1
|
Schlottmann J, Miller S, Scheurig-Münkler C, Merkl C, Weber T, Eser S, Fuchs A, Messmann H, Probst A. [Acute abdomen-Rare cause in an 80-year-old female patient under immunosuppressive treatment]. Inn Med (Heidelb) 2024; 65:503-507. [PMID: 37831085 PMCID: PMC11058932 DOI: 10.1007/s00108-023-01593-z] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/14/2023]
Abstract
An 80-year-old woman presented to the emergency department due to abdominal pain. She had a history of opportunistic pneumonia under the effects of immunosuppression after the diagnosis of autoimmune hepatitis. The imaging showed an omental cake formation and the suspicion of peritoneal carcinomatosis. The patient developed an acute abdomen during the hospital stay, followed by exploratory laparotomy. In the presence of extensive intra-abdominal abscess formation both surgically acquired material and blood culture revealed disseminated nocardiosis. The course was fatal due to fulminant septic shock.
Collapse
Affiliation(s)
- J Schlottmann
- 3. Medizinische Klinik, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland.
| | - S Miller
- Institut für Pathologie und molekulare Diagnostik, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - C Scheurig-Münkler
- Klinik für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - C Merkl
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - T Weber
- 3. Medizinische Klinik, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland
| | - S Eser
- 3. Medizinische Klinik, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland
| | - A Fuchs
- 3. Medizinische Klinik, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland
| | - H Messmann
- 3. Medizinische Klinik, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland
| | - A Probst
- 3. Medizinische Klinik, Universitätsklinikum Augsburg, Stenglinstraße 2, 86156, Augsburg, Deutschland
| |
Collapse
|
2
|
Linder J, Mehra J, Miller S, Lewis MJ, Bentley RT, Thomovsky S. Use of levetiracetam for the successful treatment of suspected myoclonic seizures: five dogs (2016-2022). J Small Anim Pract 2024. [PMID: 38566458 DOI: 10.1111/jsap.13719] [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: 06/28/2023] [Revised: 10/11/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Myoclonic seizures are considered a type of generalised seizure characterised by brief, jerking movements of the body. The aim of this study is to describe cases of suspected canine myoclonic seizure of idiopathic aetiology and to discuss the successful use of the anticonvulsant levetiracetam as treatment in each of these cases. MATERIALS AND METHODS Dogs with epileptic myoclonus suspected to be idiopathic in aetiology were considered for inclusion. Medical records were reviewed for physical and neurologic examination findings, clinicopathologic results, and diagnostic imaging results. All included dogs were treated with levetiracetam, and their response was reported. RESULTS Five dogs were included, all of which had suspected myoclonic seizures either observed in-person or on video recording by a board-certified veterinary neurologist. The duration of myoclonic seizures preceding treatment ranged from one day to one year. One dog also experienced a generalised tonic-clonic seizure. All dogs were treated with levetiracetam. Two dogs experienced long-term myoclonic seizure freedom (duration seizure-free of at least 1 year), and two dogs experienced marked decreased myoclonic seizure frequency. One dog experienced immediate abatement of myoclonic seizures, although levetiracetam was only utilised for 1 month following onset of myoclonic seizures in this patient. CLINICAL SIGNIFICANCE Myoclonic seizures can be idiopathic in aetiology. Levetiracetam can be used effectively to rapidly stop myoclonic seizures and to decrease the frequency of myoclonic seizures.
Collapse
Affiliation(s)
- J Linder
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - J Mehra
- VCA Animal Care Center of Sonoma County, Rohnert Park, CA, USA
| | - S Miller
- TruVet Specialty and Emergency Hospital, Petaluma, CA, USA
| | - M J Lewis
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - R T Bentley
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - S Thomovsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| |
Collapse
|
3
|
Miller S, Kallusky J, Zimmerer R, Tavassol F, Gellrich NC, Ptok M, Jungheim M. Differences in velopharyngeal pressures during speech sound production in patients with unilateral cleft lip and palate (UCLP) and healthy individuals. Ger Med Sci 2024; 22:Doc02. [PMID: 38651020 PMCID: PMC11034380 DOI: 10.3205/000328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/16/2023] [Indexed: 04/25/2024]
Abstract
Background During articulation the velopharynx needs to be opened and closed rapidly and a tight closure is needed. Based on the hypothesis that patients with cleft lip and palate (CLP) produce lower pressures in the velopharynx than healthy individuals, this study compared pressure profiles of the velopharyngeal closure during articulation of different sounds between healthy participants and patients with surgically closed unilateral CLP (UCLP) using high resolution manometry (HRM). Materials and methods Ten healthy adult volunteers (group 1: 20-25.5 years) and ten patients with a non-syndromic surgically reconstructed UCLP (group 2: 19.1-26.9 years) were included in this study. Pressure profiles during the articulation of four sounds (/i:/, /s/, /ʃ/ and /n/) were measured by HRM. Maximum, minimum and average pressures, time intervals as well as detection of a previously described 3-phase-model were compared. Results Both groups presented with similar pressure curves for each phoneme with regards to the phases described and pressure peaks, but differed in total pressures. An exception was noted for the sound /i:/, where a 3-phase-model could not be seen for most patients with UCLP. Differences in velopharynx pressures of 50% and more were found between the two groups. Maximum and average pressures in the production of the alveolar fricative reached statistical significance. Conclusions It can be concluded that velopharyngeal pressures of patients with UCLP are not sufficient to eliminate nasal resonance or turbulence during articulation, especially for more complex sounds. These results support a general understanding of hypernasality during speech implying a (relative) velopharyngeal insufficiency.
Collapse
Affiliation(s)
- Simone Miller
- Department of Phoniatrics and Pediatric Audiology of the Department of Otolaryngology, Hannover Medical School, Hanover, Germany
- Institute of General Practice and Palliative Care, Hannover Medical School, Hanover, Germany
| | - Johanna Kallusky
- Department of Phoniatrics and Pediatric Audiology of the Department of Otolaryngology, Hannover Medical School, Hanover, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillifacial Surgery, University Hospital Tübingen, Germany
| | - Frank Tavassol
- Department of Oral and Maxillofacial Surgery, University Medicine Halle, Germany
| | | | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hanover, Germany
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hanover, Germany
- HNO Phoniatrie Praxis, Bremen, Germany
| |
Collapse
|
4
|
Miller S, Peters K, Ptok M, Jungheim M. Modification of velopharyngeal closure pressures during phonation by neuromuscular electrical stimulation in healthy individuals. Ger Med Sci 2024; 22:Doc03. [PMID: 38651019 PMCID: PMC11034089 DOI: 10.3205/000329] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/17/2023] [Indexed: 04/25/2024]
Abstract
Introduction Rhinophonia aperta may result from velopharyngeal insufficiency. Neuromuscular electrical stimulation (NMES) has been discussed in the context of muscle strengthening. The aim of this study was to evaluate in healthy subjects whether NMES can change the velopharyngeal closure pattern during phonation and increase muscle strength. Method Eleven healthy adult volunteers (21-57 years) were included. Pressure profiles were measured by high resolution manometry (HRM): isolated sustained articulation of /a/ over 5 s (protocol 1), isolated NMES applied to soft palate above motor threshold (protocol 2) and combined articulation with NMES (protocol 3). Mean activation pressures (MeanAct), maximum pressures (Max), Area under curve (AUC) and type of velum reactions were compared. A statistical comparison of mean values of protocol 1 versus protocol 3 was carried out using the Wilcoxon signed rank test. Ordinally scaled parameters were analyzed by cross table. Results MeanAct values measured: 17.15±20.69 mmHg (protocol 1), 34.59±25.75 mmHg (protocol 3) on average, Max: 37.86±49.17 mmHg (protocol 1), 87.24±59.53 mmHg (protocol 3) and AUC: 17.06±20.70 mmHg.s (protocol 1), 33.76±23.81 mmHg.s (protocol 3). Protocol 2 produced velum reactions on 32 occasions. These presented with MeanAct values of 13.58±12.40 mmHg, Max values of 56.14±53.14 mmHg and AUC values of 13.84±12.78 mmHg.s on average. Statistical analysis comparing protocol 1 and 3 showed more positive ranks for MeanAct, Max and AUC. This difference reached statistical significance (p=0.026) for maximum pressure values. Conclusions NMES in combination with articulation results in a change of the velopharyngeal closure pattern with a pressure increase of around 200% in healthy individuals. This might be of therapeutic benefit for patients with velopharyngeal insufficiency.
