graham J, Vinayan A, Sutherland S, Rigg A, Wadhawan A, Harper-Wynne C, Spurrell E, Bond H, Raja F, King J. The impact of Oncotype DX breast cancer assay results on clinical practice: A UK experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.038] [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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10
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Golea DM, Upton A, Jarvis P, Moore G, Sutherland S, Parsons SA, Judd SJ. THM and HAA formation from NOM in raw and treated surface waters. Water Res 2017; 112:226-235. [PMID: 28167408 DOI: 10.1016/j.watres.2017.01.051] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/20/2017] [Accepted: 01/25/2017] [Indexed: 05/09/2023]
Abstract
The disinfection by-product (DBP) formation potential (FP) of natural organic matter (NOM) in surface water sources has been studied with reference to the key water quality determinants (WQDs) of UV absorption (UV254), colour, and dissolved organic carbon (DOC) concentration. The data set used encompassed raw and treated water sampled over a 30-month period from 30 water treatment works (WTWs) across Scotland, all employing conventional clarification. Both trihalomethane (THM) and haloacetic acid (HAA) FPs were considered. In addition to the standard bulk WQDs, the DOC content was fractionated and analysed for the hydrophobic (HPO) and hydrophilic (HPI) fractions. Results were quantified in terms of the yield (dDBPFP/dWQD) and the linear regression coefficient R2 of the yield trend. The NOM in the raw waters was found to comprise 30-84% (average 66%) of the more reactive HPO material, with this proportion falling to 18-63% (average 50%) in the treated water. Results suggested UV254 to be as good an indicator of DBPFP as DOC or HPO for the raw waters, with R2 values ranging from 0.79 to 0.82 for THMs and from 0.71 to 0.73 for HAAs for these three determinants. For treated waters the corresponding values were significantly lower at 0.52-0.67 and 0.46-0.47 respectively, reflecting the lower HPO concentration and thus UV254 absorption and commensurately reduced precision due to the limit of detection of the analytical instrument. It is concluded that fractionation offers little benefit in attempting to discern or predict chlorinated carbonaceous DBP yield for the waters across the geographical region studied. UV254 offered an adequate estimate of DBPFP based on a mean yield of ∼2600 and ∼2800 μg per cm-1 absorbance for THMFP for the raw and treated waters respectively and ∼3800 and2900 μg cm-1 for HAAFP, albeit with reduced precision for the treated waters.
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Affiliation(s)
- D M Golea
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | - A Upton
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | - P Jarvis
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | - G Moore
- Scottish Water, Edinburgh, Scotland, UK
| | | | | | - S J Judd
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK; Gas Processing Center, Qatar University, Qatar.
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Abstract
PURPOSE Numerous studies evaluate the use of social media as an open-learning resource in education, but there is a little published knowledge of empirical evidence that such open-learning resources produce educative outcomes, particularly with regard to student performance. This study undertook a systematic review of the published literature in medical education to determine the state of the evidence as to empirical studies that conduct an evaluation or research regarding social media and open-learning resources. METHODS The authors searched MEDLINE, ERIC, Embase, PubMed, Scopus, and Google Scholar from 2012 to 2017. This search included using keywords related to social media, medical education, research, and evaluation, while restricting the search to peer reviewed, English language articles only. To meet inclusion criteria, manuscripts had to employ evaluative methods and undertake empirical research. RESULTS Empirical work designed to evaluate the impact of social media as an open-learning resource in medical education is limited as only 13 studies met inclusion criteria. The majority of these studies used undergraduate medical education as the backdrop to investigate open-learning resources, such as Facebook, Twitter, and YouTube. YouTube appears to have little educational value due to the unsupervised nature of content added on a daily basis. Overall, extant reviews have demonstrated that we know a considerable amount about social media use, although to date, its impacts remain unclear. CONCLUSION There is a paucity of outcome-based, empirical studies assessing the impact of social media in medical education. The few empirical studies identified tend to focus on evaluating the affective outcomes of social media and medical education as opposed to understanding any linkages between social media and performance outcomes. Given the potential for social media use in medical education, more empirical evaluative studies are required to determine educational value.
