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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Dawkins YM, Rowe-Gardener S, Guthrie-Dixon N, Thompson R, Thompson T, Lee MG, Cunningham-Myrie C. H. pylori predictors and outcomes among adults undergoing upper endoscopy at a Jamaican teaching hospital: A cross-sectional study. Helicobacter 2023; 28:e12968. [PMID: 37025012 DOI: 10.1111/hel.12968] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Recent data on the prevalence of H. pylori infection in Jamaica are lacking. It is postulated that there has been a decline in the prevalence of H. pylori infection and its associated complications. We determined sociodemographic characteristics, prevalence of H. pylori infection and clinical outcomes among adults undergoing esophagogastroduodenoscopy (EGD) and histology at the University Hospital of the West Indies (UHWI) between May 2018 and December 2020. MATERIALS AND METHODS A cross-sectional study of patients (≥18 years old), who underwent EGD and histological evaluation for H. pylori infection, was conducted. Associations of H. pylori positivity and gastric cancer with sociodemographic/clinical variables and endoscopic findings were determined by stepwise logistic regression using backward selection. Unadjusted and adjusted odds ratios with related 95% confidence intervals (Cis) were calculated for H. pylori positivity and gastric cancer status. RESULTS There were 323 participants (mean age 58.6 ± 17.8 years, 54.2% females). H. pylori prevalence was 22.2% (n = 70 of 315), 5.6% had gastric neoplasia (GN), 15.5% gastric atrophy, 11.4% intestinal metaplasia and 3.7% dysplasia on histology. Mucositis (64.5%), gastric ulcer (14.9%), and duodenal ulcer (13.9%) were the most common endoscopic findings. Participants with peptic ulcer disease (PUD) (unOR = 4.0; p = .017), gastric cancer (unOR = 9.5; p = .003), gastric atrophy (unOR = 12.8; p < .001), and intestinal metaplasia (unOR = 5.0; p < .001) had a significantly higher odds of being H. pylori positive, but after multivariable analyses only gastric atrophy remained significant (aOR = 27.3; p < .001). Participants with mucositis had a significantly lower odds of gastric cancer (unOR 0.1; p = .035) while participants with dysplasia had significantly higher odds (unOR 8.0; p = .042), but these were no longer significant after multivariable analyses (aOR = 0.2; p = .156 and aOR = 18.9; p = .070, respectively). CONCLUSIONS Histology based prevalence of H. pylori infection is lower than previously reported in Jamaica. Gastric atrophy is a significant predictor of H. pylori positivity.
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Affiliation(s)
- Y M Dawkins
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - S Rowe-Gardener
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - N Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - R Thompson
- Department of Pathology, University of the West Indies, Mona, Jamaica
| | - T Thompson
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - M G Lee
- Department of Medicine, University of the West Indies, Mona, Jamaica
| | - C Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Jamaica
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Dunham M, Bacon L, Cottom S, McCrone P, Mehrpouya H, Spyridonis F, Thompson T, Schofield P. Chronic pain through COVID. Front Pain Res 2022; 3:937652. [PMID: 36341152 PMCID: PMC9629777 DOI: 10.3389/fpain.2022.937652] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives To identify good practice in the community management of chronic pain, and to understand the perspective of a group of healthcare service users towards the management of chronic pain using technology during the COVID-19 pandemic. Methods Forty-five people, recruited via social media and Pain Association Scotland, participated in three focus groups hosted over Zoom. Focus groups were conducted using semi-structured questions to guide the conversation. Data were analysed using Ritchie / Spencer's Framework Analysis. Results The participants shared observations of their experiences of remotely supported chronic pain services and insights into the potential for future chronic pain care provision. Experiences were in the majority positive with some describing their rapid engagement with technology during the COVID pandemic. Conclusion Results suggest there is strong potential for telehealth to complement and support existing provision of pain management services.
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Affiliation(s)
- M. Dunham
- School of Health / Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
- Correspondence: M. Dunham
| | - L. Bacon
- School of Design and Informatics, Abertay University, Dundee, United Kingdom
| | - S. Cottom
- Pain Association Scotland, Perth, United Kingdom
| | - P. McCrone
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| | - H. Mehrpouya
- School of Design and Informatics, Abertay University, Dundee, United Kingdom
| | - F. Spyridonis
- Department of Computer Science, Brunel University London, Uxbridge, United Kingdom
| | - T. Thompson
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | - P. Schofield
- University of Plymouth, Plymouth, United Kingdom
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Trytell A, Paratz ED, Van Heusden A, Zentner D, Morgan N, Smith K, Thompson T, James P, Connell V, Pflaumer A, Semsarian C, Ingles J, Stub D, Parsons S, La Gerche A. Prevalence of illicit drug use in young sudden cardiac death patients; an Australian prospective cohort study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2659] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Illicit drug use may accelerate coronary disease and cardiac hypertrophy or stimulate arrhythmias. Rates of illicit drug use in young sudden cardiac death (SCD) patients are uncertain.
Purpose
To identify rates of illicit drug use in young SCD patients in Australia.
Methods
A prospective multi-centre registry identified out of hospital cardiac arrest (OHCA) patients aged 1–50 years between April 2019 and April 2020. Clinical characteristics were compared between patients with and without illicit drug use (defined by toxicological results or reported regular use). Illicit drugs included stimulants such as amphetamine-type substances and cocaine, or non-stimulants such as heroin, cannabis and novel psychoactive substances (cathinones and synthetic cannabinoids).
Results
770 OHCAs occurred, with 555 patients undergoing forensic assessment. 287 patients had confirmed cardiac cause of OHCA, with 274 undergoing toxicological assessment and 79 (28.8%) having positive toxicology for illicit drugs (n=60) or reported regular drug use (n=19). An additional 121 patients experienced non-cardiac SCD due to illicit drug toxicity, resulting in a total of 200 patients (36.0% of OHCAs) with illicit drug use. Patients with SCD and illicit drug use were more commonly male (86.1% vs 72.3%, p=0.015), regular smokers (36.7% vs 21.5%, p=0.009), had cardiomegaly (76.5% vs 57.5%, p=0.007), and higher rates of coronary disease and cardiomyopathy (coronary disease 44.3% vs 33.3%, cardiomyopathy 30.4% vs 18.5%, p=0.003). Methamphetamines (n=42, 53.1%) were the most common illicit drug identified and polysubstance abuse occurred frequently (n=15, 19.0%).
Conclusion
Approximately one-third of young SCD patients use illicit drugs, with high rates of polysubstance abuse. Illicit drug use in SCD patients is associated with coronary disease and cardiomyopathy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Trytell
- St Vincent's Hospital , Melbourne , Australia
| | - E D Paratz
- St Vincent's Hospital , Melbourne , Australia
| | | | - D Zentner
- Royal Melbourne Hospital , Melbourne , Australia
| | - N Morgan
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - K Smith
- Ambulance Victoria , Melbourne , Australia
| | - T Thompson
- Royal Melbourne Hospital , Melbourne , Australia
| | - P James
- Royal Melbourne Hospital , Melbourne , Australia
| | - V Connell
- Royal Children's Hospital , Melbourne , Australia
| | - A Pflaumer
- Royal Children's Hospital , Melbourne , Australia
| | | | - J Ingles
- Garvan Institute of Medical Research , Sydney , Australia
| | - D Stub
- The Alfred Hospital , Melbourne , Australia
| | - S Parsons
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - A La Gerche
- St Vincent's Hospital , Melbourne , Australia
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Paratz E, Van Heusden A, Zentner D, Morgan N, Smith K, Ball J, Thompson T, James P, Connell V, Pflaumer A, Semsarian C, Ingles J, Stub D, Parsons S, La Gerche A. Prevalence of coronary artery anomalies in young sudden cardiac death: insights from a prospective state-wide registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1805] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Coronary artery anomalies (CAAs) have been previously implicated as a major cause of young sudden cardiac death (SCD), particularly in exercise-related SCD with a reported prevalence of up to 33%.