Collapse
Affiliation(s)
- Simone Miller
- Department of Phoniatrics and Pediatric Audiology of the Department of Otolaryngology, Hannover Medical School, Hanover, Germany
- Institute of General Practice and Palliative Care, Hannover Medical School, Hanover, Germany
| | - Katharina Peters
- Department of Phoniatrics and Pediatric Audiology of the Department of Otolaryngology, Hannover Medical School, Hanover, Germany
| | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hanover, Germany
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hanover, Germany
- HNO Phoniatrie Praxis, Bremen, Germany
| |
Collapse
|
5
|
Cruz-Lim EM, Mou B, Baker S, Arbour G, Stefanyk K, Jiang W, Liu M, Bergman A, Schellenberg D, Alexander A, Berrang T, Bang A, Chng N, Matthews Q, Carolan H, Hsu F, Miller S, Atrchian S, Chan E, Ho C, Mohamed I, Lin A, Huang V, Mestrovic A, Hyde D, Lund C, Pai H, Valev B, Lefresne S, Tyldesley S, Olson R. Prospective Longitudinal Assessment of Quality of Life After Stereotactic Ablative Radiotherapy for Oligometastases: Analysis of the Population-based SABR-5 Phase II Trial. Clin Oncol (R Coll Radiol) 2024; 36:148-156. [PMID: 38087705 DOI: 10.1016/j.clon.2023.11.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/11/2023] [Revised: 11/11/2023] [Accepted: 11/28/2023] [Indexed: 02/18/2024]
Abstract
AIMS To evaluate longitudinal patient-reported quality of life (QoL) in patients treated with stereotactic ablative radiotherapy (SABR) for oligometastases. MATERIALS AND METHODS The SABR-5 trial was a population-based single-arm phase II study of SABR to up to five sites of oligometastases, conducted in six regional cancer centres in British Columbia, Canada from 2016 to 2020. Prospective QoL was measured using treatment site-specific QoL questionnaires at pre-treatment baseline and at 3, 6, 9, 12, 15, 18, 21, 24, 30 and 36 months after treatment. Patients with bone metastases were assessed with the Brief Pain Inventory (BPI). Patients with liver, adrenal and abdominopelvic lymph node metastases were assessed with the Functional Assessment of Chronic Illness Therapy-Abdominal Discomfort (FACIT-AD). Patients with lung and intrathoracic lymph node metastases were assessed with the Prospective Outcomes and Support Initiative (POSI) lung questionnaire. The two one-sided test procedure was used to assess equivalence between the worst QoL score and the baseline score of individual patients. The mean QoL at all time points was used to determine the trajectory of QoL response after SABR. The proportion of patients with 'stable', 'improved' or 'worsened' QoL was determined for all time points based on standard minimal clinically important differences (MCID; BPI worst pain = 2, BPI functional interference score [FIS] = 0.5, FACIT-AD Trial Outcome Index [TOI] = 8, POSI = 3). RESULTS All enrolled patients with baseline QoL assessment and at least one follow-up assessment were analysed (n = 133). On equivalence testing, the patients' worst QoL scores were clinically different from baseline scores and met MCID (BPI worst pain mean difference: 1.8, 90% confidence interval 1.19 to 2.42]; BPI FIS mean difference: 1.68, 90% confidence interval 1.15 to 2.21; FACIT-AD TOI mean difference: -8.76, 90% confidence interval -11.29 to -6.24; POSI mean difference: -4.61, 90% confidence interval -6.09 to -3.14). However, the mean FIS transiently worsened at 9, 18 and 21 months but eventually returned to stable levels. The mean FACIT and POSI scores also worsened at 36 months, albeit with a limited number of responses (n = 4 and 8, respectively). Most patients reported stable QoL at all time points (range: BPI worst pain 71-82%, BPI FIS 45-78%, FACIT-AD TOI 50-100%, POSI 25-73%). Clinically significant stability, worsening and improvement were seen in 70%/13%/18% of patients at 3 months, 53%/28%/19% at 18 months and 63%/25%/13% at 36 months. CONCLUSIONS Transient decreases in QoL that met MCID were seen between patients' worst QoL scores and baseline scores. However, most patients experienced stable QoL relative to pre-treatment levels on long-term follow-up. Further studies are needed to characterise patients at greatest risk for decreased QoL.
Collapse
Affiliation(s)
- E M Cruz-Lim
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - B Mou
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - S Baker
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - G Arbour
- University of British Columbia, British Columbia, Canada
| | - K Stefanyk
- University of British Columbia, British Columbia, Canada
| | - W Jiang
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - M Liu
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - A Bergman
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - D Schellenberg
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - A Alexander
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - T Berrang
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - A Bang
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - N Chng
- BC Cancer - Prince George, Prince George, British Columbia, Canada
| | - Q Matthews
- BC Cancer - Prince George, Prince George, British Columbia, Canada
| | - H Carolan
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - F Hsu
- University of British Columbia, British Columbia, Canada; BC Cancer - Abbotsford, Abbotsford, British Columbia, Canada
| | - S Miller
- University of British Columbia, British Columbia, Canada; BC Cancer - Prince George, Prince George, British Columbia, Canada
| | - S Atrchian
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - E Chan
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - C Ho
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - I Mohamed
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - A Lin
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - V Huang
- BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - A Mestrovic
- BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - D Hyde
- University of British Columbia, British Columbia, Canada; BC Cancer - Kelowna, Kelowna, British Columbia, Canada
| | - C Lund
- University of British Columbia, British Columbia, Canada; BC Cancer - Surrey, Surrey, British Columbia, Canada
| | - H Pai
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - B Valev
- University of British Columbia, British Columbia, Canada; BC Cancer - Victoria, Victoria, British Columbia, Canada
| | - S Lefresne
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - S Tyldesley
- University of British Columbia, British Columbia, Canada; BC Cancer - Vancouver, Vancouver, British Columbia, Canada
| | - R Olson
- University of British Columbia, British Columbia, Canada; BC Cancer - Prince George, Prince George, British Columbia, Canada.
| |
Collapse
|
6
|
Cruz-Lim EM, Mou B, Jiang W, Liu M, Bergman A, Schellenberg D, Alexander A, Berrang T, Bang A, Chng N, Matthews Q, Carolan H, Hsu F, Miller S, Atrchian S, Chan E, Ho C, Mohamed I, Lin A, Huang V, Mestrovic A, Hyde D, Lund C, Pai H, Valev B, Lefresne S, Tyldesley S, Olson R, Baker S. Predictors of Quality of Life Decline in Patients with Oligometastases treated with Stereotactic Ablative Radiotherapy: Analysis of the Population-Based SABR-5 Phase II Trial. Clin Oncol (R Coll Radiol) 2024; 36:141-147. [PMID: 38296662 DOI: 10.1016/j.clon.2024.01.007] [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: 09/13/2023] [Revised: 11/15/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
AIMS Most patients experience stable quality of life (QoL) after stereotactic ablative radiotherapy (SABR) treatment for oligometastases. However, a subset of patients experience clinically relevant declines in QoL on post-treatment follow-up. This study aimed to identify risk factors for QoL decline. MATERIALS AND METHODS The SABR-5 trial was a population-based single-arm phase II study of SABR to up to five sites of oligometastases. Prospective QoL was measured using treatment site-specific tools at pre-treatment baseline and 3, 6, 9, 12, 15, 18, 21, 24, 30 and 36 months after treatment. The time to persistent QoL decline was calculated as the time from SABR to the first decline in QoL score meeting minimum clinically important difference with no improvement to baseline score on subsequent assessments. Univariable and multivariable logistic regression analyses were carried out to determine factors associated with QoL decline. RESULTS One hundred and thirty-three patients were included with a median follow-up of 32 months (interquartile range 25-43). Thirty-five patients (26%) experienced a persistent decline in QoL. The median time until persistent QoL decline was not reached. The cumulative incidence of QoL decline at 2 and 3 years were 22% (95% confidence interval 14.0-29.6) and 40% (95% confidence interval 28.0-51.2), respectively. In multivariable analysis, disease progression (odds ratio 5.23, 95% confidence interval 1.59-17.47, P = 0.007) and adrenal metastases (odds ratio 9.70, 95% confidence interval 1.41-66.93, P = 0.021) were associated with a higher risk of QoL decline. Grade 3 or higher (odds ratio 3.88, 95% confidence interval 0.92-16.31, P = 0.064) and grade 2 or higher SABR-associated toxicity (odds ratio 2.24, 95% confidence interval 0.85-5.91, P = 0.10) were associated with an increased risk of QoL decline but did not reach statistical significance. CONCLUSIONS Disease progression and adrenal lesion site were associated with persistent QoL decline following SABR. The development of grade 3 or higher toxicities was also associated with an increased risk, albeit not statistically significant. Further studies are needed, focusing on the QoL impact of metastasis-directed therapies.
Collapse
Affiliation(s)
- E M Cruz-Lim
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - B Mou
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - W Jiang
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - M Liu
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - A Bergman
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - D Schellenberg
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - A Alexander
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - T Berrang
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - A Bang
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - N Chng
- BC Cancer - Prince George, British Columbia, Canada
| | - Q Matthews
- BC Cancer - Prince George, British Columbia, Canada
| | - H Carolan
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - F Hsu
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Abbotsford, British Columbia, Canada
| | - S Miller
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Prince George, British Columbia, Canada
| | - S Atrchian
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - E Chan
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - C Ho
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - I Mohamed
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - A Lin
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - V Huang
- BC Cancer - Surrey, British Columbia, Canada
| | - A Mestrovic
- BC Cancer - Vancouver, British Columbia, Canada
| | - D Hyde
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Kelowna, British Columbia, Canada
| | - C Lund
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada
| | - H Pai
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - B Valev
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Victoria, British Columbia, Canada
| | - S Lefresne
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - S Tyldesley
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Vancouver, British Columbia, Canada
| | - R Olson
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Prince George, British Columbia, Canada
| | - S Baker
- University of British Columbia, Vancouver, British Columbia, Canada; BC Cancer - Surrey, British Columbia, Canada.
| |
Collapse
|
7
|
Walther W, Ptok M, Hager K, Miller S. Study protocol of the OrkA project: orofacial and communicative activation in old age- a cluster randomized prevention study in long-term care facilities in Lower Saxony, Germany. BMC Geriatr 2024; 24:179. [PMID: 38388406 PMCID: PMC10882768 DOI: 10.1186/s12877-024-04809-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/14/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The process of aging involves numerous changes in the body, influencing physical, mental, and emotional well-being. Age-related changes and degradation can impact various functions of the swallowing process and lead to delayed word retrieval. Individuals with limited linguistic stimulation may experience a more rapid decline in cognitive performance. Thus, this project explores a preventive training program targeting swallowing and linguistic-communicative skills, aimed at preserving the social participation of older individuals residing in nursing homes. METHODS A preventive intervention program, combining orofaciopharyngeal and linguistic-communicative components, will be offered twice weekly over 12 weeks in long-term care facilities in the greater Hanover area. The program will aim at: (a) activating sensitive and motor skills in the orofaciopharyngeal area to counter age-related swallowing disorders, and (b) enhancing communicative abilities through semantic-lexical activation. A cluster randomized controlled trial will be conducted to investigate whether the intervention program improves swallowing skills in older adults. Additionally, a secondary analysis will explore the impact on language skills and social participation, as well as program acceptance. DISCUSSION The results will provide valuable insight into the effectiveness of preventive measures addressing swallowing and speech issues in older individuals. TRIAL REGISTRATION The trial was registered with DRKS (German register for clinical trials) in June 2023 (study ID: DRKS00031594) and the WHO International Clinical Trail Registry Platform (secondary register).
