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Rauch DA, Ramos PV, Khanfar M, Harding J, Joseph A, Griffith O, Griffith M, Ratner L. Single-Cell Transcriptomic Analysis of Kaposi Sarcoma. bioRxiv 2024:2024.05.01.592010. [PMID: 38746135 PMCID: PMC11092626 DOI: 10.1101/2024.05.01.592010] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Kaposi Sarcoma (KS) is a complex tumor caused by KS-associated herpesvirus 8 (KSHV). Histological analysis reveals a mixture of "spindle cells", vascular-like spaces, extravasated erythrocytes, and immune cells. In order to elucidate the infected and uninfected cell types in KS tumors, we examined skin and blood samples from twelve subjects by single cell RNA sequence analyses. Two populations of KSHV-infected cells were identified, one of which represented a proliferative fraction of lymphatic endothelial cells, and the second represented an angiogenic population of vascular endothelial tip cells. Both infected clusters contained cells expressing lytic and latent KSHV genes. Novel cellular biomarkers were identified in the KSHV infected cells, including the sodium channel SCN9A. The number of KSHV positive tumor cells was found to be in the 6% range in HIV-associated KS, correlated inversely with tumor-infiltrating immune cells, and was reduced in biopsies from HIV-negative individuals. T-cell receptor clones were expanded in KS tumors and blood, although in differing magnitudes. Changes in cellular composition in KS tumors were identified in subjects treated with antiretroviral therapy alone, or immunotherapy. These studies demonstrate the feasibility of single cell analyses to identify prognostic and predictive biomarkers. Author Summary Kaposi sarcoma (KS) is a malignancy caused by the KS-associated herpesvirus (KSHV) that causes skin lesions, and may also be found in lymph nodes, lungs, gastrointestinal tract, and other organs in immunosuppressed individuals more commonly than immunocompetent subjects. The current study examined gene expression in single cells from the tumor and blood of these subjects, and identified the characteristics of the complex mixtures of cells in the tumor. This method also identified differences in KSHV gene expression in different cell types and associated cellular genes expressed in KSHV infected cells. In addition, changes in the cellular composition could be elucidated with therapeutic interventions.
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Chirehwa MT, Resendiz-Galvan JE, Court R, De Kock M, Wiesner L, de Vries N, Harding J, Gumbo T, Warren R, Maartens G, Denti P, McIlleron H. Optimizing Moxifloxacin Dose in MDR-TB Participants with or without Efavirenz Coadministration Using Population Pharmacokinetic Modeling. Antimicrob Agents Chemother 2023; 67:e0142622. [PMID: 36744891 PMCID: PMC10019313 DOI: 10.1128/aac.01426-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Moxifloxacin is included in some treatment regimens for drug-sensitive tuberculosis (TB) and multidrug-resistant TB (MDR-TB). Aiming to optimize dosing, we described moxifloxacin pharmacokinetic and MIC distribution in participants with MDR-TB. Participants enrolled at two TB hospitals in South Africa underwent intensive pharmacokinetic sampling approximately 1 to 6 weeks after treatment initiation. Plasma drug concentrations and clinical data were analyzed using nonlinear mixed-effects modeling with simulations to evaluate doses for different scenarios. We enrolled 131 participants (54 females), with median age of 35.7 (interquartile range, 28.5 to 43.5) years, median weight of 47 (42.0 to 54.0) kg, and median fat-free mass of 40.1 (32.3 to 44.7) kg; 79 were HIV positive, 29 of whom were on efavirenz-based antiretroviral therapy. Moxifloxacin pharmacokinetics were described with a 2-compartment model, transit absorption, and elimination via a liver compartment. We included allometry based on fat-free mass to estimate disposition parameters. We estimated an oral clearance for a typical patient to be 17.6 L/h. Participants treated with efavirenz had increased clearance, resulting in a 44% reduction in moxifloxacin exposure. Simulations predicted that, even at a median MIC of 0.25 (0.06 to 16) mg/L, the standard daily dose of 400 mg has a low probability of attaining the ratio of the area under the unbound concentration-time curve from 0 to 24 h to the MIC (fAUC0-24)/MIC target of >53, particularly in heavier participants. The high-dose WHO regimen (600 to 800 mg) yielded higher, more balanced exposures across the weight ranges, with better target attainment. When coadministered with efavirenz, moxifloxacin doses of up to 1,000 mg are needed to match these exposures. The safety of higher moxifloxacin doses in clinical settings should be confirmed.
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Affiliation(s)
- M. T. Chirehwa
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - J. E. Resendiz-Galvan
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - R. Court
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - M. De Kock
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - L. Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - N. de Vries
- Brooklyn Chest Hospital, Cape Town, South Africa
| | - J. Harding
- DP Marais Hospital, Cape Town, South Africa
| | - T. Gumbo
- Quantitative Preclinical and Clinical Sciences Department, Praedicare Inc., Dallas, Texas, USA
| | - R. Warren
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, SAMRC Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - G. Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - P. Denti
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - H. McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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Zhao K, Ziv E, Alexander E, Sotirchos V, Moussa A, Marinelli B, Erinjeri J, Sofocleous C, Harding J, Sigel C, Yarmohammadi H. Abstract No. 556 Genetic Alterations in Intrahepatic Cholangiocarcinoma and Response to Yttrium-90 Transarterial Radioembolization: A Case Series Exploring High Risk Genomics. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Toh C, Keslake A, Payne T, Onwuegbuzie A, Harding J, Baster K, Hoggard N, Shaw PJ, Wilkinson ID, Jenkins TM. Analysis of brain and spinal MRI measures in a common domain to investigate directional neurodegeneration in motor neuron disease. J Neurol 2023; 270:1682-1690. [PMID: 36509983 PMCID: PMC9971079 DOI: 10.1007/s00415-022-11520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) of the brain and cervical spinal cord is often performed in diagnostic evaluation of suspected motor neuron disease/amyotrophic lateral sclerosis (MND/ALS). Analysis of MRI-derived tissue damage metrics in a common domain facilitates group-level inferences on pathophysiology. This approach was applied to address competing hypotheses of directionality of neurodegeneration, whether anterograde, cranio-caudal dying-forward from precentral gyrus or retrograde, dying-back. METHODS In this cross-sectional study, MRI was performed on 75 MND patients and 13 healthy controls. Precentral gyral thickness was estimated from volumetric T1-weighted images using FreeSurfer, corticospinal tract fractional anisotropy (FA) from diffusion tensor imaging using FSL, and cross-sectional cervical cord area between C1-C8 levels using Spinal Cord Toolbox. To analyse these multimodal data within a common domain, individual parameter estimates representing tissue damage at each corticospinal tract level were first converted to z-scores, referenced to healthy control norms. Mixed-effects linear regression models were then fitted to these z-scores, with gradients hypothesised to represent directionality of neurodegeneration. RESULTS At group-level, z-scores did not differ significantly between precentral gyral and intracranial corticospinal tract tissue damage estimates (regression coefficient - 0.24, [95% CI - 0.62, 0.14], p = 0.222), but step-changes were evident between intracranial corticospinal tract and C1 (1.14, [95% CI 0.74, 1.53], p < 0.001), and between C5 and C6 cord levels (0.98, [95% CI 0.58, 1.38], p < 0.001). DISCUSSION Analysis of brain and cervical spinal MRI data in a common domain enabled investigation of pathophysiological hypotheses in vivo. A cranio-caudal step-change in MND patients was observed, and requires further investigation in larger cohorts.
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Affiliation(s)
- C Toh
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - A Keslake
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - T Payne
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - A Onwuegbuzie
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - J Harding
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - K Baster
- School of Mathematics and Statistics, University of Sheffield, Sheffield, UK
| | - N Hoggard
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - P J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - I D Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - T M Jenkins
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK.
- Royal Perth Hospital, Victoria Square, Perth, WA, 6000, Australia.