Methods
A state-wide prospective out-of-hospital cardiac arrest registry identified all patients aged 1–50 years who experienced an SCD and underwent autopsy from April 2019 to April 2021. Rates of normal anatomy, normal variants and CAAs were identified and circumstances and cause of death for patients with CAAs examined.
Results
Of 1,477 patients who experienced cardiac arrest during the study period, 490 underwent autopsy and were confirmed to have experienced SCD. Of these 490 patients, five (1.0%) had a CAA identified with three having anomalies of coronary origin and two having anomalies of coronary course. In no cases was the CAA deemed responsible for the SCD. In two cases, severe coronary disease and intra-coronary thrombus with histological evidence of acute myocardial infarction were identified, in the third critical coronary disease was found, the fourth had an unrelated thoracic aortic dissection and the fifth had cardiomegaly in the setting of illicit drug use. Of 27 patients who experienced their SCD during exercise, only one had a CAA identified (the patient with thoracic aortic dissection).
Conclusion
In this prospective cohort of consecutive young patients with SCD who underwent autopsy, CAAs occurred in 1.0% of patients and did not cause any deaths. The role of CAAs in causing young SCD appears to be less significant than previously hypothesised.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NHMRC, NHF
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Affiliation(s)
- E Paratz
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - A Van Heusden
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - D Zentner
- Royal Melbourne Hospital , Melbourne , Australia
| | - N Morgan
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - K Smith
- Ambulance Victoria , Melbourne , Australia
| | - J Ball
- Ambulance Victoria , Melbourne , Australia
| | - T Thompson
- Royal Melbourne Hospital , Melbourne , Australia
| | - P James
- Royal Melbourne Hospital , Melbourne , Australia
| | - V Connell
- Royal Children's Hospital , Melbourne , Australia
| | - A Pflaumer
- Royal Children's Hospital , Melbourne , Australia
| | - C Semsarian
- University of Sydney, Heart Research Institute , Sydney , Australia
| | - J Ingles
- Garvan Institute of Medical Research , Sydney , Australia
| | - D Stub
- The Alfred Hospital , Melbourne , Australia
| | - S Parsons
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute , Melbourne , Australia
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Paratz E, Rowe S, Van Heusden A, Thompson T, Morgan N, Smith K, James P, Pflaumer A, Connell V, Semsarian C, Ingles J, Parsons S, Stub D, Zentner D, La Gerche A. Clinical and pathologic features of out-of-hospital cardiac arrest in pregnancy: insights from a state-wide registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2595] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiovascular disease is the most common cause of indirect maternal mortality worldwide, and cardiac arrest occurs in up to 1 in 12,000 pregnancies.
Objective
To define rates, clinical and pathologic factors of out-of-hospital cardiac arrest (OHCA) in pregnant and post-partum females.
Methods
A prospective state-wide cardiac arrest registry combining ambulance, hospital and forensic data captured all OHCAs from 2019–2021. Clinical and pathological details for pregnant patients were identified.
Results
1,482 OHCAs occurred, including 376 females of child-bearing age of whom eight were pregnant or post-partum. OHCA incidence was lower in pregnant females compared to non-pregnant females of child-bearing age (5.2 OHCAs per 100,000 pregnant females vs 23.1 per 100,000 females of child-bearing age, p<0.0001). Seven patients (87.5%) died, with five (62.5%) having a cardiac cause of OHCA (unascertained = 2, cardiomyopathy = 2 (1 hypertrophic), ischemic heart disease = 1). Two patients had pre-existing cardiac risk factors, but none had a cardiac diagnosis pre-arrest. Compared to in-hospital cardiac arrests (IHCAs) in pregnancy, OHCAs are more likely to have a cardiac cause (odds ratio 3.81) and lower maternal survival (odds ratio 0.09).
Conclusion
Maternal OHCA affects approximately 1 in 20,000 pregnancies with high maternal mortality rates. OHCA occurs at one-quarter the rate in non-pregnant females of child-bearing age. Approximately two-thirds of maternal OHCAs had an underlying cardiac cause, but low rates of cardiac diagnosis pre-arrest. OHCAs differ markedly from IHCAs in pregnant females, requiring ongoing evaluation as to specific causes and preventability.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NHMRC, NHF
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Affiliation(s)
- E Paratz
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - S Rowe
- St Vincent's Hospital , Melbourne , Australia
| | - A Van Heusden
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - T Thompson
- Royal Melbourne Hospital , Melbourne , Australia
| | - N Morgan
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - K Smith
- Ambulance Victoria , Melbourne , Australia
| | - P James
- Royal Melbourne Hospital , Melbourne , Australia
| | - A Pflaumer
- Royal Children's Hospital , Melbourne , Australia
| | - V Connell
- Royal Children's Hospital , Melbourne , Australia
| | - C Semsarian
- University of Sydney, Heart Research Institute , Sydney , Australia
| | - J Ingles
- Garvan Institute of Medical Research , Sydney , Australia
| | - S Parsons
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - D Stub
- The Alfred Hospital , Melbourne , Australia
| | - D Zentner
- Royal Melbourne Hospital , Melbourne , Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute , Melbourne , Australia
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Ashokkumar S, Paratz E, Van Heusden A, Smith K, Zentner D, Morgan N, Parsons S, Thompson T, James P, Connell V, Pflaumer A, Semsarian C, Ingles J, Stub D, La Gerche A. Obesity in young sudden cardiac death: rates, clinical features, and insights into people with body mass index >50kg/m2. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2387] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity is common in young sudden cardiac death (SCD) victims but it is unclear whether it is more common than in the general population. This study aimed to contextualize young SCD obesity rates, identifying clinical and pathologic features in WHO class II and III obesity.
Methods
A prospective state-wide out-of-hospital cardiac arrest registry included all SCDs in Victoria, Australia from 2019–2021. Body mass indices (BMIs) of patients 18–50 years were compared to age-referenced general population. Characteristics of SCD patients with WHO Class II obesity (BMI ≥30kg/m2) and non-obesity (BMI <30kg/m2) were compared. Clinical characteristics of people with BMI >50kg/m2 were assessed.
Results
504 patients were included. Obesity was strongly over-represented in young SCD compared to the age-matched general population (55.0% vs 28.7%, p<0.0001). Obese SCD patients more frequently had hypertension, diabetes and obstructive sleep apnoea (p<0.0001, p=0.009 and p=0.001 respectively), ventricular fibrillation as their arrest rhythm (p=0.008) and left ventricular hypertrophy (LVH) (p<0.0001). Obese patients were less likely to have toxicology positive for illicit substances (22.0% vs 32.6%, p=0.008) or significant alcohol history (18.8% vs 26.9%, p=0.030). Patients with BMI >50 kg/m2 represented 8.5% of young SCD. LVH (n=26, 60.5%) was their predominant cause of death and only 10 (9.3%) patients died from coronary disease.