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Affiliation(s)
- S Sutherland
- Department of Critical Care, The Ottawa Hospital
| | - A Jalali
- Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Correspondence: A Jalali, Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada, Tel +1 613 562 5800 ext 5782, Fax +1 613 562 5687, Email
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Sutherland S, Miles D, Makris A. Use of maintenance endocrine therapy after chemotherapy in metastatic breast cancer. Eur J Cancer 2016; 69:216-222. [PMID: 27847222 DOI: 10.1016/j.ejca.2016.09.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/30/2016] [Accepted: 09/13/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND For women with oestrogen receptor+ metastatic breast cancer (MBC), the options for systemic treatment include endocrine therapy (ET) and chemotherapy. For women whose disease is also HER2+, anti-HER2 therapies are also routinely used either with chemotherapy or less commonly with ET. Where chemotherapy is used as initial therapy, treatment is often discontinued due to cumulative toxicity in the absence of disease progression. In this setting, there is the option of introducing ET with the aim of prolonging response and delaying relapse. METHODS Literature review revealed four trials addressing the question of whether there is a benefit from introducing ET following chemotherapy for MBC. We also sought evidence for alternative approaches, including concurrent chemotherapy and ET and continuing chemotherapy until disease progression. RESULTS The evidence for the use of ET after chemotherapy in MBC is limited, and the trials done were small. Furthermore, they were performed at a time when both the chemotherapy regimens and ET were different from those used currently. Despite these limitations, there is probably a modest improvement in time to progression for the sequential use of ET after chemotherapy but with no overall survival benefit. An alternative approach, particularly considering agents with relatively low toxicity, such as orally bioavailable fluoropyrimidines, is to continue chemotherapy until disease progression. CONCLUSION Where chemotherapy for MBC is discontinued due to toxicity, in the absence of progression, the use of ET, with its relatively low toxicity, is a reasonable approach with the aim of delaying relapse.
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Affiliation(s)
- S Sutherland
- Breast Cancer Research Unit, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK
| | - D Miles
- Breast Cancer Research Unit, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK
| | - A Makris
- Breast Cancer Research Unit, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK.
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Golea D, Sutherland S, Jarvis P, Judd SJ. Pilot-scale spiral wound membrane assessment for THM precursor rejection from upland waters. SEP SCI TECHNOL 2016; 51:1380-1388. [PMID: 27695148 PMCID: PMC5020326 DOI: 10.1080/01496395.2016.1162807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/03/2016] [Indexed: 11/24/2022]
Abstract
The outcomes of a pilot-scale study of the rejection of trihalomethanes (THMs) precursors by commercial ultrafiltration/nanofiltration (UF/NF) spiral-wound membrane elements are presented based on a single surface water source in Scotland. The study revealed the expected trend of increased flux and permeability with increasing pore size for the UF membranes; the NF membranes provided similar fluxes despite the lower nominal pore size. The dissolved organic carbon (DOC) passage decreased with decreasing molecular weight cut-off, with a less than one-third the passage recorded for the NF membranes than for the UF ones. The yield (weight % total THMs per DOC) varied between 2.5% and 8% across all membranes tested, in reasonable agreement with the literature, with the aromatic polyamide membrane providing both the lowest yield and lowest DOC passage. The proportion of the hydrophobic (HPO) fraction removed was found to increase with decreasing membrane selectivity (increasing pore size), and THM generation correlated closely (R2 = 0.98) with the permeate HPO fractional concentration.
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Affiliation(s)
- D Golea
- Scottish Water, Edinburgh, Scotland; Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK
| | | | - P Jarvis
- Cranfield Water Science Institute, Cranfield University , Bedfordshire , UK
| | - S J Judd
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, UK; Gas Processing Center, Qatar University, Doha, Qatar
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Sutherland S, Parsons S, Daneshkhah A, Jarvis P, Judd S. THM precursor rejection by UF membranes treating Scottish surface waters. Sep Purif Technol 2015. [DOI: 10.1016/j.seppur.2015.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bhattacharya I, Hussain T, Kadam M, Sutherland S, Ho A, Bernhardt V, Ah-See M, Shah N, Ostler P, Miles D, Makris A. Eligibility for Entry into First Line Metastatic Trials in Patients with Disease Recurrence within 12 Months of Adjuvant Chemotherapy for Early Stage Breast Cancer. Clin Oncol (R Coll Radiol) 2015. [DOI: 10.1016/j.clon.2015.01.016] [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: 10/23/2022]
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16
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Charbonney E, Wilcox E, Shan Y, d'Empaire PP, Dugal A, Glogauer M, Rubenfeld GD, Sutherland S, Lilles C, Dos Santos C. 0450. Systemic dysregulation of the angiopoietin-1/2 system in adults undergoing cardiopulmonary bypass (CBP). Intensive Care Med Exp 2014. [PMCID: PMC4798599 DOI: 10.1186/2197-425x-2-s1-o13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Borooah S, Grant B, Blaikie A, Styles C, Sutherland S, Forrest G, Curry P, Legg J, Walker A, Sanders R. Using electronic referral with digital imaging between primary and secondary ophthalmic services: a long term prospective analysis of regional service redesign. Eye (Lond) 2012; 27:392-7. [PMID: 23258310 DOI: 10.1038/eye.2012.278] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Demands on publicly funded ophthalmic services worldwide continue to increase with new treatments, waiting time targets, working time limits, and restricted budgets. These highlight the necessity to develop innovative ways of utilising existing capacity more effectively. METHOD A new regional, fully electronic ophthalmic-referral service with digital imaging was trialled using existing information-technology (IT) infrastructure. Following successful pilot study, the service was rolled out regionally. Service delivery data was prospectively collated for all the attendances in the year prior to (2006) and the year following (2008) introduction. RESULTS Comparing 2006 against 2008, median waiting times reduced (14 vs 4 weeks), and fewer new patients were observed (8714 vs 7462 P<0.0001), with 1359 referrals receiving electronic diagnosis (e-diagnosis). New patient did not arrive (635 vs 503 P<0.0001) and emergencies also reduced (2671 v 1984 P<0.0001). DISCUSSION Novel use of existing IT infrastructure improves communication between primary and secondary care. This promotes more effective use of limited outpatient capacity by retaining patients with non-progressive, asymptomatic pathology in the community, whilst fast-tracking patients with sight-threatening disease. Resultant significant, sustained improvements in regional service delivery point to a simple model that could easily be adopted by other providers of universal healthcare globally.
