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Creswell L, Rolnik DL, Burke B, Daly S, O'Gorman N. Perinatal and neonatal outcomes of high-risk asymptomatic women from a specialist preterm birth surveillance clinic. Eur J Obstet Gynecol Reprod Biol 2024; 296:114-119. [PMID: 38428382 DOI: 10.1016/j.ejogrb.2024.02.047] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/10/2024] [Accepted: 02/25/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES To report the perinatal outcomes of high-risk asymptomatic women who attended a specialist preterm surveillance clinic (PSC) to undergo screening for spontaneous preterm birth (PTB) in Ireland. METHODS Single center, retrospective cohort study of asymptomatic high risk women who attended the PSC between January 2019 and December 2022. A comprehensive database of all patients who attended the clinic during the study period was constructed and analyzed. Overall outcomes were reported, and stratified per the occurrence of preterm or term birth. Iatrogenic PTBs were included in the outcome data. RESULTS Following exclusions for loss-to-follow-up, 762 cases were analyzed, constituting 2262 PSC visits. Of those, 183 women were prescribed progesterone (24.0 %), and 100 women underwent cervical cerclage (13.1 %) to prevent spontaneous PTB. Overall, 2.4 %, 6.2 % and 18.6 % of participants gave birth prior to 30 weeks, 34 weeks, and 37 weeks, respectively. The median gestational age at birth for the entire cohort was 38.6 weeks (inter-quartile range (IQR) 37.2-39.6 weeks). Women who delivered < 37 weeks were significantly more likely to be smokers (p = 0.030), have a previous spontaneous PTB (p = 0.016), have multiple pregnancies (p < 0.001), type 1 or 2 diabetes (p = 0.044), or have a previous full dilatation caesarean section birth (p = 0.024). Infants born prior to 37 weeks were more likely to have a lower median birthweight (2270 vs 3300 g, p < 0.001), be admitted to a neonatal intensive care unit (53.8 % vs 2.3 %, p < 0.001) or experience short-term morbidity, including respiratory support (38.0 % vs 1.6 %, p < 0.001). CONCLUSIONS Over 80% of women deemed to be at high risk of PTB gave birth at term gestations following attendance at a PSC during pregnancy. Most women can be successfully managed without interventions, instead employing a policy of serial cervical surveillance, to identify those at greatest risk of PTB.
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Affiliation(s)
- L Creswell
- Department of Obstetrics and Gynecology, The Coombe Hospital, Dublin, Ireland.
| | - D L Rolnik
- Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia
| | - B Burke
- Department of Obstetrics and Gynecology, The Coombe Hospital, Dublin, Ireland
| | - S Daly
- Department of Obstetrics and Gynecology, The Coombe Hospital, Dublin, Ireland
| | - N O'Gorman
- Department of Obstetrics and Gynecology, The Coombe Hospital, Dublin, Ireland
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Zhang P, Fleming P, Andoniou CE, Waltner OG, Bhise SS, Martins JP, McEnroe BA, Voigt V, Daly S, Kuns RD, Ekwe AP, Henden AS, Saldan A, Olver S, Varelias A, Smith C, Schmidt CR, Ensbey KS, Legg SR, Sekiguchi T, Minnie SA, Gradwell M, Wagenaar I, Clouston AD, Koyama M, Furlan SN, Kennedy GA, Ward ES, Degli-Esposti MA, Hill GR, Tey SK. IL-6-mediated endothelial injury impairs antiviral humoral immunity after bone marrow transplantation. J Clin Invest 2024; 134:e174184. [PMID: 38557487 PMCID: PMC10977988 DOI: 10.1172/jci174184] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/09/2024] [Indexed: 04/04/2024] Open
Abstract
Endothelial function and integrity are compromised after allogeneic bone marrow transplantation (BMT), but how this affects immune responses broadly remains unknown. Using a preclinical model of CMV reactivation after BMT, we found compromised antiviral humoral responses induced by IL-6 signaling. IL-6 signaling in T cells maintained Th1 cells, resulting in sustained IFN-γ secretion, which promoted endothelial cell (EC) injury, loss of the neonatal Fc receptor (FcRn) responsible for IgG recycling, and rapid IgG loss. T cell-specific deletion of IL-6R led to persistence of recipient-derived, CMV-specific IgG and inhibited CMV reactivation. Deletion of IFN-γ in donor T cells also eliminated EC injury and FcRn loss. In a phase III clinical trial, blockade of IL-6R with tocilizumab promoted CMV-specific IgG persistence and significantly attenuated early HCMV reactivation. In sum, IL-6 invoked IFN-γ-dependent EC injury and consequent IgG loss, leading to CMV reactivation. Hence, cytokine inhibition represents a logical strategy to prevent endothelial injury, thereby preserving humoral immunity after immunotherapy.
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Affiliation(s)
- Ping Zhang
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Peter Fleming
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Christopher E. Andoniou
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Olivia G. Waltner
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Shruti S. Bhise
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jose Paulo Martins
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | | | - Valentina Voigt
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Sheridan Daly
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Rachel D. Kuns
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Adaeze P. Ekwe
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Andrea S. Henden
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- University of Queensland, St Lucia, Queensland, Australia
- Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
| | - Alda Saldan
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- University of Queensland, St Lucia, Queensland, Australia
| | - Stuart Olver
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Antiopi Varelias
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- University of Queensland, St Lucia, Queensland, Australia
| | - Corey Smith
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Christine R. Schmidt
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Kathleen S. Ensbey
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Samuel R.W. Legg
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Tomoko Sekiguchi
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Simone A. Minnie
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Mark Gradwell
- Cancer Sciences Unit, Centre for Cancer Immunology, University of Southampton, Southampton, United Kingdom
| | - Irma Wagenaar
- Cancer Sciences Unit, Centre for Cancer Immunology, University of Southampton, Southampton, United Kingdom
| | | | - Motoko Koyama
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Scott N. Furlan
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Pediatrics and
| | - Glen A. Kennedy
- University of Queensland, St Lucia, Queensland, Australia
- Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
| | - E Sally Ward
- Cancer Sciences Unit, Centre for Cancer Immunology, University of Southampton, Southampton, United Kingdom
| | - Mariapia A. Degli-Esposti
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Geoffrey R. Hill
- Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Division of Medical Oncology, University of Washington, Seattle, Washington, USA
| | - Siok-Keen Tey
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- University of Queensland, St Lucia, Queensland, Australia
- Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
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Creswell L, Rolnik DL, Burke B, Daly S, O'Gorman N. Performance of QUiPP app v.2 tool for prediction of preterm birth in asymptomatic high-risk women attending preterm specialist clinic: external validation study. Ultrasound Obstet Gynecol 2024. [PMID: 38379428 DOI: 10.1002/uog.27619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES External validation of the QUiPP App v.2 algorithms in an independent cohort of high-risk asymptomatic women attending an Irish preterm birth surveillance clinic (PSC). METHODS Retrospective, single center, observational study assessing discrimination and calibration of the QUiPP App v.2 at the six pre-determined clinical time points (birth prior to 30, 34, 37 weeks of pregnancy, and birth within one, two and four weeks of testing). Discrimination was assessed by estimating the area under the receiver-operating characteristics (ROC) curve (AUC) and sensitivity at fixed false-positive rates of 5%, 10% and 20%. Model calibration was assessed to evaluate the concordance between expected and observed outcomes. P-values <0.05 were considered statistically significant. No adjustments for treatment effects were made. RESULTS 762 women and 1660 preterm birth surveillance clinic (PSC) visits utilizing the QUiPP between 2019 and 2022 were analyzed. The study population included 142 patients who later experienced a PTB (18.6%). QUiPP's performance to predict short-term outcomes such as birth within one week (AUC 0.866, 95% CI 0.755-0.955), two weeks (AUC 0.721, 95% CI 0.569-0.854) and four weeks (AUC 0.775, 95% CI 0.699-0.842), and delivery before 30 weeks (AUC 0.747, 95% CI 0.613-0.865) was superior to its ability to predict longer-term outcomes (birth <37 weeks; AUC 0.631, 95% CI 0.596-0.668). Calibration was generally good for low-risk results as the predicted risk in these patients tended to match the observed incidence. However, in women deemed to be at greater risk of delivery, the predicted probability superseded the observed incidence of PTB. CONCLUSION QUiPP accurately discriminates women who are at short-term risk of PTB. A treatment paradox may influence calibration in high-risk women. Further research is needed to ascertain if QUiPP treatment thresholds can be safely adjusted in women receiving prophylactic treatment to prevent PTB, and whether this improves outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- L Creswell
- Department of Obstetrics and Gynaecology, The Coombe Hospital, Dublin, Ireland
| | - D L Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - B Burke
- Department of Obstetrics and Gynaecology, The Coombe Hospital, Dublin, Ireland
| | - S Daly
- Department of Obstetrics and Gynaecology, The Coombe Hospital, Dublin, Ireland
| | - N O'Gorman
- Department of Obstetrics and Gynaecology, The Coombe Hospital, Dublin, Ireland
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Daly S, Mohamed O, Loughrey J, Kearsley R, Drew T. 'Sip 'til Send': a prospective study of the effect of a liberal fluid fasting policy on patient reported and haemodynamic variables at elective caesarean delivery. Int J Obstet Anesth 2024; 57:103956. [PMID: 38030525 DOI: 10.1016/j.ijoa.2023.103956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/16/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Affiliation(s)
- S Daly
- Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland
| | - O Mohamed
- Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland
| | - J Loughrey
- Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland
| | - R Kearsley
- Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland
| | - T Drew
- Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland.