Conclusion
Over half of young Australian SCD patients are obese, with all obesity classes over-represented compared to the general population. Obese patients had more cardiac risk factors. Almost two thirds of patients with BMI>50 kg/m2 died with LVH, with fewer than 10% dying from coronary disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - E Paratz
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - A Van Heusden
- Baker Heart and Diabetes Institute , Melbourne , Australia
| | - K Smith
- Ambulance Victoria , Melbourne , Australia
| | - D Zentner
- Royal Melbourne Hospital , Melbourne , Australia
| | - N Morgan
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - S Parsons
- Victorian Institute of Forensic Medicine , Melbourne , Australia
| | - T Thompson
- Royal Melbourne Hospital , Melbourne , Australia
| | - P James
- Royal Melbourne Hospital , Melbourne , Australia
| | - V Connell
- Royal Children's Hospital , Melbourne , Australia
| | - A Pflaumer
- Royal Children's Hospital , Melbourne , Australia
| | | | - J Ingles
- Garvan Institute of Medical Research , Sydney , Australia
| | - D Stub
- The Alfred Hospital , Melbourne , Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute , Melbourne , Australia
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Zentner D, Wiseman A, Thompson T, Dinatale I, Macciocca I, Connell V, Mathew J, Davis A, James P. Victorian Inherited Cardiac Disorders Family Initiative (VicDFI) – Creating a Shared Cardiac Clinical Database Across the Life Spectrum. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.689] [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: 11/27/2022]
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Ashokkumar S, Paratz E, van Heusden A, Smith K, Zentner D, Morgan N, Parsons S, Thompson T, James P, Connell V, Pflaumer A, Semsarian C, Ingles J, Stub D, La Gerche A. Obesity in Young Sudden Cardiac Death: Rates, Clinical Features, and Insights Into People With Body Mass Index >50 kg/m2. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.507] [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: 10/16/2022]
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Thompson T, Zentner D, James P, Taylor S. Practise Changing Research – Adding DNAH11 to a Congenital Heart Disease Panel. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zentner D, Wiseman A, Thompson T, Dinatale I, Macciocca I, Connell V, Mathew J, Davis A, James P. Victorian Inherited Cardiac Disorders Family Initiative (VicDFI)—Creating a Shared Cardiac Clinical Database Across the Life Spectrum. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.045] [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]
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Paratz E, van Heusden A, Ball J, Smith K, Thompson T, Zentner D, James P, Parsons S, Morgan N, Connell V, Pflaumer A, Semsarian C, Ingles J, Stub D, La Gerche A. Inconsistent Discharge Diagnoses for Young Cardiac Arrest Episodes: Insights From a State-wide Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.169] [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: 10/16/2022]
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Paratz E, van Heusden A, Ball J, Smith K, Zentner D, James P, Thompson T, Morgan N, Parsons S, Connell V, Pflaumer A, Semsarian C, Ingles J, Stub D, La Gerche A. Predictors and Outcomes of In-Hospital Referrals for Forensic Investigation After Young Sudden Cardiac Death. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Paratz E, van Heusden A, Zentner D, Morgan N, Smith K, Ball J, Thompson T, James P, Connell V, Pflaumer A, Semsarian C, Ingles J, Parsons S, Stub D, La Gerche A. Prevalence of Coronary Artery Anomalies in Young Sudden Cardiac Death: Insights From a Prospective State-Wide Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.034] [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: 10/16/2022]
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Paratz E, Rowe S, van Heusden A, Thompson T, Morgan N, Smith K, James P, Pflaumer A, Connell V, Semsarian C, Ingles J, Parsons S, Stub D, Zentner D, La Gerche A. Clinical and Pathologic Features of Out-of-Hospital Cardiac Arrest in Pregnancy: Insights From a State-Wide Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Paratz E, van Heusden A, Smith K, Ball J, Zentner D, Morgan N, Thompson T, James P, Connell V, Pflaumer A, Semsarian C, Ingles J, Parsons S, Stub D, La Gerche A. Higher Rates But Similar Causes of Young Out-Of-Hospital Cardiac Arrest in Rural Australian Patients. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.503] [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: 10/16/2022]
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Thompson T, Morgan N, Connell V, Zentner D, Woodford N, Davis A, Pflaumer A, Parsons S, James P. A Model for Collaboration: Sudden Death Pathway. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.043] [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]
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Choi MJ, Yang JW, Lee S, Kim JY, Oh JW, Lee J, Stubbs B, Lee KH, Koyanagi A, Hong SH, Ghayda RA, Hwang J, Dragioti E, Jacob L, Carvalho AF, Radua J, Thompson T, Smith L, Fornaro M, Stickley A, Bettac EL, Han YJ, Kronbichler A, Yon DK, Lee SW, Shin JI, Lee E, Solmi M. Suicide associated with COVID-19 infection: an immunological point of view. Eur Rev Med Pharmacol Sci 2021; 25:6397-6407. [PMID: 34730221 DOI: 10.26355/eurrev_202110_27013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) is a pandemic and leading cause of death. Beyond the deaths directly caused by the virus and the suicides related to the psychological response to the dramatic changes as socioeconomic related to the pandemic, there might also be suicides related to the inflammatory responses of the infection. Infection induces inflammation as a cytokine storm, and there is an increasing number of studies that report a relationship between infection and suicide. MATERIALS AND METHODS We searched the World Health Organization status report and the PubMed database for keywords (COVID-19, suicide, infection, inflammation, cytokines), and reviewed five cytokine pathways between suicide and inflammation using two meta-analyses and two observational studies starting from November 31, 2020, focusing on the relationship between suicide and inflammation by infection. First, we discussed existing evidence explaining the relationship between suicidal behaviors and inflammation. Second, we summarized the inflammatory features found in COVID-19 patients. Finally, we highlight the potential for these factors to affect the risk of suicide in COVID-19 patients. RESULTS Patients infected with COVID-19 have high amounts of IL-1β, IFN-γ, IP10, and MCP1, which may lead to Th1 cell response activation. Also, Th2 cytokines (e.g., IL-4 and IL-10) were increased in COVID-19 infection. In COVID-19 patients, neurological conditions, like headache, dizziness, ataxia, seizures, and others have been observed. CONCLUSIONS COVID-19 pandemic can serve as a significant environmental factor contributing directly to increased suicide risk; the role of inflammation by an infection should not be overlooked.
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Affiliation(s)
- M J Choi
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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Lee HJ, Jeong GH, Li H, Kim MS, Kim JS, Park SJ, Han YJ, Lee KH, Kronbichler A, Hong SH, Ghayda RA, Luchini C, Nottegar A, Koyanagi A, Smith L, Jacob L, Dragioti E, Radua J, Cargnin S, Terrazzino S, Thompson T, Yon DK, Lee SW, Yang JM, Wasuwanich P, Shin JI, Gamerith G. Efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) monotherapy for advanced EGFR-mutated non-small cell lung cancer: systematic review and meta-analysis. Eur Rev Med Pharmacol Sci 2021; 25:6232-6244. [PMID: 34730203 DOI: 10.26355/eurrev_202110_26993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE It is controversial whether there is efficacy or safety benefit of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced EGFR-mutated non-small cell lung cancer (NSCLC) compared to standard chemotherapy. We aim to assess the efficacy and safety of EGFR-TKIs compared to other chemotherapeutics in EGFR-mutated NSCLC. MATERIALS AND METHODS Up to April 27th, 2020, PubMed, Embase, Medline, Scopus, Cochrane library, and ClinicalTrials.gov were searched for articles or trials meeting the inclusion criteria. After filtering, 230 eligible studies were initially identified. Data extraction followed PRISMA and included outcomes were progression-free survival (PFS), overall survival (OS), and severe adverse events (SAEs). Direct and indirect meta-analyses were generated in the context of log-linear mixed-effects models, with fixed effects for each relative comparison and random effects for each study. RESULTS The results showed that EGFR-TKI therapy had improved PFS with a hazard ratio (HR) of 0.40 (95% CI: 0.36-0.44, p<0.001) compared to standard chemotherapy. Nevertheless, the EGFR-TKIs showed no benefit on OS (HR: 0.96, 95% CI: 0.83-1.10, p=0.556). In the analysis of adverse events, EGFR-TKIs had fewer SAEs than standard chemotherapy (HR: 0.29, 95% CI: 0.26-0.33, p<0.001). CONCLUSIONS Our systemic review indicates that EGFR-TKI therapy has improved PFS, and reduced SAEs compared to standard chemotherapy in advanced EGFR-mutated NSCLC.
