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Busher A, Costello S, Culliton M, Fitzgerald J, Murphy MC. Review of the postnatal management of infants following positive direct antiglobulin test. Ir Med J 2023; 116:885. [PMID: 38259218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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Gallagher A, Hooley K, Costello S, Felsenstein S, Mullane D, Dempsey E, Ní Chróinín M. Impact of Gestational Age on Sweat Testing. Ir Med J 2022; 115:530. [PMID: 35279064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- A Gallagher
- Paediatrics Department, Cork University Hospital, Wilton, Cork, Ireland
| | - K Hooley
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork
| | - S Costello
- Department of Clinical Biochemistry, Cork University Hospital, Wilton, Cork
| | - S Felsenstein
- Paediatrics Department, Cork University Hospital, Wilton, Cork, Ireland
| | - D Mullane
- Paediatrics Department, Cork University Hospital, Wilton, Cork, Ireland
| | - E Dempsey
- Neonatology Department, Corm University Maternity Department, Wilton, Cork
| | - M Ní Chróinín
- Paediatrics Department, Cork University Hospital, Wilton, Cork, Ireland
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Schubert JP, Warner MS, Rayner CK, Roberts-Thomson IC, Mangoni AA, Costello S, Bryant RV. Increasing Helicobacter pylori clarithromycin resistance in Australia over 20 years. Intern Med J 2021; 52:1554-1560. [PMID: 34865299 DOI: 10.1111/imj.15640] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/20/2021] [Accepted: 11/28/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Helicobacter pylori infection is responsible for considerable morbidity and mortality worldwide, and eradication rates are falling in many countries, primarily due to clarithromycin and metronidazole resistance. However, there is a paucity of contemporary Australian data, which we sought to address by evaluating local rates of resistance of H. pylori to amoxicillin, clarithromycin, metronidazole, and tetracycline over the past 20 years. DESIGN All gastric biopsy specimens collected at endoscopy to detect H. pylori infection at a single centre underwent routine culture and antibiotic susceptibility testing between 1998-2017. Specimens from 12,842 patients were cultured for H. pylori, of which 1,473 positive cultures were tested for antibiotic susceptibility. RESULTS Antibiotic resistance to clarithromycin increased by 3.7% per year (IRR 1.037, p=0.014) over 20 years, with a corresponding 5.0% annual increase in minimum inhibitory concentration (MIC) (OR 1.050, p<0.001). Since 2010, average clarithromycin resistance has exceeded 20%, with >25% of isolates resistant in the last 2 years of data capture. By contrast, rates of resistance to metronidazole (35.3%), amoxicillin (0.14%) and tetracycline (0.34%) and their MICs have remained stable. Review of a representative sample of these patients (n=120, 8%) revealed that only 5% had documented prior H. pylori eradication therapy. CONCLUSIONS Over the last 20 years there has been a substantial rise in clarithromycin resistance, with stable metronidazole resistance and low rates of resistance to amoxicillin and tetracycline. Current first line H. pylori eradication therapy may fail to achieve adequate eradication rates, and optimal first line therapy in Australia should be revisited. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jonathon P Schubert
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Department of Clinical Pharmacology, Flinders Medical Centre, Flinders University, Bedford Park, Australia
| | - Morgyn S Warner
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Microbiology and Infectious Diseases Directorate, SA Pathology, Adelaide, Australia
| | - Christopher K Rayner
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia
| | - Ian C Roberts-Thomson
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, Flinders Medical Centre, Flinders University, Bedford Park, Australia
| | - Sam Costello
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville, Australia
| | - Robert V Bryant
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville, Australia
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Schubert JP, Gehlert J, Rayner CK, Roberts-Thomson IC, Costello S, Mangoni AA, Bryant RV. Antibiotic resistance of Helicobacter pylori in Australia and New Zealand: A systematic review and meta-analysis. J Gastroenterol Hepatol 2021; 36:1450-1456. [PMID: 33217029 DOI: 10.1111/jgh.15352] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/21/2020] [Accepted: 11/14/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE While the global prevalence of antibiotic-resistant Helicobacter pylori (H. pylori) is increasing, there is much regional variation, and local data are required to guide eradication therapy. We performed a systematic review and meta-analysis to determine rates of H. pylori antibiotic resistance in Australia and New Zealand. STUDY DESIGN Random effects meta-analysis of data from 15 published studies and three published abstracts reporting prevalence of primary or secondary H. pylori antibiotic resistance in Australasia. DATA SOURCES PubMed, EMBASE, MEDLINE, PROSPERO, and the Cochrane Library were searched until August, 2020. DATA SYNTHESIS Fifteen published studies and three published abstracts were identified; one study was excluded due to high risk of bias. Seventeen studies conducted between 1996 and 2013 were included in the final analysis, 12 reporting primary and five reporting secondary antibiotic resistance. Prevalence of primary resistance was clarithromycin 7.4% (95% confidence interval [CI], 5.3-9.7%), metronidazole 50.0% (95%CI, 23.9-56.1%), fluoroquinolones 3.7% (95%CI, 0.004-14.8%), and both amoxicillin and tetracycline <0.5%. Subgroup analysis (last 20 years) showed doubling of clarithromycin resistance to 16.1% (95%CI 11.2-21.7%) with other resistance stable. Prevalence of secondary resistance was high for all antibiotics, particularly clarithromycin 78.7% (95%CI, 64.1-90.1%) and metronidazole 68.3% (95%CI, 59.9-76.1%). CONCLUSIONS The outcomes reveal an increase in primary H. pylori clarithromycin resistance since the year 2000, while metronidazole resistance has remained stable and primary resistance to amoxicillin, tetracycline, and fluoroquinolones is low. Rates of secondary resistance to metronidazole and clarithromycin are high. The results highlight the need for contemporary local data on antibiotic resistance in Australia and New Zealand.