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Daly S, Rishniw M, Graham PA, Freeman KP. Repeat patient testing-quality control compared to commercial quality control material for the Sysmex XT-2000iV hematology analyzer in a multi-site veterinary laboratory. Vet Clin Pathol 2024; 53 Suppl 1:48-59. [PMID: 38356015 DOI: 10.1111/vcp.13332] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 12/28/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Quality control material (QCM) for hematology in veterinary laboratories is limited, and repeat patient testing quality control (RPT-QC) is an alternative method using excess matrix-specific samples. OBJECTIVES This study aimed to determine if median differences between RPT-QC analyses for each time interval for RBC, HGB, HCT, and WBC were the same, determine if unified RPT-QC limits can be applied to a network of veterinary laboratories, compare the performance of RPT-QC to commercial QCM for the reference analyzer and evaluate the experience over a 4 month period and design, improve and implement an automated spreadsheet for RPT-QC data management. METHODS The potential to unify individual analyzer RPT-QC limits for red blood cells (RBC), hematocrit (HCT), hemoglobin (HGB), and white blood cells (WBC) on multi-site Sysmex XT-2000-iV analyzers was explored by a difference of means test and confidence interval determination for the median difference for each network analyzer in comparison to the network reference analyzer. User experience of an automated RPT-QC data management Excel spreadsheet was collected by user feedback during monthly meetings. Numbers of out-of-control results and the root causes for these for RPT-QC were compared against those of a commercial QCM over a 4-month period. RESULTS Differences between individual analyzer RPT-QC limits were too large to allow for unification of network limits. The automated spreadsheet successfully highlighted out-of-control events for RPT-QC. Trends or shifts were more frequent for commercial QCM based on observed performance and a 1-2.5 s QC rule than for RPT-QC. Following routine troubleshooting, RPT-QC out-of-control events were resolved with an alternative RPT-QC sample indicating random error associated with excessive deterioration. Use of an automated spreadsheet for recording RPT-QC, documentation and troubleshooting of out-of-control events, and collating monthly summary calculations were considered an asset in laboratory quality management. CONCLUSIONS RPT-QC can be successfully implemented and integrated into a multi-site veterinary laboratory. Individual analyzer RPT-QC limit generation is recommended. The deterioration of commercial QCM caused shifts or trends in QC results, which initiated more repeat analyses and investigations than did RPT-QC.
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Affiliation(s)
- S Daly
- Veterinary Pathology Group, Brushville House, Dosco Business Park, Cork, Ireland
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| | - M Rishniw
- Veterinary Information Network, Davis, California, USA
| | - P A Graham
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| | - K P Freeman
- Veterinary Information Network, Davis, California, USA
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Lyons J, Harada GK, Yeakel J, Cho M, Dayyani F, Smith B, Daly S, Nguyen N, Keshava H, Kuo JV, Seyedin SN. Evaluation of Metastatic Potential in Esophageal and Gastroesophageal Junction (GEJ) Cancer with Adherence to Elective Nodal Volume Guidelines: A Retrospective Analysis of Elective Nodal Irradiation. Int J Radiat Oncol Biol Phys 2023; 117:e320-e321. [PMID: 37785146 DOI: 10.1016/j.ijrobp.2023.06.2360] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In 2015, expert guidelines on esophageal/GEJ cancer contouring for intensity-modulated radiation therapy (IMRT) were published in IJROBP, which delineate recommended elective nodal basins (celiac, para-aortic, gastrohepatic ligament, supraclavicular) to be irradiated depending on the primary tumor location. We hypothesize that incomplete coverage of these areas increases the risk of the development of distant failures. MATERIALS/METHODS Patients treated for non-metastatic esophageal or GEJ cancer with chemoradiotherapy pre-operatively or definitively from 2012 to 2021 were retrospectively identified from a single institution database. Radiation plans of eligible patients were then analyzed by tumor location. Plans were deemed guideline-compliant if radiation dose coverage, between 41.4 to 45 Gy, encompassed nodal basins recommended by the 2015 guidelines. The primary endpoint of this study was the overall rate of distant disease. Other endpoints included locoregional failures, defined as failures within the radiation field but outside of the primary tumor, and local failures within the gross tumor volume. Summary and descriptive statistics were used to define collected variables. Differences were measured using chi-square and Fisher's exact test for categorical variables and two-sided t-tests for continuous measures. Assessment of distant, locoregional, and local failures were assessed using univariate logistic regression with statistical significance at p < 0.05. RESULTS With a median follow-up of 25.0 months, 37 patients, with a median age of 66, were included in the study. Most patients were male (94.6%) with cT3 (54.1%), cN0 (43.2%), moderately differentiated (47.1%) adenocarcinoma (75.7%) located at the GEJ (56.8%). The median radiation dose used was 50.4 Gy, with the majority of patients receiving concurrent carboplatin and paclitaxel (83.8%). Four patients received induction chemotherapy and 20 (55.6%) underwent esophagectomy. When examining guideline compliance, 17 (46.0%) radiation plans demonstrated adequate ENI. The most common improperly covered nodal basin was para-aortic (65.0%), followed by gastrohepatic (30.0%). No patients with sufficient ENI coverage (0/17) developed distant failure compared to 45.0% (9/20) with insufficient coverage (p = 0.001). There were inappreciable differences in locoregional or local failure rates between those with and without complete ENI. Patients with complete ENI were more likely to be of larger craniocaudal length (p = 0.007) or have N2 disease (p = 0.003). When examining other tumor characteristics (histologic subtype, location, HER2 status, esophagectomy rate) of patients with and without complete ENI, no further differences were noted. CONCLUSION These results suggest that proper coverage of nodal basins, when indicated by expert guidelines, could improve distant metastasis. ENI analysis of previous prospective CRT studies for esophageal cancer could validate these findings.