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Jenkins P, Harborne K, Liu W, Zhong J, Harding J. Splenic embolisation practices within the UK: a national survey. Clin Radiol 2022. [DOI: 10.1016/j.crad.2022.09.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wymant C, Bezemer D, Blanquart F, Ferretti L, Gall A, Hall M, Golubchik T, Bakker M, Ong SH, Zhao L, Bonsall D, de Cesare M, MacIntyre-Cockett G, Abeler-Dörner L, Albert J, Bannert N, Fellay J, Grabowski MK, Gunsenheimer-Bartmeyer B, Günthard HF, Kivelä P, Kouyos RD, Laeyendecker O, Meyer L, Porter K, Ristola M, van Sighem A, Berkhout B, Kellam P, Cornelissen M, Reiss P, Fraser C, Aubert V, Battegay M, Bernasconi E, Böni J, Braun DL, Bucher HC, Burton-Jeangros C, Calmy A, Cavassini M, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux CA, Gorgievski M, Günthard H, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kouyos R, Kovari H, Ledergerber B, Martinetti G, de Tejada BM, Marzolini C, Metzner K, Müller N, Nadal D, Nicca D, Pantaleo G, Rauch A, Regenass S, Rudin C, Schöni-Affolter F, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Weber R, Yerly S, van der Valk M, Geerlings SE, Goorhuis A, Hovius JW, Lempkes B, Nellen FJB, van der Poll T, Prins JM, Reiss P, van Vugt M, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, Hazenberg A, van Hes AMH, Rajamanoharan S, Robinson T, Taylor B, Brewer C, Mayr C, Schmidt W, Speidel A, Strohbach F, Arastéh K, Cordes C, Pijnappel FJJ, Stündel M, Claus J, Baumgarten A, Carganico A, Ingiliz P, Dupke S, Freiwald M, Rausch M, Moll A, Schleehauf D, Smalhout SY, Hintsche B, Klausen G, Jessen H, Jessen A, Köppe S, Kreckel P, Schranz D, Fischer K, Schulbin H, Speer M, Weijsenfeld AM, Glaunsinger T, Wicke T, Bieniek B, Hillenbrand H, Schlote F, Lauenroth-Mai E, Schuler C, Schürmann D, Wesselmann H, Brockmeyer N, Jurriaans S, Gehring P, Schmalöer D, Hower M, Spornraft-Ragaller P, Häussinger D, Reuter S, Esser S, Markus R, Kreft B, Berzow D, Back NKT, Christl A, Meyer A, Plettenberg A, Stoehr A, Graefe K, Lorenzen T, Adam A, Schewe K, Weitner L, Fenske S, Zaaijer HL, Hansen S, Stellbrink HJ, Wiemer D, Hertling S, Schmidt R, Arbter P, Claus B, Galle P, Jäger H, Jä Gel-Guedes E, Berkhout B, Postel N, Fröschl M, Spinner C, Bogner J, Salzberger B, Schölmerich J, Audebert F, Marquardt T, Schaffert A, Schnaitmann E, Cornelissen MTE, Trein A, Frietsch B, Müller M, Ulmer A, Detering-Hübner B, Kern P, Schubert F, Dehn G, Schreiber M, Güler C, Schinkel CJ, Gunsenheimer-Bartmeyer B, Schmidt D, Meixenberger K, Bannert N, Wolthers KC, Peters EJG, van Agtmael MA, Autar RS, Bomers M, Sigaloff KCE, Heitmuller M, Laan LM, Ang CW, van Houdt R, Jonges M, Kuijpers TW, Pajkrt D, Scherpbier HJ, de Boer C, van der Plas A, van den Berge M, Stegeman A, Baas S, Hage de Looff L, Buiting A, Reuwer A, Veenemans J, Wintermans B, Pronk MJH, Ammerlaan HSM, van den Bersselaar DNJ, de Munnik ES, Deiman B, Jansz AR, Scharnhorst V, Tjhie J, Wegdam MCA, van Eeden A, Nellen J, Brokking W, Elsenburg LJM, Nobel H, van Kasteren MEE, Berrevoets MAH, Brouwer AE, Adams A, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Phaf S, van de Ven B, van der Ven B, Buiting AGM, Murck JL, de Vries-Sluijs TEMS, Bax HI, van Gorp ECM, de Jong-Peltenburg NC, de Mendonç A Melo M, van Nood E, Nouwen JL, Rijnders BJA, Rokx C, Schurink CAM, Slobbe L, Verbon A, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, de Groot J, Boucher CAB, Koopmans MPG, van Kampen JJA, Fraaij PLA, van Rossum AMC, Vermont CL, van der Knaap LC, Visser E, Branger J, Douma RA, Cents-Bosma AS, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van Ijperen JM, Geilings J, van der Hut G, van Burgel ND, Leyten EMS, Gelinck LBS, Mollema F, Davids-Veldhuis S, Tearno C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, Kruiper MSM, van der Bliek GL, Bor PCJ, Debast SB, Wagenvoort GHJ, Kroon FP, de Boer MGJ, Jolink H, Lambregts MMC, Roukens AHE, Scheper H, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, El Moussaoui R, Pogany K, Brouwer CJ, Smit JV, Struik-Kalkman D, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, van Wolfswinkel ME, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, van Vonderen MGA, Kampschreur LM, Faber S, Steeman-Bouma R, Al Moujahid A, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Scheiberlich L, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, Jansen ER, Hoogewerf M, Rozemeijer W, van der Reijden WA, Sinnige JC, Brinkman K, van den Berk GEL, Blok WL, Lettinga KD, de Regt M, Schouten WEM, Stalenhoef JE, Veenstra J, Vrouenraets SME, Blaauw H, Geerders GF, Kleene MJ, Kok M, Knapen M, van der Meché IB, Mulder-Seeleman E, Toonen AJM, Wijnands S, Wttewaal E, Kwa D, van Crevel R, van Aerde K, Dofferhoff ASM, Henriet SSV, Ter Hofstede HJM, Hoogerwerf J, Keuter M, Richel O, Albers M, Grintjes-Huisman KJT, de Haan M, Marneef M, Strik-Albers R, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, Ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, Lauw FN, van Broekhuizen MC, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Middel A, Postma DF, Schölvinck EH, Stienstra Y, Verhage AR, Wouthuyzen-Bakker M, Boonstra A, de Groot-de Jonge H, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Arends JE, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, van Welzen BJ, Aarsman K, Griffioen-van Santen BMG, de Kroon I, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Bont LJ, Geelen SPM, Loeffen YGT, Wolfs TFW, Nauta N, Rooijakkers EOW, Holtsema H, Voigt R, van de Wetering D, Alberto A, van der Meer I, Rosingh A, Halaby T, Zaheri S, Boyd AC, Bezemer DO, van Sighem AI, Smit C, Hillebregt M, de Jong A, Woudstra T, Bergsma D, Meijering R, van de Sande L, Rutkens T, van der Vliet S, de Groot L, van den Akker M, Bakker Y, El Berkaoui A, Bezemer M, Brétin N, Djoechro E, Groters M, Kruijne E, Lelivelt KJ, Lodewijk C, Lucas E, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Schnörr P, Scheigrond A, Tuijn E, Veenenberg L, Visser KM, Witte EC, Ruijs Y, Van Frankenhuijsen M, Allegre T, Makhloufi D, Livrozet JM, Chiarello P, Godinot M, Brunel-Dalmas F, Gibert S, Trepo C, Peyramond D, Miailhes P, Koffi J, Thoirain V, Brochier C, Baudry T, Pailhes S, Lafeuillade A, Philip G, Hittinger G, Assi A, Lambry V, Rosenthal E, Naqvi A, Dunais B, Cua E, Pradier C, Durant J, Joulie A, Quinsat D, Tempesta S, Ravaux I, Martin IP, Faucher O, Cloarec N, Champagne H, Pichancourt G, Morlat P, Pistone T, Bonnet F, Mercie P, Faure I, Hessamfar M, Malvy D, Lacoste D, Pertusa MC, Vandenhende MA, Bernard N, Paccalin F, Martell C, Roger-Schmelz J, Receveur MC, Duffau P, Dondia D, Ribeiro E, Caltado S, Neau D, Dupont M, Dutronc H, Dauchy F, Cazanave C, Vareil MO, Wirth G, Le Puil S, Pellegrin JL, Raymond I, Viallard JF, Chaigne de Lalande S, Garipuy D, Delobel P, Obadia M, Cuzin L, Alvarez M, Biezunski N, Porte L, Massip P, Debard A, Balsarin F, Lagarrigue M, Prevoteau du Clary F, Aquilina C, Reynes J, Baillat V, Merle C, Lemoing V, Atoui N, Makinson A, Jacquet JM, Psomas C, Tramoni C, Aumaitre H, Saada M, Medus M, Malet M, Eden A, Neuville S, Ferreyra M, Sotto A, Barbuat C, Rouanet I, Leureillard D, Mauboussin JM, Lechiche C, Donsesco R, Cabie A, Abel S, Pierre-Francois S, Batala AS, Cerland C, Rangom C, Theresine N, Hoen B, Lamaury I, Fabre I, Schepers K, Curlier E, Ouissa R, Gaud C, Ricaud C, Rodet R, Wartel G, Sautron C, Beck-Wirth G, Michel C, Beck C, Halna JM, Kowalczyk J, Benomar M, Drobacheff-Thiebaut C, Chirouze C, Faucher JF, Parcelier F, Foltzer A, Haffner-Mauvais C, Hustache Mathieu M, Proust A, Piroth L, Chavanet P, Duong M, Buisson M, Waldner A, Mahy S, Gohier S, Croisier D, May T, Delestan M, Andre M, Zadeh MM, Martinot M, Rosolen B, Pachart A, Martha B, Jeunet N, Rey D, Cheneau C, Partisani M, Priester M, Bernard-Henry C, Batard ML, Fischer P, Berger JL, Kmiec I, Robineau O, Huleux T, Ajana F, Alcaraz I, Allienne C, Baclet V, Meybeck A, Valette M, Viget N, Aissi E, Biekre R, Cornavin P, Merrien D, Seghezzi JC, Machado M, Diab G, Raffi F, Bonnet B, Allavena C, Grossi O, Reliquet V, Billaud E, Brunet C, Bouchez S, Morineau-Le Houssine P, Sauser F, Boutoille D, Besnier M, Hue H, Hall N, Brosseau D, Souala F, Michelet C, Tattevin P, Arvieux C, Revest M, Leroy H, Chapplain JM, Dupont M, Fily F, Patra-Delo S, Lefeuvre C, Bernard L, Bastides F, Nau P, Verdon R, de la Blanchardiere A, Martin A, Feret P, Geffray L, Daniel C, Rohan J, Fialaire P, Chennebault JM, Rabier V, Abgueguen P, Rehaiem S, Luycx O, Niault M, Moreau