Collapse
Affiliation(s)
- Wenke Walther
- Institute of General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Martin Ptok
- Emeritus of the Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, Germany
| | - Klaus Hager
- Institute of General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Simone Miller
- Institute of General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
- Department of Phoniatrics and Pediatric Audiology of the Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| |
Collapse
|
8
|
Heise KM, Miller S, Ptok M, Jungheim M. [Prevalence of mucosal injuries during flexible endoscopic evaluation of swallowing in the presence of a nasogastric tube]. HNO 2024; 72:25-31. [PMID: 37796338 PMCID: PMC10781840 DOI: 10.1007/s00106-023-01361-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The flexible endoscopic evaluation of swallowing (FEES) is an established low-risk examination method to assess the risk of penetration or aspiration in patients with dysphagia. FEES might be more difficult or of higher-risk when a nasogastric tube is in place. OBJECTIVE This study aims to identify whether the prevalence of mucosal lesions is higher when the endoscopy is carried out with a nasogastric tube in place. Pre-existing mucosal lesions were also documented. METHODS In a retrospective, monocentric study, a total of 918 FEES procedures routinely performed in hospitalized patients of a university hospital from January 2014 to March 2019 were evaluated. Mucosal lesions were identified and characterized for descriptive statistics. RESULTS In the video material analysed here, no endoscopy-related injuries were identified. However, pre-existing mucosal lesions, which often occurred as multiple lesions, were detected in 48.6% of the endoscopies. Further analysis showed that these pre-existing lesions were not worsened by the endoscopy performed. CONCLUSION The results demonstrate that transnasal flexible endoscopy is a safe, low-risk examination method, even in patients with a nasogastric tube. A very high number of pre-existing mucosal lesions were found, which is probably related to the previous insertion of the nasogastric tube. Due to the high number of pre-existing lesions, strategies should be developed to minimize injuries when placing nasogastric tubes.
Collapse
Affiliation(s)
- Kira-Milena Heise
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Simone Miller
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Martin Ptok
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Michael Jungheim
- Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| |
Collapse
|
9
|
Caine SB, Plant S, Furbish K, Yerton M, Smaragdi E, Niclou B, Lorusso JM, Chang JY, Bitter C, Basu A, Miller S, Huang CY, Komson R, Liu D, Behar S, Thomsen M. Sprague Dawley rats from different vendors vary in the modulation of prepulse inhibition of startle (PPI) by dopamine, acetylcholine, and glutamate drugs. Psychopharmacology (Berl) 2023; 240:2005-2012. [PMID: 37580441 PMCID: PMC10471717 DOI: 10.1007/s00213-023-06444-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Abstract
RATIONALE Rodent vendors are often utilized interchangeably, assuming that the phenotype of a given strain remains standardized between colonies. Several studies, however, have found significant behavioral and physiological differences between Sprague Dawley (SD) rats from separate vendors. Prepulse inhibition of startle (PPI), a form of sensorimotor gating in which a low-intensity leading stimulus reduces the startle response to a subsequent stimulus, may also vary by vendor. Differences in PPI between rat strains are well known, but divergence between colonies within the SD strain lacks thorough examination. OBJECTIVES We explored intrastrain variation in PPI by testing SD rats from two vendors: Envigo and Charles River (CR). METHODS We selected drugs acting on four major neurotransmitter systems that have been repeatedly shown to modulate PPI: dopamine (apomorphine; 0.5, 1.5, 3.0 mg/kg), acetylcholine (scopolamine; 0.1, 0.5, 1.0 mg/kg), glutamate (dizocilpine; 0.5, 1.5, 2.5 mg/kg), and serotonin (2,5-Dimethoxy-4-iodoamphetamine, DOI; 0.25, 0.5, 1.0 mg/kg). We determined PPI and startle amplitude for each drug in male and female Envigo and CR SD rats. RESULTS SD rats from Envigo showed dose-dependent decreases in PPI after apomorphine, scopolamine, or dizocilpine administration, without significant effects on startle amplitude. SD rats from CR were less sensitive to modulation of PPI and/or more sensitive to modulation of startle amplitude, across the three drugs. CONCLUSIONS SD rats showed vendor differences in sensitivity to pharmacological modulation of PPI and startle. We encourage researchers to sample rats from separate vendors before experimentation to identify the most suited source of subjects for their specific endpoints.
Collapse
Affiliation(s)
- S B Caine
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - S Plant
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - K Furbish
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - M Yerton
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - E Smaragdi
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - B Niclou
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J M Lorusso
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J Y Chang
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - C Bitter
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - A Basu
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - S Miller
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - C-Y Huang
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - R Komson
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - D Liu
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - S Behar
- Neuroscience and Behavioral Pharmacology Laboratory, Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - M Thomsen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, Forskningsenheder, Hovedvejen 17, 1. sal, 2000 Frederiksberg, Copenhagen, Denmark.
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
10
|
Id-Lahoucine S, Casellas J, Lu D, Sargolzaei M, Miller S, Cánovas A. Distortion of Mendelian segregation across the Angus cattle genome uncovering regions affecting reproduction. Sci Rep 2023; 13:13393. [PMID: 37591956 PMCID: PMC10435455 DOI: 10.1038/s41598-023-37710-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 06/26/2023] [Indexed: 08/19/2023] Open
Abstract
Nowadays, the availability of genotyped trios (sire-dam-offspring) in the livestock industry enables the implementation of the transmission ratio distortion (TRD) approach to discover deleterious alleles in the genome. Various biological mechanisms at different stages of the reproductive cycle such as gametogenesis, embryo development and postnatal viability can induce signals of TRD (i.e., deviation from Mendelian inheritance expectations). In this study, TRD was evaluated using both SNP-by-SNP and sliding windows of 2-, 4-, 7-, 10- and 20-SNP across 92,942 autosomal SNPs for 258,140 genotyped Angus cattle including 7,486 sires, 72,688 dams and 205,966 offspring. Transmission ratio distortion was characterized using allelic (specific- and unspecific-parent TRD) and genotypic parameterizations (additive- and dominance-TRD). Across the Angus autosomal chromosomes, 851 regions were clearly found with decisive evidence for TRD. Among these findings, 19 haplotypes with recessive patterns (potential lethality for homozygote individuals) and 52 regions with allelic patterns exhibiting complete or quasi-complete absence for homozygous individuals in addition to under-representation (potentially reduced viability) of the carrier (heterozygous) offspring were found. In addition, 64 (12) and 20 (4) regions showed significant influence on the trait heifer pregnancy at p-value < 0.05 (after chromosome-wise false discovery rate) and 0.01, respectively, reducing the pregnancy rate up to 15%, thus, supporting the biological importance of TRD phenomenon in reproduction.
Collapse
Affiliation(s)
- S Id-Lahoucine
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - J Casellas
- Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona, Spain
| | - D Lu
- Angus Genetics Inc., St. Joseph, MO, 64506, USA
| | - M Sargolzaei
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Department of Pathobiology, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Select Sires, Inc., Plain City, OH, 43064, USA
| | - S Miller
- AGBU, a joint venture of NSW Department of Primary Industries and University of New England, Armidale, 2351, Australia
| | - A Cánovas
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada.
| |
Collapse
|
11
|
Samara M, Thai-Van H, Ptok M, Glarou E, Veuillet E, Miller S, Reynard P, Grech H, Utoomprurkporn N, Sereti A, Bamiou DE, Iliadou VM. A systematic review and metanalysis of questionnaires used for auditory processing screening and evaluation. Front Neurol 2023; 14:1243170. [PMID: 37621857 PMCID: PMC10446894 DOI: 10.3389/fneur.2023.1243170] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/19/2023] [Indexed: 08/26/2023] Open
Abstract
The recognition of Auditory Processing Disorder (APD) as a distinct clinical condition that impacts hearing capacity and mental health has gained attention. Although pure tone audiometry is the gold standard for assessing hearing, it inadequately reflects everyday hearing abilities, especially in challenging acoustic environments. Deficits in speech perception in noise, a key aspect of APD, have been linked to an increased risk of dementia. The World Health Organization emphasizes the need for evaluating central auditory function in cases of mild hearing loss and normal audiometry results. Specific questionnaires play a crucial role in documenting and quantifying the difficulties faced by individuals with APD. Validated questionnaires such as the Children's Auditory Processing Performance Scale, the Fisher's Auditory Problems Checklist, and the Auditory Processing Domains Questionnaire are available for children, while questionnaires for adults include items related to auditory functions associated with APD. This systematic review and meta-analysis identified six questionnaires used for screening and evaluating APD with a total of 783 participants across 12 studies. The questionnaires exhibited differences in domains evaluated, scoring methods, and evaluation of listening in quiet and noise. Meta-analysis results demonstrated that individuals with APD consistently exhibited worse scores compared to healthy controls across all questionnaires. Additionally, comparisons with clinical control groups showed varying results. The study highlights (i) the importance of standardized questionnaires in identifying and assessing APD, aiding in its diagnosis and management, and (ii) the need to use sub-scores as well as overall scores of questionnaires to elaborate on specific hearing and listening situations. There is a need to develop more APD specific questionnaires for the adult population as well as for more focused research on APD diagnosed individuals to further establish the validity and reliability of these questionnaires.
