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Quigley J, Hussain T, Arthur C. False-positive HIV screening test in a healthcare student. Occup Med (Lond) 2024; 74:251-253. [PMID: 38526854 DOI: 10.1093/occmed/kqae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
This case report describes a 22-year-old female Ambulance Technician student who displayed human immunodeficiency virus (HIV) false positivity following a recent hepatitis B vaccination. Occupational health clinicians who work in a healthcare setting (with healthcare staff and/or students) should be aware of the possibility of false-positive HIV screening test results, and where a false positive is suspected, they should consider what the underlying cause could be and should consider whether further medical investigation is required.
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Affiliation(s)
- J Quigley
- Consultant Occupational Physician, Independent, Manchester, UK
| | - T Hussain
- Consultant Occupational Physician, Independent, Manchester, UK
| | - C Arthur
- Occupational Health Advisor, Optima Health, Manchester, UK
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Quigley J. Mouth taping. Br Dent J 2023; 234:845. [PMID: 37349419 DOI: 10.1038/s41415-023-6039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 06/24/2023]
Affiliation(s)
- J Quigley
- Peninsula Dental School, Plymouth, United Kingdom.
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Fragala-Pinkham M, Pasternak A, McDermott MP, Mirek E, Glanzman AM, Montes J, Dunaway Young S, Salazar R, Quigley J, Riley SO, Chiriboga CA, Finkel RS, Tennekoon G, Martens WB, De Vivo DC, Darras BT. Psychometric properties of the PEDI-CAT for children and youth with spinal muscular atrophy. J Pediatr Rehabil Med 2021; 14:451-461. [PMID: 34275913 DOI: 10.3233/prm-190664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the psychometric properties of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) in children and youth with Spinal Muscular Atrophy (SMA). METHODS In this prospective cross-sectional study, caregivers of children and youth with SMA completed the PEDI-CAT Daily Activities and Mobility domains. A subset of caregivers completed a questionnaire about the measure. RESULTS Mean ranks of scaled scores for Daily Activities (n = 96) and Mobility (n = 95) domains were significantly different across the three SMA types and across the three motor classifications. Normative scores indicated that 85 participants (89.5%) had limitations in Mobility and 51 in Daily Activities (53.1%). Floor effects were observed in≤10.4% of the sample for Daily Activities and Mobility. On average, caregivers completed the Mobility domain in 5.4 minutes and the Daily Activities domain in 3.3 minutes. Most caregivers reported that they provided meaningful information (92.1%), were willing to use the PEDI-CAT format again (79%), and suggested adding content including power wheelchair mobility items. CONCLUSION Convergent validity was demonstrated for the Daily Activities and Mobility domains. Normative scores detected limitations in Mobility and Daily Activity performance for most participants with SMA. The PEDI-CATwas feasible to administer and caregivers expressed willingness to complete the PEDI-CAT in the future.
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Affiliation(s)
- Maria Fragala-Pinkham
- Research Center, Franciscan Children's Hospital, Brighton, MA, USA.,Department of Physical Therapy and Occupational Therapy Services, Boston Children's Hospital, Boston, MA, USA
| | - Amy Pasternak
- Department of Physical Therapy and Occupational Therapy Services, Boston Children's Hospital, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael P McDermott
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA
| | - Elizabeth Mirek
- Department of Physical Therapy and Occupational Therapy Services, Boston Children's Hospital, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Allan M Glanzman
- Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Sally Dunaway Young
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Rachel Salazar
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Janet Quigley
- Department of Physical Therapy and Occupational Therapy Services, Boston Children's Hospital, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan O Riley
- Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA
| | - Claudia A Chiriboga
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Richard S Finkel
- Center for Experimental Neurotherapeutics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Gihan Tennekoon
- Departments of Neurology, Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - William B Martens
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Darryl C De Vivo
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Basil T Darras
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Abstract
BACKGROUND Disasters, crises and pandemics are emergencies which impact on businesses severely. The COVID-19 pandemic reached its peak in mid-April 2020 in the UK. During this period, NHS Occupational Health Services (OHS) were stretched to their limit along with other health services. OHS may have had to change their pattern of operation, operating times, services offered, etc. to cope with the pandemic. Data about business model modifications, services offered by the OHS businesses during the pandemic could help in better utilization of OHS resources in the future. AIMS To understand the behaviour of OHS in different parts of the country during the COVID-19 pandemic. METHODS An online survey link was sent to both accredited and unaccredited UK Occupational Health Physicians (OHPs). RESULTS Sixty-two OHPs responded to the survey. In the current pandemic, 51% of the OHS (95% CI 0.38-0.62) offered weekend or out-of-hours (OOH) services, 21% had to employ extra staff (95% CI 0.13-0.33) and 54% had to change their working hours (95% CI 0.41-0.65). Ninety per cent of the OHS (95% CI 0.78-0.94) continued to offer routine services; however, there was a decline in offering vaccination services. Fifty-six per cent of the OHS (95% CI 0.42-0.67) offered a dedicated telephone line and 46% of the OHS (95% CI 0.32-0.56) started a dedicated COVID-19 queries inbox. CONCLUSIONS There was a change in the behaviour of the OHS to cope with the pandemic. Having a dedicated helpline to manage the crisis situation seemed a logical step whilst offering routine services.