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Affiliation(s)
- S Borooah
- Princess Alexandra Eye Pavilion, Edinburgh, UK.
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Calder-Sprackman S, Doja A, Sutherland S. The Portrayal of Tourette's Syndrome in Film and Television (P06.041). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Wilcox ME, Perez P, DosSantos C, Glogauer M, Charbonney E, Duggal A, Sutherland S, Rubenfeld G. Oral neutrophil quantitation in patients undergoing elective cardiopulmonary bypass. Crit Care 2012. [PMCID: PMC3363433 DOI: 10.1186/cc10622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Stanford E, Courtieu C, Roovers JP, Zylstra S, Lukban J, Bataller E, Sutherland S. Elevate Anterior/Apical Pelvic Organ Prolapse Repair Is Effective When Performed with Uterine Preservation. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Stanford E, Moore R, Roovers JP, Giudice T, Lukban J, Bataller E, Mayne C, Sutherland S. One-Year Safety and Efficacy of Elevate® Anterior and Apical (EAA) with IntePro® Lite™ in the Surgical Treatment of Pelvic Organ Prolapse. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.189] [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: 11/29/2022]
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Ouellet D, Sutherland S, Wang T, Griffini P, Murthy V. First-time-in-human study with GSK1018921, a selective GlyT1 inhibitor: relationship between exposure and dizziness. Clin Pharmacol Ther 2011; 90:597-604. [PMID: 21866096 DOI: 10.1038/clpt.2011.154] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The pharmacokinetics (PK), safety, and tolerability of GSK1018921, a glycine transporter 1 (GlyT-1) inhibitor, were assessed in this first-time-in-human (FTIH) study. Single oral doses ranging from 0.5 to 280 mg and placebo were administered to 25 healthy subjects in a five-period, two-cohort, crossover study. GSK1018921 showed dose-proportional PK with a terminal half-life of ~17 h. The subjects reported dizziness with a dose-dependent frequency of 22-88% at doses of 70-280 mg. The time course of the dizziness paralleled the PK of the drug, with peak response at 2 h after the dose, consistent with time to maximum plasma concentration (T(max)). The dizziness was resolved by 10-12 h in all subjects. A Markov-chain logistic regression model was implemented in NONMEM to determine the probability of developing dizziness as a function of the plasma concentration of the compound. Frequency, onset (<1 h), and offset (4 h) were well described by the model. Exposure resulting in 80% receptor occupancy is predicted to be well tolerated.
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Affiliation(s)
- D Ouellet
- Clinical Pharmacology, Modeling and Simulation, GlaxoSmithKline, Research Triangle Park, Durham, North Carolina, USA.
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Demmy TL, Gu L, Burkhalter JE, Toloza EM, D'Amico TA, Sutherland S, Wang XF, Archer L, Veit LJ, Kohman L. Comparison of in-dwelling catheters and talc pleurodesis in the management of malignant pleural effusions. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9031] [Citation(s) in RCA: 5] [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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Sutherland S, Ashley S, Miles D, Chan S, Wardley A, Davidson N, Bhatti R, Shehata M, Nouras H, Camburn T, Johnston SRD. Treatment of HER2-positive metastatic breast cancer with lapatinib and capecitabine in the lapatinib expanded access programme, including efficacy in brain metastases--the UK experience. Br J Cancer 2010; 102:995-1002. [PMID: 20179708 PMCID: PMC2844035 DOI: 10.1038/sj.bjc.6605586] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 01/18/2010] [Accepted: 01/27/2010] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The global lapatinib expanded access programme provided access to lapatinib combined with capecitabine for women with HER2-positive metastatic breast cancer (MBC) who previously received anthracycline, taxane and trastuzumab. METHODS Progression-free survival (PFS) and safety data for 356 patients recruited from the United Kingdom are reported. Efficacy was assessed in 162 patients from the five lead centres, including objective tumour response rate (ORR), time to disease progression (TTP) and efficacy in those with central nervous system (CNS) metastases. Correlation of PFS and ORR with previous capecitabine treatment was also documented. RESULTS Overall, PFS for the 356 UK patients was 21 weeks (95% CI: 17.6-24.7). In the 162 assessable patients, ORR was 21% (95% CI: 15-27%) and median TTP was 22 weeks (95% CI: 17-27). Efficacy was greater in capecitabine-naive patients (ORR 23 vs 16.3%, P=0.008). For 34 patients with CNS metastases, ORR was 21% (95% CI: 9-39%), with evidence of improvement in neurological symptoms, and median TTP was 22 weeks (95% CI: 15-28). CONCLUSIONS Lapatinib combined with capecitabine is an active treatment option for women with refractory HER2-positive MBC, including those with progressive CNS disease.