Collapse
Affiliation(s)
- Myrto Samara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larisa, Greece
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hung Thai-Van
- Institut de l'audition, Institut Pasteur, Inserm, Paris, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service d’Audiologie et d’Explorations Otoneurologiques, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Martin Ptok
- Department of Phoniatrics and Pedaudiology, Hannover Medical School, Hannover, Germany
| | - Eleni Glarou
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Evelyne Veuillet
- Institut de l'audition, Institut Pasteur, Inserm, Paris, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service d’Audiologie et d’Explorations Otoneurologiques, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Simone Miller
- Department of Phoniatrics and Pedaudiology, Hannover Medical School, Hannover, Germany
| | - Pierre Reynard
- Institut de l'audition, Institut Pasteur, Inserm, Paris, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service d’Audiologie et d’Explorations Otoneurologiques, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Helen Grech
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Nattawan Utoomprurkporn
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ear Institute, University College London, London, United Kingdom
- Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Afroditi Sereti
- Clinical Psychoacoustics Laboratory, 3rd Psychiatric Department, Neurosciences Sector, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Doris-Eva Bamiou
- Ear Institute, University College London, London, United Kingdom
- National Institute for Health and Care Research, University College London Hospitals, UK Biomedical Research Centre, Deafness and Hearing Problems Theme, London, United Kingdom
- Department of Neuro-otology, University College London Hospitals, London, United Kingdom
| | - Vasiliki Maria Iliadou
- Clinical Psychoacoustics Laboratory, 3rd Psychiatric Department, Neurosciences Sector, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
12
|
Martin L, Chang M, Miller S, Gupta A, Kishore S, Kothary N. Abstract No. 78 Association of Bilirubin and Overall Survival in Veterans who Receive Radioembolization for Hepatocellular Carcinoma Treatment. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.124] [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: 02/27/2023] Open
|
13
|
Gadgeel S, Gainor J, Cappuzzo F, Garralda E, Lee D, Mazieres J, Kim DW, Zhu V, Lopes G, Miller S, Nowicka M, Trinh H, Arndorfer S, Rahman A, Noe J, Zhang Q, Subbiah V. 984P Relationship between RET fusion partner and treatment outcomes in patients (pts) with non-small cell lung cancer (NSCLC) from the phase I/II ARROW study and real-world data (RWD). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1111] [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: 11/01/2022] Open
|
14
|
Onay U, Xu D, Biyashev D, Demczuk M, Evans S, Podojil J, Miller S, Lu K. 793 The ”T” in cutaneous wound healing. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Peters K, Miller S, Ptok M, Jungheim M. Phonation-induced Upper Esophageal Sphincter Contraction Caused by Different Phonation Types. J Voice 2022:S0892-1997(22)00160-6. [PMID: 35906176 DOI: 10.1016/j.jvoice.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION The upper esophageal sphincter (UES) has been reported to show activity during phonation. As it is still unknown whether the phonation-induced UES contraction represents a reflex or a simultaneous activation phenomenon, i.e. co-innervation, this study aims to investigate and characterize the phonation-induced contraction of the UES in healthy individuals by analyzing the influence of various phonation tasks on pressure parameters of the UES. METHODS Twenty-five healthy volunteers produced the German neutral vowel [ə] in five different phonation tasks (modal voice, whispering, voiceless speech, creaky voice, and whispery voice). Simultaneously, they underwent high resolution manometry and electroglottography for measurement of pressure parameters in the region of the UES and latencies between larynx and UES activation. RESULTS During all types of phonation, the maximum pressures of the UES increased significantly (maximum pressure increases of 72%-132%). With regard to mean pressures this was valid for modal voice and whispering (mean pressure increases of 20%-25%). Differences concerning total pressure changes reached statistical significance when comparing whispering and voiceless speech as well as whispery voice. However, differences concerning the total pressure change between modal voices on the one hand and voiceless speech and whispery voice on the other hand turned out to be small. The averaged time delay between larynx and UES activation ranged from approximately -15 ms (whispery voice) to +15 ms (whispering). CONCLUSION A phonation induced pressure increase of the UES was confirmed in this study and did exist for different types of phonation. The extent of total pressure changes in the UES increases in relation with laryngeal muscle activity necessary for the phonation type. Next to varying effects of different types of phonation on UES activation, very short latencies indicate that a phonation induced contraction of the UES exists most likely due to co-innervation of UES and laryngeal muscles by the vagus nerve.
Collapse
Affiliation(s)
- Katharina Peters
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany.
| | - Simone Miller
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
16
|
Bunt S, Didehbani N, Stokes M, Miller S, Bell K, Cullum CM. A-07 Initial Symptoms, Pre-Existing Emotional Factors, and Symptoms of Stress During Recovery from Concussion. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac32.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose: Investigate the association of initial symptoms, mechanism of concussion, and emotional state with symptoms of stress reported during recovery from concussion in high school students. Methods: Concussed High School students (n = 183) aged 13–18 were evaluated within 30 days of injury at a North Texas Concussion Registry (ConTex) clinic with 71% (n = 130) sport-related. Subjects completed a medical history, the Sport Concussion Assessment Tool-5 Symptom Evaluation (PCSS), General Anxiety Disorder (GAD-7), and Patient Health Questionnaire-8 (PHQ-8) at initial visit. At three-month follow-up subjects completed the PTSD Checklist for DSM-5 (PCL-5). A linear regression was conducted predicting total scores on the follow up PCL-5. Predictors included initial Total PCSS Symptom Score, GAD-7, PHQ-8, sex, mechanism of injury (sport vs non-sport) and history of treatment for anxiety/depression. Results: A multiple regression model predicting participant’s total PCL-5 score at three month follow-up (R2 = 0.40, p < 0.001) included PHQ-8 (β = 0.34, p < 0.001), GAD-7 (β = 0.20, p = 0.016), history of treatment for depression (β = 0.17, p = 0.015), severity of initial symptoms (β = 0.15, p = 0.045) and mechanism of injury (β = −0.14, p = 0.018). There was no significant difference in PCL-5 scores between sport vs non-sport injury groups. Conclusions: Pre-existing depression and higher levels of self-reported anxiety and/or depression at time of injury may be associated with increased symptoms of stress during concussion recovery. Severity of initial symptoms and mechanism of injury may also be related to feelings of stress during recovery. Further investigations should include baseline measure of stress prior to injury.
Collapse
|
17
|
Miller S, Peters K, Ptok M. Review of the effectiveness of neuromuscular electrical stimulation in the treatment of dysphagia - an update. Ger Med Sci 2022; 20:Doc08. [PMID: 35875244 PMCID: PMC9284430 DOI: 10.3205/000310] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/20/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) has been used as a treatment option in the therapy of dysphagia for several years. In a previous review of the literature, it was concluded that NMES might be a valuable adjunct in patients with dysphagia and in patients with vocal fold paresis. However, due to different stimulation protocols, electrode positioning and various underlying pathological conditions, it was difficult to compare the studies which were identified and it was concluded that more empirical data is needed to fully understand the benefits provided by NMES. The purpose of this systematic review is, therefore, to evaluate recent studies regarding a potential effectiveness of transcutaneous NMES applied to the anterior neck as a treatment for dysphagia considering these different aspects. METHOD For this systematic review, a selective literature research in PubMed has been carried out on 5th May 2021 using the terms electrical stimulation AND dysphagia and screened for inclusion criteria by two reviewers in Rayyan. The search resulted in 62 hits. RESULTS Studies were excluded due to their publication language; because they did not meet inclusion criteria; because the topical focus was a different one; or because they did not qualify as level 2 studies. Eighteen studies were identified with varying patient groups, stimulation protocols, electrode placement and therapy settings. However, 16 studies have reported of beneficial outcomes in relation with NMES. DISCUSSION The purpose of this systematic review was to evaluate the most recent studies regarding a potential effectiveness of NMES as a treatment for oropharyngeal dysphagia considering different aspects. It could generally be concluded that there is a considerable amount of level 2 studies which suggest that NMES is an effective treatment option, especially when combined with TDT for patients with dysphagia after stroke and patients with Parkinson's disease, or with different kinds of brain injuries. Further research is still necessary in order to clarify which stimulation protocols, parameters and therapy settings are most beneficial for certain patient groups and degrees of impairment.