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Affiliation(s)
- S Ranka
- Occupational Health, Healthwork Limited, Manchester, UK
| | - J Quigley
- Occupational Health, Healthwork Limited, Manchester, UK
| | - T Hussain
- Occupational Health, Healthwork Limited, Manchester, UK
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Lombard J, Urie N, Garry F, Godden S, Quigley J, Earleywine T, McGuirk S, Moore D, Branan M, Chamorro M, Smith G, Shivley C, Catherman D, Haines D, Heinrichs AJ, James R, Maas J, Sterner K. Consensus recommendations on calf- and herd-level passive immunity in dairy calves in the United States. J Dairy Sci 2020; 103:7611-7624. [PMID: 32448583 DOI: 10.3168/jds.2019-17955] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/16/2020] [Indexed: 01/29/2023]
Abstract
Passive immunity in calves is evaluated or quantified by measuring serum or plasma IgG or serum total protein within the first 7 d of age. While these measurements inform about circulating concentrations of this important protein, they are also a proxy for evaluating all of the additional benefits of colostral ingestion. The current individual calf standard for categorizing dairy calves with successful passive transfer or failure of passive transfer of immunity are based on serum IgG concentrations of ≥10 and <10 g/L, respectively. This cutoff was based on higher mortality rates in calves with serum IgG <10 g/L. Mortality rates have decreased since 1991, but the percentage of calves with morbidity events has not changed over the same time period. Almost 90% of calves sampled in the USDA National Animal Health Monitoring System's Dairy 2014 study had successful passive immunity based on the dichotomous standard. Based on these observations, a group of calf experts were assembled to evaluate current data and determine if changes to the passive immunity standards were necessary to reduce morbidity and possibly mortality. In addition to the USDA National Animal Health Monitoring System's Dairy 2014 study, other peer-reviewed publications and personal experience were used to identify and evaluate potential standards. Four options were evaluated based on the observed statistical differences between categories. The proposed standard includes 4 serum IgG categories: excellent, good, fair, and poor with serum IgG levels of ≥25.0, 18.0-24.9, 10.0-17.9, and <10 g/L, respectively. At the herd level, we propose an achievable standard of >40, 30, 20, and <10% of calves in the excellent, good, fair, and poor categories, respectively. Because serum IgG concentrations are not practical for on-farm implementation, we provide corresponding serum total protein and %Brix values for use on farm. With one-third of heifer calves in 2014 already meeting the goal of ≥25 g/L serum IgG at 24 h of life, this achievable standard will require more refinement of colostrum management programs on many dairy farms. Implementation of the proposed standard should further reduce the risk of both mortality and morbidity in preweaned dairy calves, improving overall calf health and welfare.
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Affiliation(s)
- J Lombard
- USDA-Animal and Plant Health Inspection Service-Veterinary Services, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO 80526-8117.