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Affiliation(s)
- S Sutherland
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Fulham Road, Chelsea and Sutton, London, SW3 6JJ, UK
| | - S Ashley
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Fulham Road, Chelsea and Sutton, London, SW3 6JJ, UK
| | - D Miles
- The Mount Vernon Cancer Centre, Northwood, Middlesex HA6 2RN, UK
| | - S Chan
- Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - A Wardley
- The Christie Hospital, Manchester, UK
| | - N Davidson
- Broomfield Hospital, Chelmsford, Essex, UK
| | - R Bhatti
- The Mount Vernon Cancer Centre, Northwood, Middlesex HA6 2RN, UK
| | - M Shehata
- Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - H Nouras
- Broomfield Hospital, Chelmsford, Essex, UK
| | - T Camburn
- Broomfield Hospital, Chelmsford, Essex, UK
| | - S R D Johnston
- Department of Medicine, The Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Fulham Road, Chelsea and Sutton, London, SW3 6JJ, UK
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Horvath L, Thanigasalam R, Rasiah K, Stricker P, Earnest A, Haynes A, Sutherland S, Sutherland R, Henshall S. Stage migration and the Kattan nomogram. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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26
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Nicum SJ, Sutherland S, Smith IE, Ashley S, Johnston S. Determination of the rates of neurological toxicity associated with the use of dose-dense (DD) paclitaxel-containing schedules in patients with early breast cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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27
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Murthy NV, Passchier J, Gunn R, Searle G, Bullich S, Suarez M, Herance R, Farre M, Herdon H, Porter R, Sutherland S, Fagg R, Neve M, Slifstein M, Laruelle M, Catafau A. [11C]GSK931145: A new pet ligand for glycine transporter 1. Neuroimage 2008. [DOI: 10.1016/j.neuroimage.2008.04.195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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28
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Venook A, Niedzwiecki D, Hollis D, Sutherland S, Goldberg R, Alberts S, Benson A, Wade J, Schilsky R, Mayer R. Phase III study of irinotecan/5FU/LV (FOLFIRI) or oxaliplatin/5FU/LV (FOLFOX) ± cetuximab for patients (pts) with untreated metastatic adenocarcinoma of the colon or rectum (MCRC): CALGB 80203 preliminary results. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3509] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [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
3509 Background: FOLFIRI or FOLFOX are 1st-line treatments (Rx) for MCRC. Cetuximab is an IgG1 Mab that targets the epidermal growth factor receptor (EGFR) and is approved as monotherapy or in combination with irinotecan in irinotecan-refractory, EGFR + pts with MCRC. CALGB 80203 randomized untreated MCRC pts to FOLFOX or FOLFIRI ± cetuximab (independent of EGFR status.) Methods: Pts with performance status 0–1 with tumor blocks available for EGFR analysis received either irinotecan 180 mg/m2 over 1.5 hours (h) or oxaliplatin 85 mg/m2 over 2h combined with LV 400 mg/m2 over 2h and 5FU 400 mg/m2 bolus, then 46–48h CI 5FU 2400 mg/m2 q o w. Cetuximab dose: 400 mg/m2 loading dose, then 250 mg/m2 qw. Rx continued until progression or toxicity; subsequent Rx was not mandated although information was collected on such rx. Accrual goal was 2200 pts with intended 1° endpt of overall survival (OS). 80203 closed administratively in 1/05 (due to slow accrual) with 238 pts accrued. 2° endpts of response rate (RR), progression free survival (PFS), duration of R and toxicity are now able to be analyzed. Results: Accrual: FOLFIRI (A) - 61; FOLFIRI + cetuximab (B) - 59: FOLFOX (C) - 60; FOLFOX + cetuximab (D) - 58; approx median follow-up (f/u) is 12 months. RR (CR + PR, not all yet confirmed): A - 34%; B - 42%; C - 32%; D - 55%. RR was similar in the FOLFIRI or FOLFOX arms (A+B v. C+D; 38% v. 43%, p=0.44; chi-square) while C225 containing arms (B+D) v. non-C225 arms (A+C) had a superior RR (49% v. 33%; p=0.014, chi-square) It is too early to tell if there are differences in PFS, duration of response or OS. No significant differences in gr III diarrhea or any gr IV toxicities were seen. Conclusions: These results suggest that FOLFIRI and FOLFOX are similar in efficacy for pts with untreated MCRC and that adding cetuximab to either in1st-line Rx appears to increase response rates. PFS and duration of response do not appear different at this analysis. Further f/u and an analysis of prospective companion correlative studies may help to further clarify these results. [Table: see text]
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Affiliation(s)
- A. Venook
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - D. Niedzwiecki
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - D. Hollis
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - S. Sutherland
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - R. Goldberg
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - S. Alberts
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - A. Benson
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - J. Wade
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - R. Schilsky
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
| | - R. Mayer
- University of California San Fransisco, San Francisco, CA; CALGB Statistical Center, Durham, NC; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; Northwestern University, Chicago, IL; Central Illinois CCOP, Decatur, IL; University of Chicago, Chicago, IL; Dana-Farber Cancer Institute, Boston, MA
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Horne AW, Sutherland S, Faratian D, Farquharson DIM, Duncan WC. Ovarian choriocarcinoma masquerading as ectopic pregnancy. J OBSTET GYNAECOL 2006; 26:385-7. [PMID: 16753708 DOI: 10.1080/01443610600635303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A W Horne
- Simpson Centre for Reproductive Health, UK.