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Affiliation(s)
- H J Lee
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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21
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Madden-McKee C, Getty M, Thompson T. 154 Complete Inguinal Bladder Hernia Causing Acute Obstruction of Right Upper Urinary Tract. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.273] [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
Case Summary
An 86-year-old male nursing home resident presented with increasing confusion and was initially treated for catheter-associated urinary tract infection. CT scan demonstrated acute acalculous cholecystitis and complete inguinal bladder hernia with compression of right vesico-ureteric junction leading to acute obstructive renal failure. Percutaneous cholecystostomy and percutaneous nephrostomy were attempted but were not possible due to patient non-compliance. Patient improved with conservative management.
Discussion
Bladder involvement in inguinal herniae is rare with most cases being identified at the time of hernia repair and there is a 17% risk of intra-operative bladder injury. Key risk factors include increasing age, male gender, lower urinary tract symptoms and previous hernia repair. Percutaneous nephrostomy followed by inguinal hernia repair is the treatment of choice for most patients. Clinicians should aim to make the diagnosis of inguinal bladder hernia pre-operatively to reduce risk of intra-operative bladder injury during hernia repair. Acute acalculous cholecystitis tends to occur in critically ill patients and is a marker of poor prognosis.
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Affiliation(s)
| | - M Getty
- Mater Infirmorum Hospital, Belfast, United Kingdom
| | - T Thompson
- Belfast City Hospital, Belfast, United Kingdom
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22
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Jeong DY, Lee J, Kim JY, Lee KH, Li H, Lee JY, Jeong GH, Yoon S, Park EL, Hong SH, Kang JW, Song TJ, Leyhe T, Eisenhut M, Kronbichler A, Smith L, Solmi M, Stubbs B, Koyanagi A, Jacob L, Stickley A, Thompson T, Dragioti E, Oh H, Brunoni AR, Carvalho AF, Kim MS, Yon DK, Lee SW, Yang JM, Ghayda RA, Shin JI, Fusar-Poli P. Empirical assessment of biases in cerebrospinal fluid biomarkers of Alzheimer's disease: an umbrella review and re-analysis of data from meta-analyses. Eur Rev Med Pharmacol Sci 2021; 25:1536-1547. [PMID: 33629323 DOI: 10.26355/eurrev_202102_24862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a leading cause of years lived with disability in older age, and several cerebrospinal fluid (CSF) markers have been proposed in individual meta-analyses to be associated with AD but field-wide evaluation and scrutiny of the literature is not available. MATERIALS AND METHODS We performed an umbrella review for the reported associations between CSF biomarkers and AD. Data from available meta-analyses were reanalyzed using both random and fixed effects models. We also estimated between-study heterogeneity, small-study effects, excess significance, and prediction interval. RESULTS A total of 38 meta-analyses on CSF markers from 11 eligible articles were identified and reanalyzed. In 14 (36%) of the meta-analyses, the summary estimate and the results of the largest study showed non-concordant results in terms of statistical significance. Large heterogeneity (I2≥75%) was observed in 73% and small-study effects under Egger's test were shown in 28% of CSF biomarkers. CONCLUSIONS Our results suggest that there is an excess of statistically significant results and significant biases in the literature of CSF biomarkers for AD. Therefore, the results of CSF biomarkers should be interpreted with caution.
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Affiliation(s)
- D Y Jeong
- Yonsei University College of Medicine, Seoul, Republic of Korea.
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Soultan D, Bragg M, Thompson T, Hoover A. PO-1708 In-House Incident Learning System for FMEA Using Microsoft Sharepoints and Powerapps. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08159-7] [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: 10/20/2022]
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24
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Paratz E, Ross L, van Heusden A, Zentner D, Thompson T, James P, Smith K, Ball J, Pflaumer A, Stub D, La Gerche A, Morgan N, Bouwer H, Lynch M, Parsons S. Unrecognised Intracoronary IgG4-Related Disease: A Rare Cause of Two Sudden Cardiac Deaths. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.117] [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: 10/20/2022]
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25
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Lammoza N, Chen Y, Wong J, Yao J, Akesson L, Macciocca I, Thompson T, Zentner D. Peripartum Sinus Pauses in a Patient with a New Diagnosis of Congenital Long QT-2 Syndrome–A Management Dilemma. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.349] [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: 10/20/2022]
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Paratz E, Rowsell L, Ball J, Zentner D, Parsons S, Morgan N, Thompson T, James P, Pflaumer A, Semsarian C, Stub D, Liew D, Smith K, La Gerche A. Economic impact of sudden cardiac arrest. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3542] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Each year, there are approximately 5,000 out-of-hospital cardiac arrests (OHCAs) in the state of Victoria, Australia (population 6.4 million, state healthcare budget AUD$2.9 billion / €1.8billion). Mortality from OHCA approaches ninety percent. High mortality rates and survivors not returning to work is likely to have an adverse effect on the Victorian economy but this has not been previously investigated.
Purpose
To model the economic impact of OHCA mortality and survivors not returning to work.
Methods
Data on all OHCAs transported by Ambulance Victoria from July 2017- June 2018 in Victoria, Australia was collected, including age, gender, survival to hospital, survival to discharge, and survival to 12 months. Cases were excluded if arrest was precipitated by trauma, exsanguination, overdose, terminal illness, hanging, SIDS, electrocution, sepsis, respiratory causes, drowning, or neurological causes. Pre-arrest employment status of patients was modelled using the Australian Bureau of Statistics Economic Security dataset, which provides contemporary employment rates for gender-matched five-year cohorts for Australians aged 15–79 years. For survivors to 12 months, pre-arrest and post-arrest work status were confirmed. Economic impact was then calculated to a five year horizon utilizing a Markov model with probabilistic sensitivity analysis.
Results
4,934 arrests meeting the inclusion criteria were transported by Ambulance Victoria in twelve months, of whom 4,639 were determined to be cardiac arrests without any exclusion criteria as a precipitant. 695 patients survived to hospital (15.0%), and 325 to discharge (7.0%). At 12 months, 303 patients were alive (6.5% of overall cases, 93.2% of those discharged from hospital). Economic modelling of age and gender-matched data indicated that 1516 patients (35%) would have been employed pre-cardiac arrest, but only 216 survivors (4.7%) would be employed at five years post-arrest. Using Markov modelling incorporating estimated earnings and the pre-determined value of a statistical life, the annual economic burden of cardiac arrest approximated AUD$4 billion (€2.5 billion) at a five-year horizon.