Collapse
Affiliation(s)
- Simone Miller
- Klinik für Phoniatrie und Pädaudiologie, Hannover, Germany,*To whom correspondence should be addressed: Simone Miller, Klinik für Phoniatrie und Pädaudiologie, MHH OE 6510, 30623 Hannover, Germany, Phone: +49 511 532-5778, Fax: +49 511 532-4609, E-mail:
| | | | - Martin Ptok
- Klinik für Phoniatrie und Pädaudiologie, Hannover, Germany
| |
Collapse
|
18
|
Smith M, Penny T, Sutherland A, Pham Y, Jithoo A, Tsukamoto A, Uchinda N, Hill R, Dunn A, Paton M, Finch-Edmondson M, Jenkin G, Miller S, Fahey M, McDonald C. Tissue Engineering, Embryonic, Organ and Other Tissue Specific Stem Cells: Late Breaking Abstract: IS IMMUNOSUPPRESSION NECESSARY TO PREVENT NEURAL STEM CELL REJECTION IN PERINATAL BRAIN INJURY? Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00418-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Smith M, Finch-Edmondson M, Miller S, Webb A, Fahey M, Jenkin G, Paton M, McDonald C. Tissue Engineering, Embryonic, Organ and Other Tissue Specific Stem Cells: Late Breaking Abstract: TRANSLATING CELL THERAPIES FOR THE BRAIN: PERSPECTIVES FROM THE AUSTRALIAN CEREBRAL PALSY COMMUNITY. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
20
|
Gulle H, Prior T, Coskunsu DK, Miller S, Birn-Jeffery A, Morrissey D. The association of demographic, psychological, social and activity factors with foot health in people with plantar heel pain: Case-control study. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.261] [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: 10/19/2022]
|
21
|
Wischik CM, Bentham P, Gauthier S, Miller S, Kook K, Schelter BO. Oral Tau Aggregation Inhibitor for Alzheimer’s Disease: Design, Progress and Basis for Selection of the 16 mg/day Dose in a Phase 3, Randomized, Placebo-Controlled Trial of Hydromethylthionine Mesylate. J Prev Alzheimers Dis 2022; 9:780-790. [PMID: 36281683 PMCID: PMC9226274 DOI: 10.14283/jpad.2022.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Hydromethylthionine mesylate is a tau aggregation inhibitor shown to have exposure-dependent pharmacological activity on cognitive decline and brain atrophy in two completed Phase 3 trials in mild/moderate Alzheimer’s disease (AD). Objectives The present report summarises the basis for selection of 16 mg/day as monotherapy as the optimal treatment regime and the design rationale of a confirmatory Phase 3 trial (LUCIDITY). Design The trial comprises a 12-month double-blind, placebo-controlled phase followed by a 12-month modified delayed-start open-label treatment phase. Setting 76 clinical research sites in North America and Europe. Participants 545 patients with probable AD or MCI-AD in the final version of the protocol. Intervention Participants were assigned randomly to receive hydromethylthione mesylate at doses of 16 mg/day, 8 mg/day or placebo at a 4:1:4 ratio during the double-blind phase. All participants in the open-label phase receive the 16 mg/day dose. Measurements Co-primary clinical outcomes are the 11-item Alzheimer’s Disease Assessment Scale (ADAS-cog11) and the 23-item Alzheimer’s Disease Cooperative Study — Activities of Daily Living (ADCS-ADL23). Secondary biomarker measures include whole-brain atrophy and temporal lobe 18F-fluorodeoxyglucose positron emission tomography. Results 446 participants are expected to complete the 12-month placebo-controlled phase in March 2022. Conclusions If the primary end points are met, the data will provide confirmatory evidence of the clinical and biomarker benefits of hydromethylthionine mesylate in minimal to moderate AD. As low-dose oral hydromethylthionine mesylate is simple to use clinically, does not cause amyloid-related imaging abnormalities and has a benign safety profile, it would likely improve AD management.
Collapse
Affiliation(s)
- C M Wischik
- Professor Claude Wischik, TauRx Therapeutics Ltd, 395 King Street, Aberdeen AB24 5RP, United Kingdom. ; Tel: +441224 440905; Fax: +441224 440225
| | | | | | | | | | | |
Collapse
|
22
|
Rock C, Sutherland A, Pham Y, Miller S, Allison B. Melatonin as a Cardioprotective Treatment for Fetal Growth Restriction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.459] [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: 11/28/2022]
|
23
|
Davar K, Wilson MR, Miller S, Chiu CY, Vijayan T. A Rare Bird: Diagnosis of Psittacosis Meningitis by Clinical Metagenomic Next-Generation Sequencing. Open Forum Infect Dis 2021; 8:ofab555. [PMID: 34934772 PMCID: PMC8683260 DOI: 10.1093/ofid/ofab555] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Psittacosis is a zoonotic infectious disease caused by the transmission of Chlamydia psittaci; it often presents as a pulmonary infection but rarely as disseminated disease. Because diagnoses of psittacosis are often underreported due to infrequent pathogen-specific testing, clinical metagenomic next-generation sequencing may be helpful to diagnose such an uncommon syndrome.
Collapse
Affiliation(s)
- K Davar
- Department of Medicine, Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - M R Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - S Miller
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - C Y Chiu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA.,Department of Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA
| | - T Vijayan
- Department of Medicine, Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
24
|
Olson R, Jiang W, Liu M, Bergman A, Schellenberg D, Mou B, Alexander A, Carolan H, Hsu F, Miller S, Atrchian S, Chan E, Ho C, Mohamed I, Lin A, Berrang T, Bang A, Chng N, Matthews Q, Huang V, Mestrovic T, Hyde D, Lund C, Pai H, Valev B, Lefresne S, Tyldesley S. Population Based Phase II Trial of Stereotactic Ablative Radiotherapy (SABR) for up to 5 Oligometastases: Preliminary Results of the SABR-5 Trial. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.044] [Citation(s) in RCA: 2] [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: 10/20/2022]
|
25
|
Liu W, Liu T, Leung A, Liu L, Miller S, Honarmand K, Qu M, Ball I. Medical Assistance in Dying in Oncology Patients: A Canadian Academic Hospital Experience. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
26
|
Miller S, Hunter-Campbell P. 1100 A Closed Loop Audit Comparing Admission Rates Post Transurethral Resection of Bladder Tumour (TURBT) Before and After Day Case Procedure Was Made the Standard Goal. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.123] [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: 11/14/2022]
Abstract
Abstract
Aim
To assess the impact of making day case TURBT the standard goal.
Method
We performed a closed loop audit on the effect of listing all TURBTs as day case from the 1st December 2019. Data was collected retrospectively on all TURBTs from December 2018-March 2019, and from December 2019-March 2020 after implementing the change in protocol. Data collected included patient demographics, procedure and admission details, complications, and readmission rates.
Results
In total, 133 resections were included. Prior to the change in protocol, 36% of TURBTs were performed as day case. Of those admitted, 74% were due to haematuria, and 2% were planned. 8% were readmitted within 28 days and required urology input. There was 12% readmission rate overall. The rate of bladder perforation was 3.8%.
Post intervention, 64% of all TURBTs were performed as day case. 82% of admissions were due to haematuria, and 14% were planned. The rate of bladder perforation remained low at 1.6%, and readmission rate was 3% with no urology input required.
Conclusions
TURBT is the standard endoscopic procedure for the diagnosis, grading and removal of bladder tumours. The use of day case surgery pathways has been emphasised to help reduce lengths of stay and streamline patient care. The British Association of Day Surgery (BADS) recommends that 60% of TURBTs could be performed as a day case procedure. This study shows that this recommendation can be exceeded through a simple and low-cost intervention, whilst maintaining a low complication rate.
Collapse
Affiliation(s)
- S Miller
- Derriford Hospital, Plymouth, United Kingdom
| | | |
Collapse
|
27
|
Myatt G, Bower D, Bassan A, Cross K, Johnson C, Miller S, Pavan M. Acceptance of in silico methods for regulatory purposes. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00300-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
28
|
Miller S, Diers D, Jungheim M, Schnittger C, Stürenburg HJ, Ptok M. Studying effects of neuromuscular electrostimulation therapy in patients with dysphagia: which pitfalls may occur? A translational phase I study. Ger Med Sci 2021; 19:Doc07. [PMID: 34194290 PMCID: PMC8204381 DOI: 10.3205/000294] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/12/2021] [Indexed: 11/30/2022]
Abstract
Background: Previous results of clinical studies suggest that neuromuscular electrostimulation (NMES) therapy, especially in combination with traditional dysphagia therapy, may be helpful in patients with neurogenic swallowing disorders. In these studies, repetitive application of a rectangular current impulse was used to increase muscle strength of the anterior neck. However, according to sports physiological findings, an increase of muscle strength can be better achieved by using different NMES stimulation protocols, e.g. KOTS. The aim of the translational investigator-initiated, non-commercial pilot study presented here was to provide data and insights for the planning of subsequent phase II and III studies on the effectiveness of such stimulation protocols in dysphagia therapy. Methods: 30 post-stroke patients with oropharyngeal dysphagia were included in this prospective pilot study and randomly allocated to either neuromuscular electrostimulation (NMES) or sham stimulation in combination with traditional dysphagia therapy (TDT), a pre- and post-therapeutic fiberoptic-endoscopic evaluation of swallowing (FEES) with the Dysphagia Outcome and Severity Scale (DOSS) (primary outcome measure), Secretion Scale by Murray, Penetration and Aspiration Scale (PAS) and throat clearance (TC) abilities. Recruitment rate, interrater comparison and number of relevant adverse events were recorded as metadata. Results: Despite a recruiting time of over 24 months, only twelve patients could be included. Moreover, clinical data indicated a significant variance of clinical pictures. Significant differences in verum versus sham therapy were not observed. DOSS values in both study groups showed general improvements at the end of the trial. Interrater reliability was low. No adverse events were reported. Discussion: When planning further dysphagia therapy studies, it must be taken into account that it can be problematic to recruit sufficiently large study collectives within an appropriate study period. This is especially important since a possible additional benefit of NMES to TDT is probably rather small or may only occur in certain deficit constellations. The low interrater reliability observed here must be improved by appropriate training measures. Fortunately, no relevant undesirable side effects occurred. This could have a positive effect on the acceptance of volunteers to participate in the study.
Collapse
Affiliation(s)
- Simone Miller
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Daniela Diers
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | | | - Hans Jörg Stürenburg
- Department of Neurology, Klinik Niedersachsen, Erwin Röver GmbH und Co. KG, Bad Nenndorf, Germany
| | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
29
|
Li J, Kingsford P, Hashmi S, Onwuzurike J, Genyk P, Liu G, Saffarian M, Yang K, Abarca P, Singhal P, Sharma A, Miller S, Patel S, Miklin D, Lum C, Salimbangon A, Lee Jr R, Lee A, Nattiv J, Pizula J, Fong M, Grazette L, Rahman J, Pandya K, Wolfson A, DePasquale E, Vaidya A. One-year before and after UNOS Status Change Effect on ECMO as a Bridge to Heart Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1943] [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] Open
|
30
|
Miklin D, Bradley P, Lee R, Singhal P, Miller S, Genyk P, Li J, Saffarian M, Hashmi S, Kingsford P, Patel S, Lum C, Salimbangon A, Wolfson A, Vaidya A, Depasquale E. Impact of UNOS Policy Allocation Change on Waitlist Outcomes in Patients Bridged to Heart Transplant with an Intra-Aortic Balloon Pump. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.782] [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: 11/25/2022] Open
|
31
|
Tang JW, Bahnfleth WP, Bluyssen PM, Buonanno G, Jimenez JL, Kurnitski J, Li Y, Miller S, Sekhar C, Morawska L, Marr LC, Melikov AK, Nazaroff WW, Nielsen PV, Tellier R, Wargocki P, Dancer SJ. Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). J Hosp Infect 2021; 110:89-96. [PMID: 33453351 PMCID: PMC7805396 DOI: 10.1016/j.jhin.2020.12.022] [Citation(s) in RCA: 179] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/20/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused untold disruption throughout the world. Understanding the mechanisms for transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is key to preventing further spread, but there is confusion over the meaning of ‘airborne’ whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago which has generated mythological beliefs that obscure current thinking. This article collates and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six ‘myths’ are presented, explained and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community.
