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Abstract
Background: There is a paucity of evidence regarding optimal management of Pasteurella spp. endocarditis. The authors report the first case of Pasteurella spp. endocarditis with septic arthritis and review the literature.
Case Description: A 79-year-old patient with significant comorbidities, including prosthetic aortic valve, was admitted with left knee swelling, fever, and confusion, having been scratched by a cat 2-weeks prior. At presentation, there was a metallic click, a Grade 3 pan-systolic murmur and Grade 1 flow murmur audible on auscultation. Blood and synovial fluid cultures both isolated Pasteurella multocida, identified by matrix-assisted laser desorption ionisation–time of flight, which was sensitive to penicillin according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST); minimum inhibitory concentration: 0.094). The patient underwent joint washout and received intravenous piperacillin/tazobactam for 3 days before switching to benzylpenicillin once sensitivities were known. Due to continued pyrexia, a transthoracic echocardiogram was obtained, which revealed a small mobile mass on a thickened mitral valve suspicious for a vegetation. On review by the Infective Endocarditis team, conservative management was deemed best, given the presence of comorbidities. Despite requiring further joint washout due to persistent knee pain, the patient was successfully treated with 8 weeks of antibiotic therapy (24 days of benzylpenicillin monotherapy, 2 weeks of benzylpenicillin and ciprofloxacin, and 15 days ciprofloxacin monotherapy).
Discussion: Previous literature reviews report a higher mortality of Pasteurella spp. endocarditis when managed without cardiac surgery, thus recommending surgery in all cases. The authors found these to have confounding factors, including inadequate duration of antimicrobials, aortic root abscess, and rapid progression to death. The authors’ case of Pasteurella spp. endocarditis, complicated by septic arthritis, showed successful therapy without cardiac surgery.
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Affiliation(s)
- E Carter
- Leeds Teaching Hospital Trust, UK
| | | | - W Baig
- Leeds Teaching Hospital Trust, UK
| | - JAT Sandoe
- Leeds Teaching Hospital Trust, UK; University of Leeds, UK
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Sullivan JF, do Brasil (Res) M, Roman JW, Milder EA, Carter E, Lennon RP. Utility of Point of Care Ultrasound in Humanitarian Assistance Missions. Mil Med 2021; 186:789-794. [PMID: 33499456 DOI: 10.1093/milmed/usaa348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/28/2020] [Accepted: 09/09/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Point of care ultrasound (POCUS) is increasingly used in primary care in the USA and has been shown to provide significant benefit to care in deployed military settings and during disaster relief efforts. It is less studied as a tool during humanitarian assistance missions. We sought to determine the utility of POCUS in a humanitarian assistance setting during the February 2019 joint U.S.-Brazilian hospital assistance mission aboard the Hospitalar Assistance Ship Carlos Chagas along the Madeira River in the Brazilian Amazon. MATERIALS AND METHODS Point of care ultrasound was offered as a diagnostic modality to primary care physicians during the course of a month-long mission. A handheld IVIZ ultrasound machine was loaned for use during this mission by Sonosite. A P21v phased array (5-1 MHz) or an L38v linear (10-5 MHz) transducer was used for scanning. Requests for POCUS examinations, their findings, and changes in patient management were recorded. RESULTS Point of care ultrasound examinations were requested and performed in 24 of 814 (3%) outpatient primary care visits. Ten of these studies (42% of POCUS examinations, 1.2% of all patient visits) directed patient management decisions, in each case preventing unnecessary referral. CONCLUSIONS In this austere setting, POCUS proved to be an inexpensive, effective tool at preventing unnecessary referrals. Future medical humanitarian assistance missions may likewise find POCUS to be a primary care force-multiplier.
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Affiliation(s)
- John F Sullivan
- Naval Hospital Jacksonville, Department of Family Medicine, 2080 Child Street, Jacksonville, FL 32214, USA
| | - Marinha do Brasil (Res)
- University of Sao Paulo School of Medicine, Department of Infectious Disease, Sao Paulo, SP 05403000, Brazil
| | - John W Roman
- Naval Medical Center Portsmouth, Department of Dermatology, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA
| | - Edmund A Milder
- Naval Medical Center San Diego, Department of Pediatrics, 34800 Bob Wilson Drive, San Diego, CA 92134, USA
| | - E Carter
- Naval Hospital Jacksonville, Department of Family Medicine, 2080 Child Street, Jacksonville, FL 32214, USA
| | - Robert P Lennon
- Naval Hospital Jacksonville, Department of Family Medicine, 2080 Child Street, Jacksonville, FL 32214, USA.,Penn State College of Medicine, Department of Family Medicine, 500 University Drive, Hershey, PA 17033, USA
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Lawes R, Carter E, Hussein M, Murray J, McNair HA. Retrospective audit of inter-fraction motion for pelvic node radiotherapy in prostate cancer patients. Radiography (Lond) 2020; 27:266-271. [PMID: 32830012 DOI: 10.1016/j.radi.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Pelvic lymph nodes move independently to the prostate. When delivering radiotherapy to prostate and pelvic lymph nodes, daily inter- and intra-fraction anatomical changes need to be accounted for. Planning target volume (PTV) margins, grown from the pelvic lymph node clinical target volume need to be determined, to account for this variation in position. METHODS Twenty patients who had daily online image guided radiotherapy to prostate and pelvic lymph nodes between April and December 2018 were selected. Ten pre-treatment verification images using cone beam CT from each patient were registered to pelvic bone anatomy, prostate soft tissue or fiducial markers and pelvic lymph node soft tissue to assess the accuracy of treatment delivery. Population systematic and random errors and PTV margins were calculated. RESULTS PTV margins of 0.4 cm, 0.4 cm and 0.7 cm left-right (LR), superior-inferior (SI) and anterior-posterior (AP) respectively were derived for the pelvic lymph nodes when registering to prostate. PTV margins of 0.3 cm, 0.2 cm and 0.4 cm LR, SI and AP respectively were derived for the pelvic lymph nodes when registering to bone. There was a posterior systematic shift of the prostate during the treatment course. CONCLUSION There is differential motion of pelvic lymph nodes to prostate and in the era of prostate and pelvic radiotherapy for patients with node positive prostate cancer; there is increasing importance in the accuracy of dose delivery to the involved lymph node. Hence, this group of patients may benefit from personalised radiotherapy PTV margins, especially if the involved pelvic lymph node is within the anterior part of the clinical target volume. IMPLICATIONS FOR PRACTICE Optimisation of dose delivery to the pelvic lymph nodes when prioritising the prostate in prostate and pelvic lymph node image guided radiotherapy.