| | - N Urie
- USDA-Animal and Plant Health Inspection Service-Veterinary Services, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO 80526-8117
| | - F Garry
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523-1678
| | - S Godden
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul 55108
| | - J Quigley
- Cargill Animal Nutrition, Brookville, OH 45309
| | - T Earleywine
- Land O'Lakes Animal Milk Solutions, Cottage Grove, WI 53527
| | - S McGuirk
- School of Veterinary Medicine, University of Wisconsin, Madison 53706
| | - D Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman 99164
| | - M Branan
- USDA-Animal and Plant Health Inspection Service-Veterinary Services, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO 80526-8117
| | - M Chamorro
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849
| | - G Smith
- Department of Population Health and Pathobiology, North Carolina State University, Raleigh 27607
| | - C Shivley
- USDA-Animal and Plant Health Inspection Service-Veterinary Services, Center for Epidemiology and Animal Health, National Animal Health Monitoring System, Fort Collins, CO 80526-8117
| | | | - D Haines
- SCCL, Saskatoon, Saskatchewan, Canada, 57K 6A2
| | - A J Heinrichs
- Department of Animal Science, The Pennsylvania State University, University Park 16802
| | - R James
- Down Home Heifer Solutions, Blacksburg, VA 24060
| | - J Maas
- School of Veterinary Medicine, University of California, Davis 95616
| | - K Sterner
- Sterner Veterinary Clinic P.C., Ionia, MI 48846
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7
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Krosschell KJ, Bosch M, Nelson L, Duong T, Lowes LP, Alfano LN, Benjamin D, Carry TB, Devine G, Kelley C, Gadekan R, Malkus EC, Pasternak A, Provance-Orr S, Roemeiser-Logan L, Nicorici A, Trussell D, Young SD, Fetterman JR, Montes J, Powers PJ, Quinones R, Quigley J, Coffey CS, Yankey JW, Bartlett A, Kissel JT, Kolb SJ. Motor Function Test Reliability During the NeuroNEXT Spinal Muscular Atrophy Infant Biomarker Study. J Neuromuscul Dis 2018; 5:509-521. [PMID: 30223401 PMCID: PMC8112280 DOI: 10.3233/jnd-180327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 01/06/2023]
Abstract
BACKGROUND The NeuroNEXT SMA Infant Biomarker Study, a two year, longitudinal, multi-center study of infants with SMA type 1 and healthy infants, presented a unique opportunity to assess multi-site rater reliability on three infant motor function tests (MFTs) commonly used to assess infants with SMA type 1. OBJECTIVE To determine the effect of prospective MFT rater training and the effect of rater experience on inter-rater and intra-rater reliability for the Test of Infant Motor Performance Screening Items (TIMPSI), the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Alberta Infant Motor Scale (AIMS). METHODS Training was conducted utilizing a novel set of motor function test (MFT) videos to optimize accurate MFT administration and reliability for the study duration. Inter- and intra-rater reliability of scoring for the TIMPSI and inter-rater reliability of scoring for the CHOP INTEND and the AIMS was assessed using intraclass correlation coefficients (ICC). Effect of rater experience on reliability was examined using ICC. Agreement with 'expert' consensus scores was examined using Pearson's correlation coefficients. RESULTS Inter-rater reliability on all MFTs was good to excellent. Intra-rater reliability for the primary MFT, the TIMPSI, was excellent for the study duration. Agreement with 'expert' consensus was within predetermined limits (≥85%) after training. Evaluator experience with SMA and MFTs did not affect reliability. CONCLUSIONS Reliability of scores across evaluators was demonstrated for all three study MFTs and scores were reproducible on repeated administration. Evaluator experience had no effect on reliability.
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Affiliation(s)
- Kristin J. Krosschell
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael Bosch
- Department of Biostatistics, NeuroNEXT Data Coordinating Center, University of Iowa, Iowa City, IA, USA
| | - Leslie Nelson
- Physical Therapy, UT Southwestern Medical Center, Dallas, TX, USA
| | - Tina Duong
- Department of Neurology, Stanford University, Palo Alto, CA, USA
| | - Linda P. Lowes
- Neurology, Nationwide Children’s Hospital, Columbus, OH, USA
| | | | - Danielle Benjamin
- Physical Therapy, Oregon Health and Science University, Portland, OR, USA
| | - Terri B. Carry
- Physical Therapy, Children’s Hospital Colorado, Aurora, CO, USA
| | - Ginger Devine
- Pi Beta Phi Rehabilitation Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Carolyn Kelley
- Physical Therapy, Children’s Hospital Colorado, Aurora, CO, USA
| | - Rebecca Gadekan
- Neuromuscular Division, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Amy Pasternak
- The Department of Physical Therapy and Occupational Therapy Services, Boston Children’s Hospital, Boston, MA, USA
- The Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
| | | | | | - Alina Nicorici
- Physical Medicine and Rehabilitation, University of California – Davis, Davis, CA, USA
| | | | - Sally Dunaway Young
- Departments of Neurology and Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY, USA
| | | | - Jacqueline Montes
- Departments of Neurology and Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY, USA
| | - Penny J. Powers
- Pi Beta Phi Rehabilitation Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Janet Quigley
- The Department of Physical Therapy and Occupational Therapy Services, Boston Children’s Hospital, Boston, MA, USA
- The Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
| | - Christopher S. Coffey