P, Poinsignon Y, Goussef M, Mouton-Rioux V, Houlbert D, Alvarez-Huve S, Barbe F, Haret S, Perre P, Leantez-Nainville S, Esnault JL, Guimard T, Suaud I, Girard JJ, Simonet V, Debab Y, Schmit JL, Jacomet C, Weinberck P, Genet C, Pinet P, Ducroix S, Durox H, Denes É, Abraham B, Gourdon F, Antoniotti O, Molina JM, Ferret S, Lascoux-Combe C, Lafaurie M, Colin de Verdiere N, Ponscarme D, De Castro N, Aslan A, Rozenbaum W, Pintado C, Clavel F, Taulera O, Gatey C, Munier AL, Gazaigne S, Penot P, Conort G, Lerolle N, Leplatois A, Balausine S, Delgado J, Timsit J, Tabet M, Gerard L, Girard PM, Picard O, Tredup J, Bollens D, Valin N, Campa P, Bottero J, Lefebvre B, Tourneur M, Fonquernie L, Wemmert C, Lagneau JL, Yazdanpanah Y, Phung B, Pinto A, Vallois D, Cabras O, Louni F, Pialoux G, Lyavanc T, Berrebi V, Chas J, Lenagat S, Rami A, Diemer M, Parrinello M, Depond A, Salmon D, Guillevin L, Tahi T, Belarbi L, Loulergue P, Zak Dit Zbar O, Launay O, Silbermann B, Leport C, Alagna L, Pietri MP, Simon A, Bonmarchand M, Amirat N, Pichon F, Kirstetter M, Katlama C, Valantin MA, Tubiana R, Caby F, Schneider L, Ktorza N, Calin R, Merlet A, Ben Abdallah S, Weiss L, Buisson M, Batisse D, Karmochine M, Pavie J, Minozzi C, Jayle D, Castel P, Derouineau J, Kousignan P, Eliazevitch M, Pierre I, Collias L, Viard JP, Gilquin J, Sobel A, Slama L, Ghosn J, Hadacek B, Thu-Huyn N, Nait-Ighil L, Cros A, Maignan A, Duvivier C, Consigny PH, Lanternier F, Shoai-Tehrani M, Touam F, Jerbi S, Bodard L, Jung C, Goujard C, Quertainmont Y, Duracinsky M, Segeral O, Blanc A, Peretti D, Cheret A, Chantalat C, Dulucq MJ, Levy Y, Lelievre JD, Lascaux AS, Dumont C, Boue F, Chambrin V, Abgrall S, Kansau I, Raho-Moussa M, De Truchis P, Dinh A, Davido B, Marigot D, Berthe H, Devidas A, Chevojon P, Chabrol A, Agher N, Lemercier Y, Chaix F, Turpault I, Bouchaud O, Honore P, Rouveix E, Reimann E, Belan AG, Godin Collet C, Souak S, Mortier E, Bloch M, Simonpoli AM, Manceron V, Cahitte I, Hiraux E, Lafon E, Cordonnier F, Zeng AF, Zucman D, Majerholc C, Bornarel D, Uludag A, Gellen-Dautremer J, Lefort A, Bazin C, Daneluzzi V, Gerbe J, Jeantils V, Coupard M, Patey O, Bantsimba J, Delllion S, Paz PC, Cazenave B, Richier L, Garrait V, Delacroix I, Elharrar B, Vittecoq D, Bolliot C, Lepretre A, Genet P, Masse V, Perrone V, Boussard JL, Chardon P, Froguel E, Simon P, Tassi S, Avettand Fenoel V, Barin F, Bourgeois C, Cardon F, Chaix ML, Delfraissy JF, Essat A, Fischer H, Lecuroux C, Meyer L, Petrov-Sanchez V, Rouzioux C, Saez-Cirion A, Seng R, Kuldanek K, Mullaney S, Young C, Zucchetti A, Bevan MA, McKernan S, Wandolo E, Richardson C, Youssef E, Green P, Faulkner S, Faville R, Herman S, Care C, Blackman H, Bellenger K, Fairbrother K, Phillips A, Babiker A, Delpech V, Fidler S, Clarke M, Fox J, Gilson R, Goldberg D, Hawkins D, Johnson A, Johnson M, McLean K, Nastouli E, Post F, Kennedy N, Pritchard J, Andrady U, Rajda N, Donnelly C, McKernan S, Drake S, Gilleran G, White D, Ross J, Harding J, Faville R, Sweeney J, Flegg P, Toomer S, Wilding H, Woodward R, Dean G, Richardson C, Perry N, Gompels M, Jennings L, Bansaal D, Browing M, Connolly L, Stanley B, Estreich S, Magdy A, O'Mahony C, Fraser P, Jebakumar SPR, David L, Mette R, Summerfield H, Evans M, White C, Robertson R, Lean C, Morris S, Winter A, Faulkner S, Goorney B, Howard L, Fairley I, Stemp C, Short L, Gomez M, Young F, Roberts M, Green S, Sivakumar K, Minton J, Siminoni A, Calderwood J, Greenhough D, DeSouza C, Muthern L, Orkin C, Murphy S, Truvedi M, McLean K, Hawkins D, Higgs C, Moyes A, Antonucci S, McCormack S, Lynn W, Bevan M, Fox J, Teague A, Anderson J, Mguni S, Post F, Campbell L, Mazhude C, Russell H, Gilson R, Carrick G, Ainsworth J, Waters A, Byrne P, Johnson M, Fidler S, Kuldanek K, Mullaney S, Lawlor V, Melville R, Sukthankar A, Thorpe S, Murphy C, Wilkins E, Ahmad S, Green P, Tayal S, Ong E, Meaden J, Riddell L, Loay D, Peacock K, Blackman H, Harindra V, Saeed AM, Allen S, Natarajan U, Williams O, Lacey H, Care C, Bowman C, Herman S, Devendra SV, Wither J, Bridgwood A, Singh G, Bushby S, Kellock D, Young S, Rooney G, Snart B, Currie J, Fitzgerald M, Arumainayyagam J, Chandramani S. A highly virulent variant of HIV-1 circulating in the Netherlands. Science 2022; 375:540-545. [PMID: 35113714 DOI: 10.1126/science.abk1688] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Affiliation(s)
- Chris Wymant
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - François Blanquart
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research University, Paris, France.,IAME, UMR 1137, INSERM, Université de Paris, Paris, France
| | - Luca Ferretti
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Astrid Gall
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Matthew Hall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tanya Golubchik
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Margreet Bakker
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Swee Hoe Ong
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Lele Zhao
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - David Bonsall
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mariateresa de Cesare
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - George MacIntyre-Cockett
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucie Abeler-Dörner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Norbert Bannert
- Division for HIV and Other Retroviruses, Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Jacques Fellay
- School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - M Kate Grabowski
- Department of Pathology, John Hopkins University, Baltimore, MD, USA
| | | | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Pia Kivelä
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurence Meyer
- INSERM CESP U1018, Université Paris Saclay, APHP, Service de Santé Publique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
| | - Matti Ristola
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | | | - Ben Berkhout
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Kellam
- Kymab Ltd., Cambridge, UK.,Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Marion Cornelissen
- Laboratory of Experimental Virology, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands.,Molecular Diagnostic Unit, Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, Netherlands.,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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7
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Sangro B, Harding J, Johnson M, Palmer D, Edeline J, Abou-Alfa G, Cheng A, Decaens T, El-Khoueiry A, Finn R, Galle P, Park J, Yau T, Begic D, Shen Y, Neely J, Sama A, Kudo M. Abstract No. 117 A phase 3, double-blind, randomized study of nivolumab and Ipilimumab), nivolumab monotherapy, or placebo plus transarterial chemoembolization in patients with intermediate-stage hepatocellular carcinoma. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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8
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Harding J, Hartsfield JK, Mian AS, Allan BP, Naoum S, Lee RJH, Goonewardene MS. Accuracy of mandibular proximal segment position using virtual surgical planning and custom osteosynthesis plates. Int J Oral Maxillofac Surg 2021; 51:219-225. [PMID: 33941394 DOI: 10.1016/j.ijom.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/23/2021] [Accepted: 04/07/2021] [Indexed: 02/02/2023]
Abstract
The purpose of this study was to determine whether the use of custom osteosynthesis plates increased the accuracy of proximal segment position following bilateral sagittal split osteotomy in a cohort of 30 patients when compared to a control group of 25 patients who had surgery with conventional plates. Surgery was performed by a single surgeon between October 2015 and December 2017. Post-surgical cone beam computed tomography scans were segmented using Mimics Innovation Suite (Materialise NV), and surface-based superimposition was achieved using ProPlan CMF (Materialise NV). However, there was a tendency for the rotational error to be smaller in the custom group than in the control group. The root mean square error in both groups and for all variables fell within clinical parameters of 2 mm and 4°. In conclusion, the results of this study indicate that customized mandibular fixation plates do not necessarily improve the accuracy of the proximal segments post-surgically; however they may be of benefit in individual patients.