Conclusion
The annual economic impact of cardiac arrest in Victoria, Australia is approximately AUD$4 billion (€2.5 billion) in a five-year horizon. As the annual Victorian state budget for all healthcare is AUD$2.93 billion (€1.8 billion), our data suggests that the economic impact of cardiac arrest is under-appreciated. Therefore, research in this area and providing state-of-the-art care for all cardiac arrest patients should be a healthcare priority.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC/NHF Postgraduate Scholarship, RACP JJ Billings Scholarship
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Affiliation(s)
- E Paratz
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - L Rowsell
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - J Ball
- Ambulance Victoria, Melbourne, Australia
| | - D Zentner
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - S Parsons
- Victorian Institute of Forensic Medicine, Melbourne, Australia
| | - N Morgan
- Victorian Institute of Forensic Medicine, Melbourne, Australia
| | - T Thompson
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - P James
- Royal Melbourne Hospital, Cardiology, Melbourne, Australia
| | - A Pflaumer
- Royal Children's Hospital, Cardiology, Melbourne, Australia
| | - C Semsarian
- University of Sydney, Centenary Institute, Sydney, Australia
| | - D Stub
- The Alfred Hospital, Cardiology, Melbourne, Australia
| | - D Liew
- Monash University, School of Public Health & Preventive Medicine, Melbourne, Australia
| | - K Smith
- Ambulance Victoria, Melbourne, Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Paratz E, Rowsell L, Ball J, Zentner D, Parsons S, Morgan N, Thompson T, James P, Pflaumer A, Semsarian C, Stub D, Liew D, Smith K, La Gerche A. 259 The Economic Impact of Sudden Cardiac Arrest. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Paratz E, Rowsell L, Zentner D, Parsons S, Morgan N, Thompson T, James P, Pflaumer A, Semsarian C, Case R, Smith K, Stub D, La Gerche A. 260 The First Australian Multi-Source Sudden Cardiac Death Registry: Methodology and Early Findings. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Do J, Yeates L, Butters A, Sarina T, Nowak N, Burns C, Connell V, Hunt L, Berkman J, Ingrey A, Kevin L, Thompson T, Macciocca I, Kawa J, McTaggart D, Zentner D, Pflaumer A, Ogden K, Smith J, Turner C, Ronan A, Davis A, Weintraub R, Vohra J, Winship I, McGaughran J, Atherton J, Semsarian C, Ingles J. 591 The Australian Genetic Heart Disease Registry: 13 Years on. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hopkins S, La Gerche A, Stub D, Parsons S, Ball J, Thompson T, Morgan N, Zentner D, Pflaumer A, James P, Bernard S, Paratz E, Rowsell L, Smith K. 608 Incidence and Epidemiology of Sudden Cardiac Arrest In Younger Persons. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thompson T, Nair MN, Geornaras I, Martin JN, McFarlane B, Delmore RJ, Belk KE. Investigating the Etiology of Increased Incidence of Sour Knuckles in Commercial Beef Processing Facilities. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10809] [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: 11/03/2022] Open
Abstract
ObjectivesCattle weights have increased during the last couple of decades and have not always been accompanied by improvements in facility capabilities and management. Alongside quality issues of color, tenderness, and water holding capacity, issues such as sour muscles and bone taints are now appearing with great frequency in the meat industry. Development of off-flavor/sourness in deep muscles such as knuckles (vastus femoris, vastus lateralis, vastus medialis, and rectus femoris) has been a long-standing issue in the beef industry, however, has not been well characterized. Therefore, the objective of this study was to investigate the cause, and characterize sour odor associated with beef knuckles using microbial, odor panel, and gas chromatography-mass spectrometric (GC–MS) analyses.Materials and MethodsKnuckles (n = 10) identified as having no sour odor (control), slight odor, or severe odor were collected from the fabrication line of a commercial beef processing plant. Sponge samples of synovial fluid and femur surface of the round were also obtained at the time of collection, for determination of anaerobic sporeformer counts. The collected knuckles were transported on ice to the laboratory where they were aseptically separated into two halves, with one half destined for microbial, odor, and GC–MS analyses on the day of collection (Day 0) and the other half for the same analyses after 35 d of vacuum packaged storage at 2°C (Day 35). For microbial analysis, 15 g of tissue was excised from the muscle surface and was analyzed for aerobic plate counts (Petrifilm Aerobic Count plates) and lactic acid bacteria counts (Lactobacilli MRS agar). Samples (5 g) for GC–MS were held at –80°C until analysis. The remainder of the sample was diced and used for trained odor panels. Data were analyzed using the ANOVA function in R (v. 3.5.1.), with a significance level of α = 0.05. Upon finding significant differences (P < 0.05) the means function was used to determine differences between groups.ResultsIrrespective of sourness classification of the knuckles, similar (P > 0.05) anaerobic sporeformer counts were obtained for the synovial fluid and femur surface. Additionally, muscle tissue samples from control, slightly sour and severely sour knuckles had similar (P > 0.05) aerobic plate counts and lactic acid bacteria counts. Odor panelists identified differences (P < 0.05) for all attributes between control and sour knuckles (slight and severe) on Day 0. Similarly, on Day 35, differences (P < 0.05) were observed between control, slightly sour, and severely sour knuckles for all attributes, with severe receiving the highest score for all categories. GC–MS results showed no differences (P > 0.05) between control and sour knuckles for propionic, butyric, isobutyric, and acetonic acid.ConclusionMicrobiological analysis found no differences in culturable organisms between control, slight, and severely sour knuckles on Day 0 or Day 35. However, odor panelists were able to identify differences between control and sour knuckles even after 35 d in vacuum packaging. GC–MS analysis did not indicate a statistical difference in the abundance of volatiles between the treatments, probably due to high variations within treatment groups.
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Affiliation(s)
| | - M. N. Nair
- Colorado State University Animal Science
| | | | | | | | | | - K. E. Belk
- Colorado State University Animal Science
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32
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Walker JT, Beachley G, Amos HM, Baron JS, Bash J, Baumgardner R, Bell MD, Benedict KB, Chen X, Clow DW, Cole A, Coughlin JG, Cruz K, Daly RW, Decina SM, Elliott EM, Fenn ME, Ganzeveld L, Gebhart K, Isil SS, Kerschner BM, Larson RS, Lavery T, Lear GG, Macy T, Mast MA, Mishoe K, Morris KH, Padgett PE, Pouyat RV, Puchalski M, Pye HOT, Rea AW, Rhodes MF, Rogers CM, Saylor R, Scheffe R, Schichtel BA, Schwede DB, Sexstone GA, Sive BC, Sosa Echeverría R, Templer PH, Thompson T, Tong D, Wetherbee GA, Whitlow TH, Wu Z, Yu Z, Zhang L. Toward the improvement of total nitrogen deposition budgets in the United States. Sci Total Environ 2019; 691:1328-1352. [PMID: 31466212 PMCID: PMC7724633 DOI: 10.1016/j.scitotenv.2019.07.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
Frameworks for limiting ecosystem exposure to excess nutrients and acidity require accurate and complete deposition budgets of reactive nitrogen (Nr). While much progress has been made in developing total Nr deposition budgets for the U.S., current budgets remain limited by key data and knowledge gaps. Analysis of National Atmospheric Deposition Program Total Deposition (NADP/TDep) data illustrates several aspects of current Nr deposition that motivate additional research. Averaged across the continental U.S., dry deposition contributes slightly more (55%) to total deposition than wet deposition and is the dominant process (>90%) over broad areas of the Southwest and other arid regions of the West. Lack of dry deposition measurements imposes a reliance on models, resulting in a much higher degree of uncertainty relative to wet deposition which is routinely measured. As nitrogen oxide (NOx) emissions continue to decline, reduced forms of inorganic nitrogen (NHx = NH3 + NH4+) now contribute >50% of total Nr deposition over large areas of the U.S. Expanded monitoring and additional process-level research are needed to better understand NHx deposition, its contribution to total Nr deposition budgets, and the processes by which reduced N deposits to ecosystems. Urban and suburban areas are hotspots where routine monitoring of oxidized and reduced Nr deposition is needed. Finally, deposition budgets have incomplete information about the speciation of atmospheric nitrogen; monitoring networks do not capture important forms of Nr such as organic nitrogen. Building on these themes, we detail the state of the science of Nr deposition budgets in the U.S. and highlight research priorities to improve deposition budgets in terms of monitoring and flux measurements, leaf- to regional-scale modeling, source apportionment, and characterization of deposition trends and patterns.
