1
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McAlister S, van den Biggelaar A, Thornton R. Suboptimal protection with 3 + 0 PCV13: a need for change? Lancet Infect Dis 2022; 22:1657-1658. [PMID: 36029794 DOI: 10.1016/s1473-3099(22)00521-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Sonia McAlister
- School of Medicine, The University of Western Australia, Crawley, WA 6009, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Anita van den Biggelaar
- Centre for Child Health Research, The University of Western Australia, Crawley, WA 6009, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Ruth Thornton
- Centre for Child Health Research, The University of Western Australia, Crawley, WA 6009, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia.
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2
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Rodriguez-Valle M, McAlister S, Moolhuijzen PM, Booth M, Agnew K, Ellenberger C, Knowles AG, Vanhoff K, Bellgard MI, Tabor AE. Immunomic Investigation of Holocyclotoxins to Produce the First Protective Anti-Venom Vaccine Against the Australian Paralysis Tick, Ixodes holocyclus. Front Immunol 2021; 12:744795. [PMID: 34671357 PMCID: PMC8522651 DOI: 10.3389/fimmu.2021.744795] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/20/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022] Open
Abstract
Venom producing animals are ubiquitously disseminated among vertebrates and invertebrates such as fish, snakes, scorpions, spiders, and ticks. Of the ~890 tick species worldwide, 27 have been confirmed to cause paralysis in mammalian hosts. The Australian paralysis tick (Ixodes holocyclus) is the most potent paralyzing tick species known. It is an indigenous three host tick species that secretes potent neurotoxins known as holocyclotoxins (HTs). Holocyclotoxins cause a severe and harmful toxicosis leading to a rapid flaccid paralysis which can result in death of susceptible hosts such as dogs. Antivenins are generally polyclonal antibody treatments developed in sheep, horses or camels to administer following bites from venomous creatures. Currently, the methods to prevent or treat tick paralysis relies upon chemical acaricide preventative treatments or prompt removal of all ticks attached to the host followed by the administration of a commercial tick-antiserum (TAS) respectively. However, these methods have several drawbacks such as poor efficacies, non-standardized dosages, adverse effects and are expensive to administer. Recently the I. holocyclus tick transcriptome from salivary glands and viscera reported a large family of 19 holocyclotoxins at 38-99% peptide sequence identities. A pilot trial demonstrated that correct folding of holocyclotoxins is needed to induce protection from paralysis. The immunogenicity of the holocyclotoxins were measured using commercial tick antiserum selecting HT2, HT4, HT8 and HT11 for inclusion into the novel cocktail vaccine. A further 4 HTs (HT1, HT12, HT14 and HT17) were added to the cocktail vaccine to ensure that the sequence variation among the HT protein family was encompassed in the formulation. A second trial comparing the cocktail of 8 HTs to a placebo group demonstrated complete protection from tick challenge. Here we report the first successful anti-venom vaccine protecting dogs from tick paralysis.
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Affiliation(s)
- Manuel Rodriguez-Valle
- Centre for Animal Science, The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, St. Lucia, QLD, Australia
| | - Sonia McAlister
- Centre for Animal Science, The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, St. Lucia, QLD, Australia
| | | | - Mitchell Booth
- Centre for Animal Science, The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, St. Lucia, QLD, Australia
| | - Kim Agnew
- Paul Dick & Associates Ltd, Castle Hill, NSW, Australia
| | - Claudia Ellenberger
- Elanco Animal Health, Yarrandoo Research and Development Centre, Kemps Creek, NSW, Australia
| | | | - Kathleen Vanhoff
- Elanco Animal Health, Yarrandoo Research and Development Centre, Kemps Creek, NSW, Australia
| | - Matthew I Bellgard
- eResearch Office, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ala E Tabor