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Affiliation(s)
- Jonathon P Schubert
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Department of Clinical Pharmacology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Jessica Gehlert
- Department of Clinical Pharmacology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Christopher K Rayner
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Ian C Roberts-Thomson
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Sam Costello
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Department of Gastroenterology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Robert V Bryant
- Faculty of Health Sciences, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Department of Gastroenterology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Vanlint AS, Kaazan P, Kwok M, Bryant RV, Ooi M, Bak N, Costello S. Lessons from practice Low attenuation lymphadenopathy on computed tomography leading to diagnosis of Whipple disease. Med J Aust 2020; 213:161-162.e1. [PMID: 32712997 DOI: 10.5694/mja2.50713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andrew S Vanlint
- University of Adelaide, Adelaide, SA.,Central Adelaide Local Health Network, Adelaide, SA
| | - Patricia Kaazan
- University of Adelaide, Adelaide, SA.,Central Adelaide Local Health Network, Adelaide, SA
| | | | - Robert V Bryant
- Queen Elizabeth Hospital, Adelaide, SA.,Adelaide Gastroenterology Consultants, Adelaide, SA
| | - Marie Ooi
- Central Adelaide Local Health Network, Adelaide, SA
| | - Narin Bak
- Royal Adelaide Hospital, Adelaide, SA
| | - Sam Costello
- University of Adelaide, Adelaide, SA.,Queen Elizabeth Hospital, Adelaide, SA
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Affiliation(s)
- A. G. Marchetti
- CIFASIS (CONICET - Universidad Nacional de Rosario), S2000EZP Rosario, Argentina
| | - T. de Avila Ferreira
- Laboratoire d’Automatique, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
| | - S. Costello
- Laboratoire d’Automatique, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
| | - D. Bonvin
- Laboratoire d’Automatique, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
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Gallagher A, Hooley K, Mullane D, Costello S, Ni Chroinin M. P036 Newborn Screening Cork University Hospital 2011–2019 - impact of gestational age on sweat testing. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30331-5] [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: 11/29/2022]
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Lyng A, McCarthy T, Glynn R, Costello S, Harte A, Bonas F, Laffoy M. Ireland Takes Action on Alcohol and Cancer. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.39900] [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
Background and context: The 2006 EU strategy to reduce alcohol-related harm focuses on protecting young people and children; preventing alcohol-related harm in adults; raising awareness of the impact of harmful alcohol consumption. Ireland is the first EU country to develop alcohol legislation with a focus on cancer control. The Irish Public Health Alcohol Bill (PHAB) aims to reduce alcohol harm. Each year in Ireland > 900 new cancer cases are attributed to alcohol. < 20% of people are aware of the link between alcohol and breast cancer. It was timely the theme for 2017 European Awareness Week on Alcohol Related Harm (20-24th Nov) was “Alcohol and Cancer”. Aim: Capitalising on the theme, Ireland's National Cancer Control Program partnered with the Health Service Alcohol Program for “Action on Alcohol” a national public campaign to - raise awareness of the link between alcohol and cancer - call the public to action, to assess alcohol intake using the drinks calculator on askaboutalcohol.ie - enhance support for the PHAB Strategy/Tactics: Overarching message: “Drinking alcohol increases your risk of developing cancer. Drink less to reduce the risk”. Each day a target audience and message was identified: Monday: Women – 1 in 8 breast cancers are caused by alcohol Tuesday: Youth – drinking less in your teens and 20s can reduce your risk of developing cancer in later life Wednesday: Men – drinking less cancer reduce your risk of developing mouth, head and neck cancer. Thursday: LGBT – drinking less can reduce your risk of developing 7 types of cancer Program/Policy process: Statutory bodies, NGOs and charities were briefed and supplied with partner packs containing key messages, social assets, supporting research and planned campaign activity: - Press release to local and national media and health service staff - Local radio interviews with spokespeople (cancer expert and target audience expert) - National radio advertisement highlighted link between alcohol and breast cancer - Articles in print and online media - Social media campaign. Outcomes: - askaboutalcohol.ie received 35,855 page views (highest in 2 week period) 1,157 direct Web site visits, 427 completed drinks calculator (previous fortnight 409 visits, 58 completed drinks calculator) - > 25k people read “6 alcohol-related health risks everyone in their 20s should know about”, 38% completed drinks calculator - 9 Facebook posts had 109,852 views - National TV program invited spokesperson for interview - National and local newspapers coverage. In the period after campaign the PHAB passed through the next stage of legislation process with an amendment nominated by senators to add cancer warning labels to alcohol products.What was learned: - Clear division of target audiences and themes provided varied content with a consistent message - Partner pack empowered partners to deliver messages - Allow time for structured collaboration and communication with partners in advance.
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Affiliation(s)
- A. Lyng
- National Cancer Control Programme, Dublin, Ireland
| | - T. McCarthy
- National Cancer Control Programme, Dublin, Ireland
| | - R. Glynn
- HSE, Public Health, Dublin, Ireland
| | - S. Costello
- HSE, Alcohol Programme, Dublin, Ireland
- Alcohol Action Ireland, Dublin, Ireland
| | - A. Harte
- HSE, Communications, Dublin, Ireland
| | - F. Bonas
- National Cancer Control Programme, Dublin, Ireland
| | - M. Laffoy
- National Cancer Control Programme, Dublin, Ireland
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Murphy V, Hallahan B, Smithwick D, Costello S, Moloney N, Gulati G. Epilepsy in Irish psychiatric inpatient settings. Ir Med J 2018; 111:809. [PMID: 30547542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aims To ascertain epilepsy prevalence in Irish psychiatric inpatient units and compliance with care planning guidelines. Methods Case records were reviewed in seven psychiatric inpatient units. Results The prevalence of epilepsy across seven psychiatric inpatient units (n=9/267) was three times that of general population estimates. Minimal data was recorded pertaining to seizure type (n=1,11.1%), triggers (n=2,22.2%), clinical investigations relating to epilepsy (n=2,22%) and no epilepsy risk assessments were recorded (n=0,0%). Conclusions The introduction of appropriate care plans is needed to optimise physical and mental wellbeing of those with epilepsy in psychiatric units.