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Affiliation(s)
- J Lyons
- University of California, Irvine School of Medicine, Irvine, CA
| | - G K Harada
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - J Yeakel
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - M Cho
- Division of Hematology/Oncology, Department of Medicine, University of California - Irvine, Orange, CA
| | - F Dayyani
- Division of Hematology/Oncology, Department of Medicine, University of California - Irvine, Orange, CA
| | - B Smith
- Department of General Surgery, University of California - Irvine, Orange, CA
| | - S Daly
- Department of General Surgery, University of California - Irvine, Orange, CA
| | - N Nguyen
- Department of General Surgery, University of California - Irvine, Orange, CA
| | - H Keshava
- Division of Cardiothoracic Surgery, Department of Surgery, University of California - Irvine, Orange, CA
| | - J V Kuo
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
| | - S N Seyedin
- Department of Radiation Oncology, University of California - Irvine, Orange, CA
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Schuster IS, Sng XYX, Lau CM, Powell DR, Weizman OE, Fleming P, Neate GEG, Voigt V, Sheppard S, Maraskovsky AI, Daly S, Koyama M, Hill GR, Turner SJ, O'Sullivan TE, Sun JC, Andoniou CE, Degli-Esposti MA. Infection induces tissue-resident memory NK cells that safeguard tissue health. Immunity 2023; 56:2173-2174. [PMID: 37703831 DOI: 10.1016/j.immuni.2023.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
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Schuster IS, Sng XYX, Lau CM, Powell DR, Weizman OE, Fleming P, Neate GEG, Voigt V, Sheppard S, Maraskovsky AI, Daly S, Koyama M, Hill GR, Turner SJ, O'Sullivan TE, Sun JC, Andoniou CE, Degli-Esposti MA. Infection induces tissue-resident memory NK cells that safeguard tissue health. Immunity 2023; 56:531-546.e6. [PMID: 36773607 PMCID: PMC10360410 DOI: 10.1016/j.immuni.2023.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 10/17/2022] [Accepted: 01/17/2023] [Indexed: 02/12/2023]
Abstract
Tissue health is dictated by the capacity to respond to perturbations and then return to homeostasis. Mechanisms that initiate, maintain, and regulate immune responses in tissues are therefore essential. Adaptive immunity plays a key role in these responses, with memory and tissue residency being cardinal features. A corresponding role for innate cells is unknown. Here, we have identified a population of innate lymphocytes that we term tissue-resident memory-like natural killer (NKRM) cells. In response to murine cytomegalovirus infection, we show that circulating NK cells were recruited in a CX3CR1-dependent manner to the salivary glands where they formed NKRM cells, a long-lived, tissue-resident population that prevented autoimmunity via TRAIL-dependent elimination of CD4+ T cells. Thus, NK cells develop adaptive-like features, including long-term residency in non-lymphoid tissues, to modulate inflammation, restore immune equilibrium, and preserve tissue health. Modulating the functions of NKRM cells may provide additional strategies to treat inflammatory and autoimmune diseases.
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Affiliation(s)
- Iona S Schuster
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia.
| | - Xavier Y X Sng
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Colleen M Lau
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David R Powell
- Monash Bioinformatics Platform, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Orr-El Weizman
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter Fleming
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia
| | - Georgia E G Neate
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Valentina Voigt
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia
| | - Sam Sheppard
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andreas I Maraskovsky
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia
| | - Sheridan Daly
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia
| | - Motoko Koyama
- Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Geoffrey R Hill
- Translational Science and Therapeutics, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Stephen J Turner
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Timothy E O'Sullivan
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Joseph C Sun
- Immunology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christopher E Andoniou
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia
| | - Mariapia A Degli-Esposti
- Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia; Centre for Experimental Immunology, Lions Eye Institute, Nedlands, WA, Australia.
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Daly S, Gibbons C, Callaly E, Gaynor E. 240 STANDARDISING POST-FALL MEDICAL REVIEWS FOR HOSPITAL INPATIENTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.209] [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: 11/13/2022] Open
Abstract
Abstract
Background
Falls are the most common adverse incident of inpatients in Irish hospitals. 6% of inpatient falls cause serious injury. Older inpatients have the highest risk of falling and the highest risk of injury. The post-fall medical review is critical to assess why a patient fell, did the fall cause injury and for the introduction of measures to prevent future falls. We assessed the quality of the post fall reviews in a large hospital. We then introduced a standardised post-fall medical review pro forma and reassessed the quality of the reviews.
Methods
We reviewed 18 charts of patients that fell in hospital and assessed the documentation of the post fall review in terms of the inclusion of key elements such as patient identifiers, history, examination, injury management and future falls prevention. We then introduced a post-fall standardised pro-forma on five wards in the hospital and following this assessed 19 charts of patients who had fallen looking at the same key elements of the post fall review. We compared the quality of the post-fall review before and after the introduction of the pro forma.
Results
The post-falls medical review pro forma improved the quality of the post fall medical review. Hip Trauma: 11.1% of doctors asked about hip strike prior to proforma versus 100% who asked with the proforma. Joint examination: 50% assessed this prior to the proforma versus 100% with the pro-forma. Other aspects of the review that improved included head-strike assessment (89% versus 100%), loss of consciousness history (61% versus 95%), medication reviewed (22% versus 68%) and vital signs assessed (67% versus 95%).
Conclusion
The introduction of a standardised post fall review pro forma improves the quality of this important medical review. It is a useful aid for doctors and provides a framework to follow when reviewing the patient.
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Affiliation(s)
- S Daly
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - C Gibbons
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - E Callaly
- Mater Misericordiae University Hospital , Dublin, Ireland
| | - E Gaynor
- Mater Misericordiae University Hospital , Dublin, Ireland
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Menzies S, Daly S, O’Connor R, Kelly A, Fitzgerald M, Bourke J, McKenna DB. A re-evaluation of teenage sunbed use following the introduction of banning legislation for under 18-year-olds. J Public Health (Oxf) 2020; 42:588-593. [DOI: 10.1093/pubmed/fdz015] [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] [Received: 07/29/2018] [Revised: 12/26/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is little information on the effectiveness of introducing age restriction legislation alone to reduce the rate of sunbed usage by teenagers. Prior to the Public Health (Sunbed) Act of 2014 prohibiting the use of sunbeds in under 18-year-olds in Ireland we reported the rate of sunbed use at 7.5%.
Objectives
The aim of the study was to compare the rate of sunbed usage among Irish teenagers before and after the introduction of banning legislation to determine if it had the desired effect of reducing its rate of use.
Methods
In a cross-sectional survey, students from the same schools as in our previous study completed an anonymous, written questionnaire pertaining to sunbed usage.
Results
In total, 783 questionnaires, from 13 schools across Ireland, were completed. The rate of sunbed use in the current study was 7.2%, compared to 7.5% in the pre-ban study, (P = 0.76). A higher rate of sunbed use was observed in Dublin schools and female public students.
Conclusion
Our study suggests that legislation alone is ineffective at reducing sunbed usage in a teenage population. A multifaceted approach is required that includes enforcement of the legislation together with targeted public education and awareness campaigns using all aspects of the media.