- Department of Biostatistics, NeuroNEXT Data Coordinating Center, University of Iowa, Iowa City, IA, USA
| | - Jon W. Yankey
- Department of Biostatistics, NeuroNEXT Data Coordinating Center, University of Iowa, Iowa City, IA, USA
| | - Amy Bartlett
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - John T. Kissel
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Stephen J. Kolb
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Biological Chemistry and Pharmacology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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8
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Ramsey D, Scoto M, Mayhew A, Main M, Mazzone ES, Montes J, de Sanctis R, Dunaway Young S, Salazar R, Glanzman AM, Pasternak A, Quigley J, Mirek E, Duong T, Gee R, Civitello M, Tennekoon G, Pane M, Pera MC, Bushby K, Day J, Darras BT, De Vivo D, Finkel R, Mercuri E, Muntoni F. Revised Hammersmith Scale for spinal muscular atrophy: A SMA specific clinical outcome assessment tool. PLoS One 2017; 12:e0172346. [PMID: 28222119 PMCID: PMC5319655 DOI: 10.1371/journal.pone.0172346] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/03/2017] [Indexed: 01/18/2023] Open
Abstract
Recent translational research developments in Spinal Muscular Atrophy (SMA), outcome measure design and demands from regulatory authorities require that clinical outcome assessments are 'fit for purpose'. An international collaboration (SMA REACH UK, Italian SMA Network and PNCRN USA) undertook an iterative process to address discontinuity in the recorded performance of the Hammersmith Functional Motor Scale Expanded and developed a revised functional scale using Rasch analysis, traditional psychometric techniques and the application of clinical sensibility via expert panels. Specifically, we intended to develop a psychometrically and clinically robust functional clinician rated outcome measure to assess physical abilities in weak SMA type 2 through to strong ambulant SMA type 3 patients. The final scale, the Revised Hammersmith Scale (RHS) for SMA, consisting of 36 items and two timed tests, was piloted in 138 patients with type 2 and 3 SMA in an observational cross-sectional multi-centre study across the three national networks. Rasch analysis demonstrated very good fit of all 36 items to the construct of motor performance, good reliability with a high Person Separation Index PSI 0.98, logical and hierarchical scoring in 27/36 items and excellent targeting with minimal ceiling. The RHS differentiated between clinically different groups: SMA type, World Health Organisation (WHO) categories, ambulatory status, and SMA type combined with ambulatory status (all p < 0.001). Construct and concurrent validity was also confirmed with a strong significant positive correlation with the WHO motor milestones rs = 0.860, p < 0.001. We conclude that the RHS is a psychometrically sound and versatile clinical outcome assessment to test the broad range of physical abilities of patients with type 2 and 3 SMA. Further longitudinal testing of the scale with regards change in scores over 6 and 12 months are required prior to its adoption in clinical trials.
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Affiliation(s)
- Danielle Ramsey
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mariacristina Scoto
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Anna Mayhew
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle, United Kingdom
| | - Marion Main
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Elena S. Mazzone
- Department of Child Neurology, Catholic University in Rome, Rome, Italy
| | - Jacqueline Montes
- Department of Neurology, Columbia University Medical Center, New York, New York, United States of America
| | | | - Sally Dunaway Young
- Department of Neurology, Columbia University Medical Center, New York, New York, United States of America
| | - Rachel Salazar
- Department of Neurology, Columbia University Medical Center, New York, New York, United States of America
| | - Allan M. Glanzman
- Department of Physical Therapy, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Amy Pasternak
- Departments of Neurology and Physical Therapy and Occupational Therapy Services, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Janet Quigley
- Departments of Neurology and Physical Therapy and Occupational Therapy Services, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Elizabeth Mirek
- Departments of Neurology and Physical Therapy and Occupational Therapy Services, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Tina Duong
- Department of Neurology, Stanford University, Palo Alto, California, United States of America
| | - Richard Gee
- Lucille Packard Children’s Hospital, Stanford University, Palo Alto, California, United States of America
| | - Matthew Civitello
- Nemours Children’s Hospital, University of Central Florida College of Medicine, Orlando, Florida, United States of America
| | - Gihan Tennekoon
- Department of Neurology, The Children’s Hospital of Philadelphia and the Pearlman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Marika Pane
- Department of Child Neurology, Catholic University in Rome, Rome, Italy
| | | | - Kate Bushby
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle, United Kingdom
| | - John Day
- Department of Neurology, Stanford University, Palo Alto, California, United States of America
| | - Basil T. Darras
- Departments of Neurology and Physical Therapy and Occupational Therapy Services, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Darryl De Vivo
- Department of Neurology, Columbia University Medical Center, New York, New York, United States of America
| | - Richard Finkel