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Affiliation(s)
- J Harding
- Orthodontic Department, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - J K Hartsfield
- Orthodontics and Oral Health Research, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA; Division of Oral Development and Behavioural Sciences, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - A S Mian
- School of Computer Science and Software Engineering, The University of Western Australia, Crawley, Western Australia, Australia
| | - B P Allan
- Private Maxillofacial Surgery Practice, Perth, Australia
| | - S Naoum
- Orthodontic Department, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - R J H Lee
- Orthodontic Department, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - M S Goonewardene
- Orthodontic Department, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia.
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9
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Harding J, Hofheinz R, Elez E, Kuboki Y, Geng J, Schmohl M, Dowling E, Feng Y, Rasco D. P-169 A first-in-human phase Ia/b, open-label, multicentre, dose-escalation study of BI 905711 in patients with advanced gastrointestinal cancers. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Sangro B, Park J, Finn R, Cheng A, Mathurin P, Edeline J, Kudo M, Han K, Harding J, Merle P, Rosmorduc O, Wyrwicz L, Schott E, Choo S, Kelley R, Begic D, Chen G, Neely J, Tschaika M, Yau T. LBA-3 CheckMate 459: Long-term (minimum follow-up 33.6 months) survival outcomes with nivolumab versus sorafenib as first-line treatment in patients with advanced hepatocellular carcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.078] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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11
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Geevarghese R, Harding J, Parsons N, Hutchinson C, Parsons C. The relationship of embolic particle size to patient outcomes in prostate artery embolisation for benign prostatic hyperplasia: a systematic review and meta-regression. Clin Radiol 2020; 75:366-374. [PMID: 32000985 DOI: 10.1016/j.crad.2019.12.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/24/2019] [Indexed: 01/06/2023]
Abstract
AIM To explore the relationship of embolic particle size used in prostate artery embolisation (PAE) to patient outcomes. MATERIALS AND METHODS A systematic review of PubMed, EMBASE, and the Cochrane database was undertaken to identify all existing studies using PAE for benign prostatic hyperplasia (BPH). Inclusion criteria included prospective studies reporting baseline and 12-month International Prostate Symptom Score (IPSS) and particle size. Exclusion criteria were overlapping studies, commentaries, abstracts, and letters. Data extraction from eligible studies included the size of embolic particle, particle material, and baseline and 12-month values for the following patient outcomes: IPSS, IPSS quality of life, urinary flow rate (Q-max), prostate volume, prostate specific antigen, and post-void residual volume. A meta-regression analysis was then undertaken to examine the relationship of particle size to patient outcome measures. RESULTS Six studies with a total of 687 patients were identified. Meta-regression analysis demonstrated particle size as a statistically significant (p<0.001) moderator of 12-month IPSS change following PAE. No statistically significant relationships were identified with other patient outcome measures. CONCLUSION Smaller embolic particle size is associated with a greater reduction in IPSS following PAE.
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Affiliation(s)
- R Geevarghese
- Department of Clinical and Interventional Radiology, University Hospital Coventry and Warwickshire, Coventry, UK.
| | - J Harding
- Department of Clinical and Interventional Radiology, University Hospital Coventry and Warwickshire, Coventry, UK
| | - N Parsons
- Department of Statistics and Epidemiology, Warwick Medical School, University of Warwick, Warwick, UK
| | - C Hutchinson
- Department of Clinical and Interventional Radiology, University Hospital Coventry and Warwickshire, Coventry, UK; Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Warwick, UK
| | - C Parsons
- Department of Clinical and Interventional Radiology, University Hospital Coventry and Warwickshire, Coventry, UK
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12
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Court R, Wiesner L, Stewart A, de Vries N, Harding J, Maartens G, Gumbo T, McIlleron H. Steady state pharmacokinetics of cycloserine in patients on terizidone for multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2019; 22:30-33. [PMID: 29297422 DOI: 10.5588/ijtld.17.0475] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Terizidone/cycloserine (TRD/CS) is included in standard treatment regimens for multidrug-resistant tuberculosis (MDR-TB) in many countries. The steady state pharmacokinetics (PKs) of CS after TRD administration are not known. OBJECTIVES AND DESIGN We recruited in-patients treated with 250-750 mg oral TRD daily as part of standard treatment regimens for pulmonary MDR-TB in Cape Town, South Africa. Plasma CS assays were performed in samples taken pre-dose and at 2, 4, 6, 8 and 10 h post-dose. CS concentrations were measured using a validated liquid chromatography-tandem mass spectrometry method. Non-compartmental PK analyses were performed. RESULTS Of 35 participants enrolled, 22 were males, and 20 (57%) were infected with the human immunodeficiency virus; the median age was 37 years. The median duration on TRD at the time of sampling was 33 days (interquartile range [IQR] 28-39). The area under the concentration-time curve at 0-10 h (AUC0-10) was 319 μg.h/ml (IQR 267.5-378.7), and peak concentration was 38.1 μg/ml (IQR 32.6-47.2). On multiple regression, dose (mg/kg) was the only factor independently associated with AUC0-10. CONCLUSION Steady state concentrations of CS in patients treated with TRD for MDR-TB were higher than those reported with CS formulations. Our findings support once-daily dosing.
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Affiliation(s)
- R Court
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
| | - A Stewart
- Clinical Research Centre, Health Sciences Faculty, University of Cape Town, Cape Town
| | | | - J Harding
- D P Marais Hospital, Cape Town, South Africa
| | - G Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
| | - T Gumbo
- Center for Infectious Diseases Research and Experimental Therapeutics, Baylor Research Institute, Baylor University Medical Center, Dallas, Texas, USA
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town
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13
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Court R, Chirehwa MT, Wiesner L, de Vries N, Harding J, Gumbo T, Maartens G, McIlleron H. Effect of tablet crushing on drug exposure in the treatment of multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2019; 23:1068-1074. [PMID: 31627771 PMCID: PMC7402384 DOI: 10.5588/ijtld.18.0775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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] [Indexed: 11/10/2022] Open
Abstract
SETTING: Treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) are poor. Due to drug toxicity and a long treatment duration, approximately half of patients are treated successfully. Medication is often crushed for patients who have difficulty swallowing whole tablets. Whether crushing tablets affects drug exposure in MDR-TB treatment is not known.OBJECTIVE AND DESIGN: We performed a sequential pharmacokinetic study in patients aged >18 years on MDR-TB treatment at two hospitals in Cape Town, South Africa. We compared the bioavailability of pyrazinamide, moxifloxacin, isoniazid (INH), ethambutol and terizidone when the tablets were crushed and mixed with water before administration vs. swallowed whole. We sampled blood at six time points over 10 h under each condition separated by 2 weeks. Non-compartmental analysis was used to derive the key pharmacokinetic measurements.RESULTS: Twenty participants completed the study: 15 were men, and the median age was 31.5 years. There was a 42% reduction in the area under the curve AUC0-10 of INH when the tablets were crushed compared with whole tablets (geometric mean ratio 58%; 90%CI 47-73). Crushing tablets of pyrazinamide, moxifloxacin, ethambutol and terizidone did not affect the bioavailability significantly.CONCLUSION: We recommend that crushing of INH tablets in the MDR-TB treatment regimen be avoided. Paediatric INH formulations may be a viable alternative if the crushing of INH tablets is indicated.
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Affiliation(s)
- R Court
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town
| | - M T Chirehwa
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town
| | | | - J Harding
- DP Marais Hospital, Cape Town, South Africa
| | - T Gumbo
- Center for Infectious Diseases Research and Experimental Therapeutics, Baylor Research Institute, Baylor University Medical Center, Dallas, TX, USA
| | - G Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town
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14
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Harding J, Cleary J, Shapiro G, Braña I, Moreno V, Quinn D, Borad M, Loi S, Spanggaard I, Stemmer S, Dujka M, Cutler R, Xu F, Eli L, Macia S, Lalani A, Bryce R, Bernstam FM, Solit D, Hyman D, Piha-Paul S. Treating HER2-mutant advanced biliary tract cancer with neratinib: benefits of HER2-directed targeted therapy in the phase 2 SUMMIT ‘basket’ trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Knopp JL, Signal M, Harris DL, Marics G, Weston P, Harding J, Tóth-Heyn P, Hómlok J, Benyó B, Chase JG. Modelling intestinal glucose absorption in premature infants using continuous glucose monitoring data. Comput Methods Programs Biomed 2019; 171:41-51. [PMID: 30344050 DOI: 10.1016/j.cmpb.2018.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 09/11/2018] [Accepted: 10/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Model-based glycaemic control protocols have shown promise in neonatal intensive care units (NICUs) for reducing both hyperglycaemia and insulin-therapy driven hypoglycaemia. However, current models for the appearance of glucose from enteral feeding are based on values from adult intensive care cohorts. This study aims to determine enteral glucose appearance model parameters more reflective of premature infant physiology. METHODS Peaks in CGM data associated with enteral milk feeds in preterm and term infants are used to fit a two compartment gut model. The first compartment describes glucose in the stomach, and the half life of gastric emptying is estimated as 20 min from literature. The second compartment describes glucose in the small intestine, and absorption of glucose into the blood is fit to CGM data. Two infant cohorts from two NICUs are used, and results are compared to appearances derived from data in highly controlled studies in literature. RESULTS The average half life across all infants for glucose absorption from the gut to the blood was 50 min. This result was slightly slower than, but of similar magnitude to, results derived from literature. No trends were found with gestational or postnatal age. Breast milk fed infants were found to have a higher absorption constant than formula fed infants, a result which may reflect known differences in gastric emptying for different feed types. CONCLUSIONS This paper presents a methodology for estimation of glucose appearance due to enteral feeding, and model parameters suitable for a NICU model-based glycaemic control context.