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Affiliation(s)
- R Lawes
- Radiotherapy, Royal Marsden NHS Foundation Trust, UK.
| | - E Carter
- Radiotherapy, Royal Marsden NHS Foundation Trust, UK
| | - M Hussein
- Radiotherapy, Royal Marsden NHS Foundation Trust, UK
| | - J Murray
- Radiotherapy, Royal Marsden NHS Foundation Trust, UK; Academic Urology Unit, Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, UK
| | - H A McNair
- Radiotherapy, Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, UK
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Kanagasabai T, Lee M, Carter E, Yan L, Guo D, Chan Q, Elliott P, Ezzati M, Wu Y, Baumgartner J. Exposure to air pollution is associated with lower sleep duration and higher odds of snoring and suspected osa in China. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Puzzolo E, Zerriffi H, Carter E, Clemens H, Stokes H, Jagger P, Rosenthal J, Petach H. Supply Considerations for Scaling Up Clean Cooking Fuels for Household Energy in Low- and Middle-Income Countries. Geohealth 2019; 3:370-390. [PMID: 32159025 PMCID: PMC7038875 DOI: 10.1029/2019gh000208] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 05/20/2023]
Abstract
Promoting access to clean household cooking energy is an important subject for policy making in low- and middle-income countries, in light of urgent and global efforts to achieve universal energy access by 2030 (Sustainable Development Goal 7). In 2014, the World Health Organization issued "Guidelines for Indoor Air Quality: Household Fuel Combustion", which recommended a shift to cleaner fuels rather than promotion of technologies that more efficiently combust solid fuels. This study fills an important gap in the literature on transitions to household use of clean cooking energy by reviewing supply chain considerations for clean fuel options in low- and middle-income countries. For the purpose of this study, we consider electricity, liquefied petroleum gas (LPG), alcohol fuels, biogas, and compressed biomass pellets burned in high performing gasifier stoves to be clean fuel options. Each of the clean fuels reviewed in this study, as well as the supply of electricity, presents both constraints and opportunities for enhanced production, supply, delivery, and long-term sustainability and scalability in resource-poor settings. These options are reviewed and discussed together with policy and regulatory considerations to help in making these fuel and energy choices available and affordable. Our hope is that researchers, government officials and policy makers, and development agencies and investors will be aided by our comparative analysis of these clean household energy choices.
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Affiliation(s)
- E. Puzzolo
- Department of Public Health and PolicyUniversity of LiverpoolLiverpoolUnited Kingdom
- Global LPG PartnershipNew YorkUSA
| | - H. Zerriffi
- University of British Columbia, Forest Resources ManagementCanada
| | - E. Carter
- Colorado State University, Civil and Environmental EngineeringUSA
| | | | | | - P. Jagger
- University of Michigan, School for Environment and SustainabilityUSA
| | | | - H. Petach
- U.S. Agency for International DevelopmentWashingtonDCUSA
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Patel S, Carter E, Cheng L. A paediatric sublingual lesion. A diagnostic challenge. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.738] [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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Rizvi S, Carter E. Case series of myofascial pain misdiagnosed as odontogenic pain and a review of the literature surrounding this. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.205] [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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Blumencranz P, Habibi M, Treece T, Blumencranz L, Yoder E, Audeh W, Carter E, McNaughton L, Roussos J, Shivers S, Acs G, Cox C, MINT Investigators G. Abstract PD8-04: Neoadjuvant chemotherapy for breast cancer: Nodal downstaging is highly correlated with pathological complete response. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd8-04] [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
Background: Neoadjuvant chemotherapy (NAC) is employed in patients with larger tumors to attempt to downstage locally advanced cancers to allow breast conservation and to assess in vivo tumor response. The Multi-Institutional Neoadjuvant Therapy MammaPrint Project I (MINT) study asked a secondary question of whether complete nodal downstaging could also be achieved with NAC.
Methods: This analysis included 147 eligible invasive breast cancer patients with high tumor burdens, classified as cT2-4N0-3M0 (T2 greater than 3.5cm if N0). Patients who had a positive core biopsy and/or fine needle aspiration (FNA) on an axillary node prior to starting NAC were included in this analysis. Those who had a surgical sentinel lymph node biopsy were not included. Nodal involvement was established following neoadjuvant treatment by axillary lymph node dissection (ALND).
Results: This population was 54% postmenopausal, average age 53 yrs (range 25 to 80 yrs). Tumor characteristics were 91% invasive ductal carcinoma; 65% T2, 29% T3, 6% T4; 87% LN1, 13% LN2-3; 3% low grade, 38% intermediate grade, 59% high grade; 65% ER-positive, 49% PR-positive, and 28% HER2-positive by immunohistochemistry; 84% High Risk (HR) and 16% Low Risk (LR) by MammaPrint (MP). After NAC, 45% (66/147) of these LN-positive patients were down-staged to ypN0 and also achieved a complete pathological response in the primary tumor. The potential for down-staging was inversely-related to tumor burden, where 47% (60/128) of N1, 35% (6/17) of N2, and 0% (0/2) of N3 patients were down-staged to ypN0. There were 3 patients who were down-staged (2 N2 to N1, and 1 N3 to N2), but not to ypN0. At surgery, 34% (44/128) of patients had no change, and 19% (24/129) progressed in LN staging.
Pre vs Post NAC Nodal StagePre NAC Nodal StageypN0ypN1ypN2ypN3TotalcN16044222128cN2626317cN3 112Total6646296147
Conclusions: We confirmed that upon achieving a complete response of the primary tumor that there was also a pathologic complete response in the LN. About 53% of patients had no change or progression of LN involvement following NAC.
Citation Format: Blumencranz P, Habibi M, Treece T, Blumencranz L, Yoder E, Audeh W, Carter E, McNaughton L, Roussos J, Shivers S, Acs G, Cox C, MINT Investigators Group. Neoadjuvant chemotherapy for breast cancer: Nodal downstaging is highly correlated with pathological complete response [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD8-04.