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Affiliation(s)
- J T Walker
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America.
| | - G Beachley
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - H M Amos
- AAAS Science and Technology Policy Fellow hosted by the U.S. Environmental Protection Agency, Office of Research and Development, Washington, DC, United States of America
| | - J S Baron
- U.S. Geological Survey, Fort Collins Science Center, Fort Collins, CO, United States of America
| | - J Bash
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - R Baumgardner
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - M D Bell
- National Park Service, Air Resources Division, Lakewood, CO, United States of America
| | - K B Benedict
- Colorado State University, Department of Atmospheric Science, Fort Collins, CO, United States of America
| | - X Chen
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - D W Clow
- U.S. Geological Survey, Colorado Water Science Center, Denver, CO, United States of America
| | - A Cole
- Environment and Climate Change Canada, Air Quality Research Division, Toronto, ON, Canada
| | - J G Coughlin
- U.S. Environmental Protection Agency, Region 5, Chicago, IL, United States of America
| | - K Cruz
- U.S. Department of Agriculture, National Institute of Food and Agriculture, Washington, DC, United States of America
| | - R W Daly
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - S M Decina
- University of California, Department of Chemistry, Berkeley, CA, United States of America
| | - E M Elliott
- University of Pittsburgh, Department of Geology & Environmental Science, Pittsburgh, PA, United States of America
| | - M E Fenn
- U.S. Department of Agriculture, Forest Service, Pacific Southwest Research Station, Riverside, CA, United States of America
| | - L Ganzeveld
- Meteorology and Air Quality (MAQ), Wageningen University and Research Centre, Wageningen, Netherlands
| | - K Gebhart
- National Park Service, Air Resources Division, Fort Collins, CO, United States of America
| | - S S Isil
- Wood Environment & Infrastructure Solutions, Inc., Newberry, FL, United States of America
| | - B M Kerschner
- Prairie Research Institute, University of Illinois, Champaign, IL, United States of America
| | - R S Larson
- Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, WI, United States of America
| | - T Lavery
- Environmental Consultant, Cranston, RI, United States of America
| | - G G Lear
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - T Macy
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - M A Mast
- U.S. Geological Survey, Colorado Water Science Center, Denver, CO, United States of America
| | - K Mishoe
- Wood Environment & Infrastructure Solutions, Inc., Newberry, FL, United States of America
| | - K H Morris
- National Park Service, Air Resources Division, Lakewood, CO, United States of America
| | - P E Padgett
- U.S. Department of Agriculture, Forest Service, Pacific Southwest Research Station, Riverside, CA, United States of America
| | - R V Pouyat
- U.S. Forest Service, Bethesda, MD, United States of America
| | - M Puchalski
- U.S. Environmental Protection Agency, Office of Air and Radiation, Washington, DC, United States of America
| | - H O T Pye
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - A W Rea
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - M F Rhodes
- D&E Technical, Urbana, IL, United States of America
| | - C M Rogers
- Wood Environment & Infrastructure Solutions, Inc., Newberry, FL, United States of America
| | - R Saylor
- National Oceanic and Atmospheric Administration, Air Resources Laboratory, Oak Ridge, TN, United States of America
| | - R Scheffe
- U.S. Environmental Protection Agency, Office of Air Quality Planning and Standards, Durham, NC, United States of America
| | - B A Schichtel
- National Park Service, Cooperative Institute for Research in the Atmosphere, Colorado State University, Fort Collins, CO, United States of America
| | - D B Schwede
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - G A Sexstone
- U.S. Geological Survey, Colorado Water Science Center, Denver, CO, United States of America
| | - B C Sive
- National Park Service, Air Resources Division, Lakewood, CO, United States of America
| | - R Sosa Echeverría
- Centro de Ciencias de la Atmosfera, Universidad Nacional Autónoma de México, Mexico
| | - P H Templer
- Boston University, Department of Biology, Boston, MA, United States of America
| | - T Thompson
- AAAS Science and Technology Policy Fellow hosted by the U.S. Environmental Protection Agency, Office of Policy, Washington, DC, United States of America
| | - D Tong
- George Mason University. National Oceanic and Atmospheric Administration, Air Resources Laboratory, College Park, MD, United States of America
| | - G A Wetherbee
- U.S. Geological Survey, Hydrologic Networks Branch, Denver, CO, United States of America
| | - T H Whitlow
- Cornell University, Department of Horticulture, Ithaca, NY, United States of America
| | - Z Wu
- U.S. Environmental Protection Agency, Office of Research and Development, Durham, NC, United States of America
| | - Z Yu
- University of Pittsburgh, Department of Geology & Environmental Science, Pittsburgh, PA, United States of America
| | - L Zhang
- Environment and Climate Change Canada, Air Quality Research Division, Toronto, ON, Canada
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Duffy JMN, Thompson T, Hinton L, Salinas M, McManus RJ, Ziebland S. What outcomes should researchers select, collect and report in pre-eclampsia research? A qualitative study exploring the views of women with lived experience of pre-eclampsia. BJOG 2019; 126:637-646. [DOI: 10.1111/1471-0528.15616] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Affiliation(s)
- JMN Duffy
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
- Balliol College; University of Oxford; Oxford UK
| | - T Thompson
- Radcliffe Women's Health Patient and Public Involvement Panel; Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - L Hinton
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - M Salinas
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - RJ McManus
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - S Ziebland
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
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Johnson R, Peters S, Ingles J, Correnti G, Ingrey A, Mountain H, Zentner D, Thompson T, Oates E, Ronan A, Pachter N, Haan E, Van Spaendonck-Zwarts K, Semsarian C, McGaughran J, Atherton J, James P, Fatkin D. Penetrance of Dilated Cardiomyopathy in Families with Truncating TTN Variants: a National Perspective. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.019] [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: 10/26/2022]
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Paratz E, Rowsell L, Zentner D, Parsons S, Morgan N, Thompson T, James P, Pflaumer A, Semsarian C, Smith K, Stub D, La Gerche A. Cardiac Arrest and Sudden Cardiac Death Registries: A Systematic Review of Global Coverage and Data capture Strategies. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.357] [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: 11/27/2022]
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Paratz E, Costello B, Rowsell L, Morgan N, Smith K, Thompson T, Semsarian C, Pflaumer A, James P, Stub D, La Gerche A, Zentner D, Parsons S. Coronary Artery Calcium Score in a Post-Mortem Population: Feasibility and Clinical Utility. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.006] [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: 10/26/2022]
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Thompson T, Nair MN, Geornaras I, Martin JN, McFarlane B, Delmore RJ, Belk KE. Investigating the Etiology of Increased Incidence of Sour Knuckles in Commercial Beef Processing Facilities. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0113] [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] Open