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Affiliation(s)
- J L Knopp
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand.
| | - M Signal
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand.
| | - D L Harris
- Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand; Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - G Marics
- First Department of Paediatrics, Intensive Care Unit, Semmelweis University, Budapest, Hungary
| | - P Weston
- Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand.
| | - J Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - P Tóth-Heyn
- First Department of Paediatrics, Intensive Care Unit, Semmelweis University, Budapest, Hungary.
| | - J Hómlok
- Budapest University of Technology and Economics, Budapest, Hungary
| | - B Benyó
- Budapest University of Technology and Economics, Budapest, Hungary.
| | - J G Chase
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand.
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16
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Court RG, Wiesner L, Chirehwa MT, Stewart A, de Vries N, Harding J, Gumbo T, McIlleron H, Maartens G. Effect of lidocaine on kanamycin injection-site pain in patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2018; 22:926-930. [PMID: 29991403 PMCID: PMC6040239 DOI: 10.5588/ijtld.18.0091] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/18/2018] [Indexed: 11/10/2022] Open
Abstract
SETTING Reducing pain from intramuscular injection of kanamycin (KM) could improve the tolerability of multidrug-resistant tuberculosis (MDR-TB) treatment. Lidocaine has been shown to be an effective anaesthetic diluent for some intramuscular injections, but has not been investigated with KM in the treatment of adult patients with MDR-TB. OBJECTIVE AND DESIGN We performed a randomised single-blinded crossover study to determine if lidocaine reduces KM injection-site pain. We recruited patients aged 18 years on MDR-TB treatment at two TB hospitals in Cape Town, South Africa. KM pharmacokinetic parameters and a validated numeric pain scale were used at intervals over 10 h following the injection of KM with and without lidocaine on two separate occasions. RESULTS Twenty participants completed the study: 11 were males, the median age was 36 years, 11 were HIV-infected, and the median body mass index was 17.5 kg/m2. The highest pain scores occurred early, and the median pain score was 0 by 30 min. The use of lidocaine with KM significantly reduced pain at the time of injection and 15 min post-dose. On multiple regression analysis, lidocaine halved pain scores (adjusted OR 0.5, 95%CI 0.3-0.9). The area under the curve at 0-10 h of KM with and without lidocaine was respectively 147.7 and 143.6 μg·h/ml. CONCLUSION Lidocaine significantly reduces early injection-site pain and has no effect on KM pharmacokinetics.
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Affiliation(s)
- R G Court
- Division of Clinical Pharmacology, Department of Medicine
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine
| | - M T Chirehwa
- Division of Clinical Pharmacology, Department of Medicine
| | - A Stewart
- Clinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town
| | | | - J Harding
- D P Marais Hospital, Cape Town, South Africa
| | - T Gumbo
- Center for Infectious Diseases Research and Experimental Therapeutics, Baylor Research Institute, Baylor University Medical Center, Dallas, Texas, USA
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine
| | - G Maartens
- Division of Clinical Pharmacology, Department of Medicine
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Harding J, Vintersten K, Yang H, Nagy A. Evading transplant rejection without systemic immune suppression. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.255] [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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Borgaonkar M, Pace D, McGrath JS, Harding J. A18 IMPROVING COMPLIANCE WITH COLONOSCOPY SURVEILLANCE INTERVAL GUIDELINES. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - D Pace
- Memorial University, St. John’s, Canada
| | | | - J Harding
- Gastroenterology, Eastern Health, St. John’s, Canada
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Garcia-Corbacho J, Spira A, Boni V, Feliu J, Middleton M, Burris H, Yang Weaver A, Will M, Harding J, Meric-Bernstam F, Heinemann V. PROCLAIM-CX-2009: A first-in-human trial to evaluate CX-2009 in adults with metastatic or locally advanced unresectable solid tumors. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Cullington HE, Bele D, Brinton JC, Cooper S, Daft M, Harding J, Hatton N, Humphries J, Lutman ME, Maddocks J, Maggs J, Millward K, O'Donoghue G, Patel S, Rajput K, Salmon V, Sear T, Speers A, Wheeler A, Wilson K. United Kingdom national paediatric bilateral project: Results of professional rating scales and parent questionnaires. Cochlear Implants Int 2017; 18:23-35. [PMID: 28098502 DOI: 10.1080/14670100.2016.1265189] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This fourteen-centre project used professional rating scales and parent questionnaires to assess longitudinal outcomes in a large non-selected population of children receiving simultaneous and sequential bilateral cochlear implants. METHODS This was an observational non-randomized service evaluation. Data were collected at four time points: before bilateral cochlear implants or before the sequential implant, one year, two years, and three years after. The measures reported are Categories of Auditory Performance II (CAPII), Speech Intelligibility Rating (SIR), Bilateral Listening Skills Profile (BLSP) and Parent Outcome Profile (POP). RESULTS Thousand and one children aged from 8 months to almost 18 years were involved, although there were many missing data. In children receiving simultaneous implants after one, two, and three years respectively, median CAP scores were 4, 5, and 6; median SIR were 1, 2, and 3. Three years after receiving simultaneous bilateral cochlear implants, 61% of children were reported to understand conversation without lip-reading and 66% had intelligible speech if the listener concentrated hard. Auditory performance and speech intelligibility were significantly better in female children than males. Parents of children using sequential implants were generally positive about their child's well-being and behaviour since receiving the second device; those who were less positive about well-being changes also generally reported their children less willing to wear the second device. CONCLUSION Data from 78% of paediatric cochlear implant centres in the United Kingdom provide a real-world picture of outcomes of children with bilateral implants in the UK. This large reference data set can be used to identify children in the lower quartile for targeted intervention.
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Affiliation(s)
- H E Cullington
- a University of Southampton Auditory Implant Service , Southampton , UK
| | - D Bele
- a University of Southampton Auditory Implant Service , Southampton , UK
| | - J C Brinton
- a University of Southampton Auditory Implant Service , Southampton , UK
| | - S Cooper
- b St Thomas' Hospital Hearing Implant Centre , London , UK
| | - M Daft
- c Nottingham Auditory Implant Programme , Nottingham , UK
| | - J Harding
- d Cardiff Paediatric Cochlear Implant Programme , London , UK
| | - N Hatton
- e Emmeline Centre , Cambridge , UK
| | - J Humphries
- f The Oxford Cochlear Implant Programme , London , UK
| | - M E Lutman
- g Hearing and Balance Centre, University of Southampton , Southampton , UK
| | - J Maddocks
- h West of England Paediatric Hearing Implant Programme , Bristol , UK
| | - J Maggs
- i The Midlands Children's Hearing Implant Programme , Birmingham , UK
| | - K Millward
- j The Richard Ramsden Centre for Hearing Implants , Manchester , UK
| | - G O'Donoghue
- c Nottingham Auditory Implant Programme , Nottingham , UK
| | - S Patel
- k St George's Hospital Auditory Implant Service , London , UK
| | - K Rajput
- l Great Ormond Street Cochlear Implant Programme , London , UK
| | - V Salmon
- m North East Cochlear Implant Programme , Middlesbrough , UK
| | - T Sear
- n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK
| | - A Speers
- o Belfast Regional Cochlear Implant Centre , Belfast , UK
| | - A Wheeler
- n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK
| | - K Wilson
- b St Thomas' Hospital Hearing Implant Centre , London , UK
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21
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Cullington HE, Bele D, Brinton JC, Cooper S, Daft M, Harding J, Hatton N, Humphries J, Lutman ME, Maddocks J, Maggs J, Millward K, O'Donoghue G, Patel S, Rajput K, Salmon V, Sear T, Speers A, Wheeler A, Wilson K. United Kingdom national paediatric bilateral project: Demographics and results of localization and speech perception testing. Cochlear Implants Int 2016; 18:2-22. [PMID: 28010679 DOI: 10.1080/14670100.2016.1265055] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess longitudinal outcomes in a large and varied population of children receiving bilateral cochlear implants both simultaneously and sequentially. METHODS This observational non-randomized service evaluation collected localization and speech recognition in noise data from simultaneously and sequentially implanted children at four time points: before bilateral cochlear implants or before the sequential implant, 1 year, 2 years, and 3 years after bilateral implants. No inclusion criteria were applied, so children with additional difficulties, cochleovestibular anomalies, varying educational placements, 23 different home languages, a full range of outcomes and varying device use were included. RESULTS 1001 children were included: 465 implanted simultaneously and 536 sequentially, representing just over 50% of children receiving bilateral implants in the UK in this period. In simultaneously implanted children the median age at implant was 2.1 years; 7% were implanted at less than 1 year of age. In sequentially implanted children the interval between implants ranged from 0.1 to 14.5 years. Children with simultaneous bilateral implants localized better than those with one implant. On average children receiving a second (sequential) cochlear implant showed improvement in localization and listening in background noise after 1 year of bilateral listening. The interval between sequential implants had no effect on localization improvement although a smaller interval gave more improvement in speech recognition in noise. Children with sequential implants on average were able to use their second device to obtain spatial release from masking after 2 years of bilateral listening. Although ranges were large, bilateral cochlear implants on average offered an improvement in localization and speech perception in noise over unilateral implants. CONCLUSION These data represent the diverse population of children with bilateral cochlear implants in the UK from 2010 to 2012. Predictions of outcomes for individual patients are not possible from these data. However, there are no indications to preclude children with long inter-implant interval having the chance of a second cochlear implant.