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Affiliation(s)
- P Blumencranz
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - M Habibi
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - T Treece
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - L Blumencranz
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - E Yoder
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - W Audeh
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - E Carter
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - L McNaughton
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - J Roussos
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - S Shivers
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - G Acs
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - C Cox
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
| | - Group MINT Investigators
- Morton Plant Hospital, Clearwater, FL; Johns Hopkins Breast Center at Bayview, Baltimore, MD; Agendia, Inc, Irvine, CA; University of South Florida, Tampa, FL; Florida Hospital Tampa, Tampa, FL
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, 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Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Carter E, Macleod MA, Visser E. THUR 199 MS DMT monitoring according to abn guidelines & product specification. J Neurol Psychiatry 2018. [DOI: 10.1136/jnnp-2018-abn.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AimRetrospective audit monitoring Multiple Sclerosis (MS) patients on Disease Modifying Therapies (DMT’s) according to Association of British Neurologists (ABN) guidelines (2015) and product specifications. This requires blood tests prior and during treatment and reviews by MS professionals.MethodsMS nurse database identified patients, records were reviewed and data extracted including bloods, JC virus (JCV) testing, imaging, specialist tests and counselling. Analysis was presented to the MS team. Protocols and referral pathways were designed, and new patients were re-audited.ResultsThe first cycle comprised of 280 patients, representing 325 individual DMT regimens. Prior to commencing treatments 90.7% blood tests, 58% imaging, and 60% JCV testing was completed on average. At 12 months, this decreased to 88.7% bloods, 30% imaging, and 25% JCV testing. Electronic records revealed that counselling documentation was sometimes incomplete. The second cycle analysed 55 patients showing improvement in Progressive multifocal leukoencephalopathy counselling and annual imaging.ConclusionMonitoring of bloods is done at a high standard, imaging and JCV testing less frequently meet monitoring guidelines. Factors influencing this include rural locations, variation in practice, and changing guidelines. Further work will include yearly follow-up, documentation of stopping criteria and regular review of monitoring guidelines. Patient involvement should be considered.
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Kelemen P, Aines R, Bennett E, Benson S, Carter E, Coggon J, de Obeso J, Evans O, Gadikota G, Dipple G, Godard M, Harris M, Higgins J, Johnson K, Kourim F, Lafay R, Lambart S, Manning C, Matter J, Michibayashi K, Morishita T, Noël J, Okazaki K, Renforth P, Robinson B, Savage H, Skarbek R, Spiegelman M, Takazawa E, Teagle D, Urai J, Wilcox J. In situ carbon mineralization in ultramafic rocks: Natural processes and possible engineered methods. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.egypro.2018.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kodros JK, Carter E, Brauer M, Volckens J, Bilsback KR, L'Orange C, Johnson M, Pierce JR. Quantifying the Contribution to Uncertainty in Mortality Attributed to Household, Ambient, and Joint Exposure to PM 2.5 From Residential Solid Fuel Use. Geohealth 2018; 2:25-39. [PMID: 32158998 PMCID: PMC7007171 DOI: 10.1002/2017gh000115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/15/2017] [Accepted: 12/01/2017] [Indexed: 05/13/2023]
Abstract
While there have been substantial efforts to quantify the health burden of exposure to PM2.5 from solid fuel use (SFU), the sensitivity of mortality estimates to uncertainties in input parameters has not been quantified. Moreover, previous studies separate mortality from household and ambient air pollution. In this study, we develop a new estimate of mortality attributable to SFU due to the joint exposure from household and ambient PM2.5 pollution and perform a variance-based sensitivity analysis on mortality attributable to SFU. In the joint exposure calculation, we estimate 2.81 (95% confidence interval: 2.48-3.28) million premature deaths in 2015 attributed to PM2.5 from SFU, which is 580,000 (18%) fewer deaths than would be calculated by summing separate household and ambient mortality calculations. Regarding the sources of uncertainties in these estimates, in China, India, and Latin America, we find that 53-56% of the uncertainty in mortality attributable to SFU is due to uncertainty in the percent of the population using solid fuels and 42-50% from the concentration-response function. In sub-Saharan Africa, baseline mortality rate (72%) and the concentration-response function (33%) dominate the uncertainty space. Conversely, the sum of the variance contributed by ambient and household PM2.5 exposure ranges between 15 and 38% across all regions (the percentages do not sum to 100% as some uncertainty is shared between parameters). Our findings suggest that future studies should focus on more precise quantification of solid fuel use and the concentration-response relationship to PM2.5, as well as mortality rates in Africa.
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Affiliation(s)
- J. K. Kodros
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
| | - E. Carter
- Department of Civil and Environmental EngineeringColorado State UniversityFort CollinsCOUSA
| | - M. Brauer
- School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - J. Volckens
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - K. R. Bilsback
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - C. L'Orange
- Department of Mechanical EngineeringColorado State UniversityFort CollinsCOUSA
| | - M. Johnson
- Berkeley Air Monitoring GroupBerkeleyCAUSA
| | - J. R. Pierce
- Department of Atmospheric ScienceColorado State UniversityFort CollinsCOUSA
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Shivers SC, Russell S, Blumencrancz L, Mehindru A, Acs G, Ellis D, Vrcelj V, Zanchi A, Blumencrancz PW, Carter E, King J, Cox CE. Abstract P6-09-45: Long-term follow-up of early stage breast cancer patients with results of MammaPrint®, Oncotype DX® and MammoStrat® risk classification assays. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-09-45] [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
Introduction: The use of genomic tests for the prediction of breast cancer recurrence is becoming more common. MammaPrint® (MP, Agendia Inc.) is a 70-gene microarray assay designed to assess the 10-year risk of recurrence in an untreated population that was not selected for ER/HER2 results. The Oncotype DX® Recurrence Score® (RS, Genomic Health, Inc.) is a 21-gene RT-PCR assay that is clinically validated to predict the 10-year risk of distant recurrence in ER+ patients treated with Tamoxifen. MammoStrat® (MS, Clarient, Inc.) is an IHC assay that uses 5 antibodies and has been validated in a similar population as RS. Several recent reports show that these assays classify patients differently with significant discordances for all risk groups (Shivers, et al., SABCS 2013; Denduluri, et al., ASCO Breast 2011; Poulet, et al., SABCS 2012; Schneider, et al., ASCO 2013). The present study is an analysis of long-term follow-up in a cohort of patients who have results for all three of these risk-stratifying assays side by side in the same samples.