- Centre for Animal Science, The University of Queensland, Queensland Alliance for Agriculture & Food Innovation, St. Lucia, QLD, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
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3
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Johnson BZ, McAlister S, McGuire HM, Palanivelu V, Stevenson A, Richmond P, Palmer DJ, Metcalfe J, Prescott SL, Wood FM, Fazekas de St Groth B, Linden MD, Fear MW, Fear VS. Corrigendum: Pediatric Burn Survivors Have Long-Term Immune Dysfunction With Diminished Vaccine Response. Front Immunol 2020; 11:598646. [PMID: 33163008 PMCID: PMC7581988 DOI: 10.3389/fimmu.2020.598646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/05/2022] Open
Affiliation(s)
- Blair Z Johnson
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Sonia McAlister
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Helen M McGuire
- Ramaciotti Facility for Human Systems Biology and the Charles Perkins Centre, Discipline of Pathology, The University of Sydney, Sydney, NSW, Australia
| | | | - Andrew Stevenson
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Peter Richmond
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Debra J Palmer
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Centre for Allergy and Immunology Research, Telethon Kids Institute, Perth, WA, Australia
| | - Jessica Metcalfe
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Centre for Allergy and Immunology Research, Telethon Kids Institute, Perth, WA, Australia
| | - Susan L Prescott
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Centre for Allergy and Immunology Research, Telethon Kids Institute, Perth, WA, Australia
| | - Fiona M Wood
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Department of Health WA, Perth, WA, Australia
| | - Barbara Fazekas de St Groth
- Ramaciotti Facility for Human Systems Biology and the Charles Perkins Centre, Discipline of Pathology, The University of Sydney, Sydney, NSW, Australia
| | - Matthew D Linden
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Mark W Fear
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Vanessa S Fear
- Genetic and Rare Diseases, Telethon Kids Institute, Perth, WA, Australia
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4
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Johnson BZ, McAlister S, McGuire HM, Palanivelu V, Stevenson A, Richmond P, Palmer DJ, Metcalfe J, Prescott SL, Wood FM, Fazekas de St Groth B, Linden MD, Fear MW, Fear VS. Pediatric Burn Survivors Have Long-Term Immune Dysfunction With Diminished Vaccine Response. Front Immunol 2020; 11:1481. [PMID: 32793203 PMCID: PMC7385079 DOI: 10.3389/fimmu.2020.01481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/23/2020] [Accepted: 06/08/2020] [Indexed: 01/04/2023] Open
Abstract
Epidemiological studies have demonstrated that survivors of acute burn trauma are at long-term increased risk of developing a range of morbidities. The mechanisms underlying this increased risk remain unknown. This study aimed to determine whether burn injury leads to sustained immune dysfunction that may underpin long-term morbidity. Plasma and peripheral blood mononuclear cells were collected from 36 pediatric burn survivors >3 years after a non-severe burn injury (<10% total body surface area) and from age/sex-matched non-injured controls. Circulating cytokine and vaccine antibody levels were assessed using multiplex immunoassays and cell profiles compared using a panel of 40 metal-conjugated antibodies and mass cytometry. TNF-α (1.31-fold change from controls), IL-2 (1.18-fold), IL-7 (1.63-fold), and IFN-γ (1.18-fold) were all significantly elevated in the burn cohort. Additionally, burn survivors demonstrated diminished antibody responses to the diphtheria, tetanus, and pertussis vaccine antigens. Comparisons between groups using unsupervised clustering identified differences in proportions of clusters within T-cells, B-cells and myeloid cells. Manual gating confirmed increased memory T-regulatory and central memory CD4+ T-cells, with altered expression of T-cell, B-cell, and dendritic cell markers. Conclusions: This study demonstrates a lasting change to the immune profile of pediatric burn survivors, and highlights the need for further research into post-burn immune suppression and regulation.