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Affiliation(s)
- S Menzies
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - S Daly
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - R O’Connor
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - A Kelly
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - M Fitzgerald
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - J Bourke
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - D B McKenna
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
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12
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Thomas R, Daly S. EP1.06-08 A Retrospective Analysis on Sarcomatoid Mesothelioma to Identify If Chemotherapy Provides Greater Overall Survival Compared to BSC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2182] [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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13
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Hehir MP, Burke N, Burke G, Turner MJ, Breathnach FM, Mcauliffe FM, Morrison JJ, Dornan S, Higgins J, Cotter A, Geary MP, Mcparland P, Daly S, Cody F, Dicker P, Tully E, Malone FD. Sonographic markers of fetal adiposity and risk of Cesarean delivery. Ultrasound Obstet Gynecol 2019; 54:338-343. [PMID: 30887629 DOI: 10.1002/uog.20263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/11/2018] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Increased fetal size is associated with shoulder dystocia during labor and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically in late pregnancy is associated with increased risk of operative delivery. METHODS This secondary analysis of the Genesis Study recruited 2392 nulliparous women with singleton pregnancy in cephalic presentation, in a prospective, multicenter study, to examine prenatal and intrapartum predictors of Cesarean delivery. Participants underwent ultrasound and clinical evaluation between 39 + 0 and 40 + 6 weeks' gestation. Data on fetal biometry were not revealed to patients or to their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal wall thickness was compiled for each infant in order to determine whether fetal adiposity > 90th centile was associated with an increased risk of Cesarean or operative vaginal delivery. RESULTS After exclusions, data were available for 2330 patients. Patients with a fetal adiposity composite > 90th centile had a higher maternal body mass index (BMI) (25 ± 5 kg/m2 vs 24 ± 4 kg/m2 ; P = 0.005), birth weight (3872 ± 417 g vs 3585 ± 401 g; P < 0.0001) and rate of induction of labor (47% (108/232) vs 40% (834/2098); P = 0.048) than did those with an adiposity composite ≤ 90th centile. Fetuses with adiposity composite > 90th centile were more likely to require Cesarean delivery than were those with adiposity composite ≤ 90th centile (P < 0.0001). After adjusting for birth weight, maternal BMI and need for induction of labor, fetal adiposity > 90th centile remained a risk factor for Cesarean delivery (P < 0.0001). A fetal adiposity composite > 90th centile was more predictive of the need for unplanned Cesarean delivery than was an estimated fetal weight > 90th centile (odds ratio, 2.20 (95% CI, 1.65-2.94; P < 0.001) vs 1.74 (95% CI, 1.29-2.35; P < 0.001). Having an adiposity composite > 90th centile was not associated with an increased likelihood of operative vaginal delivery when compared with having an adiposity composite ≤ 90th centile (P = 0.37). CONCLUSIONS Fetuses with increased adipose deposition are more likely to require Cesarean delivery than are those without increased adiposity. Consideration should, therefore, be given to adding fetal thigh adiposity and abdominal wall thickness to fetal sonographic assessment in late pregnancy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M P Hehir
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - N Burke
- Rotunda Hospital, Dublin, Ireland
| | - G Burke
- Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - M J Turner
- University College Dublin Centre for Human Reproduction, School of Medicine and Medical Science, Coombe Women and Infants Maternity Hospital, Dublin, Ireland
| | - F M Breathnach
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
| | - F M Mcauliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - J J Morrison
- Department of Obstetrics and Gynaecology, National University of Ireland, Galway, Ireland
| | - S Dornan
- Royal Jubilee Maternity Hospital, Belfast, Ireland
| | - J Higgins
- University College Cork, Cork University Maternity Hospital, Cork, Ireland
| | - A Cotter
- Department of Obstetrics and Gynaecology, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | | | - P Mcparland
- National Maternity Hospital, Dublin, Ireland
| | - S Daly
- Coombe Women and Infants Maternity Hospital, Dublin, Ireland
| | - F Cody
- Rotunda Hospital, Dublin, Ireland
| | - P Dicker
- Epidemiology & Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - E Tully
- Rotunda Hospital, Dublin, Ireland
| | - F D Malone
- Royal College of Surgeons in Ireland, Rotunda Hospital, Dublin, Ireland
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14
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Martins JP, Andoniou CE, Fleming P, Kuns RD, Schuster IS, Voigt V, Daly S, Varelias A, Tey SK, Degli-Esposti MA, Hill GR. Strain-specific antibody therapy prevents cytomegalovirus reactivation after transplantation. Science 2019; 363:288-293. [PMID: 30655443 DOI: 10.1126/science.aat0066] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 08/19/2018] [Accepted: 11/15/2018] [Indexed: 12/18/2022]
Abstract
Cytomegalovirus infection is a frequent and life-threatening complication that significantly limits positive transplantation outcomes. We developed preclinical mouse models of cytomegalovirus reactivation after transplantation and found that humoral immunity is essential for preventing viral recrudescence. Preexisting antiviral antibodies decreased after transplant in the presence of graft-versus-host disease and were not replaced, owing to poor reconstitution of donor B cells and elimination of recipient plasma cells. Viral reactivation was prevented by the transfer of immune serum, without a need to identify and target specific antigenic determinants. Notably, serotherapy afforded complete protection, provided that the serum was matched to the infecting viral strain. Thus, we define the mechanisms for cytomegalovirus reactivation after transplantation and identify a readily translatable strategy of exceptional potency, which avoids the constraints of cellular therapies.
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Affiliation(s)
- Jose Paulo Martins
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Christopher E Andoniou
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia.,Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Peter Fleming
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia
| | - Rachel D Kuns
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Iona S Schuster
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia.,Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Valentina Voigt
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia
| | - Sheridan Daly
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia
| | - Antiopi Varelias
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Siok-Keen Tey
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Mariapia A Degli-Esposti
- Immunology and Virology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia. .,Centre for Experimental Immunology, Lions Eye Institute, Perth, Western Australia, Australia.,Infection and Immunity Program and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Geoffrey R Hill
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. .,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Medical Oncology, University of Washington, Seattle, WA, USA
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15
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Affiliation(s)
- S. Menzies
- Department of Dermatology Sligo University Hospital Sligo Ireland
| | - S. Daly
- Department of Dermatology Sligo University Hospital Sligo Ireland
| | - D.B. McKenna
- Department of Dermatology Sligo University Hospital Sligo Ireland
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16
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Gilhooley E, Daly S, Gallagher O, Glacken M, McKenna D. 皮肤疾病的经验及与医疗提供者的关系. Br J Dermatol 2019. [DOI: 10.1111/bjd.17969] [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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17
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Gilhooley E, Daly S, Gallagher O, Glacken M, McKenna D. Experience of skin disease and relationships with healthcare providers. Br J Dermatol 2019. [DOI: 10.1111/bjd.17952] [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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18
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Gilhooley E, Daly S, Gallagher O, Glacken M, McKenna D. Experience of skin disease and relationships with healthcare providers: a qualitative study of Traveller women in Ireland. Br J Dermatol 2019; 180:1405-1411. [PMID: 30693477 DOI: 10.1111/bjd.17697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Significant health disparities exist between members of the Travelling community and those of the general population. Barriers to Traveller engagement with health services include the experience or perception of discrimination, and cultural and health literacy barriers. Experience of skin disease and interactions with healthcare providers has not been widely explored in this ethnic minority. The formation of positive relationships between the Travelling community and healthcare providers is important in the promotion of treatment adherence and improving health outcomes. OBJECTIVES To investigate Travellers' experience of skin disease and their relationships with healthcare providers. METHODS Focus groups were conducted with a purposive sample of female members of the Irish Travelling community with experience of skin health issues, between January 2018 and April 2018. Three focus groups were conducted at three separate locations with 10 participants in each group. Themes were identified from the focus group transcripts using an inductive thematic analysis framework. RESULTS Emergent themes surrounding relationships between Travellers and healthcare providers included health literacy, discrimination, information inconsistency, trust and communication. Factors that were valued in the creation of positive relationships included an appreciation of varying degrees of health literacy, the provision of sufficient information tailored to an individual's needs and a demonstration of cultural competence. CONCLUSIONS Dermatologists are well placed to provide practical, customized, treatment guidance and engage patients while integrating their culturally based beliefs.
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Affiliation(s)
- E Gilhooley
- Dermatology Department, Sligo University Hospital, Sligo, Ireland
| | - S Daly
- Dermatology Department, Sligo University Hospital, Sligo, Ireland
| | - O Gallagher
- Dermatology Department, Sligo University Hospital, Sligo, Ireland
| | - M Glacken
- Institute of Technology, Sligo, Ireland
| | - D McKenna
- Dermatology Department, Sligo University Hospital, Sligo, Ireland
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19
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Menzies S, Daly S, McKenna DB. Evaluating patients' perspectives on social media: the importance of clearly reporting data search, cleaning and processing. Reply from the authors. Br J Dermatol 2019; 181:222-223. [PMID: 30851205 DOI: 10.1111/bjd.17871] [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: 11/28/2022]
Affiliation(s)
- S Menzies
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - S Daly
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - D B McKenna
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
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20
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Blake RA, Hartman SJ, Kleinheinz TL, White J, Daly S, Goodwin R, Zhou W, Liang J, Wang X, O'Rourke M, Metcalfe C, Friedman L. Abstract P4-04-07: Characterization of the effects of estrogen receptor alpha Y537S and D538G mutations on receptor function and pharmacology. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-04-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The frontline therapy for estrogen receptor alpha (ERα) positive Breast Cancer (ER+BC) involves various forms of endocrine therapy, consisting of either Selective Estrogen Receptor Modulators (SERMs) or aromatase inhibitors. An emerging mechanism of ER+BC resistance to endocrine therapy, and consequently disease relapse, has been associated with a set of “hotspot” mutations in and near to helix-12 of the ERα ligand binding domain. Selective Estrogen Receptor Degraders/Down-regulators (SERDs), such as GDC-0810, AZD9496 and GDC-0927, represent a current major pharmacological strategy being applied to develop treatments for such resistant ER+BC. Here, we compare 2 of the most frequent ERα hotspot mutations (Y537S and D538G), with ERα wildtype (WT) and the ability of a set of ERα ligands (including GDC-0810, AZD9496 and GDC-0927) to bind, antagonize and degrade ERα. The concentration of each drug required to bind, antagonize or degrade ERα Y537S or ERα D538G was typically higher than that required for ERα WT. Importantly, ERα Y537S is resistant to estradiol stimulated protein degradation and 4-hydroxy-tamoxifen (a major active metabolite of tamoxifen) stabilizes ERα Y537S protein. This represents a potential mechanism of resistance of ERα Y537S ER+BC to Tamoxifen therapy.