Methods: Patients with ER+ N0-N1 early-stage breast cancer with an MP result obtained as part of their routine clinical care were identified at the University of South Florida (USF, N=65) and Morton Plant Hospital (N=83). After local IRB approval, slides and/or blocks were cut and de-identified at USF and sent to Genomic Health and Clarient for blinded testing. Clinicopathological features were also reviewed by 3 breast pathologists.
Results: 148 patients with an MP result had tissue available to send for RS and MS assays. These patients had a median age of 62 years; median tumor size 1.8 cm; 9% low grade, 59% intermediate grade and 32% high grade. In our previous analysis of this study, of 148 patients with MP results, 53% were low risk and 47% were high risk. Of 135 samples that yielded enough RNA to produce an RS result, 53% were low risk, 26% were intermediate risk and 21% were high risk. Of 129 samples that yielded an MS result, 44% were low risk, 28% were moderate risk and 28% were high risk. Of 121 patients with results for all 3 assays, only 22% were concordant for low risk and 9% were concordant for high risk across all 3 assays. Overall, 30% of cases showed a major discordance such as low risk for one assay and high risk for another. After median follow-up of 54 months, 9 patients have had a distant metastasis and/or 8 patients have died (11 patients total). One patient who had bone metastasis and died had been classified as low risk by all 3 assays. Three patients with distant metastases had a major discordance between assays, with two high risk and one low risk result. Seven patients were classified as high or intermediate/moderate risk by all 3 assays.
Conclusions: This direct comparison demonstrates that although the assays classify a large proportion of patients differently, the patients who ended up with a distant metastasis and/or died of breast cancer had been classified as high risk by at least two of the three assays. This study has important clinical implications since these assays are used to help make treatment decisions regarding which patients might benefit from chemotherapy.
Citation Format: Shivers SC, Russell S, Blumencrancz L, Mehindru A, Acs G, Ellis D, Vrcelj V, Zanchi A, Blumencrancz PW, Carter E, King J, Cox CE. Long-term follow-up of early stage breast cancer patients with results of MammaPrint®, Oncotype DX® and MammoStrat® risk classification assays [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-45.
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Affiliation(s)
- SC Shivers
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - S Russell
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - L Blumencrancz
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - A Mehindru
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - G Acs
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - D Ellis
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - V Vrcelj
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - A Zanchi
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - PW Blumencrancz
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - E Carter
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - J King
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
| | - CE Cox
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL; Agendia, Inc., Irvine, CA; Florida Hospital Tampa, Tampa, FL; Morton Plant Hospital, Clearwater, FL
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Shukla SC, Shivers SC, Mattingly A, Russell S, Mehindru A, Carter E, Cox CE. Abstract P1-11-06: Learning curve for the SAVI SCOUT breast localization and surgical guidance system. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-11-06] [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
Background: The gold standard for localizing non-palpable breast lesions for surgical excision is wire localization (WL). Multiple disadvantages for WL include complicated scheduling and migration of the wire after placement. Radioactive seed localization (RSL) mitigates these disadvantages, but regulatory requirements regarding radiation limit more universal adoption. The SAVI SCOUT surgical guidance system (an FDA cleared medical device) eliminates the drawbacks of WL without the regulatory requirements of RSL. SCOUT utilizes electromagnetic wave technology and infrared light to provide intra-operative guidance during surgical excision. The purpose of this study is to describe the learning curve associated with adoption of this new technology.
Method: An IRB-approved prospective, single-arm, multi-site trial enrolled women with non-palpable breast lesions requiring localized surgical excision. After informed consent, a radiologist or surgeon used imaging guidance to implant the SCOUT reflector into the target lesion. Intraoperatively, the surgeon used SCOUT for localization of the reflector and removal of the target lesion. We evaluated the association of several independent variables with respect to successful localization and surgical excision including: tumor side, tumor quadrant, distance of reflector from the skin, and the number of SCOUT localized breast excisions performed by operating surgeon up to the 1st five cases. We studied the relationship between these independent variables and the following dependent variables: reflector detection post-placement, reflector detection pre-incision, and reflector localization post-incision.Statistical analysis utilized the z-test to perform a two-sided test of equality at an alpha level of 0.05 with adjustment for multiple comparisons by the Bonferroni method. T-tests were used to perform two-sided tests of equality for numeric variables.
Results: Across 11 institutions, 16 surgeons performed a total of 153 surgical excisions. Overall success rates of reflector detection pre-incision and post-incision were 98% (150/153) and 99% (151/153), respectively. The reflectors were successfully removed in 100% (153/153) of cases. Difficulty with reflector detection immediately post placement was significantly associated with reflectors more than 4 cm (P=0.034) or 5 cm (P=0.007) from the skin, or the procedure being the 1st SCOUT case by the operating surgeon (P=0.036). Operating surgeons performing their 1st SAVI localization procedure were significantly associated with difficult reflector detection post-incision (p=0.044). Subsequent procedures, up to the first five SCOUT localizations, noted no significant difficulty with reflector detection.
Conclusions: The SAVI SCOUT surgical guidance system is a viable surgical localization procedure for non-palpable breast lesions. Surgeons were 100% successful at removing the reflectors during surgical excision. Difficulty with reflector detection was not noted after the surgeon's 1st SCOUT procedure. Overall, it appears the learning curve for reflector placement and localization for non-palpable breast lesions is relatively short. However, depth of the reflector in relation to skin likely affects reflector detection during this early learning period.
Citation Format: Shukla SC, Shivers SC, Mattingly A, Russell S, Mehindru A, Carter E, Cox CE. Learning curve for the SAVI SCOUT breast localization and surgical guidance system [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-11-06.