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Affiliation(s)
- H E Cullington
- a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK
| | - D Bele
- a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK
| | - J C Brinton
- a University of Southampton Auditory Implant Service , Highfield , Southampton SO17 1BJ , UK
| | - S Cooper
- b St. Thomas' Hospital Hearing Implant Centre , London , UK
| | - M Daft
- c Nottingham Auditory Implant Programme , Nottingham , UK
| | - J Harding
- d Cardiff Paediatric Cochlear Implant Programme , London , UK
| | - N Hatton
- e Emmeline Centre , Cambridge , UK
| | - J Humphries
- f The Oxford Cochlear Implant Programme , London , UK
| | - M E Lutman
- g Hearing and Balance Centre , University of Southampton , Southampton , UK
| | - J Maddocks
- h West of England Paediatric Hearing Implant Programme , Bristol , UK
| | - J Maggs
- i The Midlands Children's Hearing Implant Programme , Birmingham , UK
| | - K Millward
- j The Richard Ramsden Centre for Hearing Implants , Manchester , UK
| | - G O'Donoghue
- c Nottingham Auditory Implant Programme , Nottingham , UK
| | - S Patel
- k St George's Hospital Auditory Implant Service , London , UK
| | - K Rajput
- l Great Ormond Street Cochlear Implant Programme , London , UK
| | - V Salmon
- m North East Cochlear Implant Programme , Middlesbrough , UK
| | - T Sear
- n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK
| | - A Speers
- o Belfast Regional Cochlear Implant Centre , Belfast , UK
| | - A Wheeler
- n Royal National Throat Nose and Ear Cochlear Implant Programme , London , UK
| | - K Wilson
- b St. Thomas' Hospital Hearing Implant Centre , London , UK
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Lowery M, You D, Samoila A, Peerschke E, Viale A, Patel R, Selcuklu D, Rusek M, Cercek A, Kemeny N, Harding J, Mellinghoff I, Tap W, Abou-Alfa G, Moynahan M. Detection of IDH1 mutations in circulating free DNA in patients with cholangiocarcinoma. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33021-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Meric-Bernstam F, Tannir N, Harding J, Voss M, Mier J, DeMichele A, Munster P, Patel M, Iliopoulos O, Owonikoko T, Whiting S, Orford K, Bennett M, Carvajal R, McKay R, Fan A, Telli M, Infante J. Phase 1 study of CB-839, a small molecule inhibitor of glutaminase, in combination with everolimus in patients (pts) with clear cell and papillary renal cell cancer (RCC). Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32626-0] [Citation(s) in RCA: 6] [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] [Indexed: 11/16/2022]
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Steinway C, Harding J, Garcia-Espana F, Schott W, Akers A. Randomized controlled trial of paracervical blocks for pain control among adolescents receiving intrauterine systems. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Naud J, Harding J, Lamarche C, Beauchemin S, Leblond FA, Pichette V. Effects of Chronic Renal Failure on Brain Cytochrome P450 in Rats. Drug Metab Dispos 2016; 44:1174-9. [DOI: 10.1124/dmd.116.070052] [Citation(s) in RCA: 6] [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: 02/12/2016] [Accepted: 05/18/2016] [Indexed: 11/22/2022] Open
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Ratner L, Rauch D, Abel H, Caruso B, Noy A, Barta SK, Parekh S, Ramos JC, Ambinder R, Phillips A, Harding J, Baydoun HH, Cheng X, Jacobson S. Dose-adjusted EPOCH chemotherapy with bortezomib and raltegravir for human T-cell leukemia virus-associated adult T-cell leukemia lymphoma. Blood Cancer J 2016; 6:e408. [PMID: 27015285 PMCID: PMC4817103 DOI: 10.1038/bcj.2016.21] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- L Ratner
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - D Rauch
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - H Abel
- Department of Genetics, Washington University School of Medicine, St Louis, MO, USA
| | - B Caruso
- Viral Immunology Section, Neuroimmunology and Neurovirology Division, NINDS, NIH, Bethesda, MD, USA
| | - A Noy
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S K Barta
- Division of Hematology-Oncology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - S Parekh
- Division of Hematology-Oncology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - J C Ramos
- Division of Hematology-Oncology, Department of Medicine, University of Miami School of Medicine, Miami, FL, USA
| | - R Ambinder
- Division of Hematologic Malignancies, Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A Phillips
- Division of Hematology-Oncology, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - J Harding
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - H H Baydoun
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - X Cheng
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - S Jacobson
- Viral Immunology Section, Neuroimmunology and Neurovirology Division, NINDS, NIH, Bethesda, MD, USA
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Griffin C, Harding J, Sutton C. Re: The vaginal microbiome, vaginal anti-microbial defence mechanisms and the clinical challenge of reducing infection-related preterm birth. BJOG 2015; 122:1033. [PMID: 26011464 DOI: 10.1111/1471-0528.13229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2014] [Indexed: 12/26/2022]
Affiliation(s)
- C Griffin
- University of Western Australia Clinical School, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - J Harding
- University of Western Australia Clinical School, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - C Sutton
- University of Western Australia Clinical School, King Edward Memorial Hospital, Subiaco, WA, Australia
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Harding J, Sooriyakumaran M, Anstey KJ, Adams R, Balkau B, Briffa T, Davis TME, Davis WA, Dobson A, Giles GG, Grant J, Knuiman M, Luszcz M, Mitchell P, Pasco JA, Reid C, Simmons D, Simons L, Tonkin A, Woodward M, Shaw JE, Magliano DJ. The metabolic syndrome and cancer: Is the metabolic syndrome useful for predicting cancer risk above and beyond its individual components? Diabetes Metab 2015; 41:463-9. [PMID: 26037090 DOI: 10.1016/j.diabet.2015.04.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/22/2015] [Indexed: 11/17/2022]
Abstract
AIMS The metabolic syndrome (MetS) is a risk factor for cancer. However, it is not known if the MetS confers a greater cancer risk than the sum of its individual components, which components drive the association, or if the MetS predicts future cancer risk. MATERIALS AND METHODS We linked 20,648 participants from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on the MetS to national cancer registries and used Cox proportional hazards models to estimate associations of the MetS, the number of positive MetS components, and each of the five MetS components separately with the risk for overall, colorectal, prostate and breast cancer. Hazard ratios (HR) and 95% confidence intervals (95%CI) are reported. We assessed predictive ability of the MetS using Harrell's c-statistic. RESULTS The MetS was inversely associated with prostate cancer (HR 0.85; 95% CI 0.72-0.99). We found no evidence of an association between the MetS overall, colorectal and breast cancers. For those with five positive MetS components the HR was 1.12 (1.02-1.48) and 2.07 (1.26-3.39) for overall, and colorectal cancer, respectively, compared with those with zero positive MetS components. Greater waist circumference (WC) (1.38; 1.13-1.70) and elevated blood pressure (1.29; 1.01-1.64) were associated with colorectal cancer. Elevated WC and triglycerides were (inversely) associated with prostate cancer. MetS models were only poor to moderate discriminators for all cancer outcomes. CONCLUSIONS We show that the MetS is (inversely) associated with prostate cancer, but is not associated with overall, colorectal or breast cancer. Although, persons with five positive components of the MetS are at a 1.2 and 2.1 increased risk for overall and colorectal cancer, respectively, and these associations appear to be driven, largely, by elevated WC and BP. We also demonstrate that the MetS is only a moderate discriminator of cancer risk.