Citation Format: Blake RA, Hartman SJ, Kleinheinz TL, White J, Daly S, Goodwin R, Zhou W, Liang J, Wang X, O'Rourke M, Metcalfe C, Friedman L. Characterization of the effects of estrogen receptor alpha Y537S and D538G mutations on receptor function and pharmacology [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-04-07.
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Affiliation(s)
- RA Blake
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - SJ Hartman
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - TL Kleinheinz
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - J White
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - S Daly
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - R Goodwin
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - W Zhou
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - J Liang
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - X Wang
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - M O'Rourke
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - C Metcalfe
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
| | - L Friedman
- Genentech, South San Francisco, CA; Charles River Laboratories, Harlow, United Kingdom
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21
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Pajic M, Froio D, Daly S, Doculara L, Millar E, Graham PH, Drury A, Steinmann A, de Bock CE, Boulghourjian A, Zaratzian A, Carroll S, Toohey J, O'Toole SA, Harris AL, Buffa FM, Gee HE, Hollway GE, Molloy TJ. miR-139-5p Modulates Radiotherapy Resistance in Breast Cancer by Repressing Multiple Gene Networks of DNA Repair and ROS Defense. Cancer Res 2018; 78:501-515. [PMID: 29180477 DOI: 10.1158/0008-5472.can-16-3105] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/12/2017] [Accepted: 11/02/2017] [Indexed: 11/16/2022]
Abstract
Radiotherapy is essential to the treatment of most solid tumors and acquired or innate resistance to this therapeutic modality is a major clinical problem. Here we show that miR-139-5p is a potent modulator of radiotherapy response in breast cancer via its regulation of genes involved in multiple DNA repair and reactive oxygen species defense pathways. Treatment of breast cancer cells with a miR-139-5p mimic strongly synergized with radiation both in vitro and in vivo, resulting in significantly increased oxidative stress, accumulation of unrepaired DNA damage, and induction of apoptosis. Several miR-139-5p target genes were also strongly predictive of outcome in radiotherapy-treated patients across multiple independent breast cancer cohorts. These prognostically relevant miR-139-5p target genes were used as companion biomarkers to identify radioresistant breast cancer xenografts highly amenable to sensitization by cotreatment with a miR-139-5p mimetic.Significance: The microRNA described in this study offers a potentially useful predictive biomarker of radiosensitivity in solid tumors and a generally applicable druggable target for tumor radiosensitization. Cancer Res; 78(2); 501-15. ©2017 AACR.
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Affiliation(s)
- Marina Pajic
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Danielle Froio
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Sheridan Daly
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Louise Doculara
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Ewan Millar
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Anatomical Pathology, South Eastern Area Laboratory Service (SEALS), St George Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Peter H Graham
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Alison Drury
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Angela Steinmann
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Charles E de Bock
- Laboratory for the Molecular Biology of Leukemia, Center for Human Genetics, KU Leuven and Center for the Biology of Disease, VIB, Leuven, Belgium
| | - Alice Boulghourjian
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Anaiis Zaratzian
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Susan Carroll
- The Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Joanne Toohey
- The Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Sandra A O'Toole
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Adrian L Harris
- Growth Factor Group, Cancer Research UK, Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford, United Kingdom
| | - Francesca M Buffa
- Growth Factor Group, Cancer Research UK, Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford, United Kingdom
| | - Harriet E Gee
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- The Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Georgina E Hollway
- Cancer Research Division, The Kinghorn Cancer Centre/Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Timothy J Molloy
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
- St Vincent's Centre for Applied Medical Research, Darlinghurst, New South Wales, Australia
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22
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Clifford G, Daly S, Collins O. 31THE INTRODUCTION OF A POST-FALL MEDICAL REVIEW: PROFORMA IN A LARGE ACADEMIC HOSPITAL. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.31] [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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23
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Dunlevy F, Tadesse W, Daly S, Kinsley B, Turner M. SUN-P008: Dietary Structured Group Education is Effective and Efficient in Treating Gestational Diabetes Mellitus. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30351-x] [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: 10/21/2022]
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24
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Kelleher SM, Nooney RI, Flynn SP, Clancy E, Burke M, Daly S, Smith TJ, Daniels S, McDonagh C. Multivalent linkers for improved covalent binding of oligonucleotides to dye-doped silica nanoparticles. Nanotechnology 2015; 26:365703. [PMID: 26294441 DOI: 10.1088/0957-4484/26/36/365703] [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: 06/04/2023]
Abstract
This paper describes the fabrication of oligonucleotide-coated Cy5-doped silica nanoparticles using a combination of multivalent linkers and their use in surface-based DNA sandwich hybridization assays. Dipodal silane is introduced as a means to fabricate amine-coated silica nanoparticles and its advantages compared to monopodal silanes are discussed. The use of dipodal silane in conjunction with three different polymer linkers (oxidized dextran, linear and 8-arm polyethylene glycol (PEG)) to immobilize single-stranded DNA to Cy5-doped nanoparticles is investigated and dynamic light scattering measurements and Fourier transform infrared spectroscopy are used to follow the progression of the functionalization of the nanoparticles. We observe a significant improvement in the binding stability of the single-stranded DNA when the dipodal silane and 8-arm PEG are used in combination, when compared to alternative conjugation strategies. Both 8mer and 22mer oligonucleotides are securely conjugated to the high-brightness nanoparticles and their availability to hybridize with a complementary strand is confirmed using solution-based DNA hybridization experiments. In addition, a full surface-based sandwich assay demonstrates the potential these nanoparticles have in the detection of less than 500 femtomolar of a DNA analogue of micro RNA, miR-451.
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Affiliation(s)
- S M Kelleher
- Biomedical Diagnostics Institute, Dublin City University, Glasnevin, Dublin 9, Ireland
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25
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Anglim B, O'Connor H, Daly S. Prevena™, negative pressure wound therapy applied to closed Pfannenstiel incisions at time of caesarean section in patients deemed at high risk for wound infection. J OBSTET GYNAECOL 2014; 35:255-8. [PMID: 25383909 DOI: 10.3109/01443615.2014.958442] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of our retrospective study is to report on our experience using the Prevena™ wound system in obese patients undergoing caesarean section delivery. A total of 26 cases were identified from July 2012 to October 2013. The median BMI of these women was 45.3 kg/m(2). Elective caesarean sections were performed in 20 women (77%). There were four cases (15%) of superficial dehiscence. Factors associated with wound breakdown were wound infection (p = 0.03), increasing BMI (p < 0.001) and emergency LSCS (p = 0.04). In a logistic regression model the presence of infection was the only factor which remained associated with wound breakdown. Wound disruption is a major cause of morbidity following caesarean section in morbidly obese patients. The wound complication rate in our experience was low with the Prevena™ dressing with no cases of sheath dehiscence, and no patient required a second operation. The presence of infection is the most important factor in wound breakdown and should be the focus for management protocols.