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Affiliation(s)
- SC Shukla
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
| | - SC Shivers
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
| | - A Mattingly
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
| | - S Russell
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
| | - A Mehindru
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
| | - E Carter
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
| | - CE Cox
- Morsani College of Medicine at the University of South Florida (USF), Tampa, FL
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Macluskey M, Shepherd S, Carter E, Bulsara Y, Durham JA, Bell A, Dargue A, Emanuel C, Freeman C, Jones J, Khawaja N, Leeson R, Marley J, Andiappan M, Millsopp L, Nayyer N, Renton T, Taylor K, Thomson P, Toedtling V. A national follow-up survey of UK graduates opinion of undergraduate oral surgery teaching. Eur J Dent Educ 2016; 20:174-179. [PMID: 26121937 DOI: 10.1111/eje.12158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION A national follow-up survey was undertaken to determine whether dental graduates from 2009 perceived that their undergraduate oral surgery education had equipped them for general dental practice 4 years after graduating. MATERIALS AND METHODS Graduates from the same 13 United Kingdom dental schools who had taken part in the original survey were invited to take part in this follow-up online survey. Their contact details were identified via the general dental council register, social media and alumni groups. RESULTS In total, 161 responded (2009b) which represents 16% of the graduates of the original survey in 2009a. A similar percentage of these respondents perceived that the teaching in oral surgery had given them sufficient knowledge to undertake independent practice (83% and 79% in 2009a and 2009b, respectively). Most respondents (99% in both years) reported confidence in undertaking simple forceps exodontia. Confidence in surgical exodontia was poor in both surveys, but one area that appeared improved in the follow-up related to the sectioning of teeth (84% in 2009b compared with 49% in 2009a). Areas of weakness identified in 2009 were reported to be improved in the follow-up. CONCLUSION This follow-up survey supports the findings of the original survey. Future longitudinal studies would allow institutions to identify possible weaknesses in their curriculum and to track the career development of their graduates and facilitate robust data collection.
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MESH Headings
- Clinical Competence
- Competency-Based Education
- Curriculum
- Education, Dental/organization & administration
- Education, Dental/statistics & numerical data
- Education, Dental, Graduate/standards
- Education, Medical, Undergraduate/standards
- Female
- Follow-Up Studies
- General Practice, Dental
- Humans
- Male
- Schools, Dental
- Students, Dental/psychology
- Students, Dental/statistics & numerical data
- Surgery, Oral/education
- Teaching
- United Kingdom
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Affiliation(s)
- M Macluskey
- Unit of Oral Surgery and Medicine, Univeristy of Dundee, Dundee, UK
| | - S Shepherd
- Unit of Oral Surgery and Medicine, Univeristy of Dundee, Dundee, UK
| | - E Carter
- Oral Surgery, Barts and The London School of Medicine and Dentistry, London, UK
| | - Y Bulsara
- Oral Surgery, The School of Dentistry, Birmingham, UK
| | - J A Durham
- Oral and Maxillofacial Sciences, Newcastle University, Newcastle, UK
| | - A Bell
- Glasgow University, Glasgow, UK
| | - A Dargue
- Oral Surgery, School of Oral and Dental Sciences, Bristol, UK
| | - C Emanuel
- Oral Surgery, Cardiff University School of Dentistry, Cardiff, UK
| | - C Freeman
- Oral Surgery, University of Sheffield School of Dentistry, Sheffield, UK
| | - J Jones
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry Barts and The London School of Medicine and Dentistry, London, UK
| | - N Khawaja
- Oral Surgery, Guys Kings and St Thomas' Dental Institute, London, UK
| | - R Leeson
- Oral Surgery, Eastman Dental Institute, London, UK
| | - J Marley
- Oral Surgery, Queens University of Belfast, Belfast, UK
| | - M Andiappan
- Dental Institute, King's College London, London, UK
| | - L Millsopp
- Oral Surgery, School of Dentistry, University of Liverpool, Liverpool, UK
| | - N Nayyer
- Unit of Oral Surgery and Medicine, Univeristy of Dundee, Dundee, UK
| | - T Renton
- Oral surgery, Kings College London Dental Institute, London, UK
| | - K Taylor
- Oral Surgery, School of Dentistry, University of Liverpool, Liverpool, UK
| | - P Thomson
- Oral and Maxillofacial Sciences, Newcastle University, Newcastle, UK
| | - V Toedtling
- Oral surgery, The School of Dentistry, The University of Manchester, Manchester, UK
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Phillips K, Carter E. Assessment of Chronic Watchman Left Atrial Appendage Occlusion by Cardiac Computed Tomography Angiography. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.501] [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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Carter E, Yilmaz Z, Devine M, Renton T. An update on the causes, assessment and management of third division sensory trigeminal neuropathies. Br Dent J 2016; 220:627-35. [DOI: 10.1038/sj.bdj.2016.444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2016] [Indexed: 11/09/2022]
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Rives C, Pourmorteza M, Carter E, Young M. P17: PNEUMOMEDIASTINUM A RARE COMPLICATION OF COLONOSCOPY POLYPECTOMY SUCCESSFULLY TREATED WITH CONSERVATIVE MANAGEMENT. J Investig Med 2016. [DOI: 10.1136/jim-2016-000080.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose of StudyColonoscopies are a relatively safe and are associated with few complications. We present a rare case of post-colonoscopy polypectomy resulting in a pneumomediastinum and subcutaneous emphysema.Methods UsedAn 84 year old male with a history of colonoscopy with polypectomy the day prior was admitted due to a syncopal episode. The only complaint was a small amount of dark red blood per rectum. On examination vital signs were stable, the patient appeared pale with dry membrane mucosa, abdominal and pulmonary exam were benign, labs were concerning for a Hgb 6.9 g/dl. Chest X-ray depicted free air beneath the right hemidiaphragm, computed tomography demonstrated pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema. Visceral angiogram failed to demonstrate any source of active bleeding. Due to the overall stable condition of the patient conservative management with prophylactic zosyn and transfusion of 2 units of packed red blood cells was initiated. Patient was discharged 5 days after admission with stable respiratory and hemodynamic signs.Summary of ResultsDiagnostic colonoscopies are relatively safe procedures with the most common complications being bleeding and perforations, with an incidence of less than .2%. Though perforations are rare they are associated with a high mortality and morbidity. Causes of perforation can be due to excessive insufflations, instrumental trauma and usually present with intra-abdominal free air but rarely with a pneumomediastinum. A pneumomediastinum is the presence of free air within the mediastinum and in our case was due to a micro-perforation from a colonic polypectomy. The colonic wall defect allowed free air into the retroperitoneum, which spread along the fascial planes and entered the mediastinum and subcutaneous tissues. The most sensitive test for pneumomediastinum is computed tomography and extra-pulmonary causes of pneumomediastinum can be successfully treated conservatively with rest and antibiotics.ConclusionsThough complications from polypectomies are rare, they can be associated with a high morbidity and mortality but rarely associated with pneumomediastinum and in certain stable patients can be treated with conservative management.