Collapse
Affiliation(s)
- J W Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - W P Bahnfleth
- Department of Architectural Engineering, The Pennsylvania State University, State College, PA, USA
| | - P M Bluyssen
- Faculty of Architecture and the Built Environment, Delft University of Technology, Delft, The Netherlands
| | - G Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy
| | - J L Jimenez
- Department of Chemistry and CIRES, University of Colorado, Boulder, CO, USA
| | - J Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Tallinn, Estonia
| | - Y Li
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
| | - S Miller
- Mechanical Engineering, University of Colorado, Boulder, CO, USA
| | - C Sekhar
- Department of Building, National University of Singapore, Singapore
| | - L Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - L C Marr
- Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - A K Melikov
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - W W Nazaroff
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - P V Nielsen
- Faculty of Engineering and Science, Department of Civil Engineering, Aalborg University, Aalborg, Denmark
| | - R Tellier
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - P Wargocki
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - S J Dancer
- Department of Microbiology, NHS Lanarkshire, Glasgow, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
| |
Collapse
|
32
|
Miller S, Ptok M, Jungheim M. Correction to: Influence of Acid Swallows on the Dynamics of the Upper Esophageal Sphincter. Dysphagia 2020; 36:456. [PMID: 33188489 PMCID: PMC8163678 DOI: 10.1007/s00455-020-10210-2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Simone Miller
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, Germany.
| | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, Germany
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, Germany
| |
Collapse
|
33
|
Meisoll FJ, Jungheim M, Fast JF, Miller S, Ptok M. Upper Esophageal Sphincter Response to Laryngeal Adductor Reflex Elicitation in Humans. Laryngoscope 2020; 131:E1778-E1784. [PMID: 33111975 DOI: 10.1002/lary.29166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/28/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The laryngeal adductor reflex (LAR) is an important mechanism to secure the airways from potential foreign body aspiration. An involvement of the upper esophageal sphincter (UES) in terms of a laryngo-UES contractile reflex has been identified after laryngeal mucosa stimulation. However, the LAR-UES relationship has not yet been fully explained. This study aimed to determine the magnitude, latency, and occurrence rate of the UES pressure response when the LAR is triggered in order to elucidate the functional relationship between the larynx and the UES. METHODS This prospective study included seven healthy volunteers (5 female, 2 male, age 22-34 years). Laryngeal penetration was simulated by eliciting the LAR 20 times in each individual by applying water-based microdroplets onto the laryngeal mucosa. UES pressures were measured simultaneously using high-resolution manometry. RESULTS Two distinct pressure phases (P1, P2) associated with the LAR were identified. P1 corresponded with a short-term UES pressure decrease in two subjects and a pressure increase in five subjects occurring 200 to 500 ms after the stimulus. In P2, all subjects experienced an increase in UES pressure with a latency time of approximately 800 to 1700 ms and an average of 40 to 90 mmHg above the UES resting tone. CONCLUSION Foreign bodies penetrating the laryngeal inlet lead to a reflex contraction of the UES. Phase P1 could be a result of vocal fold activity caused by the LAR, leading to pressure changes in the UES. The constriction during P2 could strengthen the barrier function of the UES in preparation to a subsequent cough that may be triggered to clear the airways. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1778-E1784, 2021.
Collapse
Affiliation(s)
- Frederik J Meisoll
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Jacob F Fast
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany.,Institute of Mechatronic Systems, Leibniz Universität Hannover, Hannover, Germany
| | - Simone Miller
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
34
|
Johnston K, Salhany R, Ciafaloni E, Mickle A, Miller S, Gooch K. DMD & BMD – CLINICAL. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
35
|
Coughlin DG, Ittyerah R, Peterson C, Phillips JS, Miller S, Rascovsky K, Weintraub D, Siderowf AD, Duda JE, Hurtig HI, Wolk DA, McMillan CT, Yushkevich PA, Grossman M, Lee EB, Trojanowski JQ, Irwin DJ. Hippocampal subfield pathologic burden in Lewy body diseases vs. Alzheimer's disease. Neuropathol Appl Neurobiol 2020; 46:707-721. [PMID: 32892355 DOI: 10.1111/nan.12659] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/21/2020] [Accepted: 08/22/2020] [Indexed: 12/16/2022]
Abstract
AIMS Lewy body diseases (LBD) are characterized by alpha-synuclein (SYN) pathology, but comorbid Alzheimer's disease (AD) pathology is common and the relationship between these pathologies in microanatomic hippocampal subfields is understudied. Here we use digital histological methods to test the association between hippocampal SYN pathology and the distribution of tau and amyloid-beta (Aβ) pathology in LBD and contrast with AD subjects. We also correlate pathologic burden with antemortem episodic memory testing. METHODS Hippocampal sections from 49 autopsy-confirmed LBD cases, 30 with no/low AD copathology (LBD - AD) and 19 with moderate/severe AD copathology (LBD + AD), and 30 AD patients were stained for SYN, tau, and Aβ. Sections underwent digital histological analysis of subfield pathological burden which was correlated with antemortem memory testing. RESULTS LBD - AD and LBD + AD had similar severity and distribution of SYN pathology (P > 0.05), CA2/3 being the most affected subfield (P < 0.02). In LBD, SYN correlated with tau across subfields (R = 0.49, P < 0.001). Tau burden was higher in AD than LBD + AD (P < 0.001), CA1/subiculum and entorhinal cortex (ERC) being most affected regions (P = 0.04 to <0.01). However, tau pathology in LBD - AD was greatest in CA2/3, which was equivalent to LBD + AD. Aβ severity and distribution was similar between LBD + AD and AD. Total hippocampal tau and CA2/3 tau was inversely correlated with memory performance in LBD (R = -0.52, -0.69, P = 0.04, 0.009). CONCLUSIONS Our findings suggest that tau burden in hippocampal subfields may map closely with the distribution of SYN pathology in subfield CA2/3 in LBD diverging from traditional AD and contribute to episodic memory dysfunction in LBD.
Collapse
Affiliation(s)
- D G Coughlin
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurosciences, University California San Diego, San Diego, CA, USA
| | - R Ittyerah
- Department of Radiology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C Peterson
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J S Phillips
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - S Miller
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - K Rascovsky
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D Weintraub
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA
| | - A D Siderowf
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J E Duda
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA
| | - H I Hurtig
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D A Wolk
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Alzheimer's disease Research Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C T McMillan
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - P A Yushkevich
- Department of Radiology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M Grossman
- Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E B Lee
- Department of Pathology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J Q Trojanowski
- Department of Pathology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D J Irwin
- Penn Digital Neuropathology Laboratory at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Frontotemporal Dementia Center at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,LBDA Research Center of Excellence at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
36
|
Clements D, Miller S, Johnson SR. Pulmonary Lymphangioleiomyomatosis originates in the pleural mesothelial cell population. Med Hypotheses 2020; 141:109703. [PMID: 32276237 DOI: 10.1016/j.mehy.2020.109703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/17/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023]
Abstract
Lymphangioleiomyomatosis (LAM) is a cystic lung disease mainly affecting women, in which degradation of the lung parenchyma is associated with a cell of unknown provenance, known as a LAM cell. LAM cells carry TSC2 mutations and can be identified in the lung parenchyma by their expression of both smooth muscle actin and antigens characteristic of melanocytes and melanocytic tumors. The nature of the cell-of-origin of LAM is controversial, and despite continued research effort remains elusive. Further, it has not been possible to culture pulmonary LAM cells in vitro, and current research relies on cells and animal models which may not recapitulate all features of the disease. We noted aberrant expression of melanoma antigens in pleural mesothelial cells in lung tissue from LAM patients, indicating that these cells could be the precursors of parenchymal LAM cells. We hypothesise that loss of tuberin function following TSC2 mutation in the mesothelial cell lineage gives rise to the cell-of-origin of pulmonary LAM (P-LAM), and of other associated conditions commonly noted in LAM patients. The unique properties of mesothelial cells provide a straightforward explanation of the diverse presentation of LAM.
Collapse
Affiliation(s)
- D Clements
- Division of Respiratory Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham NG7 2RD, UK.
| | - S Miller
- Division of Respiratory Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham NG7 2RD, UK
| | - S R Johnson
- Division of Respiratory Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham NG7 2RD, UK; National Centre for Lymphangioleiomyomatosis, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK
| |
Collapse
|
37
|
Tarkenton T, Presley C, Hynan LS, Miller S, Silver CH, Didehbani N, Cullum CM. A-43 Post-Traumatic Stress Symptoms in Sport-Related Concussion and Orthopedic Injury: An Initial Comparison. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Few studies have compared psychological responses to injury following sport-related concussion versus injury in general. The aim of this pilot investigation was to explore whether trauma-related stress symptoms differ between adolescents with sport-related concussion (SRC) vs. orthopedic injury (OI).
Method
Participants age 12-18 with SRC (n=48) or OI (n=12) presented to specialty clinics in the North Texas Concussion Registry (ConTex) within 21 days of injury (M= 6.7). Total scores from the PTSD Checklist for DSM-5 (PCL-5) were calculated (range=0-80). Independent t-test compared PCL-5 symptom scores between SRC and OI, and post-hoc analyses examined frequency of symptoms reported within each group.