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Affiliation(s)
- Blair Z Johnson
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Sonia McAlister
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Helen M McGuire
- Ramaciotti Facility for Human Systems Biology and the Charles Perkins Centre, Discipline of Pathology, The University of Sydney, Sydney, NSW, Australia
| | | | - Andrew Stevenson
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Peter Richmond
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Debra J Palmer
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Centre for Allergy and Immunology Research, Telethon Kids Institute, Perth, WA, Australia
| | - Jessica Metcalfe
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Centre for Allergy and Immunology Research, Telethon Kids Institute, Perth, WA, Australia
| | - Susan L Prescott
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Centre for Allergy and Immunology Research, Telethon Kids Institute, Perth, WA, Australia
| | - Fiona M Wood
- School of Medicine, The University of Western Australia, Perth, WA, Australia.,Department of Health WA, Perth, WA, Australia
| | - Barbara Fazekas de St Groth
- Ramaciotti Facility for Human Systems Biology and the Charles Perkins Centre, Discipline of Pathology, The University of Sydney, Sydney, NSW, Australia
| | - Matthew D Linden
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Mark W Fear
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Vanessa S Fear
- Genetic and Rare Diseases, Telethon Kids Institute, Perth, WA, Australia
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5
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Court MW, McAlister S, Pierce JMT, Sutton R. Converting gas-driven ventilators from oxygen to air: environmental implications. Anaesthesia 2020; 76:285-286. [PMID: 32677035 PMCID: PMC7404417 DOI: 10.1111/anae.15214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M W Court
- Wythenshawe Hospital, Manchester, UK
| | - S McAlister
- University of Melbourne, Melbourne, Australia
| | - J M T Pierce
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R Sutton
- Royal Manchester Children's Hospital, Manchester, UK
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6
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Affiliation(s)
- F McGain
- Footscray, Melbourne, Victoria, Australia
| | - D Story
- Footscray, Melbourne, Victoria, Australia
| | - T Lim
- Footscray, Melbourne, Victoria, Australia
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7
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Van Dyk TR, Combs A, Whitacre C, McAlister S, Beebe DW. 0267 Feasibility of an Experimental Protocol Inducing Variable Sleep in Healthy Teens. Sleep 2018. [DOI: 10.1093/sleep/zsy061.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T R Van Dyk
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - A Combs
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - C Whitacre
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - S McAlister
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - D W Beebe
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- University of Cincinnati College of Medicine, Cincinnati, OH
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8
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McGain F, Story D, Lim T, McAlister S. Financial and environmental costs of reusable and single-use anaesthetic equipment. Br J Anaesth 2017; 118:862-869. [PMID: 28505289 DOI: 10.1093/bja/aex098] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND. An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits. METHODS. We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use variants. The primary environmental costs were CO 2 emissions (in CO 2 equivalents) and water use (in litres). We compared energy source mixes between Australia, the UK/Europe, and the USA. RESULTS. For an Australian hospital with six operating rooms, the annual financial cost of converting from single-use equipment to reusable anaesthetic equipment would be an AUD$32 033 (£19 220), 46% decrease. In Australia, converting from single-use to reusable equipment would result in an increase of CO 2 emissions from 5095 (95% CI: 4614-5658) to 5575 kg CO 2 eq (95% CI: 5542-5608), a 480 kg CO 2 eq (9%) increase. Using the UK/European power mix, converting from single-use (5575 kg CO 2 eq) to reusable anaesthetic equipment (802 kg CO 2 eq) would result in an 84% reduction (4873 kg CO 2 eq) in CO 2 emissions, whilst in the USA converting to reusables would have led to a 2427 kg CO 2 eq (48%) reduction. In Australia, converting from single-use to reusable equipment would more than double water use from 34.4 to 90.6 kilolitres. CONCLUSIONS. For an Australian hospital with six operating rooms, converting from single-use to reusable anaesthetic equipment saved more than AUD$30 000 (£18 000) per annum, but increased the CO 2 emissions by almost 10%. The CO 2 offset is highly dependent on the power source mix, while water consumption is greater for reusable equipment.