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Carter E. Fluid Curtailment during Childhood Diarrhea: Analysis of Six National Surveys. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.272] [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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Skelly MJ, Chappell AE, Carter E, Weiner JL. Adolescent social isolation increases anxiety-like behavior and ethanol intake and impairs fear extinction in adulthood: Possible role of disrupted noradrenergic signaling. Neuropharmacology 2015; 97:149-59. [PMID: 26044636 PMCID: PMC4537360 DOI: 10.1016/j.neuropharm.2015.05.025] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/16/2015] [Accepted: 05/14/2015] [Indexed: 11/21/2022]
Abstract
Alcohol use disorder, anxiety disorders, and post-traumatic stress disorder (PTSD) are highly comorbid, and exposure to chronic stress during adolescence may increase the incidence of these conditions in adulthood. Efforts to identify the common stress-related mechanisms driving these disorders have been hampered, in part, by a lack of reliable preclinical models that replicate their comorbid symptomatology. Prior work by us, and others, has shown that adolescent social isolation increases anxiety-like behaviors and voluntary ethanol consumption in adult male Long-Evans rats. Here we examined whether social isolation also produces deficiencies in extinction of conditioned fear, a hallmark symptom of PTSD. Additionally, as disrupted noradrenergic signaling may contribute to alcoholism, we examined the effect of anxiolytic medications that target noradrenergic signaling on ethanol intake following adolescent social isolation. Our results confirm and extend previous findings that adolescent social isolation increases anxiety-like behavior and enhances ethanol intake and preference in adulthood. Additionally, social isolation is associated with a significant deficit in the extinction of conditioned fear and a marked increase in the ability of noradrenergic therapeutics to decrease ethanol intake. These results suggest that adolescent social isolation not only leads to persistent increases in anxiety-like behaviors and ethanol consumption, but also disrupts fear extinction, and as such may be a useful preclinical model of stress-related psychopathology. Our data also suggest that disrupted noradrenergic signaling may contribute to escalated ethanol drinking following social isolation, thus further highlighting the potential utility of noradrenergic therapeutics in treating the deleterious behavioral sequelae associated with early life stress.
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Affiliation(s)
- M J Skelly
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - A E Chappell
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - E Carter
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - J L Weiner
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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Robb C, Linder D, Djire B, Carter E, Jacobsen P, Extermann M. Impact of time, personal control and self-rated health on older cancer patients undergoing a chemotherapy regimen. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.132] [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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Robb C, Djire B, Carter E. Impact of urban/rural residency and poverty level on survivorship in older adults diagnosed with lung cancer in Georgia, USA. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.146] [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: 12/01/2022]
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Doering L, Hickey K, Chen B, Idemundia F, Carter E, Pickham D, Castillo C, Mancini D, Deng M, Kobashigawa J, Drew B. Perceived Control: A Target for Improving Psychosocial Outcomes Early After Heart Transplant. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Chauhan M, Carter E, Rood P. Intravenous midazolam dose ranges in older patients sedated for oral surgery--a preliminary retrospective cohort study. Br Dent J 2014; 216:E12. [PMID: 24603272 DOI: 10.1038/sj.bdj.2014.197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2013] [Indexed: 11/09/2022]
Abstract
AIM The aim of this study was to investigate differences in the titrated midazolam doses in older patients undergoing oral surgery procedures under intravenous sedation. METHOD The records of 50 patients aged 40-92 years who had undergone oral surgery procedures under intravenous sedation at Kings College Hospital between May 2008 and February 2009 were selected at random in each of the age groups: 40, 50, 60, 70 or 80+.Results The mean dose for patients over the age of 70 (2.8 mg) was 50% less than the mean dose for those under the age of 70 (5.7 mg). CONCLUSIONS Our study found a correlation between the age of the patient and the dose of midazolam required for sedation before oral surgery procedures, with, on average, older patients requiring less midazolam. A range of doses are required in any age group, but the range decreases as age increases.
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Affiliation(s)
- M Chauhan
- Department of Oral Surgery, King's College Hospital NHS Foundation Trust, Bessemer Road, Denmark Hill, London, SE5 9RS
| | - E Carter
- Department of Oral Surgery, King's College Hospital NHS Foundation Trust, Bessemer Road, Denmark Hill, London, SE5 9RS
| | - P Rood
- Department of Oral Surgery, King's College Hospital NHS Foundation Trust, Bessemer Road, Denmark Hill, London, SE5 9RS
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Suri A, Carter E, Edwards J, Erickson B, Huh W, Alvarez Secord A, Havrilesky L, Kim K, Horowitz N, Gehrig P. Effects of obesity and adjuvant chemotherapy regimens on progression free survival in patients with ovarian granulosa cell tumors. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.026] [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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Sharma A, Muir R, Johnston R, Carter E, Bowden G, Wilson-MacDonald J. Diabetes is predictive of longer hospital stay and increased rate of complications in spinal surgery in the UK. Ann R Coll Surg Engl 2013; 95:275-9. [PMID: 23676813 PMCID: PMC4132503 DOI: 10.1308/003588413x13511609958299] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Diabetes is a common co-morbidity of patients undergoing spinal surgery in the UK but there are no published studies from the UK, particularly with respect to length of hospital stay and complications. The aims of this study were to identify complications and length of hospital stay in patients with diabetes undergoing spinal surgery. METHODS Data were collected retrospectively for 111 consecutive patients with diabetes (and 97 age and sex matched control patients, identified using computer records) who underwent spinal surgery between 2004 and 2010 in a single centre. The data collected included operative time, blood loss, details of surgery, Clavien complications and length of hospital stay. RESULTS No significant differences were found by group in operative time, blood loss, instrumentation, use of graft or revision surgery. Overall complication rates were higher in the patients with diabetes than in the controls (28.8% vs 15.5%). The mean hospital stay was significantly longer for patients with diabetes than for control patients (4.6 vs 3.2 days, p<0.001). CONCLUSIONS This study identified a significantly higher Clavien grade I complication rate and length of hospital stay in patients with diabetes undergoing spinal surgery than control patients (p=0.02). This has resulted in a predictive model being generated. Of note, no infections were seen in patients with diabetes, suggesting that infection rates in this particular group of patients undergoing spinal surgery might not be as high as considered previously.
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Affiliation(s)
- A Sharma
- Oxford University Hospitals NHS Trust, UK.