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Francis J, Barrett SP, Ogilvie MM, Sutherland S. Best Practice No 175. Guidelines for virological and non-viral serological examination of specimens in routine diagnostic microbiological laboratories. J Clin Pathol 2004; 57:1-5. [PMID: 14693826 PMCID: PMC1770154 DOI: 10.1136/jcp.57.1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Viral examination is routinely carried out in most routine diagnostic microbiology laboratories. Most often, this comprises the detection of viral antigens and antibodies, and less commonly the isolation of viruses and the detection of viral nucleic acids. However, there are no standards or guidelines available for processing these specimens in routine diagnostic laboratories or for referral to specialist virology centres or units. Clinical Pathology Accreditation (CPA) has defined standards for assessing the quality of service provided by laboratories, but these do not include the scientific and technical aspects of provision of service. The Association of Medical Microbiologists has recently published Standards for Laboratory practice in medical microbiology, which covers scientific and technical aspects of provision of microbiology service, mainly bacteriological examination of specimens in routine diagnostic microbiology laboratories. These guidelines are complementary to the CPA guidelines and aim to ensure a consistent and high quality service. This article presents guidelines for the examination of specimens for the diagnosis of viral infections.
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Affiliation(s)
- J Francis
- ULH NHS Trust, Grantham District Hospital, Lincolnshire NG31 8DG, UK.
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31
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Affiliation(s)
- S Sutherland
- UK Transplant, Fox Den Road, Stoke Gilford, Bristol, Wales B534 8RR, UK
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32
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Abstract
In order to determine the effectiveness of a screen-and-treat policy for Chlamydia trachomatis within a busy medical and surgical abortion service, a retrospective audit was conducted of 2058 women undergoing induced abortion over 12 months. The prevalence of C. trachomatis was 6%. Although most positive results were available before a surgical abortion (97%), only 76% were available before a medical abortion (P = 0.007). This resulted in more treatment delays in the medical group (P = 0.04). Although the majority of women (94% surgical and 84% medical) were seen by genitourinary medicine, only one-quarter of partners attended for contact tracing. The current screen-and-treat policy has been shown to be deficient in several areas. Of most concern are the treatment delays with medical abortion, which may be due to the faster 'processing' of women since this method is only available at < or = 9 weeks' gestation. Such challenges to a screen-and-treat policy, are likely to become more common as medical abortion becomes more widely adopted.
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Affiliation(s)
- S T Cameron
- Department of Obstetrics and Gynaecology, Centre for Reproductive Biology, University of Edinburgh, Edinburgh, UK.
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33
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Sutherland S. A memorable patient: Communication problems. West J Med 2002. [DOI: 10.1136/bmj.325.7374.1231/a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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34
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Affiliation(s)
- S T Cameron
- Department of Reproductive and Developmental Sciences, Obstetrics and Gynaecology, University of Edinburgh, UK
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Abstract
A palliative care team in north Scotland identified serious drug errors occurring in the local health-care trust. These were connected with the use of variable rate syringe drivers (IVAC P100) to deliver pain and symptom management rather than the more suitable Graseby MS26. An action research approach was taken to effecting change. An educational workshop was set up which 23 nurses attended. Clinical support was provided and 3 months later an evaluation was carried out. Of the 13 nurses who had used an MS26, most were able to correctly follow the process of setting up the driver and had made appropriate observations, but drug calculations were a problem. Change was stated to have taken place in seven clinical areas but the degree of change was variable. Facilitators and obstacles to the change process are identified and recommendations made for the next round in the action research cycle.