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Affiliation(s)
- V Murphy
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - B Hallahan
- Department of Psychiatry, NUI Galway, Galway, Ireland
| | - D Smithwick
- Department of Psychiatry, Ennis General Hospital, Ireland
| | - S Costello
- Department of Psychiatry, University Hospital Galway, Ireland
| | - N Moloney
- Department of Psychiatry, University of Limerick, Ireland
| | - G Gulati
- Department of Psychiatry, University of Limerick, Ireland
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Checkoway H, Lundin JI, Costello S, Ray RM, Li W, Eisen EA, Astrakianakis G, Applebaum K, Gao DL, Thomas DB. Reply to Comment on: 'Possible pro-carcinogenic association of endotoxin on lung cancer among Shanghai women textile workers'. Br J Cancer 2015; 112:1840-1. [PMID: 25412237 PMCID: PMC4647246 DOI: 10.1038/bjc.2014.584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- H Checkoway
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - J I Lundin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - S Costello
- Department of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - R M Ray
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - W Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - E A Eisen
- Department of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - G Astrakianakis
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T1Z4, Canada
| | - K Applebaum
- Department of Environmental and Occupational Health, George Washington University, Washington, DC 20052, USA
| | - D L Gao
- Zhong Shan Hospital Cancer Center, Shanghai 2000030, China
| | - D B Thomas
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
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Ghaly S, Costello S, Beswick L, Pudipeddi A, Agarwal A, Sechi A, Antoniades S, Headon B, Connor S, Lawrance IC, Sparrow M, Walsh AJ, Andrews JM. Dose tailoring of anti-tumour necrosis factor-alpha therapy delivers useful clinical efficacy in Crohn disease patients experiencing loss of response. Intern Med J 2015; 45:170-7. [DOI: 10.1111/imj.12621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 10/02/2014] [Indexed: 12/22/2022]
Affiliation(s)
- S. Ghaly
- Department of Gastroenterology; St Vincent's Hospital; Sydney New South Wales Australia
- Centre for Inflammatory Bowel Disease; Fremantle Hospital; Fremantle Western Australia Australia
| | - S. Costello
- IBD Service; Department of Gastroenterology and Hepatology; School of Medicine; University of Adelaide at Royal Adelaide Hospital; Adelaide South Australia Australia
| | - L. Beswick
- Department of Gastroenterology; The Alfred Hospital; Melbourne Victoria Australia
| | - A. Pudipeddi
- Department of Gastroenterology; St Vincent's Hospital; Sydney New South Wales Australia
| | - A. Agarwal
- IBD Service; Department of Gastroenterology and Hepatology; School of Medicine; University of Adelaide at Royal Adelaide Hospital; Adelaide South Australia Australia
| | - A. Sechi
- Department of Gastroenterology; Liverpool Hospital; University of NSW; Sydney New South Wales Australia
| | - S. Antoniades
- Department of Gastroenterology; St Vincent's Hospital; Sydney New South Wales Australia
| | - B. Headon
- Department of Gastroenterology; The Alfred Hospital; Melbourne Victoria Australia
| | - S. Connor
- Department of Gastroenterology; Liverpool Hospital; University of NSW; Sydney New South Wales Australia
| | - I. C. Lawrance
- Centre for Inflammatory Bowel Disease; Fremantle Hospital; Fremantle Western Australia Australia
| | - M. Sparrow
- Department of Gastroenterology; The Alfred Hospital; Melbourne Victoria Australia
| | - A. J. Walsh
- Department of Gastroenterology; St Vincent's Hospital; Sydney New South Wales Australia
| | - J. M. Andrews
- IBD Service; Department of Gastroenterology and Hepatology; School of Medicine; University of Adelaide at Royal Adelaide Hospital; Adelaide South Australia Australia
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Progar RA, Blackford DC, Cluck DR, Costello S, Dunning LB, Eager T, Jorgensen CL, Munson AS, Steed B, Rinella MJ. Population densities and tree diameter effects associated with verbenone treatments to reduce mountain pine beetle-caused mortality of lodgepole pine. J Econ Entomol 2013; 106:221-228. [PMID: 23448035 DOI: 10.1603/ec12292] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae: Scolytinae), is among the primary causes of mature lodgepole pine, Pinus contorta variety latifolia mortality. Verbenone is the only antiaggregant semiochemical commercially available for reducing mountain pine beetle infestation of lodgepole pine. The success of verbenone treatments has varied greatly in previous studies because of differences in study duration, beetle population size, tree size, or other factors. To determine the ability of verbenone to protect lodgepole pine over long-term mountain pine beetle outbreaks, we applied verbenone treatments annually for 3 to 7 yr at five western United States sites. At one site, an outbreak did not develop; at two sites, verbenone reduced lodgepole pine mortality in medium and large diameter at breast height trees, and at the remaining two sites verbenone was ineffective at reducing beetle infestation. Verbenone reduced mountain pine beetle infestation of lodgepole pine trees in treated areas when populations built gradually or when outbreaks in surrounding untreated forests were of moderate severity. Verbenone did not protect trees when mountain pine beetle populations rapidly increase.
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Affiliation(s)
- R A Progar
- USFS, Pacific Northwest Research Station, La Grande, OR 97850, USA.