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Affiliation(s)
- B Anglim
- Department of Obstetrics and Gynaecology, Coombe Women and Infant University Hospital , Dublin , Ireland
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26
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Mulcahy C, McAuliffe FM, Breathnach F, Geary M, Daly S, Higgins J, Hunter A, Morrison J, Burke G, Higgins S, Dicker P, Mahony R, Tully E, Malone F. Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation. Ultrasound Obstet Gynecol 2014; 44:461-467. [PMID: 24407772 DOI: 10.1002/uog.13302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 08/22/2013] [Revised: 12/23/2013] [Accepted: 12/30/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To construct monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twin reference ranges for umbilical artery (UA) pulsatility index (PI), UA resistance index (RI), fetal middle cerebral artery (MCA) PI and peak systolic velocity (PSV) and cerebroplacental ratio (CPR) from 24 weeks' to 38 weeks' gestation and compare these with published normal values for singleton pregnancies. METHODS This prospective multicenter cohort study included 1028 unselected twin pairs recruited over a 2-year period. Participants with dichorionic twins underwent fortnightly ultrasound surveillance from 24 weeks' gestation, with monochorionic twins being followed every 2 weeks from 16 weeks until delivery. A total of 7536 fetal Doppler examinations in 618 twin pregnancies were included in the analysis, with reference ranges for MCDA and DCDA pregnancies constructed for each of the Doppler indices using multilevel modeling. RESULTS UA-PI and UA-RI appear to be higher in twins than in singletons, and MCA-PI and MCA-PSV appear to be lower. The CPR also appears to be lower in twins than in singletons. Similar MCA indices were observed in MCDA and DCDA twins. CONCLUSION We have established longitudinal reference ranges for UA-PI and UA-RI, MCA-PI and MCA-PSV and CPR in twin pregnancies, which appear to differ from those in singleton pregnancies. The derived twin-specific reference ranges may be more appropriate in the surveillance of these high-risk pregnancies. Applying the singleton CPR cut-off of ≤ 1.0 may lead to a large number of false-positive diagnoses of cerebral redistribution in twin fetuses.
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Affiliation(s)
- C Mulcahy
- National Maternity Hospital, Dublin, Ireland
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Unterscheider J, Daly S, O'Donoghue K, Malone FD. Critical umbilical artery Doppler abnormalities in early fetal growth restriction and the timing of delivery: an overestimated clinical challenge in daily obstetric practice? Ultrasound Obstet Gynecol 2014; 43:236-237. [PMID: 24497421 DOI: 10.1002/uog.13266] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 11/19/2013] [Indexed: 06/03/2023]
Affiliation(s)
- J Unterscheider
- Department of Obstetrics and Gynecology, Royal College of Surgeons in Ireland, Dublin, Ireland
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Neff KJ, Forde R, Gavin C, Byrne MM, Firth RGR, Daly S, McAuliffe FM, Foley M, Coffey M, Coulter-Smith S, Kinsley BT. Pre-pregnancy care and pregnancy outcomes in type 1 diabetes mellitus: a comparison of continuous subcutaneous insulin infusion and multiple daily injection therapy. Ir J Med Sci 2013; 183:397-403. [DOI: 10.1007/s11845-013-1027-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
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Garcia GA, Cunha de Miranda BK, Tia M, Daly S, Nahon L. DELICIOUS III: a multipurpose double imaging particle coincidence spectrometer for gas phase vacuum ultraviolet photodynamics studies. Rev Sci Instrum 2013; 84:053112. [PMID: 23742537 DOI: 10.1063/1.4807751] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We present a versatile double imaging particle coincidence spectrometer operating in fully continuous mode, named DELICIOUS III, which combines a velocity map imaging device and a modified Wiley-McLaren time of flight momentum imaging analyzer for photoelectrons and photoions, respectively. The spectrometer is installed in a permanent endstation on the DESIRS vacuum ultraviolet (VUV) beamline at the French National Synchrotron Radiation Facility SOLEIL, and is dedicated to gas phase VUV spectroscopy, photoionization, and molecular dynamics studies. DELICIOUS III is capable of recording mass-selected threshold photoelectron photoion coincidence spectra with a sub-meV resolution, and the addition of a magnifying lens inside the electron drift tube provides a sizeable improvement of the electron threshold/ion mass resolution compromise. In fast electron mode the ultimate kinetic energy resolution has been measured at ΔE/E = 4%. The ion spectrometer offers a mass resolution--full separation of adjacent masses--of 250 amu for moderate extraction fields and the addition of an electrostatic lens in the second acceleration region allows measuring the full 3D velocity vector for a given mass with an ultimate energy resolution of ΔE/E = 15%, without sacrificing the mass resolution. Hence, photoelectron images are correlated both to the mass and to the ion kinetic energy and recoil direction, to access the electron spectroscopy of size-selected species, to study the photodissociation processes of state-selected cations in detail, or to measure in certain cases photoelectron angular distributions in the ion recoil frame. The performances of DELICIOUS III are explored through several examples including the photoionization of N2, NO, and CF3.
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Affiliation(s)
- G A Garcia
- Synchrotron SOLEIL, L'Orme des Merisiers, St. Aubin BP 48, 91192 Gif sur Yvette, France.
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Basit I, Johnson SN, Mocanu E, Geary M, Daly S, Wingfield M. Mode of conception of triplets and high order multiple pregnancies. Ir Med J 2012; 105:80-83. [PMID: 22558814] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A retrospective audit was performed of all high order multiple pregnancies (HOMPs) delivered in three maternity hospitals in Dublin between 1999 and 2008. The mode of conception for each pregnancy was established with a view to determining means of reducing their incidence. A total of 101 HOMPs occurred, 93 triplet, 7 quadruplet and 1 quintuplet. Information regarding the mode of conception was available for 78 (81%) pregnancies. Twenty eight (27.7%) were spontaneous, 34 (33.7%) followedlVF/ICSI/FET treatment (in-vitro fertilisation, intracytoplasmic sperm injection, frozen embryo transfer), 16 (15.8%) resulted from Clomiphene Citrate treatment and 6 (6%) followed ovulation induction with gonadotrophins. Triplet and HOMPs are a major cause of maternal, feta land neonatal morbidity. Many are iatrogenic, arising from fertility treatments including Clomiphene. Reducing the numbers of embryos transferred will address IVF/ICSI/FET-related multiple pregnancy rates and this is currently happening in Ireland. Clomiphene and gonadotrophins should only be prescribed when appropriate resources are available to monitor patients adequately.
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Affiliation(s)
- I Basit
- Department of Obstetrics and Gynaecology, Coombe Women and Infant's University Hospital, Cork St., Dublin.
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Niedhammer I, Murrin C, O'Mahony D, Daly S, Morrison J, Kelleher C. P1-454 Explanations for social inequalities in preterm delivery in the lifeways cohort. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976g.44] [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: 11/04/2022]
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Niedhammer I, Murrin C, O'Mahony D, Daly S, Morrison JJ, Kelleher CC. Explanations for social inequalities in preterm delivery in the prospective Lifeways cohort in the Republic of Ireland. Eur J Public Health 2011; 22:533-8. [DOI: 10.1093/eurpub/ckr089] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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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Kaplan PD, Polefka T, Grove G, Daly S, Jumbelic L, Harper D, Nori M, Evans T, Ramaprasad R, Bianchini R. Grey hair: clinical investigation into changes in hair fibres with loss of pigmentation in a photoprotected population. Int J Cosmet Sci 2011; 33:171-82. [DOI: 10.1111/j.1468-2494.2010.00614.x] [Citation(s) in RCA: 12] [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: 11/28/2022]
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O’Donoghue B, Lyne J, Hill M, O’Rourke L, Daly S, Larkin C, Feeney L, O’Callaghan E. PW01-206 - People's perception of their involuntary admission at one year follow-up and readmission rates to hospital. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71613-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Kabir Z, Clarke V, Conroy R, McNamee E, Daly S, Clancy L. Low birthweight and preterm birth rates 1 year before and after the Irish workplace smoking ban. BJOG 2009; 116:1782-7. [PMID: 19832830 DOI: 10.1111/j.1471-0528.2009.02374.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It is well-established that maternal smoking has adverse birth outcomes (low birthweight, LBW, and preterm births). The comprehensive Irish workplace smoking ban was successfully introduced in March 2004. We examined LBW and preterm birth rates 1 year before and after the workplace smoking ban in Dublin. DESIGN A cross-sectional observational study analysing routinely collected data using the Euroking K2 maternity system. SETTING Coombe University Maternal Hospital. POPULATION Only singleton live births were included for analyses (7593 and 7648, in 2003 and 2005, respectively). METHODS Detailed gestational and clinical characteristics were collected and analysed using multivariable logistic regression analyses and subgroup analyses. MAIN OUTCOME MEASURES Maternal smoking rates, mean birthweights, and adjusted odds ratios (ORs) of LBW and preterm births in 2005 versus 2003. RESULTS There was a 25% decreased risk of preterm births (OR, 0.75; 95% CI, 0.59-0.96), a 43% increased risk of LBW (OR, 1.43; 95% CI, 1.10-1.85), and a 12% fall in maternal smoking rates (from 23.4 to 20.6%) in 2005 relative to 2003. Such patterns were significantly maintained when specific subgroups were also analysed. Mean birthweights decreased in 2005, but were not significant (P=0.99). There was a marginal increase in smoking cessation before pregnancy in 2005 (P=0.047). CONCLUSIONS Significant declines in preterm births and in maternal smoking rates after the smoking ban are welcome signs. However, the increased LBW birth risks might reflect a secular trend, as observed in many industrialised nations, and merits further investigations.