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Affiliation(s)
- P J McCormack
- Marie Curie Cancer Care/Department of Palliative Medicine, Roxburghe House, Aberdeen, UK
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36
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Sutherland S. Book Review: Paediatric Ophthalmology. Scott Med J 2001. [DOI: 10.1177/003693300104600522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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37
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Sutherland S. An evaluation and comparison of three digital image databases. J Audiov Media Med 2001; 24:115-20. [PMID: 11584599 DOI: 10.1080/01405110120071548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Both the Western Infirmary and Gartnavel General Hospital's Medical Illustration Departments have been using digital cameras since 1998. This has led to a dramatic increase in the number of digital images held on the department's computers. As all digital files were named with a job number, consultant and department, searches carried out using other parameters was labour intensive. A new system of defining and organizing digital images across both departments was needed. This system needed to be efficient, flexible and easy to use. Choosing the right software was vital and it was decided that the only way to make an informed decision would be to test the three best software products to see how they compared.
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Affiliation(s)
- S Sutherland
- Western Infirmary, Glasgow G11 6NT, Scotland, UK.
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38
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Abstract
Because the atypical antipsychotic olanzapine may be efficacious in treating post-traumatic stress disorder (PTSD) symptoms, we conducted a 10-week, double-blind, placebo-controlled evaluation in which 15 patients were randomized 2:1 to either olanzapine or placebo. The initial dosage was 5 mg/day and was titrated to a maximum of 20 mg/day. Eleven patients completed the study. Patients in both groups showed improvement in PTSD symptoms, but no between-group differences in treatment response were observed and a high placebo response rate was found. Both treatments were tolerated well, although the olanzapine treatment group had more weight gain. Olanzapine fared no better than placebo in this preliminary study in the treatment of PTSD. The lack of difference between olanzapine and placebo may in part be due to olanzapine's not being effective in PTSD or, alternatively, a small sample size, a high placebo response in certain forms of PTSD and the chronicity of PTSD symptoms in some patients.
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Affiliation(s)
- M I Butterfield
- Department of Psychiatry and Behavioral Medicine, Duke University Medical Center, Durham, NC, USA.
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39
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Affiliation(s)
- C Thompson
- Fife Acute Hospitals NHS Trust, Victoria Hospital, Kirkcaldy, KY2 5AH.
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40
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Abstract
OBJECTIVE To study opportunistic screening in primary care, in such a way that would include teenage women. Setting-Screening for chlamydia infection was offered opportunistically in eight general practices in Edinburgh to women aged < or = 35 years attending for cervical smear, and women aged < or = 20 years attending for contraception. The numbers of women eligible to be offered screening were 901 in the cervical smear group, and 595 in the contraception group. RESULTS Effective screening rate (offered test, consented, and urine sample returned) was 30% for the cervical smear group compared with 23% for the contraception group. Among those tested, chlamydia prevalence was strongly associated with young age, ranging from 11.8% in those <18 years, to 0% in those >25 years. Number of sexual partners in past year did not improve prediction of infection. CONCLUSION These findings raise concerns regarding the feasibility of opportunistic screening in general practice, particularly for those with highest prevalence of chlamydia--teenage women.
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Affiliation(s)
- M Santer
- Department of Community Health Sciences (General Practice), The University of Edinburgh, UK.
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41
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Alkout AM, Ramsay EJ, Mackenzie DA, Weir DM, Bentley AJ, Elton RA, Sutherland S, Busuttil A, Blackwell CC. Quantitative assessment of IgG antibodies to Helicobacter pylori and outcome of ischaemic heart disease. FEMS Immunol Med Microbiol 2000; 29:271-4. [PMID: 11118907 DOI: 10.1111/j.1574-695x.2000.tb01533.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Criticisms of serological studies on Helicobacter pylori and ischaemic heart disease (IHD) include: undiagnosed heart disease in live controls; no assessment of severity or outcome of IHD; and qualitative not quantitative measurements of IgG to the bacteria. The aim was to assess quantitatively IgG levels specific for H. pylori (ng ml(-1)) among patients who survived a myocardial infarction (MI) with those who died of IHD. Sera were from four groups: (1) men who survived one MI; (2) men matched for age and socioeconomic background to group 1; (3) individuals who died suddenly of IHD; (4) accidental deaths matched for age and sex to group 3. Levels of IgG to H. pylori increased with age (P<0.005) but were not associated with smoking or socioeconomic groups. There was a correlation between IgG to the bacteria and decreasing socioeconomic levels only among group 1 (P<0.01). IgG levels were higher for subjects who died of heart disease (median=151 ng ml(-1)) compared with survivors (median=88 ng ml(-1)) (P=0.034) and higher for survivors compared with their controls (median=58 ng ml(-1)) (P=0.039). Future serological studies of H. pylori in relation to IHD should be quantitative and severity of disease considered in analyses.