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Costello S, Singh R. Endoscopic Imaging in Barrett's Oesophagus: Applications in Routine Clinical Practice and Future Outlook. Clin Endosc 2011; 44:87-92. [PMID: 22741118 PMCID: PMC3363063 DOI: 10.5946/ce.2011.44.2.87] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 12/08/2011] [Accepted: 12/14/2011] [Indexed: 12/20/2022] Open
Abstract
The practice for endoscopic surveillance of Barrett's oesophagus has evolved from "blind" or random 4 quadrant biopsies (Seattle protocol) to a more "intelligent" targeted biopsy approach. This evolution has been possible due to the rapid advances in endoscopic imaging technology and expertise in the last decade. Previous endoscopes had relatively poor image resolution that often did not allow the subtle mucosal changes associated with dysplastic Barrett's mucosa to be identified. Newer endoscopic imaging techniques available today may allow endoscopists to identify areas of dysplasia or malignancy and target biopsies accordingly. These modalities which include narrow band imaging, chromoendoscopy, autofluorescence imaging, and confocal endomicroscopy as well as a few novel imaging modalities on the horizon will be discussed further.
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Affiliation(s)
- Sam Costello
- Lyell McEwin Hospital, University of Adelaide, South Australia, Australia
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McGuire V, Van Den Eeden SK, Tanner CM, Kamel F, Umbach DM, Marder K, Mayeux R, Ritz B, Ross GW, Petrovitch H, Topol B, Popat RA, Costello S, Manthripragada AD, Southwick A, Myers RM, Nelson LM. Association of DRD2 and DRD3 polymorphisms with Parkinson's disease in a multiethnic consortium. J Neurol Sci 2011; 307:22-9. [PMID: 21663922 PMCID: PMC3155471 DOI: 10.1016/j.jns.2011.05.031] [Citation(s) in RCA: 30] [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: 10/29/2010] [Revised: 05/16/2011] [Accepted: 05/18/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine genetic associations of polymorphisms in the dopamine receptor D2 (DRD2) and D3 (DRD3) genes with risk of Parkinson's disease (PD). METHODS The study included 1325 newly diagnosed patients with PD and 1735 controls from a consortium of five North American case-control studies. We collected risk factor information by in-person or telephone interview. Six DRD2 and two DRD3 polymorphisms were genotyped using a common laboratory. Odds ratios were estimated using logistic regression. RESULTS Among non-Hispanic whites, homozygous carriers of Taq1A DRD2 (rs1800497) polymorphism had an increased risk of PD compared to homozygous wildtype carriers (OR=1.5, 95% CI 1.0-2.3). In contrast, the direction of association for Taq1A polymorphism was opposite for African-Americans, showing an inverse association with PD risk (OR=0.10, 95% CI 0.2-0.7). Among white Hispanics who carried two alleles, the Ser9Gly DRD3 (rs6280) polymorphism was associated with a decreased risk of PD (OR=0.4, 95% CI 0.2-0.8). The inverse association of smoking with PD risk was not modified by any of the DRD2 or DRD3 polymorphisms. CONCLUSIONS DRD2 polymorphisms are unlikely to be true disease-causing variants; however, three DRD2 polymorphisms (including Taq1A) may be in linkage disequilibrium with possible disease associated variants in the DRD2-ANKK1-NCAM1-TTC12 gene cluster.
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Affiliation(s)
- V McGuire
- Department of Health Research and Policy, Division of Epidemiology, Stanford University School of Medicine, Stanford, CA 94305-5405, USA.
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Popat RA, Van Den Eeden SK, Tanner CM, Kamel F, Umbach DM, Marder K, Mayeux R, Ritz B, Ross GW, Petrovitch H, Topol B, McGuire V, Costello S, Manthripragada AD, Southwick A, Myers RM, Nelson LM. Coffee, ADORA2A, and CYP1A2: the caffeine connection in Parkinson's disease. Eur J Neurol 2011; 18:756-65. [PMID: 21281405 PMCID: PMC3556904 DOI: 10.1111/j.1468-1331.2011.03353.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE In 1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine animal models of Parkinson's disease (PD), caffeine protects neurons by blocking the adenosine receptor A2A (ADORA2A). Caffeine is primarily metabolized by cytochrome P450 1A2 (CYP1A2). Our objective was to examine whether ADORA2A and CYP1A2 polymorphisms are associated with PD risk or modify the caffeine-PD association. METHODS Parkinson's Epidemiology and Genetic Associations Studies in the United States (PEGASUS) included five population-based case-control studies. One laboratory genotyped four ADORA2A and three CYP1A2 polymorphisms in 1325 PD cases and 1735 age- and sex-matched controls. Information regarding caffeine (coffee) consumption and other lifestyle factors came from structured in-person or telephone interviews. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. RESULTS Two ADORA2A polymorphisms were inversely associated with PD risk - rs71651683, a 5' variant (adjusted allelic OR = 0.51, 95% CI 0.33-0.80, permutation-adjusted P = 0.015) and rs5996696, a promoter region variant (adjusted OR for AC and CC genotypes compared with the AA wild-type genotype were 0.76 (95% CI 0.57-1.02) and 0.37 (95% CI 0.13-1.01), respectively (permutation-adjusted P for trend = 0.04). CYP1A2 polymorphisms were not associated with PD risk; however, the coffee-PD association was strongest among subjects homozygous for either variant allele rs762551 (P(interaction) = 0.05) or rs2470890 (P(interaction) = 0.04). CONCLUSION In this consortium study, two ADORA2A polymorphisms were inversely associated with PD risk, but there was weak evidence of interaction with coffee consumption. In contrast, the coffee-PD association was strongest among slow metabolizers of caffeine who were homozygous carriers of the CYP1A2 polymorphisms.