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Rydze R, Torralba HS, Gibbons W, Rajkovic A, Thompson T, Pangas S. A novel gremlin-2 mutation from a patient with primary ovarian insufficiency is predicted to affect bone morphogenetic protein binding and may alter the ovarian reserve. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.225] [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: 11/17/2022]
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39
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Stubbs B, Vancampfort D, Veronese N, Thompson T, Fornaro M, Schofield P, Solmi M, Mugisha J, Carvalho AF, Koyanagi A. Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries. Psychol Med 2017; 47:2906-2917. [PMID: 28637534 DOI: 10.1017/s0033291717001477] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs. METHODS Community-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country-wide meta-analysis adjusting for age and sex was also conducted. RESULTS The prevalence of severe pain was 8.0, 28.2, 20.2, and 34.0% for no depression, subsyndromal depression, brief depressive episode, and depressive episode, respectively. Logistic regression adjusted for socio-demographic variables, anxiety and chronic medical conditions (arthritis, diabetes, angina, asthma) demonstrated that compared with no depression, subsyndromal depression, brief depressive episode, and depressive episode were associated with a 2.16 [95% confidence interval (CI) 1.83-2.55], 1.45 (95% CI 1.22-1.73), and 2.11 (95% CI 1.87-2.39) increase in odds of severe pain, respectively. Similar results were obtained when a continuous pain scale was used as the outcome. Depression was significantly associated with severe pain in 44/47 countries with a pooled odds ratio of 3.93 (95% CI 3.54-4.37). CONCLUSION Depression and severe pain are highly comorbid across LMICs, independent of anxiety and chronic medical conditions. Whether depression treatment or pain management in patients with comorbid pain and depression leads to better clinical outcome is an area for future research.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill, London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven,Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division,Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - T Thompson
- Faculty of Education and Health,University of Greenwich,London,UK
| | - M Fornaro
- New York Psychiatric Institute,Columbia University,New York, NY,USA
| | - P Schofield
- Faculty of Health,Social Care and Education,Anglia Ruskin University,Chelmsford,UK
| | - M Solmi
- Institute of clinical Research and Education in Medicine (IREM),Padova,Italy
| | | | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group,Faculty of Medicine,Federal University of Ceará,Fortaleza, CE,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Thomas B, McIntosh D, Fildes T, Smith L, Hargrave F, Islam M, Thompson T, Layfield R, Scott D, Shaw B, Burrell CL, Gonzalez S, Taylor S. Second-harmonic generation imaging of collagen in ancient bone. Bone Rep 2017; 7:137-144. [PMID: 29124084 PMCID: PMC5671394 DOI: 10.1016/j.bonr.2017.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/27/2017] [Accepted: 10/24/2017] [Indexed: 12/01/2022] Open
Abstract
Second-harmonic generation imaging (SHG) captures triple helical collagen molecules near tissue surfaces. Biomedical research routinely utilizes various imaging software packages to quantify SHG signals for collagen content and distribution estimates in modern tissue samples including bone. For the first time using SHG, samples of modern, medieval, and ice age bones were imaged to test the applicability of SHG to ancient bone from a variety of ages, settings, and taxa. Four independent techniques including Raman spectroscopy, FTIR spectroscopy, radiocarbon dating protocols, and mass spectrometry-based protein sequencing, confirm the presence of protein, consistent with the hypothesis that SHG imaging detects ancient bone collagen. These results suggest that future studies have the potential to use SHG imaging to provide new insights into the composition of ancient bone, to characterize ancient bone disorders, to investigate collagen preservation within and between various taxa, and to monitor collagen decay regimes in different depositional environments. Second-Harmonic Generation (SHG) confocal laser scanning microscopy is used to investigate collagen remnants in ancient bone. Four independent techniques confirm the presence of collagen remnants in ancient bone samples with SHG-detected collagen. SHG imaging can visualise collagen remnants in ancient bone of various taxa, ages, and settings.
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Affiliation(s)
- B Thomas
- Mass Spectrometry Research Group, University of Liverpool, Brownlow Hill, Liverpool L69 3GJ, UK
| | - D McIntosh
- Mass Spectrometry Research Group, University of Liverpool, Brownlow Hill, Liverpool L69 3GJ, UK
| | - T Fildes
- Mass Spectrometry Research Group, University of Liverpool, Brownlow Hill, Liverpool L69 3GJ, UK.,Norton Priory Museum, Runcorn WA7 1SX, UK
| | - L Smith
- Norton Priory Museum, Runcorn WA7 1SX, UK
| | - F Hargrave
- Norton Priory Museum, Runcorn WA7 1SX, UK
| | - M Islam
- School of Science and Engineering, Teesside University, Borough Road, Middlesbrough TS1 3BA, UK
| | - T Thompson
- School of Science and Engineering, Teesside University, Borough Road, Middlesbrough TS1 3BA, UK
| | - R Layfield
- School of Life Sciences, University of Nottingham Medical School, Nottingham NG9 6HZ, UK
| | - D Scott
- School of Life Sciences, University of Nottingham Medical School, Nottingham NG9 6HZ, UK
| | - B Shaw
- School of Life Sciences, University of Nottingham Medical School, Nottingham NG9 6HZ, UK
| | - C L Burrell
- Liverpool John Moores University, Liverpool, UK
| | - S Gonzalez
- Liverpool John Moores University, Liverpool, UK
| | - S Taylor
- Mass Spectrometry Research Group, University of Liverpool, Brownlow Hill, Liverpool L69 3GJ, UK
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Kouidrat Y, Pizzol D, Cosco T, Thompson T, Carnaghi M, Bertoldo A, Solmi M, Stubbs B, Veronese N. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabet Med 2017; 34:1185-1192. [PMID: 28722225 DOI: 10.1111/dme.13403] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2017] [Indexed: 12/24/2022]
Abstract
Erectile dysfunction may be common among men with diabetes, but its prevalence is still debated. We aimed to assess the relative prevalence of erectile dysfunction in diabetes searching major databases from inception to November 2016 for studies reporting erectile dysfunction in men with Type 1 and Type 2 diabetes mellitus. We conducted a meta-analysis of the prevalence [and 95% confidence intervals (95% CIs)] of erectile dysfunction in diabetes compared with healthy controls, calculating the relative odds ratios (ORs) and 95% CIs. A random effect model was applied. From 3747 initial hits, 145 studies were included representing 88 577 men (age: 55.8 ± 7.9 years). The prevalence of erectile dysfunction in diabetes overall was 52.5% (95% CI, 48.8 to 56.2) after adjusting for publication bias, and 37.5%, 66.3% and 57.7% in Type 1, Type 2 and both types of diabetes, respectively (P for interaction < 0.0001). The prevalence of erectile dysfunction was highest in studies using the Sexual Health Inventory for Men (82.2%, 17 studies, P for interaction < 0.0001). Studies with a higher percentage of people with hypertension moderated our results (beta = 0.03; 95% CI, 0.008 to 0.040; P = 0.003; R2 = 0.00). Compared to healthy controls (n = 5385) men with diabetes (n = 863) were at increased odds of having erectile dysfunction (OR 3.62; 95% CI, 2.53 to 5.16; P < 0.0001; I2 = 67%, k = 8). Erectile dysfunction is common in diabetes, affecting more than half of men with the condition and with a prevalence odds of approximately 3.5 times more than controls. Our findings suggest that screening and appropriate intervention for men with erectile dysfunction is warranted.