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Affiliation(s)
- Z Kabir
- Tobacco Free Research Institute (RIFTFS), Dublin, Ireland.
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English J, Daly S, McGuinness N, Kiernan E, Prendiville W. Medical preparation of the endometrium prior to resection: Decapeptyl SR (triptorelin) versus danazol versus placebo. MINIM INVASIV THER 2009. [DOI: 10.3109/13645709809152859] [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]
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Abstract
OBJECTIVE To determine the rate of bioavailability of oral misoprostol in the tablet and a new capsule form in women with term pregnancies in the postpartum period. METHODS Twenty-seven women received 400 microg of misoprostol orally after delivery of the fetal vertex in either the standard tablet form or crushed in methylcellulose capsules prepared in our pharmacy. Serum levels of misoprostol free acid, the principal metabolite, were measured at 5-, 15- and 30-min intervals after administration of the medication. The pharmacokinetics of the tablet and capsule groups were then compared. RESULTS Twenty patients were included in the analysis. At 5 min, there was a trend towards a statistically significant difference in the concentration of misoprostol acid in the tablet group (89 pg/ml) versus the capsule group (20 pg/ml) (p = 0.007). No significant difference in plasma concentration was noted in the two groups at 15 min (tablet group, 256 pg/ml; capsule group, 245 pg/ml; p = 0.85) or 30 min (tablet group, 381 pg/ml; capsule group, 455 pg/ml; p = 0.45). CONCLUSION Oral misoprostol is rapidly absorbed and bioavailable in the postpartum period. Misoprostol may prove useful in postpartum management. The novel packaging of misoprostol in capsule form allows for double-blinded studies with similar pharmacokinetics to the standard tablet.
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Affiliation(s)
- K L Andolina
- Department of Obstetrics and Gynecology, Lankenau Hospital, Wynnewood, Pennsylvania, USA
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Turner MJ, Gardeil F, Daly S, Barry-Walsh C, Prendiville W, Clinch J. Large loop excision of the transformation zone: A histological audit. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619609007754] [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]
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Abstract
OBJECTIVE The objective of this study was to explore the association between occupational factors and pregnancy outcomes in a prospective cohort of Irish pregnant women. DESIGN This study has a prospective design. POPULATION The Lifeways cohort included 1124 pregnant women, 676 of whom delivered a single baby and were working at their first prenatal care visit when they filled in a self-administered questionnaire. METHODS Occupational factors were measured using this questionnaire and included eight factors describing job and working conditions. Data including pregnancy outcomes were also obtained from clinical hospital records. Logistic regression analysis was used to adjust for well-known risk factors. MAIN OUTCOME MEASURES Birthweight (< or =3000 g and < or =2500 g), preterm delivery (<37 gestation weeks) and small-for-gestational-age. RESULTS Significant associations were found between physical work demands and low birthweight (< or =2500 g) and working with between a temporary contract and preterm delivery. Trends were also observed between working 40 hours or more a week and shift work, and birthweight of 3000 g or less. The study of a cumulative index showed that being exposed to at least two of these occupational factors significantly predicted birthweight of < or =3000 g (OR = 2.44, 95% CI: 1.17-5.08) and of < or =2500 g (OR = 4.65, 95% CI: 1.08-20.07) and preterm delivery (OR = 5.18, 95% CI: 1.00-27.01). CONCLUSIONS Our findings suggest that occupational factors may predict birthweight through their predictive effects on preterm delivery. This is one of the few prospective studies on pregnancy outcomes that include working conditions. As they may be modifiable, occupational factors deserve more attention in relation to birth outcomes.
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Affiliation(s)
- I Niedhammer
- UCD School of Public Health & Population Science, University College Dublin, Dublin, Ireland.
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Sim D, Hussain A, Tebbal A, Daly S, Pringle E, Ionides A. National survey of the management of eye emergencies in the accident and emergency departments by senior house officers: 10 years on--has anything changed? Emerg Med J 2008; 25:76-7. [PMID: 18212138 DOI: 10.1136/emj.2007.049999] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess changes in basic ophthalmic training of accident and emergency (A&E) senior house officers (SHOs) in the last 10 years, their own perceived level of confidence and the availability of appropriate equipment in their departments. METHODS A standardised structured questionnaire from a telephone survey carried out in 1993 was used. One SHO from each A&E department listed in the British Association of Emergency Medicine directory of 2003 was chosen at random and interviewed. RESULTS 168 A&E departments were contacted and 133 SHOs were successfully interviewed (response rate 79.2%). The number of A&E departments with a slit lamp increased by 25.7% from 1993, and slit lamp training increased by 21%. There was no significant change in the prevalence of training in the management of eye emergencies (74.0% in 1993 vs 77.4% in 2003) and the proportion of SHOs who felt confident in dealing with these cases was unchanged. CONCLUSIONS A&E departments are better equipped with slit lamps 10 years on, and staff are being trained to use them. This has unfortunately not improved the confidence levels in dealing with eye emergencies, reflecting the lack of adequate basic ophthalmic training for A&E SHOs. Recent changes in postgraduate medical training could provide a platform to bring about the changes required.
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Affiliation(s)
- D Sim
- Moorfields Eye Hospital, London, UK.
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O’Sullivan S, Neligan A, Mullins G, Daly S, McNamara B, Galvin R, Sweeney B. Aetiology and prognosis of encephalopathic patterns on electroencephalogram in a general hospital. J Clin Neurosci 2008; 15:637-42. [DOI: 10.1016/j.jocn.2007.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2007] [Revised: 03/28/2007] [Accepted: 04/05/2007] [Indexed: 11/15/2022]
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Lynch CM, Sheridan C, Breathnach FM, Said S, Daly S, Byrne B. Near miss maternal morbidity. Ir Med J 2008; 101:134-136. [PMID: 18624257] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Audit of severe maternal morbidity is a potent tool in determining standards of maternity care. This study determines the incidence of severe acute maternal morbidity in our population, identifies the underlying organ dysfunction and associated obstetric risk factors, and compares them to published international reports. Over a 5 year period, 1999-2003, data were collected prospectively from patients with severe acute maternal morbidity. There were 36,802 women who delivered infants weighing more than 500 g over the 5 years with 53 cases of severe maternal morbidity. There were two indirect maternal deaths yielding an incidence of 1.4/1000 for severe maternal morbidity and 5.4/100,000 for maternal mortality. The severe maternal morbidity to mortality ratio was 26.5:1. Massive obstetric haemorrhage requiring acute blood transfusion of > or = 5 units of packed red cells occurred in 77% of cases. This study identifies the feasibility of audit of severe maternal morbidity using simple defined clinical criteria. The incidence and underlying aetiology of severe maternal morbidity in our unit is comparable to other developed countries. It is essential that data on severe maternal morbidity are reviewed and analysed continuously at local hospital and national level to assess, maintain and improve clinical standards.