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Affiliation(s)
- R A Popat
- Division of Epidemiology, Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, CA 94305-5405, USA.
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Abstract
BACKGROUND We constructed a cohort of first-degree relatives of participants in a population-based case-control study of Parkinson disease (PD) and compared the occurrence of Alzheimer disease (AD) and essential tremor (ET) in relatives of PD cases and controls. METHODS We relied on proband interviews to assess family history in 372 probands with incident PD confirmed by a movement disorder specialist and 404 controls from three rural California counties. RESULTS Overall, for the 2980 first-degree relatives of PD cases, the risk of AD was not increased compared with the 2981 relatives of controls. But relatives of younger onset PD cases (<or=60 years of age) were three times more likely to have received an AD diagnosis [hazard ratios (HR): 2.86; 95%CI: 1.44, 5.71]. Our data also suggest that some relatives of PD probands might be at a slightly increased risk of receiving an ET diagnosis, especially relatives of tremor dominant cases (HR: 1.69; 95%CI 0.99, 2.88), younger onset cases (HR: 2.03; 95%CI 0.93, 4.44), and male relatives (HR: 2.31; 95%CI 1.13, 4.73). In addition, fathers of cases were almost 15 years younger than fathers of controls when diagnosed with ET. Results were stable in sensitivity analyses. CONCLUSION Our study suggests a familial susceptibility to AD amongst first-degree relatives of younger onset PD cases.
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Affiliation(s)
- S Costello
- University of California, Los Angeles, Schools of Public Health and Medicine, Los Angeles, CA, USA.
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Lee CW, Buckley F, Costello S, Kelly S. A systematic review of the characteristics of randomised control trials featuring prostaglandins for the treatment of glaucoma. Curr Med Res Opin 2008; 24:2265-70. [PMID: 18582396 DOI: 10.1185/03007990802273652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To classify the comparative quantity and quality of the RCT evidence of pharmacological treatment for glaucoma. METHOD A systematic review of MEDLINE, EMBASE Cochrane CENTRAL and relevant conference proceedings was conducted up to March 2007. RCTs recruiting adults with primary open angle glaucoma (POAG) and/or ocular hypertension (OH) receiving any topical medication or placebo were included. RCTs containing a prostaglandin treatment arm were specifically considered. RESULTS A total of 510 publications were identified. Of these, 181 studies had a prostaglandin treatment arm. The median study duration was 12 weeks (IQR 4-13) and 78% of included trials had a duration of 3 months or less. The four studies over 1 year in duration all included a latanoprost and timolol treatment arm. There was a lack of data on younger populations (median of the mean ages of included patients was 63.4 years [IQR: 61-66 years]). Caucasians constituted 79.6% of the studied population. Evidence by ethnicity as well as by co-morbidity, was scarce. The primary outcome for 92% of studies was IOP reduction; little was reported on other indicators. Most trials reported adverse events, with hyperaemia most commonly reported. CONCLUSION The RCT evidence base for glaucoma treatment is extensive. This systematic review is the first to consider the characteristics of all RCTs containing a prostaglandin arm. The majority of trials are of short duration and focus on IOP as the efficacy outcome. The limitations of this study are that only trials with a prostaglandin treatment arm are included and due to the large number of included trials only top line data were extracted.
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Affiliation(s)
- C-W Lee
- Pfizer Ltd., Tadworth, Surrey, UK.
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19
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Costello S, O’Doherty E, Troy D, Ernst C, Kim KS, Stapleton P, Sweeney T, Mullen A. Association of polymorphisms in the calpain I, calpain II and growth hormone genes with tenderness in bovine M. longissimus dorsi. Meat Sci 2007; 75:551-7. [DOI: 10.1016/j.meatsci.2006.06.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Revised: 06/12/2006] [Accepted: 06/12/2006] [Indexed: 11/24/2022]
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Wolf MS, Zagory JA, Chang C, Knight S, Ray P, Kozloff M, Starr A, Lyons EA, Costello S, Bennett CL. Literacy and race predictors in localized prostate cancer treatment choice. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14541] [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
14541 Background: Studies have shown that African American populations have low rates of surgery, while similar assessments based on literacy skills have not been reported. Methods: Newly diagnosed prostate cancer patients (n = 311) were approached at 3 hospitals: private, county, and VA. Patients completed demographic and quality of life questionnaires as well as a literacy assessment at baseline, 3 month, and 12 month intervals. Results: Majority (60%) of African American patients were at low functional literacy. In multinomial regression analysis controlling for patient age, clinical stage at presentation, comorbidity, and treatment site, both African American race (RRR 2.4, 95% CI 1.35–5.91) and low literacy (6th grade reading level or below) were significantly and independently associated with a greater likelihood to receive external beam radiation treatment only in relation to other treatment options (AOR 4.26, 95% CI 2.34–7.75). Conclusions: In our inner city population of prostate cancer patients, white patients with high literacy skills opted for radical prostatectomy and persons with low literacy and/or African American race opted for radiation therapy. No significant financial relationships to disclose.