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Affiliation(s)
- Y Kouidrat
- Department of Nutrition, Maritime Hospital of Berck, France
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - D Pizzol
- Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique
| | - T Cosco
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
- Oxford Institute of Population Ageing, University of Oxford, London, UK
| | - T Thompson
- Faculty of Education and Health, University of Greenwich, London, UK
| | - M Carnaghi
- Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique
| | - A Bertoldo
- Zerouno Procreazione, Centro di Medicina, Venezia Mestre, Padova, Italy
| | - M Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - B Stubbs
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - N Veronese
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
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Liao S, De A, Thompson T, Chapman L, Bitoun JP, Yao X, Yu Q, Ma F, Wen ZT. Expression of BrpA in Streptococcus mutans is regulated by FNR-box mediated repression. Mol Oral Microbiol 2017; 32:517-525. [PMID: 28744965 DOI: 10.1111/omi.12193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2017] [Indexed: 11/30/2022]
Abstract
Our previous studies showed that brpA in Streptococcus mutans, which encodes a member of the LytR-CpsA-Psr family of proteins, can be co-transcribed with brpB upstream as a bicistronic operon, and the intergenic region also has strong promoter activity. To elucidate how brpA expression is regulated, the promoter regions were analyzed using polymerase chain reaction-based deletions and site-directed mutagenesis and a promoterless luciferase gene as a reporter. Allelic exchange mutagenesis was also used to examine genes encoding putative trans-acting factors, and the impact of such mutations on brpA expression was analyzed by reporter assays. Multiple elements in the short brpA promoter (nucleotide -1 to -344 relative to start cordon ATG) were shown to have a major impact on brpA expression, including an FNR-box, for a putative binding site of an FNR-type of transcriptional regulator. When compared with the intact brpA promoter, mutations of the highly conserved nucleotides in FNR-box from TTGATgtttAcCtt to TTACAgaaaGtTac resulted in 1362-fold increases of luciferase activity (P < .001), indicative of the FNR-box-mediated repression as a major mechanism in regulation of brpA expression. When luciferase reporter was fused to the upstream brpBA promoter (nucleotides -784 to -1144), luciferase activity was decreased by 4.5-fold (P < .001) in the brpA mutant, TW14D, and by 67.7-fold (P < .001) in the brpB mutant, JB409, compared with the wild-type, UA159. However, no such effects were observed when the reporter gene was fused to the short brpA promoter and its derivatives. These results also suggest that brpA expression in S. mutans is auto-regulated through the upstream brpBA promoter.
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Affiliation(s)
- S Liao
- Center of Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - A De
- Department of Comprehensive Dentistry and Biomaterials, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - T Thompson
- Department of Comprehensive Dentistry and Biomaterials, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - L Chapman
- Center of Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - J P Bitoun
- Center of Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - X Yao
- Center of Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Q Yu
- Department of Biostatistics, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - F Ma
- Center for Virology, University of Nebraska, Lincoln, NE, USA
| | - Z T Wen
- Center of Oral and Craniofacial Biology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.,Department of Comprehensive Dentistry and Biomaterials, Louisiana State University Health Sciences Center, New Orleans, LA, USA.,Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Bull M, Maddock T, Acquaye E, Hnynnsi P, Thompson T, Wild S, Wiseman K, Cosgrove E, Cameron R, Wojtowicz A, Mannion H. 57COGNITIVE IMPAIRMENT: IMPROVING ASSESSMENT AND MANAGEMENT THROUGH THE MEDICAL CLERKING PROFORMA. Age Ageing 2017. [DOI: 10.1093/ageing/afx055.57] [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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Bunyan M, Crowley J, Smedley N, Mutti MF, Cashen A, Thompson T, Foster J. Feasibility of training nurses in motivational interviewing to improve patient experience in mental health inpatient rehabilitation: a pilot study. J Psychiatr Ment Health Nurs 2017; 24:221-231. [PMID: 28248447 DOI: 10.1111/jpm.12382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Recently, concerns have been raised about how well United Kingdom National Health Service nurses care for their patients and their level of compassion. Motivational interviewing (MI) is an established approach to helping people make positive behaviour changes, through directive, person-centred counselling within a collaborative relationship between clinician and recipient. Based on evidence that MI may influence nursing practice positively, an investigation into the feasibility of training nurses on mental health inpatient rehabilitation wards ('rehabilitation') in MI to improve patient experience was reported. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This pilot study demonstrates that training rehabilitation nurses in MI is feasible and provides preliminary evidence suggesting that a larger study to examine efficacy is warranted, including a calculation of sample size required to draw robust statistical conclusions. Nurses evaluated the training as highly relevant to their work. Patients responded well to interviews and focus groups with support from experts-by-experience; they were generally fairly satisfied with the rehabilitation ward and slight improvements in their experience were found following MI training for nurses but not at 6-month follow-up. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Rehabilitation nurses may face conflicting demands between ensuring patients with severe difficulties meet their basic needs and working with them to develop greater independence. Qualitative findings question whether nurse-patient interactions are fully valued as nursing interventions in inpatient rehabilitation. Learning MI might be a useful way of helping nurses think in detail about their interactions with patients and how to improve communications with their patients. The principles of MI should be incorporated into pre-registration training. ABSTRACT Introduction There is limited research addressing the experiences of patients in inpatient rehabilitation (rehabilitation), who often spend long periods in hospital, and the nursing approaches utilized. Aim Based on evidence that motivational interviewing (MI) may improve nursing practice, this was a pilot study evaluating the feasibility of training rehabilitation nurses in MI and measuring patient experience. Method Nurses underwent training and supervision focusing on MI spirit. Quantitative and qualitative measures were taken pretraining, 2 months post-training and 8 months post-training. Expert-by-experience research assistants facilitated patients' participation in the study. Results This study showed that training rehabilitation nurses in MI was feasible and relevant to their work. Patients participated in interviews and focus groups with support and potential improvements that require further empirical investigation in patient experience were found following the MI training. Discussion This pilot study establishes the feasibility of a larger study addressing efficacy. Tentative qualitative findings question whether interactions between nurses and patients are valued in rehabilitation and support MI as a promising skill set for rehabilitation nurses. Implications for practice Bringing MI into inpatient rehabilitation provoked reflection on nursing practice. Dilemmas for nurses about balancing safety with promoting autonomy and communicating constructively with patients emerged as important.
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Affiliation(s)
- M Bunyan
- Oxleas NHS Foundation Trust, Dartford, UK
| | - J Crowley
- Faculty of Education and Health, University of Greenwich, London, UK
| | - N Smedley
- Oxleas NHS Foundation Trust, Dartford, UK
| | - M-F Mutti
- Oxleas NHS Foundation Trust, Dartford, UK
| | - A Cashen
- Oxleas NHS Foundation Trust, Dartford, UK
| | - T Thompson
- Faculty of Education and Health, University of Greenwich, London, UK
| | - J Foster
- Faculty of Education and Health, University of Greenwich, London, UK
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Wu M, Thompson T, Ryerson B, Miller J, Singh S. Abstract P5-08-31: Triple negative breast cancer and factors associated with its treatment in the US – A population study using central cancer registry data. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-08-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- M Wu
- Centers for Disease Control and Prevention, Atlanta, GA
| | - T Thompson
- Centers for Disease Control and Prevention, Atlanta, GA
| | - B Ryerson
- Centers for Disease Control and Prevention, Atlanta, GA
| | - J Miller
- Centers for Disease Control and Prevention, Atlanta, GA
| | - S Singh
- Centers for Disease Control and Prevention, Atlanta, GA
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Zentner D, Thompson T, Taylor J, Bogwitz M, Trainer A, Vohra J, Winship I, James P. Predicting Yield From Cardiac Genetic Testing–A Clinically Achievable Way to Achieve Equity and Triage Appropriately. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.611] [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: 11/24/2022]
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Weissman S, Thompson T, Quinby T, Henn C. Addressing Gaps in Infectious Disease Training and Care in the Caribbean Region: The University of the West Indies - Jamaica / University of South Carolina Partnership to Develop a Postgraduate Infectious Diseases Fellowship. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.321] [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
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Blusztein D, Jayadeva P, Thompson T, Zentner D, Trainer A, James P, Winship I, Kalman J, Vohra J. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): Genotype and Phenotype Analysis of a Cohort of Probands. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zentner D, Thompson T, Taylor J, Bogwitz M, Macciocca I, Trainer A, Winship I, Vohra J, James P. The Advent of Gene Panel Testing: Has It Changed the Outcome of Mutation Detection Gene Testing in a Cardiac Genetics Clinic? Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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