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Affiliation(s)
- F McGain
- Department of Anaesthesia.,Department of Intensive Care, Western Health, Gordon Street, Footscray, VIC 3011, Australia
| | - D Story
- Department of Anaesthesia, Austin Hospital, Banksia Street, Heidelberg, VIC 3084, Australia
| | - T Lim
- Department of Anaesthesia
| | - S McAlister
- Ecoquantum Consulting Suite 43A Crisp Avenue, Brunswick, VIC 3056, Australia
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9
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Beebe DW, Whitacre C, McAlister S, Van Dyk TR, Stough CO, Brammer C, Saelens BE. 0968 SEDENTARY ACTIVITY, NOT MODERATE-TO-VIGOROUS ACTIVITY, FILLS THE EXTRA TIME AWAKE WHEN ADOLESCENTS RESTRICT THEIR SLEEP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Beebe DW, McAlister S, Van Dyk TR, Cornist K, Saelens BE. 0969 INDUCING MORE SLEEP ON SCHOOL NIGHTS REDUCES SEDENTARY BEHAVIOR WITHOUT AFFECTING MORE VIGOROUS PHYSICAL ACTIVITY IN SHORT- SLEEPING ADOLESCENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.968] [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: 11/12/2022] Open
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11
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Abstract
Although haemophilia is an expensive disorder, no studies have estimated health care costs for Americans with haemophilia enrolled in Medicaid as distinct from those with employer-sponsored insurance (ESI). The objective of this study is to provide information on health care utilization and expenditures for publicly insured people with haemophilia in the United States in comparison with people with haemophilia who have ESI. Data from the MarketScan Medicaid Multi-State, Commercial and Medicare Supplemental databases were used for the period 2004-2008 to identify cases of haemophilia and to estimate medical expenditures during 2008. A total of 511 Medicaid-enrolled males with haemophilia were identified, 435 of whom were enrolled in Medicaid for at least 11 months during 2008. Most people with haemophilia qualified for Medicaid based on 'disability'. Average Medicaid expenditures in 2008 were $142,987 [median, $46,737], similar to findings for people with ESI. Average costs for males with haemophilia A and an inhibitor were 3.6 times higher than those for individuals without an inhibitor. Average costs for 56 adult Medicaid enrollees with HCV or HIV infection were not statistically different from those for adults without the infection, but median costs were 1.6 times higher for those treated for blood-borne infections. Haemophilia treatment can lead to high costs for payers. Further research is needed to understand the effects of public health insurance on haemophilia care and expenditures, to evaluate treatment strategies and to implement strategies that may improve outcomes and reduce costs of care.
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Affiliation(s)
- S Guh
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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12
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Guh S, Grosse SD, McAlister S, Kessler CM, Soucie JM. Healthcare expenditures for males with haemophilia and employer-sponsored insurance in the United States, 2008. Haemophilia 2011; 18:268-75. [PMID: 22151000 DOI: 10.1111/j.1365-2516.2011.02692.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although hemophilia has a potentially high economic impact, published estimates of health care costs for Americans with hemophilia are sparse and non-specific as to the non-bleeding complications of the disease. The objective of this study is to estimate average annual health care expenditures for people with hemophilia covered by employer-sponsored insurance, stratified according to the influence of age, type of hemophilia [A (factor VIII deficiency) versus B (factor IX)], presence of neutralizing alloantibody inhibitors and exposure to blood-borne viral infections. Data from the MarketScan Commercial and Medicare Research Databases were used for the period 2002-2008 to identify cases of hemophilia and to estimate mean and median medical expenditures during 2008. A total of 1,164 males with hemophilia were identified with continuous enrollment during 2008, 933 with hemophilia A and 231 with hemophilia B. Mean health care expenditures were $155,136 [median $73,548]. Mean costs for 30 (3%) males with an inhibitor were 5 times higher than for males without an inhibitor, approximately $697,000 [median $330,835] and $144,000 [median $73,321], respectively. Clotting factor concentrate accounted for 70%-82% of total costs. Average costs for 207 adults with HCV or HIV infection were 1.5 times higher than those for adults without infection. Hemophilia treatment is costly, particularly for individuals with neutralizing alloantibody inhibitors who require bypassing agents. Efforts to understand the cause of inhibitors are needed so that prevention strategies can be implemented and the excess costs resulting from this serious complication of hemophilia care can be avoided.