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Affiliation(s)
- A M Alkout
- Department of Medical Microbiology, Forensic Medicine Unit, Medical Statistics Unit, The Medical School, University of Edinburgh, Teviot Place, EH8 9AG, Edinburgh, UK
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42
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Sutherland S. Rapid in vitro stimulation of parathyroid hypertensive factor secretion by 1,25-dihydroxyvitamin D3. Am J Hypertens 2000. [DOI: 10.1016/s0895-7061(00)01105-5] [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] Open
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Abstract
Chlorofluorocarbon-11 inventories for the deep Southern Ocean appear to confirm physical oceanographic and geochemical studies in the Southern Ocean, which suggest that no more than 5 x 10(6) cubic meters per second of ventilated deep water is currently being produced. This result conflicts with conclusions based on the distributions of the carbon-14/carbon ratio and a quasi-conservative property, PO(4)(*), in the deep sea, which seem to require an average of about 15 x 10(6) cubic meters per second of Southern Ocean deep ventilation over about the past 800 years. A major reduction in Southern Ocean deep water production during the 20th century (from high rates during the Little Ice Age) may explain this apparent discordance. If this is true, a seesawing of deep water production between the northern Atlantic and Southern oceans may lie at the heart of the 1500-year ice-rafting cycle.
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Affiliation(s)
- WS Broecker
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY 10964, USA. Ocean Chemistry Division, Atlantic Oceanographic and Meteorological Laboratory, National Oceanic and Atmospheric Administration, Miami, FL 33149-1026, USA
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Abstract
Social phobia was initially classified with phobic anxiety states and was believed to be quite rare, but it is now gaining due recognition as a widespread and often crippling disorder. The boundaries of social phobia merge into traits of shyness and universal performance anxiety, with symptoms commonly appearing in the teenage years. If left untreated, social phobia is a remarkably persistent condition, leading to potentially lifelong impairment in social development and occupational functioning. It may also give rise to other co-morbid disorders, particularly dysthymia, depression, obsessive-compulsive disorder, other phobic disorders, and substance abuse. Over the years, social phobia has been all too frequently viewed as a somewhat trivial, minor form of psychiatric illness and has received little clinical attention. This erroneous perception is now giving way under the mounting evidence in support of the extensive morbidity and disability associated with social phobia and the probable role of genetic and environmental influences. Furthermore, data from multiple controlled clinical trials reveal that this is a treatable condition, responding to both psychosocial and pharmacologic interventions. Here we examine issues to consider in the differential diagnosis of social phobia, review the goals of treatment, and summarize evidence in support of the effectiveness of individual pharmacologic treatments.
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Affiliation(s)
- K M Connor
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA
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45
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Kirkwood K, Horn K, Glasier A, Sutherland S, Young H, Patrizio C. Non-invasive screening of teenagers for Chlamydia trachomatis in a family planning setting. Br J Fam Plann 1999; 25:11-2. [PMID: 10228243] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
One hundred women aged 20 or younger attending two family planning clinics specifically targeting teenagers were screened for Chlamydia trachomatis using first void urine specimens. An overall prevalence of 6.2 per cent was found, but there was a marked difference between women attending a city centre site (three per cent) and those attending a clinic in a small rural town.
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Affiliation(s)
- K Kirkwood
- Family Planning and Well Women's Health, 18 Dean Terrace, Edinburgh EH4 INL, UK
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Abstract
Carbohydrate-deficient transferrin (CDT) has been studied as an index of heavy alcohol use. The present study evaluates the utility of CDT as a marker for chronic alcohol use in medical examiner cases. Over a 5-month period, serum specimens were collected in consecutive deaths that were referred to the medical examiner's office (N = 25). Manner of death was accidental in nine cases, homicide/suicide for eight cases, and natural causes for seven cases. Fifteen of the 17 cases having alcohol abuse had positive CDT levels above threshold, indicating chronic use (sensitivity 88%). Eight cases had no evidence of alcohol abuse but three of these cases had CDT levels also above threshold (specificity 63%). There was no correlation between serum CDT levels and the time of death to blood collection for the total sample, indicating that CDT is stable postmortem for at least 36 h. CDT appears to have value as a marker of ante-mortem alcohol use prior to time of death in medical examiner cases.
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Affiliation(s)
- R Malcolm
- Department of Psychiatry, Medical University of South Carolina, Charleston 29425-0742, USA
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Young H, Moyes A, Horn K, Scott GR, Patrizio C, Sutherland S. PCR testing of genital and urine specimens compared with culture for the diagnosis of chlamydial infection in men and women. Int J STD AIDS 1998; 9:661-5. [PMID: 9863578 DOI: 10.1258/0956462981921314] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Our aim was to determine the number of chlamydial infections detected by Cobas Amplicor CT/NG multiplex polymerase chain reaction (PCR) testing of genital and first-voided urine (FVU) specimens compared with routine culture. Two hundred and eighty-six female and 276 male patients attending the Genito-Urinary Medicine (GUM) Unit at Edinburgh Royal Infirmary were included in the study. Case notes were analysed retrospectively to determine how many infected patients would not have been treated had diagnosis relied on routine culture. Polymerase chain reaction on FVU from women had a sensitivity, specificity, positive and negative predictive value of 91%, 100%, 100% and 99.1%: corresponding values for genital PCR and culture were 96%, 100%, 100%, 99.6% and 65%, 100%, 100%, 96.7% respectively. PCR on FVU from men had a sensitivity, specificity, positive and negative predictive value of 96%, 99.1%, 92.6% and 99.5%: corresponding values for genital PCR and culture were 89%, 99.5%, 95.8%, 98.6% and 48%, 100%, 100%, 94.3% respectively. In both men and women genital PCR and urine PCR were significantly more sensitive than culture. PCR almost doubled the number of patients detected by culture (49 vs 27). Of the 22 cases detected only by PCR 8 would not have received treatment on the basis of clinic treatment policy.