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Affiliation(s)
- M. S. Wolf
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - J. A. Zagory
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - C. Chang
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - S. Knight
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - P. Ray
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - M. Kozloff
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - A. Starr
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - E. A. Lyons
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - S. Costello
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
| | - C. L. Bennett
- Northwestern University, Chicago, IL; University of California San Francisco, San Francisco, CA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; Ingalls Hospital, Harvey, IL
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Witt WP, Pickard S, Kuzel T, McDade T, Perry S, Hung S, Zagory J, Lin H, Costello S, Colella K, Bennett CL. Relationship between biological and self-reported measures of stress among informal caregivers of patients with prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18506] [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
18506 Background: Informal caregivers of prostate cancer patients often experience chronic psychological stress that may adversely impact their physical and mental health, and their ability to care for their families and the patient. This study aims to determine the association between perceived and biological stress among informal caregivers of prostate cancer patients. Methods: A total of 24 informal caregivers of prostate cancer patients were recruited from both the Jesse Brown VA Center (Lakeside and Westside, Chicago) and the Robert H. Lurie Comprehensive Cancer Center at Northwestern University. Caregivers completed self-reported measures of stress, somatization, life events, burden, health status (SF-36) and mental health. Capillary blood spot samples from caregivers were used to examine two measures of biological stress, Epstein-Barr virus antibody titer and C-reactive protein. Results: Informal caregivers had a mean age of 63 years and were mostly female and spouses of patients with prostate cancer. Many had preexisting co-morbidities, including 45.8% with hypertension, 45.8% with arthritis, and 33.3% with diabetes. Nearly 30% had been hospitalized in the last 12 months. 33.3% of caregivers experienced at least one major life event in the last year and 62.5% had symptoms of somatization illness. Caregivers with symptoms of somatization illness had higher mean Epstein-Barr antibody titers as compared with those without symptoms (Mean EBV antibody titer: 198.3 versus 141.8, respectively (p < 0.05)). Caregiver-reported measures were not correlated with C-reactive protein levels. Caregivers with higher levels of strain perceived more stress in their lives (p < 0.05), but showed relatively high self-esteem (mean = 30.6, SD = 2.8, on a 7–35 scale). Conclusions: These preliminary findings suggest that informal caregivers who report symptoms of somatization illness exhibit signs of relative suppression of the cell-mediated immune processes as a result of the reactivation of the Epstein-Barr virus. Final analyses will be conducted that control for potential confounders and will further elucidate if caregiver stress is associated with suppression of the immune system. No significant financial relationships to disclose.
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Affiliation(s)
- W. P. Witt
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Pickard
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - T. Kuzel
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - T. McDade
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Perry
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Hung
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - J. Zagory
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - H. Lin
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - S. Costello
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - K. Colella
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
| | - C. L. Bennett
- Northwestern University, Chicago, IL; University of Illinois, Chicago, IL; University of Wisconsin, Madison, WI; Jesse Brown VA Center, Chicago, IL
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22
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Costello S, Bordelon Y, Ritz B. Lack of Familial Association of Alzheimer Disease and Essential Tremor with Parklnson Disease. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s177-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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McCaffrey K, Patel U, Rosen F, Carson K, Okano G, Auto H, Sharma R, Costello S, Argiris A, Pickard A, Schumock G, Bennett C. Inpatient and Outpatient Costs for Head and Neck (HNC) and Non-Small Cell Lung Cancer (NSCLC) Patients with Oral Mucositis (OM) and/or Esophagitis Who Undergo Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Costello S, Bronstein J, Ritz B. 135-S: Percolating on Parkinson Disease: The Effect of Dietary Caffeine Intake on Incident Parkinson Disease. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s34b] [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)
- S Costello
- UCLA School of Public Health, Los Angeles, CA 90095
| | - J Bronstein
- UCLA School of Public Health, Los Angeles, CA 90095
| | - B Ritz
- UCLA School of Public Health, Los Angeles, CA 90095
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Costello S, Wolf MS, Lyons EA, Ray P, Kozloff M, Bennett CL. Variations in treatment of lower SES prostate cancer patients at a VA, a county and a private hospital. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6072] [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: 11/20/2022] Open
Affiliation(s)
- S. Costello
- Northwestern Univ, Chicago, IL; Cook County Hosp, Chicago, IL; Ingalls Hosp, Chicago, IL
| | - M. S. Wolf
- Northwestern Univ, Chicago, IL; Cook County Hosp, Chicago, IL; Ingalls Hosp, Chicago, IL
| | - E. A. Lyons
- Northwestern Univ, Chicago, IL; Cook County Hosp, Chicago, IL; Ingalls Hosp, Chicago, IL
| | - P. Ray
- Northwestern Univ, Chicago, IL; Cook County Hosp, Chicago, IL; Ingalls Hosp, Chicago, IL
| | - M. Kozloff
- Northwestern Univ, Chicago, IL; Cook County Hosp, Chicago, IL; Ingalls Hosp, Chicago, IL
| | - C. L. Bennett
- Northwestern Univ, Chicago, IL; Cook County Hosp, Chicago, IL; Ingalls Hosp, Chicago, IL
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26
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Gupta S, Zhou P, Hassoun H, Kewalramani T, Reich L, Costello S, Drake L, Klimek V, Dhodapkar M, Teruya-Feldstein J, Hedvat C, Kalakonda N, Fleisher M, Filippa D, Qin J, Nimer SD, Comenzo RL. Hematopoietic stem cell mobilization with intravenous melphalan and G-CSF in patients with chemoresponsive multiple myeloma: report of a phase II trial. Bone Marrow Transplant 2005; 35:441-7. [PMID: 15640822 DOI: 10.1038/sj.bmt.1704779] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 11/09/2022]
Abstract
Multiple myeloma (MM) is an incurable hematologic malignancy for which autologous hematopoietic stem cell transplantation (HCT) is a standard therapy. The optimal method of stem cell mobilization is not defined. We evaluated intravenous melphalan (60 mg/m2), the most effective agent for MM, and G-CSF (10 microg/kg/day) for mobilization. End points were safety, adequacy of CD34+ collections, MM response, and contamination of stem cell components (SCC). In total, 32 patients were mobilized. There were no deaths or significant bleeding episodes; 14 patients (44%) required hospitalization for neutropenic fever. Median days of grade 3 or 4 neutropenia or thrombocytopenia were 7 (2-20) and 8 (3-17). Median mobilization days, CD34+ cells/kg and total leukaphereses were 16 (12-30), 12.1 million (2.6-52.8), and 2 (1-5) respectively. Four patients (12.5 %) failed to achieve the target of 4 million CD34+ cells/kg in five leukaphereses. Reduction in myeloma was seen in 11 patients (34%) with 3 (9%) achieving complete response; 15 (47%) maintained prior responses. Estimated MM contamination per SCC (N=48) was 0.0009% (range 0-0.1) and 0.21 x 10(4) cells per kg (range 0-41.2). Increased contamination was associated with increased patient age. This strategy for mobilization is feasible, frequently requires hospitalization and transfusion, and controls disease in most patients.