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Carter E, Williams D, Mahler M, Hodgins J. Animated character appearance affects viewing patterns and subjective ratings of personality characteristics. J Vis 2012. [DOI: 10.1167/12.9.403] [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] Open
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Veenith T, Sanfilippo F, Ercole A, Carter E, Goldman N, Bradley P, Gunning K, Burnstein R. Nosocomial H1N1 infection during 2010–2011 pandemic: a retrospective cohort study from a tertiary referral hospital. J Hosp Infect 2012; 81:202-5. [DOI: 10.1016/j.jhin.2012.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 04/09/2012] [Indexed: 11/26/2022]
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Hryniewicz K, Moazami N, Lillyblad M, Shao E, Feldman D, Maxfield C, Cabuay B, Carter E, Sun B. 37 Optimal Medical Management and Lowering LVAD Speed Prevents Progression of Aortic Insufficiency. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.040] [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: 10/28/2022] Open
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Carter E. Book Review: Asthma: A Clinician's Guide. Margaret Varnell Clark MS RN RRT-NPS. Sudbury, Massachusetts: Jones & Bartlett. 2011. Soft cover, 174 pages, $39.95. Respir Care 2011. [DOI: 10.4187/respcare.01233] [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: 11/05/2022]
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Carter E, Fallis IA, Kariuki BM, Morgan IR, Murphy DM, Tatchell T, Van Doorslaer S, Vinck E. Structure and pulsed EPR characterization of N,N′-bis(5-tert-butylsalicylidene)-1,2-cyclohexanediamino-vanadium(iv) oxide and its adducts with propylene oxide. Dalton Trans 2011; 40:7454-62. [DOI: 10.1039/c1dt10378d] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Flower F, Sedlbauer M, Carter E, von Keyserlingk M, Sanderson D, Weary D. Analgesics Improve the Gait of Lame Dairy Cattle. J Dairy Sci 2008; 91:3010-4. [DOI: 10.3168/jds.2007-0968] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Waxman M, Kimaiyo S, Ongaro N, Wools-Kaloustian K, Flanigan T, Carter E. Initial Outcomes of a Rapid HIV Testing Program in an Emergency Department in Western Kenya. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1209] [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: 11/10/2022]
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Carter E, French S. Are current processes for nuclear emergency management in Europe adequate? J Radiol Prot 2006; 26:405-14. [PMID: 17146125 DOI: 10.1088/0952-4746/26/4/005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We describe the results of process mapping of nuclear emergency management procedures in four European countries. We find clear differences and explore these in relation to their suitability for building a shared understanding across the emergency management team of the evolving situation and a balanced appreciation of the uncertainties. Our findings indicate that there are some issues that cause concern in that the procedures may run smoothly and efficiently but they may also risk underestimating uncertainty or ignore key issues that have only been identified by a minority of experts or models. We are concerned that they do not facilitate the building of shared mental models that the literature such as that on highly reliable organisations has shown is important.
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Affiliation(s)
- E Carter
- Manchester Business School, University of Manchester, Booth Street West, Manchester M15 6PB, UK
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Morlion B, Jansen J, Hermanns K, Sabatowski R, Snidow J, Pierce A, Mortensen E, Kleoudis C, Carter E. 633 SYMPTOM RELIEF CORRELATES WITH GLOBAL IMPROVEMENT OF OPIOID-INDUCED GASTROINTESTINAL SIDE EFFECTS (OGS): RESULTS FROM AN ALVIMOPAN STUDY IN NON-CANCER PAIN (SB-767905/011). Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60636-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jansen J, Webster L, Peppin J, Lasko B, Snidow J, Pierce A, Mortensen E, Kleoudis C, Carter E. 679 ALVIMOPAN DOSAGE REGIMENS FOR THE TREATMENT OF OPIOID-INDUCED GASTROINTESTINAL (GI) SIDE EFFECTS IN SUBJECTS WITH PERSISTENT NON-CANCER PAIN (SB-767905/011). Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60682-4] [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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Hermanns K, Irving G, Cousins M, Pierce A, Snidow J, Mortensen E, Kleoudis C, Carter E. 669 GASTROINTESTINAL (GI) SIDE EFFECTS ASSOCIATED WITH CHRONIC OPIOID ANALGESIC THERAPY IN A LARGE, PERSISTENT NON-CANCER PAIN POPULATION (SB-767905/011): BASELINE DATA. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Rayner B, Harris H, Carter E, Vogt S, Cai Z, Lai B, Chin C, Lee Y, Lay P, Witting P. Th-P17:425 The use of synchronton radiation to measure ion flux and cellular protein and lipid changes within cardiac ischemia reperfusion injury. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)82383-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The application of calibration and prediction (CAP) to joint measurements of near-infrared (NIR) and Raman spectra for the same reference data requires the development of joint inversion methodologies for the implementation of the calibration step. Joint inversion has been successfully utilized in geophysical prospecting and in medical diagnosis, where the need to perform CAP is not involved. However, the obvious ways in which joint inversion might be implemented in spectroscopy, where some form of CAP must be performed, do not appear to work. Here, a new methodology, leap-frog calibration and prediction (LF-CAP), is proposed. It allows naturally for the information in the joint NIR and Raman spectra to yield a quite robust predictor of the property of interest. This new procedure is examined in some detail. The major limitation of CAP, as a strategy for recovering information from indirect measurements, is that it is a one-step process, in that the calibration step can only be applied once. If multiple independent spectral data are available for the same reference data, then the leap-frog implementation of CAP turns the recovery of information into an iterative process that converges under a wide range of circumstances.
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Affiliation(s)
- R S Anderssen
- CSIRO Mathematical and Information Sciences, G.P.O. Box 664, Canberra, ACT 2601, Australia.
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Fischman A, Letrent S, Bonab A, Livni E, Carter E, Rubin R, Mauro D, Tarby C, Galbraith S, Griffin T. PET as a biomarker of the antitumor effects of the CDK2 inhibitor BMS-387032. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Fischman
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - S. Letrent
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - A. Bonab
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - E. Livni
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - E. Carter
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - R. Rubin
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - D. Mauro
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - C. Tarby
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - S. Galbraith
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
| | - T. Griffin
- Massachusetts General Hospital, Boston, MA; Bristol-Myers Squibb, Princeton, NJ
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Carter E. Noseclips in children performing spirometry. Eur Respir J 2003; 22:1046; author reply 1046. [PMID: 14680098 DOI: 10.1183/09031936.03.00079803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
A 25-day-old neonate developed an unusual eruption with bullae and marked systemic symptoms. Investigation for bacterial, viral, autoimmune and immunobullous causes did not reveal any identifiable trigger and histological examination was highly suggestive of bullous erythema multiforme. Pulmonary infiltrates were noted late in the course of the disease. Differential diagnoses included bullous impetigo, primary herpes simplex infection, immunobullous disease, neonatal lupus and erythema multiforme. This case illustrates the difficulties in diagnosing and managing an unwell child with bullae and emphasizes the need to exclude treatable underlying causes.