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Affiliation(s)
- S Guh
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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13
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Byams VR, Kouides PA, Kulkarni R, Baker JR, Brown DL, Gill JC, Grant AM, James AH, Konkle BA, Maahs J, Dumas MM, McAlister S, Nance D, Nugent D, Philipp CS, Soucie JM, Stang E. Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment Centres. Haemophilia 2011; 17 Suppl 1:6-13. [PMID: 21692922 DOI: 10.1111/j.1365-2516.2011.02558.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Inherited bleeding disorders are especially problematic for affected girls and women due to the monthly occurrence of menstrual periods and the effects on reproductive health. Although heavy menstrual bleeding (HMB) is the most common manifestation, females with inherited bleeding disorders (FBD) experience other bleeding symptoms throughout the lifespan that can lead to increased morbidity and impairment of daily activities. The purpose of this article is to describe the utility of a female-focused surveillance effort [female Universal Data Collection (UDC) project] in the United States Haemophilia Treatment Centres (HTCs) and to describe the baseline frequency and spectrum of diagnoses and outcomes. All FBD aged 2 years and older receiving care at selected HTCs were eligible for enrollment. Demographic data, diagnoses and historical data regarding bleeding symptoms, treatments, gynaecological abnormalities and obstetrical outcomes were analysed. Analyses represent data collected from 2009 to 2010. The most frequent diagnoses were type 1 von Willebrand's disease (VWD) (195/319; 61.1%), VWD type unknown (49/319; 15.4%) and factor VIII deficiency (40/319; 12.5%). HMB was the most common bleeding symptom (198/253; 78.3%); however, 157 (49.2%) participants reported greater than four symptoms. Oral contraceptives were used most frequently to treat HMB (90/165; 54.5%), followed by desmopressin [1-8 deamino-D-arginine vasopressin (DDAVP)] (56/165; 33.9%). Various pregnancy and childbirth complications were reported, including bleeding during miscarriage (33/43; 76.7%) and postpartum haemorrhage (PPH) (41/109; 37.6%). FBD experience multiple bleeding symptoms and obstetrical-gynaecological morbidity. The female UDC is the first prospective, longitudinal surveillance in the US focusing on FBD and has the potential to further identify complications and reduce adverse outcomes in this population.
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Affiliation(s)
- V R Byams
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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14
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McGain F, McAlister S, McGavin A, Story D. The financial and environmental costs of reusable and single-use plastic anaesthetic drug trays. Anaesth Intensive Care 2010; 38:538-44. [PMID: 20514965 DOI: 10.1177/0310057x1003800320] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We modelled the financial and environmental costs of two commonly used anaesthetic plastic drug trays. We proposed that, compared with single-use trays, reusable trays are less expensive, consume less water and produce less carbon dioxide, and that routinely adding cotton and paper increases financial and environmental costs. We used life cycle assessment to model the financial and environmental costs of reusable and single-use trays. From our life cycle assessment modelling, the reusable tray cost (Australian dollars) $0.23 (95% confidence interval [CI] $0.21 to $0.25) while the single-use tray alone cost $0.47 (price range of $0.42 to $0.52) and the single-use tray with cotton and gauze added was $0.90 (no price range in Melbourne). Production of CO2 was 110 g CO2 (95% CI 98 to 122 g CO2) for the reusable tray, 126 g (95% CI 104 to 151 g) for single-use trays alone (mean difference of 16 g, 95% CI -8 to 40 g) and 204 g CO2 (95% CI 166 to 268 g CO2) for the single-use trays with cotton and paper Water use was 3.1 l (95% CI 2.5 to 3.7 l) for the reusable tray, 10.4 l (95% CI 8.2 to 12.7 l) for the single-use tray and 26.7 l (95% CI 20.5 to 35.4 l) for the single-use tray with cotton and paper Compared with reusable plastic trays, single-use trays alone cost twice as much, produced 15% more CO2 and consumed three times the amount of water Packaging cotton gauze and paper with single-use trays markedly increased the financial, energy and water costs. On both financial and environmental grounds it appears difficult to justify the use of single-use drug trays.
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Affiliation(s)
- F McGain
- Department ofAnaesthesia and Intensive Care, Western Hospital, Melbourne, Victoria, Australia.
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15
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16
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Thompson WM, Johnsrude IS, Jackson DC, McAlister S, Miller MD, Pizzo SV. Vessel occlusion with transcatheter electrocoagulation: initial clinical experience. Radiology 1979; 133:335-40. [PMID: 315077 DOI: 10.1148/133.2.335] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Transcatheter electrocoagulation (TCEC) was used for vessel occlusion in combination with embolization by Gelfoam and/or Ivalon in six patients in whom other interventional or surgical techniques were considered dangerous or unfeasible. The technique was effective in decreasing or obliterating the blood supply to variously located lesions in all cases. The only complications were small skin burns in one patient and a small ulceration of the upper lip in another.
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