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Affiliation(s)
- S Gupta
- Hematology Service, Division of Hematologic Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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27
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Smith P, Masterson A, Basford L, Boddy G, Costello S, Marvell G, Redding M, Wallis B. Action research: a suitable method for promoting change in nurse education. Nurse Educ Today 2000; 20:563-570. [PMID: 12173260 DOI: 10.1054/nedt.2000.0466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This paper arose from a research study and its follow-up in four schools of nursing and midwifery. The study was concerned with evaluating the extent to which a philosophy of health had been integrated into the educational curricula of nurses, midwives and health visitors. The purpose of the follow-up was to disseminate and implement the study findings in the four centres. The findings showed that the interpretation and implementation of a philosophy of health in nursing had been variable. Health was operationalized as both health education and health promotion ranging from individualized information giving and disease prevention. Action research was chosen as the appropriate methodology for the follow-up because of its emphasis on participation and partnership. As the follow-up study progressed a number of issues emerged which were indicative of the changes taking place in nurse education as its institutional base shifted into higher education. Other issues were associated with the gap between the rhetoric and reality of action research and the expectations and needs of the key partners. The authors conclude that the follow-up study presented both challenges and opportunities to nurse educators in their endeavour to undertaken research and implement educational change.
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Affiliation(s)
- P Smith
- Faculty of Health, South Bank University, Essex Campus, Harold Wood Education Centre, Romford RM3 OBE, UK.
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Abstract
The purpose of this retrospective evaluation study was to compare outcomes related to two distinct processes for screening people referred for admission to a geriatric rehabilitation program at a chronic care hospital in southern Ontario. Data were collected through chart review and focus group methods. The results were unexpected in that the projected outcomes associated with the newer referral screening process did not materialize. For both referral screening processes, findings are discussed in terms of the percentage of achieved patient rehabilitation goals. The average lengths of patient stay associated with both screening processes were also compared. No statistically significant differences between the two processes were found in terms of either the percentage of goals achieved or the length of patient stay. Focus group sessions were held to elicit team members' perceptions of the effectiveness of each of the referral processes. Participants in the focus groups were supportive of the newer referral screening and admission process although the evidence gathered from the chart review did not demonstrate improvements in patients' length of stay or an increase in the percentage of rehabilitation goals achieved.
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Theriault RL, Lipton A, Hortobagyi GN, Leff R, Glück S, Stewart JF, Costello S, Kennedy I, Simeone J, Seaman JJ, Knight RD, Mellars K, Heffernan M, Reitsma DJ. Pamidronate reduces skeletal morbidity in women with advanced breast cancer and lytic bone lesions: a randomized, placebo-controlled trial. Protocol 18 Aredia Breast Cancer Study Group. J Clin Oncol 1999; 17:846-54. [PMID: 10071275 DOI: 10.1200/jco.1999.17.3.846] [Citation(s) in RCA: 472] [Impact Index Per Article: 18.9] [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: 11/20/2022] Open
Abstract
PURPOSE To assess whether pamidronate can reduce the frequency of skeletal morbidity in women with lytic bone metastases from breast cancer treated with hormone therapy. PATIENTS AND METHODS Three hundred seventy-two women with breast cancer who had at least one lytic bone lesion and who were receiving hormonal therapy were randomized to receive 90 mg of pamidronate or placebo as a 2-hour intravenous infusion given in double-blind fashion every 4 weeks for 24 cycles. Patients were evaluated for skeletal complications: pathologic fractures, spinal cord compression, irradiation of or surgery on bone, or hypercalcemia. The skeletal morbidity rate (the ratio of the number of skeletal complications to the time on trial) was the primary efficacy variable. Bone pain, use of analgesics, quality of life, performance status, bone tumor response, and biochemical parameters were also evaluated. RESULTS One hundred eighty-two patients who received pamidronate and 189 who received placebo were assessable. The skeletal morbidity rate was significantly reduced at 12, 18, and 24 cycles in patients treated with 90 mg of pamidronate (P = .028, .023, and .008, respectively). At 24 cycles, the proportion of patients having had any skeletal complication was 56% in the pamidronate group and 67% in the placebo group (P = .027). The time to the first skeletal complication was longer for patients receiving pamidronate than for those given placebo (P = .049). There was no statistical difference in survival or in objective bone response rate. Pamidronate was well tolerated. CONCLUSION Treatment with 90 mg of pamidronate as a 2-hour intravenous infusion every 4 weeks in addition to hormonal therapy significantly reduces skeletal morbidity from osteolytic metastases.
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Affiliation(s)
- R L Theriault
- Department of Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
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Abstract
Laryngeal rhabdomyosarcoma is a rare disease. Only nine of these tumours have been adequately described in world literature in the adult population. Adult patients with laryngeal rhabdomyosarcoma often present at a later stage than other laryngeal tumours, including squamous cell carcinoma. Diagnosis is made by identification of cross-striations histochemically or cytoplasmic myoglobin by immunohistological methods. We present a 66-year-old woman with pleomorphic rhabdomyosarcoma of her larynx. This is the first female in the adult age group to be presented. Surgical treatment with adjuvant radiotherapy is currently the treatment of choice for this disease. We provide a review of the literature on laryngeal rhabdomyosarcoma, including presentation, pathology and management of this rare disease.