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Affiliation(s)
- J Harding
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
| | - M Sooriyakumaran
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - K J Anstey
- Research School of Population Health, the Australian National University, Canberra, Australia
| | - R Adams
- The Health Observatory Discipline of Medicine, the University of Adelaide, Adelaide, Australia
| | - B Balkau
- Inserm, U1018, Centre for Research in Epidemiology and Population Health, France
| | - T Briffa
- School of Population Health, the University of Western Australia, Crawley, Australia
| | - T M E Davis
- School of Medicine and Pharmacology, the University of Western Australia, Fremantle, Australia
| | - W A Davis
- School of Medicine and Pharmacology, the University of Western Australia, Fremantle, Australia
| | - A Dobson
- School of Population Health, the University of Queensland, Brisbane, Australia
| | - G G Giles
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Cancer Epidemiology Centre, the Cancer Council Victoria, Melbourne, Australia; Centre for Epidemiology and Biostatistics, School of Population and Global Heath, the University of Melbourne, Melbourne, Australia
| | - J Grant
- Population Research & Outcome Studies, the University of Adelaide, Adelaide, Australia
| | - M Knuiman
- School of Population Health, the University of Western Australia, Crawley, Australia
| | - M Luszcz
- Flinders Centre for Ageing Studies, Flinders University, Adelaide, Australia
| | - P Mitchell
- Westmead Millennium Institute, the University of Sydney, Sydney, Australia
| | - J A Pasco
- IMPACT Strategic Research Centre School of Medicine, Deakin University, Geelong, Australia; NorthWest Academic Centre, Department of Medicine, the University of Melbourne, St Albans, Australia
| | - C Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - D Simmons
- School of Medicine, University of Western Sydney, Campbelltown, Australia; Department of Rural Health, the University of Melbourne, Shepparton, Australia
| | - L Simons
- UNSW Australia Lipid Research Dept, St Vincent's Hospital, Sydney, Australia
| | - A Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - M Woodward
- The George Institute for Global Health, the University of Sydney, Sydney, Australia; The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, UK
| | - J E Shaw
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - D J Magliano
- Department of Clinical Diabetes and Epidemiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Burrows V, Zayyan KS, Harding J. Visceral Pseudoaneurysm Embolisation Using 'Ping-Pong' Technique: Importance of Dual Arterial Catheterisation to Prevent Rupture. Acta Chir Belg 2015; 115:227-31. [PMID: 26158256 DOI: 10.1080/00015458.2015.11681102] [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: 10/21/2022]
Abstract
Supracolic peri-pancreatic visceral pseudoaneurysms combine the challenges of difficult location for open surgical repair with unpredictable risk of fatal exsanguination. Endovascular embolisation is a well-established method of safely decompressing these lesions using a variety of thrombogenic agents. A single catheter technique is commonly employed to achieve this outcome. However, there is also a risk of iatrogenic rupture during these procedures as a result of occlusion of one vessel allowing pressure to rise through any other vessel(s). Thus a thorough understanding of the flow dynamics prior to and during occlusion is essential for safe decompression. We report the adaptation of dual arterial catheter technique in treating these lesions in an 80-year old man with a large, leaking peripancreatic visceral pseudo-aneurysm. Our technique of alternating between intervention and observation of effect allows greater control of the potentially unpredictable haemodynamic situation.
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Harding A, Vernazza CR, Wilson K, Harding J, Girdler NM. What are dental non-attenders' preferences for anxiety management techniques? A cross-sectional study based at a dental access centre. Br Dent J 2015; 218:415-20; discussion 421. [PMID: 25858739 DOI: 10.1038/sj.bdj.2015.249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Dental anxiety is a barrier to attendance. Dental non-attenders may seek emergency care and may prefer to receive anxiety management measures for treatment required. Little is known about the preferences of these dental non-attenders for different anxiety management techniques. Understanding such preferences may inform management pathways, improve experiences, alleviate anxieties and encourage a more regular attendance pattern. As such, the aim of this study was to gain a greater understanding of the dental anxiety of patients attending a dental access centre for emergency dental treatment and to ascertain preferences for different anxiety management techniques. DESIGN Cross-sectional study involving self-completed questionnaires and clinical observation. SETTING NHS Dental Access Centre, York, UK. SUBJECTS AND METHODS Two hundred participants not registered with a general dental practitioner, aged 18 years or over, experiencing pain and self-referred were recruited on a consecutive sampling basis. Participants completed a questionnaire eliciting demographic and dental history details, dental anxiety and preferences for dental anxiety management options. MAIN OUTCOME MEASURES Correlation of the modified dental anxiety scale with preference for different dental anxiety management techniques. RESULTS No significant predictive factors were found that explained preferring local anaesthetic to sedation, or general anaesthesia for restorations or extractions. Those highly anxious were less likely to consider tell-show-do techniques (p=0.001) or watching explanatory videos (p=0.004) to be helpful for overcoming their anxieties than the low or moderate anxiety groups. CONCLUSIONS People attending access centres may represent a group who are unwilling to explore non-pharmacological methods to overcome their anxieties. This supports the need for sedation to provide treatment. Future work may include exploring in more depth the thoughts and opinions of this group of patients to improve understanding of their complex dental attitudes. From this, more effective strategies may be developed to encourage regular dental attendance.
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Affiliation(s)
- A Harding
- Monkgate Dental Department, 31-33 Monkgate, York
| | - C R Vernazza
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle
| | - K Wilson
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle
| | - J Harding
- 1] Department of Social Sciences and Languages, University of Northumbria, Ellison Place, Newcastle [2] Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle
| | - N M Girdler
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle
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Mahdi H, Rose P, Elshaikh M, Munkarah A, Isrow D, Singh S, Waggoner S, Ali-Fehmi R, Harding J, Morris R, DeBernardo R. Adjuvant vaginal brachytherapy decreases the risk of vaginal recurrence in patients with stage I non-invasive uterine papillary serous carcinoma. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mahdi H, DeBernardo R, Elshaikh M, Munkarah A, Isrow D, Singh S, Waggoner S, Ali R, Harding J, Morris R, Moslemi-Kebria M. Impact of surgical staging and adjuvant therapy on recurrence risk and outcome in stage I non-invasive uterine papillary serous carcinoma. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Griffin C, Harding J, Sutton C. Re: Intake of dairy products and calcium and prevalence of depressive symptoms during pregnancy in Japan: a cross-sectional study. BJOG 2015; 122:586. [PMID: 25702544 DOI: 10.1111/1471-0528.13087] [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] [Accepted: 08/02/2014] [Indexed: 11/30/2022]
Affiliation(s)
- C Griffin
- The School of Women's and Infant's Health, University of Western Australia, King Edward Hospital, Subiaco, WA, Australia
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Fernando KA, Fowler T, Harding J, Flew S, Caley M, Phattey J, Ross J. Detecting re-infection in patients after an initial diagnosis of gonorrhoea: is routine recall for re-screening useful? Int J STD AIDS 2014; 26:640-7. [PMID: 25161175 DOI: 10.1177/0956462414548905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 07/24/2014] [Indexed: 11/15/2022]
Abstract
To assess the outcome of routine sexually transmitted infection re-screening after a three-month interval in unselected patients diagnosed with gonorrhoea, we sought to assess whether this active approach would result in an increase in the number of people attending clinic and subsequently diagnosed with gonorrhoea re-infection, compared with normal re-presentation rates. A recall group of patients were invited for re-screening three months after their initial diagnosis of gonorrhoea. Permission was sought to send a reminder two weeks prior to their scheduled recall appointment. Comparisons were made with a historical control group of patients with gonorrhoea in the absence of any formal recall. Of the 242 patients in the intervention arm, 96 (40%) re-attended within six months, and 15 (6%) tested gonorrhoea positive. Two hundred and two patients were assessed in the control group, of whom 45 (22%) re-attended within six months, and 13 (6%) tested gonorrhoea positive. Women were more likely than men to re-attend following active recall, but they were not at higher risk of re-attending while re-infected with gonorrhoea. Active recall following a gonorrhoea diagnosis significantly increases re-attendance rates for repeat screening but did not result in an increased number of subsequent gonorrhoea diagnoses.