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Affiliation(s)
- C M Lynch
- Coombe Women and Infants University Hospital, Dublin
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Murrin C, Fallon UB, Hannon F, Nolan G, O'Mahony D, Crowley D, Bury G, Daly S, Morrison JJ, Murphy AW, Kelleher CC. Dietary habits of pregnant women in Ireland. Ir Med J 2007; 100:12-15. [PMID: 17955694] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This analysis of the Lifeways Cohort study mothers during pregnancy (n = 1124), utilises information from a standard food frequency questionnaire completed at baseline recruitment during early pregnancy. We demonstrate that 76% of women achieved recommended intakes of 5 plus portions of fruit and vegetables daily, though this is strongly socially patterned, inversely associated with age and positively associated with level of education. Achievement of the other recommended shelf intakes of the Food Pyramid is much lower, ranging from 12% achieving the recommended sparing intake of foods high in fat, salt or sugar, to 45% consuming the recommended 3 portions per day of meat and poultry. General medical services eligible respondents are generally less likely to achieve recommended intakes. While 61% of women under 25 years old stopped drinking during pregnancy, this dropped to 38% of expectant mothers over 35 years. Less than half (45%) of those (n = 860) who responded specifically to the question reported peri-conceptual folate supplement intake, again strongly socially patterned. These findings both provide important prevalence data and highlight the need for more concerted and supportive health promotion interventions during pregnancy.
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Affiliation(s)
- C Murrin
- School of Public Health and Population Science, University College Dublin.
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Murrin C, Segonds-Pichon A, Fallon UB, Hannon F, Bury G, Loftus BG, Murphy AW, Morrison JJ, Daly S, Kelleher CC. Self-reported pre-pregnancy maternal body mass index and infant birth-weight. Ir Med J 2007; 100:20-23. [PMID: 17955696] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This analysis examines the association between maternal characteristics, particularly body mass index (BMI) and infant birth weight in 1048 live infants. Mean reported pre pregnancy BMI of mothers was 23.74 kg/m2 (SD 4.21). The educational level of the mother's parents was independently associated with maternal BMI, those with higher educated parents having a lower reported BMI (F = 2.787, p = 0.029). Mean infant birth weight was 3493 g (SD 18.1) and there was a strong graduated relationship to estimated gestational age. In a sub-group of participating maternal grandmothers (n = 171), reported BMI was 26.7Kg/m2. The BMI of expectant mothers was significantly associated with their own mother's BMI. (r = 0.179, p = 0.005) in this sub-group. These preliminary findings, which will be investigated further with recorded height and weight information, suggest that familial factors are influential, perhaps through genetic predisposition or shared socio-cultural factors such as diet.
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Affiliation(s)
- C Murrin
- UCD School of Public Health and Population Science.
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Segonds-Pichon A, Hannon F, Daly S, Morrison JJ, Bury G, Murphy AW, Kelleher CC. Socio-demographic, lifestyle and cross-generation predictors of self-rated health in mothers during pregnancy. Ir Med J 2007; 100:7-12. [PMID: 17955693] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The Lifeways Cross-generation study was established to assess the influence of socio-economic and familial characteristics on the health status and early development of children. Between October 2001 and June 2002, 1124 women were recruited to the Lifeways study at booking or first visit to maternity hospital. Lifeways mothers were 29.4 (SD 5.9) years old at recruitment, two-thirds from greater Dublin area, 17.9% held a General Medical Services (GMS) card, 64.3% were married and 40.8% were third level educated. At uni-variate level, GMS eligibility, own and parents' education and marital status all predicted mother's self rated health during pregnancy, whilst in the final multivariate logistic regression model, GMS status, household-adjusted income, marital status and grand-maternal education were each independently predictors. The Lifeways cohort confirms the importance of social position in predicting health in pregnant Irish women.
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Parker AJ, Webb AW, Fanning CM, Oliver RL, Cooper JA, Daly S, Benbow MC, Blissett AH, Lemon NM, Ramsay R, Coin CDA, Mortimer GE, Bradley GM, Cohen P, James PR, Radke F, Giles CW, Goode ADT. Symposium on the Gawler Craton, 11 December 1979. ACTA ACUST UNITED AC 2007. [DOI: 10.1080/00167618008729117] [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: 10/23/2022]
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Mullins GM, O'Sullivan SS, Neligan A, Daly S, Galvin RJ, Sweeney BJ, McNamara B. Non-traumatic brachial plexopathies, clinical, radiological and neurophysiological findings from a tertiary centre. Clin Neurol Neurosurg 2007; 109:661-6. [PMID: 17624660 DOI: 10.1016/j.clineuro.2007.05.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Revised: 05/15/2007] [Accepted: 05/16/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To establish the clinical characteristics, aetiology, neuro-physiological characteristics, imaging findings and other investigations in a cohort of patients with non-traumatic brachial plexopathy (BP). METHODS A 3-year retrospective study of patients with non-traumatic BP identified by electromyography (EMG) and nerve conduction studies (NCS). Clinical information was retrieved from patients' medical charts. RESULTS Twenty-five patients were identified. Causes of BP included neuralgic amyotrophy (NA) (48%), neoplastic (16%), radiation (8%), post infectious (12%), obstetric (4%), rucksack injury (4%), thoracic outlet syndrome (4%) and iatrogenic (4%). Patients with NA presented acutely in 50%. The onset was subacute in all others. Outcome was better for patients with NA. All patients with neoplastic disease had a previous history of cancer. MRI was abnormal in 3/16 patients (18.8%). PET scanning diagnosed metastatic plexopathy in two cases. CONCLUSIONS NA was the most common cause of BP in our cohort and was associated with a more favourable outcome. The authors note potentially discriminating clinical characteristics in our population that aid in the assessment of patients with brachial plexopathies. We advise NCS and EMG be performed in all patients with suspected plexopathy. Imaging studies are useful in selected patients.
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Affiliation(s)
- G M Mullins
- Department of Neurology Cork University Hospital, Ireland.
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Berth-Jones J, Grotzinger K, Rainville C, Pham B, Huang J, Daly S, Herdman M, Firth P, Hotchkiss K. A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physician's Global Assessment and Lattice System Physician's Global Assessment. Br J Dermatol 2006; 155:707-13. [PMID: 16965419 DOI: 10.1111/j.1365-2133.2006.07389.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician's Global Assessment (PGA) is also often used. However, both instruments have some drawbacks and neither has been fully evaluated in terms of 'validity' and 'reliability' as a psoriasis rating scale. The Lattice System Physician's Global Assessment (LS-PGA) scale has recently been developed to address some disadvantages of the PASI and PGA. OBJECTIVES To evaluate the inter-rater and intrarater reliability of the PASI, PGA and LS-PGA. METHODS On the day before the study, 14 dermatologists (raters), with varied experience of assessing psoriasis, received detailed training (2.5 h) on use of the scales. On the study day, each rater evaluated 16 adults with chronic plaque psoriasis in the morning and again in the afternoon. Raters were randomly assigned to assess subjects using the scales in a specific sequence, either PGA, LS-PGA, PASI or PGA, PASI, LS-PGA. Each rater used one sequence in the morning and the other in the afternoon. The primary endpoint was the inter-rater and intrarater reliability as determined by intraclass correlation coefficients (ICCs). RESULTS All three scales demonstrated 'substantial' (a priori defined as ICC > 80%) intrarater reliability. The inter-rater reliability for each of the PASI and LS-PGA was also 'substantial' and for the PGA was 'moderate' (ICC 75%). CONCLUSIONS Each one of the three scales provided reproducible psoriasis severity assessments. In terms of both intrarater and inter-rater reliability values, the three scales can be ranked from highest to lowest as follows: PASI, LS-PGA and PGA.
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Affiliation(s)
- J Berth-Jones
- Department of Dermatology, University Hospitals Coventry and Warkwickshire NHS Trust, Coventry, CV2 2DX, UK.
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Sankhala KK, Chawla SP, Iagaru A, Dellamaggiora R, Chua V, Daly S, Bedrosian CL, Edwards GK, Cohen S, Demetri GD. Early response evaluation of therapy with AP23573 (an mTOR inhibitor) in sarcoma using [18F]2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) scan. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9028] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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)
- K. K. Sankhala
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - S. P. Chawla
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - A. Iagaru
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - R. Dellamaggiora
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - V. Chua
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - S. Daly
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - C. L. Bedrosian
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - G. K. Edwards
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - S. Cohen
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
| | - G. D. Demetri
- The Cancer Ctr of Midway Hosp, Los Angeles, CA; Keck Sch of Medicine of USC, Los Angeles, CA; ARIAD Pharmaceuticals, Inc., Cambridge, MA; St John’s Hosp, Santa Monica, CA; Tower Beverly Radiology, Los Angeles, CA; Dana-Farber Cancer Inst, Boston, MA
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