Results
There was no significant difference between mean PCL-5 scores in SRC and OI groups, and both obtained scores above the typical cutoff for PTSD, defined as scores >30 (range= 0-46; SRC=10%, OI=16%). Most commonly reported symptoms for both SRC and OI were sleep problems, feeling jumpy, and being “super alert.” SRC subjects were more likely to report difficulty concentrating (SRC=42%; OI=16%), while OI subjects were more likely to report feeling distant from other people (OI=50%; SRC=20%).
Conclusions
While total post-traumatic stress symptoms may not differ between SRC and OI groups, there may be differences in individual trauma-related symptoms based upon the nature of injury. Both injury groups may be susceptible to sleep difficulties and hypervigilance, yet SRC individuals may experience more cognitive complaints, while OI may report more feelings of isolation. Furture studies will need to use the PCL-5 with larger sample sizes and recovery indices to provide a more detailed comparison of the injury groups.
Collapse
|
38
|
Presley C, Meredith-Duliba T, Tarkenton T, Stokes M, Miller S, Bell K, Batjer H, Cullum CM. A-32 Acute Concussive Symptom Profiles in Adolescents and Young Adults with History of Depression and Anxiety. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
The aims of this study are (1) to examine the clinical symptom profiles of individuals with depression and/or anxiety history following a concussion and (2) to compare profile differences across groups.
Method
Participants aged 12-25 (n=129, mean=15.6) with premorbid diagnoses of depression (n=24), anxiety (n=50), or depression+anxiety (n=55) were evaluated within 21 days after sustaining a concussion as part of the North Texas Concussion Registry (ConTex) using the Post-Concussion Symptom Scale (PCSS). Following the model described by Kontos and Collins (2014), symptom clusters were derived from the PCSS to create six domains (cognitive/fatigue, vestibular, ocular, posttraumatic migraine, anxiety/mood, cervical). ANOVAs with Tukey’s post-hoc tests were conducted to compare domain symptom severity and total symptom severity across groups.
Results
There were no demographic differences between groups. A single symptom profile was prominent across each group, with the primary, secondary, and tertiary symptomatic domains being posttraumatic migraine, ocular, and cognitive/fatigue, respectively. Across each domain the depression+anxiety group was most symptomatic, followed in order by the depression and anxiety groups. The depression+anxiety group reported significantly higher anxiety/mood (M=2.0 vs. M=1.3) and cognitive/fatigue (M=2.9 vs M=2.1) symptom severity compared to the anxiety group. Group differences on total symptom severity approached significance (F=2.83, p=.06).
Conclusions
The observed symptom profiles suggest that the acute-concussive response is similar in adolescents and young adults with history of depression and/or anxiety. Multiple premorbid conditions, such as depression and anxiety, appear to magnify overall symptom severity. Further research is warranted to understand the relationship between symptom burden and premorbid mental health factors.
Collapse
|
39
|
Kearns M, Chou L, Aguillon M, Passano E, Miller S, Czer L, Megna D, Emerson D, Esmailian F, Trento A, Ramzy D. Impella 5.0 as a Bridge to Cardiac Transplantation before and after Reclassification of the United Network for Organ Sharing Heart Allocation Criteria. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
40
|
Diers D, Fast JF, Götz F, Kahrs LA, Miller S, Jungheim M, Ptok M. Euclidean distances of laryngopharyngeal structures obtained from CT data for preclinical development of laryngoscopic devices. Surg Radiol Anat 2019; 42:695-700. [PMID: 31858189 DOI: 10.1007/s00276-019-02397-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aims to determine Euclidean distances between landmark structures in the larynx and pharynx to optimize endoscope shaft designs with regard to gentle and patient-oriented handling. METHODS Four Euclidean distances between landmarks in the larynx and pharynx were analyzed based on CT data of 66 patients. Distance (1): labium inferius oris-posterior pharyngeal wall at the cervical vertebra C1 (atlas), anterior edge of the tuberculum anterius atlantis. Distance (2): posterior pharyngeal wall adjacent to C1-entrance of pyriform sinus. Distance (3): inferior edge of the uvula-superior edge of the epiglottis. Distance (4): base of the vallecula-posterior pharyngeal wall. The minimum angular field of view α required to observe the glottis with a rigid transoral laryngoscope was derived trigonometrically from distances (2) and (4). RESULTS Average Euclidean distances measured: Distance (1): 90.7 mm ± 6.9 mm in men and 86.9 mm ± 5.9 mm in women. (2): 73.7 mm ± 13.4 mm and 56.2 mm ± 7.6 mm. (3): 25.2 mm ± 8.6 mm and 18.5 mm ± 6.8 mm. (4): 20.8 mm ± 4.6 mm and 16.5 mm ± 3.4 mm. α: 16.0° ± 3.9° and 16.6 ± 4.3°. CONCLUSIONS As expected, statistically significant sex-related differences could be observed for distances (1)-(4). The results indicate that the length of transoral laryngoscopes should not be below 110 mm and that a minimum angular field of view of α = 17° is required to fully observe the laryngeal inlet.
Collapse
Affiliation(s)
- Daniela Diers
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Jacob Friedemann Fast
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany.,Institute of Mechatronic Systems (imes), Leibniz Universität Hannover, Hannover, Germany
| | - Friedrich Götz
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Lüder Alexander Kahrs
- The Hospital for Sick Children, Centre for Image Guided Innovation and Therapeutic Intervention (CIGITI), Toronto, Canada.,Department of Mathematical and Computational Sciences, University of Toronto Mississauga, Mississauga, Canada
| | - Simone Miller
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany.
| | - Michael Jungheim
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| | - Martin Ptok
- Department of Phoniatrics and Pediatric Audiology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
41
|
Lee D, Subbiah V, Gainor J, Taylor M, Zhu V, Doebele R, Lopes G, Baik C, Garralda E, Gadgeel S, Kim DW, Turner C, Palmer M, Miller S, Curigliano G. Treatment with pralsetinib (formerly BLU-667), a potent and selective RET inhibitor, provides rapid clearance of ctDNA in patients with RET-altered non-small cell lung cancer (NSCLC) and medullary thyroid cancer (MTC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz431] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
42
|
Curigliano G, Subbiah V, Gainor J, Lee D, Taylor M, Zhu V, Doebele R, Lopes G, Baik C, Garralda E, Gadgeel S, Kim DW, Turner C, Palmer M, Miller S. Treatment with BLU-667, a potent and selective RET inhibitor, provides rapid clearance of ctDNA in patients with RET-altered non-small cell lung cancer (NSCLC) and thyroid cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
43
|
Melin H, Fletcher LN, Stallard TS, Miller S, Trafton LM, Moore L, O'Donoghue J, Vervack RJ, Dello Russo N, Lamy L, Tao C, Chowdhury MN. The H 3+ ionosphere of Uranus: decades-long cooling and local-time morphology. Philos Trans A Math Phys Eng Sci 2019; 377:20180408. [PMID: 31378181 PMCID: PMC6710888 DOI: 10.1098/rsta.2018.0408] [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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 05/04/2023]
Abstract
The upper atmosphere of Uranus has been observed to be slowly cooling between 1993 and 2011. New analysis of near-infrared observations of emission from H3+ obtained between 2012 and 2018 reveals that this cooling trend has continued, showing that the upper atmosphere has cooled for 27 years, longer than the length of a nominal season of 21 years. The new observations have offered greater spatial resolution and higher sensitivity than previous ones, enabling the characterization of the H3+ intensity as a function of local time. These profiles peak between 13 and 15 h local time, later than models suggest. The NASA Infrared Telescope Facility iSHELL instrument also provides the detection of a bright H3+ signal on 16 October 2016, rotating into view from the dawn sector. This feature is consistent with an auroral signal, but is the only of its kind present in this comprehensive dataset. This article is part of a discussion meeting issue 'Advances in hydrogen molecular ions: H3+, H5+ and beyond'.
Collapse
Affiliation(s)
- Henrik Melin
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - L. N. Fletcher
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - T. S. Stallard
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| | - S. Miller
- Department of Physics & Astronomy, University College London, London, UK
| | - L. M. Trafton
- Department of Astronomy, University of Texas, Austin, TX, USA
| | - L. Moore
- Center for Space Physics, Boston University, Boston, MA, USA
| | | | - R. J. Vervack
- Johns Hopkins Applied Physics Laboratory, Laurel, MD, USA
| | - N. Dello Russo
- Johns Hopkins Applied Physics Laboratory, Laurel, MD, USA
| | - L. Lamy
- LESIA, Observatoire de Paris, PSL, CNRS, Sorbonne Université, Meudon, France
| | - C. Tao
- National Institute of Information and Communications Technology, Tokyo, Japan
| | - M. N. Chowdhury
- Department of Physics & Astronomy, University of Leicester, Leicester, UK
| |
Collapse
|
44
|
Moore L, Melin H, O'Donoghue J, Stallard TS, Moses JI, Galand M, Miller S, Schmidt CA. Modelling H 3+ in planetary atmospheres: effects of vertical gradients on observed quantities. Philos Trans A Math Phys Eng Sci 2019; 377:20190067. [PMID: 31378180 PMCID: PMC6710898 DOI: 10.1098/rsta.2019.0067] [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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2019] [Indexed: 05/20/2023]
Abstract
Since its detection in the aurorae of Jupiter approximately 30 years ago, the H3+ ion has served as an invaluable probe of giant planet upper atmospheres. However, the vast majority of monitoring of planetary H3+ radiation has followed from observations that rely on deriving parameters from column-integrated paths through the emitting layer. Here, we investigate the effects of density and temperature gradients along such paths on the measured H3+ spectrum and its resulting interpretation. In a non-isothermal atmosphere, H3+ column densities retrieved from such observations are found to represent a lower limit, reduced by 20% or more from the true atmospheric value. Global simulations of Uranus' ionosphere reveal that measured H3+ temperature variations are often attributable to well-understood solar zenith angle effects rather than indications of real atmospheric variability. Finally, based on these insights, a preliminary method of deriving vertical temperature structure is demonstrated at Jupiter using model reproductions of electron density and H3+ measurements. The sheer diversity and uncertainty of conditions in planetary atmospheres prohibits this work from providing blanket quantitative correction factors; nonetheless, we illustrate a few simple ways in which the already formidable utility of H3+ observations in understanding planetary atmospheres can be enhanced. This article is part of a discussion meeting issue 'Advances in hydrogen molecular ions: H3+, H5+ and beyond'.