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Affiliation(s)
- D R Ruske
- Department of Otolaryngology, Dunedin Hospital, New Zealand
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31
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Arthur MA, Muller RN, Costello S. Species Composition in a Central Hardwood Forest in Kentucky 11 Years After Clear-cutting. American Midland Naturalist 1997. [DOI: 10.2307/2426846] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Blackmore M, Richardson J, Costello S, Harpur E, Gray T. In vitro toxicity of cephalosporin and aminoglycoside antibiotics to LLC-PK1 cells assessed by changes in glucose uptake. Toxicol In Vitro 1994; 8:771-3. [DOI: 10.1016/0887-2333(94)90064-7] [Citation(s) in RCA: 3] [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: 10/27/2022]
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Lui K, Bryson SM, Irwin DB, Costello S. Evaluation of bayesian forecasting for individualized gentamicin dosage in infants weighing 1000 g or less. Am J Dis Child 1991; 145:463-7. [PMID: 2012032 DOI: 10.1001/archpedi.1991.02160040125021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We evaluated the use of Bayesian forecasting for gentamicin therapy in outborn infants weighing 1000 g or less irrespective of postnatal age. Dosages were individualized using a computer program, guided by early serum gentamicin assays after a loading dose and a database of population kinetics. Steady-state gentamicin levels achieved were compared with those from a regimen based on guidelines. A total of 26 gentamicin courses were individualized in 19 infants of 22 to 33 weeks' gestation, weighing 500 to 1000 g at 1 to 41 days of age. All steady-state trough levels were between 1 and 2.4 mg/L; peak levels were between 4.4 and 9.3 mg/L. The 95% confidence intervals were in almost identical ranges. The prevalence of toxic and suboptimal trough levels was less when compared with that of 23 gentamicin courses based on guidelines in 17 control infants. We conclude that early individualized gentamicin dosage over a range of postnatal age is a practical alternative and serum level distributions appear superior.
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Affiliation(s)
- K Lui
- Department of Pediatrics, Hospital For Sick Children, Toronto, Ontario
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34
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Costello S, Macbeth F. Management of lung cancer. BMJ 1991; 302:293. [PMID: 1847836 PMCID: PMC1668967 DOI: 10.1136/bmj.302.6771.293-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Blayney M, Costello S, Perlman M, Lui K, Frank J. A new system for location of endotracheal tube in preterm and term neonates. Pediatrics 1991; 87:44-7. [PMID: 1984617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A randomized, controlled trial was conducted to evaluate a new noninvasive system for placement of the endotracheal tube, based on a magnetic field interference-sensing technique. Seventy-two neonates treated by the standard technique were compared with 70 treated by the new system (TRACH MATE), with radiographic localization as the standard. As judged by the author(s) on the morning after the intubation, correct initial placement was achieved in 69 (78%) of 88 intubations using the new system, compared with 71 (66%) of 107 using the standard technique (Fisher's Test, one-tailed, P = .044). Repositioning was actually done in 23 (26%) of 88 TRACH MATE intubations, compared with 42 (39%) of 107 standard intubations (Fisher's test, one-tailed; P = .037). Intubation of the right main bronchus occurred in 7 standard intubations, but in none of the TRACH MATE intubations (Fisher's test, one-tailed; P = .014). Endotracheal tube position (high, low, or appropriate) was correctly determined by TRACH MATE in 77 (90%) of 85 intubations; the position was not recorded on three occasions. No differences in the number of complications (eg, unplanned extubations, distal displacement, subglottic stenosis) were found between the two groups. It is concluded that the TRACH MATE technique is superior to the standard clinical method in initial placement of the endotracheal tube.
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Affiliation(s)
- M Blayney
- Division of Neonatology (Department of Paediatrics), Hospital for Sick Children, Toronto, Ontario, Canada
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36
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Lui K, Boag G, Daneman A, Costello S, Kirpalani H, Whyte H. Widened subarachnoid space in pre-discharge cranial ultrasound: evidence of cerebral atrophy in immature infants? Dev Med Child Neurol 1990; 32:882-7. [PMID: 2257986 DOI: 10.1111/j.1469-8749.1990.tb08100.x] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The authors examined the incidence of widened subarachnoid spaces (SAS) among 75 infants with birthweights less than or equal to 1250g, and their significance in developmental outcome. Nine of 30 infants with gestations less than or equal to 27 weeks had widened SAS in their pre-discharge ultrasound scans. Three of the nine, including two with periventricular leukomalacia (PVL), had late-onset ventricular enlargement, unrelated to intraventricular haemorrhage (IVH): all three were developmentally impaired. The other six infants without ventricular enlargement developed normally, including one with IVH. Five of the remaining 21 infants with gestations less than or equal to 27 weeks and without widened SAS were developmentally impaired. Widened SAS was not associated with a significantly increased risk of developmental impairment; ventricular enlargement and PVL were the only significant factors. The authors conclude that an isolated finding of widened SAS is not predictive of impairment in immature infants.
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Affiliation(s)
- K Lui
- Department of Paediatrics, Westmead Hospital, N.S.W., Australia
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Affiliation(s)
- S Costello
- Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
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Jennings E, Costello S, Durkin P, Rotkovitch R. Nursing service--nursing education: a collaborative venture. Nurs Manag (Harrow) 1987; 18:104. [PMID: 3650750 DOI: 10.1097/00006247-198709000-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Costello S, Summers BY. Documenting patient care: getting it all together. Nurs Manag (Harrow) 1985; 16:31-4. [PMID: 3846848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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