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Affiliation(s)
- K A Fernando
- Department of Genitourinary Medicine, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Cobridge Community Health Centre, Stoke-on-Trent, UK
| | - T Fowler
- Field Epidemiology Services - West Midlands, Public Health England, Birmingham, UK Public Health, Epidemiology & Biostatistics Home, University of Birmingham, Birmingham, UK
| | - J Harding
- Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - S Flew
- Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - M Caley
- Department of Public Health, NHS Warwickshire/Warwickshire County Council, Warwick, UK
| | - J Phattey
- Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - Jdc Ross
- Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK
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Aboagye EO, Aigbirhio FI, Allen P, Arent R, Arrowsmith RL, Banci G, Bagley MC, Bailey CD, Blake T, Bunt AJ, Bushby N, Carroll L, Cons BD, Cortezon F, Dilworth JR, Dorff PN, Eggleston IM, Ellames G, Elmore CS, Ernst G, Estrela P, Faithfull J, Ge H, Geach NJ, Hall J, Harding J, Harwood LM, Hickey MJ, Heys JR, Hogg C, Hudson MJ, James T, Kerr WJ, Killick D, Kingston LP, Kociok-Köhn G, Landvatter S, Lewis F, Lockley WJS, Marken F, Mudd RJ, Pascu SI, Pheko T, Powell ME, Reid M, Riss PJ, Ruhl T, Rustidge DC, Schenk DJ, Schofield C, Schweiger L, Sharma P, Smith D, Tuttle CTT, Testa A, Tyson JA, Tyrrell RM, Urbanek R, Wilkinson DJ, Willis CL, Zanda M. Abstracts of the 22nd International Isotope Society (UK Group) Symposium: synthesis and applications of labelled compounds 2013. J Labelled Comp Radiopharm 2014. [DOI: 10.1002/jlcr.3173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- E. O. Aboagye
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - F. I. Aigbirhio
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - P. Allen
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - R. Arent
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - R. L. Arrowsmith
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - G. Banci
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - M. C. Bagley
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. D. Bailey
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - T. Blake
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - A. J. Bunt
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - N. Bushby
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - L. Carroll
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - B. D. Cons
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - F. Cortezon
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - J. R. Dilworth
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - P. N. Dorff
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - I. M. Eggleston
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - G. Ellames
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. S. Elmore
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - G. Ernst
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - P. Estrela
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - J. Faithfull
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - H. Ge
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - N. J. Geach
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - J. Hall
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - J. Harding
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - L. M. Harwood
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - M. J. Hickey
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - J. R. Heys
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. Hogg
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - M. J. Hudson
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - T. James
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - W. J. Kerr
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - D. Killick
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - L. P. Kingston
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - G. Kociok-Köhn
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - S. Landvatter
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - F. Lewis
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - W. J. S. Lockley
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - F. Marken
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - R. J. Mudd
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - S. I. Pascu
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - T. Pheko
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - M. E. Powell
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - M Reid
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - P. J. Riss
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - T. Ruhl
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - D. C. Rustidge
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - D. J. Schenk
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. Schofield
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - L. Schweiger
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - P. Sharma
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - D. Smith
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. T. T. Tuttle
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - A. Testa
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - J. A. Tyson
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - R. M. Tyrrell
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - R. Urbanek
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - D. J. Wilkinson
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - C. L. Willis
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
| | - M. Zanda
- Department of Chemistry, Faculty of Engineering and Physical Sciences; University of Surrey; Guildford Surrey GU2 7XH UK
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West SD, Hellman A, Tawil I, Harding J. Emergent endotracheal tube exchange following acute obstruction of an electromyography monitoring endotracheal tube. Anaesth Intensive Care 2014; 42:271-273. [PMID: 24580403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Senapati A, Gray RG, Middleton LJ, Harding J, Hills RK, Armitage NCM, Buckley L, Northover JMA. PROSPER: a randomised comparison of surgical treatments for rectal prolapse. Colorectal Dis 2013; 15:858-68. [PMID: 23461778 DOI: 10.1111/codi.12177] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 02/05/2013] [Indexed: 02/06/2023]
Abstract
AIM Rectal prolapse is a profoundly disabling condition, occurring mainly in elderly and parous women. There is no accepted standard surgical treatment, with previous studies limited in methodological quality and size. PROSPER aimed to address these deficiencies by comparing the relative merits of different procedures. METHOD In a pragmatic, factorial (2 × 2) design trial, patients could be randomised between abdominal and perineal surgery (i), and suture vs resection rectopexy for those receiving an abdominal procedure (ii) or Altemeier's vs Delorme's for those receiving a perineal procedure (iii). Primary outcome measures were recurrence of the prolapse, incontinence, bowel function and quality of life scores (Vaizey, bowel thermometer and EQ-5D) measured up to 3 years. RESULTS Two hundred and ninety-three patients were recruited: 49 were randomised between surgical approaches (i); 78 between abdominal procedures (ii); and 213 between perineal procedures (iii). Recurrence rates were higher than anticipated, but not significantly different in any comparison: Altemeier's vs Delorme's 24/102 (24%) and 31/99 (31%) [hazard ratio (HR) 0.81; 95% CI 0.47, 1.38; P = 0.4]; resection vs suture rectopexy 4/32 (13%) and 9/35 (26%) (HR 0.45; 95% CI 0.14, 1.46; P = 0.2); perineal vs abdominal 5/25 (20%) and 5/19 (26%) (HR 0.83; 95% CI 0.24, 2.86; P = 0.8). Vaizey, bowel thermometer and EQ-5D scores were not significantly different in any of the comparisons. CONCLUSION No significant differences were seen in any of the randomised comparisons, although substantial improvements from baseline in quality of life were noted following all procedures.
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Affiliation(s)
- A Senapati
- Queen Alexandra Hospital, Portsmouth, UK.
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Land L, Sizmur S, Harding J, Ross JDC. P6.061 Development of a Validated Questionnaire For HIV Attendees. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Patients are becoming more actively involved in decisions about their care and have greater influence to change and improve the quality of services by reporting their experiences. A recent systematic review failed to reveal a method of measuring HIV patient satisfaction that reflects their experience of contemporary treatment and care. The aim of this study was to design a specific HIV patient satisfaction questionnaire that can be used as a patient reported outcome measure. Key themes in the systematic review were identified and used as a topic guide for focus group discussion to confirm their relevance and importance. HIV patients were also interviewed about their motivation to complete a questionnaire. The data from the focus groups and interviews were used to develop an initial questionnaire and cognitive testing was used to provide face validity for the questionnaire design, layout and wording. A revised version was used in a pilot study of 80 respondents, which demonstrated that the questionnaire's completion rate and content validity were high.
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Affiliation(s)
- L Land
- Birmingham City University, Westbourne Road, Edgbaston, Birmingham B15 3TN
| | | | | | - JDC Ross
- University Hospital, Birmingham, UK
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Dhakal S, Auckland C, Huang Y, Ambros B, Duke T, Wilson D, Foxcroft G, Harding J. Uterine spaciousness during embryo and fetal development in multiparous sows improves birth weight and postnatal growth performance. Livest Sci 2013. [DOI: 10.1016/j.livsci.2013.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Llurba E, Baschat AA, Turan OM, Harding J, McCowan LM. Childhood cognitive development after fetal growth restriction. Ultrasound Obstet Gynecol 2013; 41:383-389. [PMID: 23288449 DOI: 10.1002/uog.12388] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/18/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To examine the relationship between prenatal umbilical artery (UA) and internal carotid artery (ICA) Doppler findings and cognitive development at 3 and 6 years in low-birth-weight children. METHODS This was a study of 209 low-birth-weight (< 10(th) centile) children born after 28 gestational weeks with UA resistance index (RI) measured within 2 weeks before delivery. Children with normal UA- and ICA-RI were defined as small-for-gestational age (SGA) and those with abnormal UA or ICA Doppler findings as having fetal growth restriction (FGR). Cognitive ability at 3 and 6 years' corrected age was assessed using the fourth edition of the Stanford-Binet Intelligence Scale (SBIS) and compared between SGA and FGR groups. An SBIS score < 85 was considered to indicate delayed development. RESULTS The median gestational age at diagnosis of abnormal fetal growth was 36.6 (range, 28-41) weeks. There were 87 (41.6%) children classified as having FGR and 122 (58.4%) as SGA. The mean global SBIS score at 3 years was 109.4 (SD, 22.8) and at 6 years it was 110.5 (SD, 13.9). Overall, 22 (10.5%) children had delayed development at 3 years. Total SBIS scores and individual domain scores did not differ between FGR and SGA groups at 3 or 6 years and similar proportions in each group had delayed development. CONCLUSION Abnormal prenatal UA and ICA Doppler findings are not associated with lower developmental scores in low-birth-weight children delivered in the third trimester of pregnancy.
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Affiliation(s)
- E Llurba
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Hofman P, Cutfield W, Derraik J, Mathai S, Dalziel S, Harding J, Jefferies C. Preterm birth is associated with increased adiposity in men and their children. Obes Res Clin Pract 2012. [DOI: 10.1016/j.orcp.2012.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zhang Y, Hardwicke T, Goldstone A, Harding J, Dexter M, Kourtzi Z. Learning to predict: unsupervised training of temporal sequences. J Vis 2012. [DOI: 10.1167/12.9.692] [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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Fernando K, Flew S, Phattey J, Harding J, Fowler T, Caley M, Ross J. P47 Systematic recall vs standard care, addressing the increased risk of re-infection in patients presenting with gonorrhoea. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.47] [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: 11/04/2022]
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Young R, Harding J, Kingsly A, Bradley M. Therapeutic hip injections: Is the injection volume important? Clin Radiol 2012; 67:55-60. [DOI: 10.1016/j.crad.2011.07.040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 06/18/2011] [Accepted: 07/05/2011] [Indexed: 12/01/2022]
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Harding J, Freak-Poli R, Peeters A. The association between participation in a 4-month pedometer-based workplace physical activity program and health-related quality of life (HRQOL). Obes Res Clin Pract 2010. [DOI: 10.1016/j.orcp.2010.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Weston RL, Hopwood B, Harding J, Sizmur S, Ross JDC. Development of a validated patient satisfaction survey for sexual health clinic attendees. Int J STD AIDS 2010; 21:584-90. [DOI: 10.1258/ijsa.2010.010159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patient experience of and satisfaction with health-care services is increasingly being used to evaluate and guide health-care provision. A recent systematic review failed to identify a validated method of measuring patient satisfaction in sexually transmitted infection (STI) clinics. The aim of this study was to design and validate a specific STI clinic patient satisfaction survey that could be used as a patient-derived outcome measure. Key themes of importance to patients were identified from a recent systematic review of STI clinic patient satisfaction surveys. Semi-structured interviews were performed with patients attending a sexual health clinic to further refine these themes, and then used to compile a patient questionnaire. Cognitive testing was used to provide face validity for the questionnaire design, layout and wording. The questionnaire was further reviewed and revised by the research team prior to being piloted over a five-week period. Five key patient themes were incorporated into the questionnaire and the pilot phase included responses from 936 patients. The completion rate for individual items and the whole questionnaire (95% [885/936]) was high. Internal consistency and validity also scored highly.
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Affiliation(s)
| | | | - J Harding
- Whittall Street Clinic, Birmingham, UK
| | - S Sizmur
- Picker Institute Europe, Oxford, UK
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Harding J, Craig M, Jakeman N, Young R, Jabarin C, Kendall J. Emergency physician interpretation of head CT in trauma and suspected subarachnoid haemorrhage--is it viable? An audit of current practice. Emerg Med J 2010; 27:116-20. [DOI: 10.1136/emj.2008.071688] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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