Collapse
Affiliation(s)
- L. Moore
- Boston University, Boston, MA, USA
| | - H. Melin
- University of Leicester, Leicester, UK
| | - J. O'Donoghue
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | | | - M. Galand
- Department of Physics, Imperial College London, London, UK
| | - S. Miller
- University College London, London, UK
| | | |
Collapse
|
45
|
Meredith-Duliba T, Bunt S, Didehbani N, Miller S, Straub J, Wang H, Cullum C. B-51 Impact of Resilience on Symptoms and Mood during Recovery in Adolescents and Young Adults Following Sports-Related Concussion. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
It is unclear how resilience, the ability to “bounce back” from a stressful experience, is associated with recovery following a sport-related concussion (SRC). The aim of this project is to assess how resilience is related to symptoms following SRC.
Method
Participants (N = 353) aged 12-25 were evaluated within 30 days of injury at clinics in the ConTex Concussion Registry. The Sport Concussion Assessment Tool-5 symptom evaluation, Brief Resilience Scale (BRS), General Anxiety Disorder-7 Item (GAD-7), and Patient Health Questionnaire-8 Item (PHQ-8) were administered at initial visit and at three-months. BRS scores were used to place subjects into low (n = 40), average (n = 214), and high (n = 99) resilience groups, with a 2 (time) by 3 (group) repeated measures ANOVA to compare symptom scales.
Results
At initial visit subjects with low resilience reported higher GAD-7 [F (2,308) = 3.95, p = .02; 95% C.I. 5.19, 7.64] and PHQ-8 [F (2,311) = 4.40, p = .01; 95% C.I. 4.76, 7.47] scores compared to average and high resilience samples and demonstrated significant interaction effects with time. Subjects with low resilience also endorsed more initial SCAT5 symptoms [F (2,350) = 3.69, p = .026, 95% C.I. 10.99, 14.18] but showed no interaction with time.
Conclusion
Findings suggest that resilience may influence mood (anxiety & depression) initially and during SRC recovery. Consideration of resilience as a pre-injury factor may be important in SRC research.
Collapse
|
46
|
Presley C, Tarkenton T, Meredith-Duliba T, Sabo T, Miller S, Bell K, Batjer H, Cullum CM. The Role of Premorbid Psychiatric History and Current Mood Ratings on Self-Reported Concussion Symptom Severity. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz026.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
Psychiatric history is known to be relevant to concussion outcomes, although less is known about the role of such factors or current mood ratings in adolescents. The aim of this study was to assess the role of premorbid psychiatric history (PPH) and current mood ratings (CMR) on overall sports-related concussion (SRC) symptomology and cognitive outcomes in adolescent and young adult athletes.
Methods
Participants age 12–25 years (M=14.8) diagnosed with SRC (n=560) were evaluated within 14 days of injury as part of the North Texas Concussion Registry (ConTex) using the Patient Health Questionnaire-8 Items (PHQ-8), General Anxiety Disorder-7 Item Scale (GAD-7), and ImPACT. Subjects were dichotomized into those with (PPH+) and without (PPH-) pre-existing reported psychiatric diagnoses, and CMR groups were determined by normal vs. elevated scores on the GAD-7 and PHQ-8. T-tests were used to compare groups.
Results
Significant differences in total symptom severity scores were found between both PPH (p=.01) and CMR (p<.001) groupings. PPH+ (n=27) reported significantly higher symptom scores (M=31.6) than PPH- subjects (n=316, M=20.9). Additionally, those reporting elevated CMR endorsed 2.3x higher symptom severity scores (n=48, M=42.1 vs. n=276, M=18.2). Among ImPACT cognitive scores, only Visual Memory differed between CMR groups (p=.047).
Conclusion
Findings suggest that PPH and elevated CMR are associated with greater self-reported symptom severity in adolescent SRC, but have little relationship to cognitive outcomes as assessed by ImPACT. Further research is needed to understand the interaction between PPH, CMR, and SRC recovery across the age spectrum.
Collapse
|
47
|
Carreiro S, Miller S, Wang B, Wax P, Campleman S, Manini AF. Clinical predictors of adverse cardiovascular events for acute pediatric drug exposures. Clin Toxicol (Phila) 2019; 58:183-189. [PMID: 31267804 DOI: 10.1080/15563650.2019.1634272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Context: Risk factors for adverse cardiovascular events (ACVE) from drug exposures have been well-characterized in adults but not studied in children. The objective of the present study is to describe the incidence, characteristics, and risk factors for in-hospital ACVEs among pediatric emergency department (ED) patients with acute drug exposures.Methods: This is a prospective cohort design evaluating patients in the Toxicology Investigators Consortium (ToxIC) Registry. Pediatric patients (age <18 years) who were evaluated at the bedside by a medical toxicologist for a suspected acute drug exposure were included. The primary outcome was in-hospital ACVE (myocardial injury, shock, ventricular dysrhythmia, or cardiac arrest). The secondary outcome was in-hospital death. Multiple logistic regression analyses were performed to examine novel clinical risk factors and extrapolate adult risk factors (bicarbonate <20 mEq/L; QTc ≥500 ms), for the primary/secondary outcomes.Results: Among the 13,097 patients (58.5% female), there were 278 in-hospital ACVEs (2.1%) and 39 in-hospital deaths (0.3%). Age and drug class of exposure (specifically opioids and cardiovascular drugs) were independently associated with ACVE. Compared with adolescents, children under 2 years old (OR: 0.41, 95% CI: 0.21-0.80), ages 2-6 (OR: 0.37, 95% CI: 0.21-0.80), and ages 7-12 (OR: 0.51, 95% CI: 0.27-0.95) were significantly less likely to experience an ACVE. Serum bicarbonate concentration <20 mEq/L (OR: 2.31, 95% CI: 1.48-3.60) and QTc ≥ 500 ms (OR: 2.83, 95% CI: 1.67-4.79) were independently associated with ACVE.Conclusion: Previously derived clinical predictors of ACVE from an adult drug overdose population were successfully extrapolated to this pediatric population. Novel associations with ACVE and death included adolescent age and opioid drug exposures. In the midst of the opioid crisis, these findings urgently warrant further investigation to combat adolescent opioid overdose morbidity and mortality.
Collapse
Affiliation(s)
- Stephanie Carreiro
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Simone Miller
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Bo Wang
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Paul Wax
- American College of Medical Toxicology, Phoenix, AZ, USA.,Department of Emergency Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
| | | | - Alex F Manini
- Division of Medical Toxicology, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York, NY, USA
| |
Collapse
|
48
|
Agarwal A, Miller S, Hadden W, Johnston L, Wang W, Arnold G, Abboud RJ. Comparison of gait kinematics in total and unicondylar knee replacement surgery. Ann R Coll Surg Engl 2019; 101:391-398. [PMID: 31155888 DOI: 10.1308/rcsann.2019.0016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/22/2022] Open
Abstract
INTRODUCTION This study is aimed to compare kinematic gait data of patients who have undergone total and unicondylar knee replacement. MATERIALS AND METHODS This single-surgeon retrospective cohort study evaluated 13 patients with unilateral total knee arthroplasty (TKA) and 14 unicondylar knee arthroplasty (UKA). Gait analysis was carried out using a Vicon motion analysis system. The limits of knee flexion during stance phase, at heel strike and at loading response were measured. RESULTS The total range of motion of the UKA knees was significantly greater than the TKA knees. UKA knees exhibited significantly greater knee extension during the stance phase than the TKA knees. Unlike TKA, UKA knees demonstrated improved knee flexion during the gait cycle when compared to the contralateral non-operated knee. The hips also demonstrated near normal hip flexion in UKA patients. Predictably, UKA knees had significantly greater varus compared with TKA in the coronal plane. Spatiotemporal variables demonstrated similar walking speed and step length to aid a fair comparison between knee replacement groups. CONCLUSIONS The UKA knees moved more physiologically in the sagittal plane with a greater range of motion during gait. Despite having a stiff gait pattern, the patients undergoing TKA demonstrated a more neutral alignment in the coronal plane. Neither type of knee arthroplasty restored knee kinematics to those of the non-operated side.
Collapse
Affiliation(s)
- A Agarwal
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| | - S Miller
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| | - W Hadden
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| | - L Johnston
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| | - W Wang
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| | - G Arnold
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| | - R J Abboud
- Institute of Motion Analysis & Research (IMAR), Department of Orthopaedics & Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University Of Dundee , Dundee DD19SY , UK
| |
Collapse
|
49
|
Xu D, Bhattacharyya S, Wang W, Miller S, Varga J. 698 Novel immunomodulatory therapies for systemic sclerosis (SSc) using biodegradable nanoparticles. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.774] [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: 10/27/2022]
|
50
|
Shi B, Wang W, Wei J, Bhattacharyya S, Korman B, Marangoni R, Xu D, Miller S, Akbarpour M, Bharat A, Kamp D, Cheresh P, Procissi D, de Olivera G, Chini E, Varga J. 700 Targeting SIRT/CD38/NAD+ homeostasis to mitigate fibrosis in scleroderma. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|