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Affiliation(s)
- H Young
- Department of Medical Microbiology, Edinburgh University Medical School, UK.
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Shattock RM, Patrizio C, Simmonds P, Sutherland S. Detection of Chlamydia trachomatis in genital swabs: comparison of commercial and in house amplification methods with culture. Sex Transm Infect 1998; 74:289-93. [PMID: 9924472 PMCID: PMC1758124 DOI: 10.1136/sti.74.4.289] [Citation(s) in RCA: 23] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
AIMS To evaluate the sensitivity of the Roche Cobas, Roche Amplicor plate kit, ligase chain reaction (LCR), and an in house polymerase chain reaction (PCR) by titration of purified elementary bodies (EB) and also to test 245 urethral and endocervical specimens for Chlamydia trachomatis by the four assays as well as conventional culture. STUDY DESIGN EB titrations were run in duplicate in each commercial assay and six times in the in house PCR. Clinical samples were aliquoted and tested by each assay and were considered positive if C trachomatis was detected by two or more separate tests or if the sample was either culture or immunofluorescence positive. Major outer membrane protein (MOMP) specific primers were used as a confirmatory assay for the in house PCR. RESULTS The in house PCR, Roche Cobas Amplicor, LCR, and Amplicor plate kit gave detection limits of approximately 1, 1-2, 2, and 2-4 EBs respectively. By the criteria described above for definition of a C trachomatis positive result in clinical samples we identified 23 true positives among the 245 clinical specimens. The in house PCR detected all 23 giving a sensitivity of 100% and a specificity of 98%. The Roche Cobas Amplicor, Roche Amplicor plate kit, and LCR detected 21, 19, and 19 of these respectively giving sensitivities of 87.5%, 82%, and 82% respectively and specificities of 99.5%, 99%, and 100% respectively. The culture gave a sensitivity of 78% and specificity of 100%. CONCLUSION All four amplification assays had a greater sensitivity than the culture used routinely in this laboratory. The in house plasmid PCR had the greatest sensitivity and when combined with confirmation by immunofluorescence detected the greatest number of positives. This increased sensitivity is likely to have been achieved by the use of a DNA purification step and of nested primers in the amplification stage and their combined use in routine diagnostic assays for chlamydia might increase the frequency of C trachomatis detections. However, this assay is much less user friendly than the two semiautomated commercial assays investigated in this study.
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Affiliation(s)
- R M Shattock
- Department of Medical Microbiology, University of Edinburgh, Medical School
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McCain D, Sutherland S. Nursing essentials: skin grafts for patients with burns. Am J Nurs 1998; 98:34-8; quiz 39. [PMID: 9663131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- D McCain
- ICU, University of California-Davis Medical Center, Sacramento
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Doorey A, Patel S, Reese C, O'Connor R, Geloo N, Sutherland S, Price N, Gleasner E, Rodrigue R. Dangers of delay of initiation of either thrombolysis or primary angioplasty in acute myocardial infarction with increasing use of primary angioplasty. Am J Cardiol 1998; 81:1173-7. [PMID: 9604940 DOI: 10.1016/s0002-9149(98)00160-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We observed treatment delays and suboptimal outcomes when beginning to treat patients with acute myocardial infarction (AMI) with primary angioplasty. Of the 37 patients treated during a 12-month period, 12 (32%) required either emergency bypass surgery or died. Delayed time intervals to balloon reperfusion (mean 134 minutes) probably contributed to these adverse outcomes, with hemodynamic instability requiring pressors or intra-aortic balloon pumping in 15 patients, 12 (75%) before the first balloon inflation. Eleven of the 12 patients with significant adverse outcomes required such intervention. As angioplasty use increased, time intervals to thrombolysis in those not treated with angioplasty increased from an average of 29 minutes (53% treated less than the national standard of 30 minutes) to 39 minutes (32% treated <30 minutes, p <0.001). During the last 2 months of the study period, the time intervals had increased to 48 minutes (14% treated <30 minutes, p <0.0001). There was no change in thrombolytic time intervals at a local community hospital that did not offer primary angioplasty. Emergency Department physician confusion about the best therapy (angioplasty or thrombolysis) was documented in the medical records in 42% of cases (53 of 127). Confusion regarding therapy of AMI led to unacceptable delays in the administration of thrombolytic agents and probably contributed to the adverse outcomes in patients receiving primary angioplasty.
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Affiliation(s)
- A Doorey
- Department of Medicine, Medical Center of Delaware and Jefferson Medical College, Newark 19713, USA
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