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Affiliation(s)
- G A Johnston
- Department of Dermatology, Leicester Royal Infirmary, Leicester, UK.
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Affiliation(s)
- J P McNeil
- Department of Pathology, University of South Alabama, Mobile, AL 36617, USA
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46
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Abstract
Nurses in a variety of clinical settings are often involved in educating and managing patients with irritable bowel syndrome, though their knowledge and perceptions of irritable bowel syndrome are not well known. A national survey was undertaken as a part of a larger study of patients and healthcare providers to determine nurses' knowledge of irritable bowel syndrome, including diagnosis, etiology, disease impact, management, beliefs, and attitudes regarding irritable bowel syndrome. In addition, the nurses' perceptions of the effect of irritable bowel syndrome on the patient's lifestyle and the severity of symptoms were compared to those of irritable bowel syndrome patients. One hundred practicing registered nurses were randomly selected and then interviewed by telephone using a questionnaire. A random-digit dialing method was used to identify and recruit 1,014 women with irritable bowel syndrome. The majority of registered nurses interviewed (75%) felt that nurses played a moderate-to-major role in counseling patients with irritable bowel syndrome. Only 13%, however, were aware of the diagnostic criteria for irritable bowel syndrome. The majority of nurse subjects felt the current therapies for irritable bowel syndrome had limited effectiveness varying from 6-21% depending on the symptom being treated. Almost half of the nurses felt they had an important role in management of irritable bowel syndrome and that both they and their patients needed more education about irritable bowel syndrome. There was close agreement between the nurses and the patients with regard to the impact of irritable bowel syndrome. With increased public attention on irritable bowel syndrome as a common problem affecting women, there is a need for nurses working in a variety of settings to have increased knowledge regarding the syndrome. In this article, recommendations are made regarding how to increase nurses' knowledge about this common health problem.
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Affiliation(s)
- M Heitkemper
- Department of Biobehavioral Nursing and Health Systems, Box 357266, University of Washington, Seattle, WA 98195-7266, USA.
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Lembo T, Wright RA, Bagby B, Decker C, Gordon S, Jhingran P, Carter E. Alosetron controls bowel urgency and provides global symptom improvement in women with diarrhea-predominant irritable bowel syndrome. Am J Gastroenterol 2001; 96:2662-70. [PMID: 11569692 DOI: 10.1111/j.1572-0241.2001.04128.x] [Citation(s) in RCA: 148] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Bowel urgency is one of the most bothersome symptoms for nonconstipated IBS patients. The efficacy of alosetron in control of bowel urgency and Global Improvement of IBS symptoms were evaluated in a multicenter double-blind, randomized, placebo-controlled study. METHODS Female IBS patients with lack of satisfactory control of bowel urgency were randomized 2:1 to alosetron 1 mg twice daily or placebo treatment groups. The primary endpoint was the proportion of days with satisfactory control of bowel urgency during the 12-wk treatment period and 2-wk follow-up period. Secondary endpoints included IBS Global Improvement (responder defined as patient-reported moderate or substantial improvement in IBS symptoms) and improvements in bowel function (stool frequency, consistency, and sensation of incomplete evacuation). RESULTS A total of 801 women were randomized to the alosetron (n = 532) or placebo groups (n = 269). Physicians classified 98% of patients with diarrhea-predominant IBS. Patients treated with alosetron had a significantly greater proportion of days with satisfactory control of urgency compared to placebo for the treatment period (73% vs 57%, p < 0.001). A significantly greater number of patients treated with alosetron were IBS Global Improvement responders compared to placebo at week 12 (76% vs 44%, p < 0.001). IBS Global Improvement responders had more days with satisfactory control of urgency at week 12 (88% vs 48%) as well as firmer stools, fewer stools/day, and fewer days with incomplete evacuation compared with nonresponders. Alosetron-treated patients showed improvements in bowel functions compared to placebo-treated patients. Constipation was the most commonly reported adverse event.
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Affiliation(s)
- T Lembo
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Affiliation(s)
- A Nicoll
- International Task Force on Children Affected by War and Absolute Poverty of the Royal College of Paediatrics and Child Health (RCPCH), UK.
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Carter E. Perspectives of those impacted: flight attendant's perspective. Health Phys 2000; 79:600-601. [PMID: 11045537 DOI: 10.1097/00004032-200011000-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
New regulations regarding radiation exposure to flight attendants are compared to regulations regarding airlines' "no smoking" policies. The new regulations will not be accepted as wholeheartedly by the industry because the ill effects of radiation are not as tangible as those of cigarettes, and there is a risk of a loss of wages due to restrictions during pregnancy. Nevertheless, the carrier's unions would like to act responsibly to ensure the safety of all flight attendants.
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Affiliation(s)
- E Carter
- Association of Professional Flight Attendants, National Health Coordinator, Euless, TX 76404, USA
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Abstract
Some forms of mastocytosis are caused by c-kit mutations which cause constitutive activation of kit kinase. Compounds that inhibit kit kinase, such as indolinones, are therefore attractive as potential therapeutic agents. A hierarchy exists in the ability of compounds to inhibit kit kinase effectively. Some compounds can inhibit ligand-induced activation of wild-type receptor but are ineffective against constitutively activated mutants. Other compounds can inhibit ligand-induced activation of wild-type kit and ligand-independent activation by juxtamembrane domain mutations but not activation by activation loop mutations. Still others effectively inhibit wild-type kit and constitutively activated kit bearing either juxtamembrane or kinase domain mutations and kill the neoplastic mast cells expressing these mutants. No therapy currently exists that specifically targets a cause of mastocytosis, but there are good reasons to believe that kit kinase inhibitors may fulfill that role someday.
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Affiliation(s)
- B J Longley
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
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