- Nemours Children’s Hospital, University of Central Florida College of Medicine, Orlando, Florida, United States of America
| | - Eugenio Mercuri
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Child Neurology, Catholic University in Rome, Rome, Italy
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- * E-mail:
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9
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McEvoy J, Treacy B, Quigley J. A matter of life and death: knowledge about the body and concept of death in adults with intellectual disabilities. J Intellect Disabil Res 2017; 61:89-98. [PMID: 27862508 DOI: 10.1111/jir.12347] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND An increased awareness of how people with intellectual disabilities (ID) understand death and dying is necessary in supporting life-long learning, post-bereavement support and planning end-of-life care. Previous research suggests that adults with ID have a limited or 'patchy' understanding of the basic biological components of death. However, the relationship between biological understanding of how the body works and conceptualisation of death remains unexplored in this population. METHOD Thirty adults with ID were interviewed to assess their knowledge of human body function and their understanding of the concept of death. Using pictures, participants were asked if they recognised certain organs, asked to explain the function of various body parts and what would happen if certain body parts were missing or did not work. Participants who referred to 'life' or 'not dying' as the goal of body function were categorised as 'Life Theorisers'. In addition, participants were asked about the causes of death, whether all things die and the status of the body after death. RESULTS The results support previous studies suggesting that understanding of death in adults with ID varies from partial to full comprehension and is associated with level of ID. Also, death comprehension was positively correlated with total body interview scores and 'Life Theorisers' who understood that body parts maintain life and who spontaneously appealed to 'vitalistic' concepts when reasoning about the human body were also more sophisticated in their understanding of death. CONCLUSION The study highlights the relationship between knowledge about the goal of human body functioning and death comprehension in adults with ID. The potential that learning to adopt a 'vitalistic' approach to human functioning may have on the acquisition of a greater understanding of death and dying, understanding illness and supporting end-of-life planning is discussed.
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Affiliation(s)
- J McEvoy
- School of Psychology, University College Dublin, Dublin, Ireland
| | - B Treacy
- School of Psychology, University of Dublin, Trinity College, Dublin, Ireland
| | - J Quigley
- School of Psychology, University of Dublin, Trinity College, Dublin, Ireland
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10
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Pasternak A, Sideridis G, Fragala-Pinkham M, Glanzman AM, Montes J, Dunaway S, Salazar R, Quigley J, Pandya S, O'Riley S, Greenwood J, Chiriboga C, Finkel R, Tennekoon G, Martens WB, McDermott MP, Fournier HS, Madabusi L, Harrington T, Cruz RE, LaMarca NM, Videon NM, Vivo DCD, Darras BT. Rasch analysis of the Pediatric Evaluation of Disability Inventory-computer adaptive test (PEDI-CAT) item bank for children and young adults with spinal muscular atrophy. Muscle Nerve 2016; 54:1097-1107. [DOI: 10.1002/mus.25164] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 01/27/2023]
Affiliation(s)
- Amy Pasternak
- Department of Physical Therapy and Occupational Therapy Services, 300 Longwood Avenue; Boston Children's Hospital; Boston Massachusetts USA
| | - Georgios Sideridis
- Clinical Research Center, Department of Medicine and Division of Developmental Medicine, Boston Children's Hospital; Harvard Medical School; Boston Massachusetts USA
| | - Maria Fragala-Pinkham
- Research Center for Children with Special Health Care Needs; Franciscan Hospital for Children; Brighton Massachusetts USA
| | - Allan M. Glanzman
- Department of Physical Therapy; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
| | - Jacqueline Montes
- Department of Rehabilitation and Regenerative Medicine; Columbia University Medical Center; New York New York USA
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Sally Dunaway
- Department of Rehabilitation and Regenerative Medicine; Columbia University Medical Center; New York New York USA
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Rachel Salazar
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Janet Quigley
- Department of Physical Therapy and Occupational Therapy Services, 300 Longwood Avenue; Boston Children's Hospital; Boston Massachusetts USA
| | - Shree Pandya
- Department of Neurology; University of Rochester; Rochester New York USA
| | - Susan O'Riley
- Department of Physical and Occupational Therapy; Massachusetts General Hospital; Boston Massachusetts USA
| | - Jonathan Greenwood
- Department of Physical Therapy and Occupational Therapy Services, 300 Longwood Avenue; Boston Children's Hospital; Boston Massachusetts USA
| | - Claudia Chiriboga
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Richard Finkel
- Department of Pediatrics; Nemours Children's Hospital; Orlando Florida USA
| | - Gihan Tennekoon
- Department of Neurology; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
- Department of Pediatrics; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
| | - William B. Martens
- Department of Neurology; University of Rochester; Rochester New York USA
| | - Michael P. McDermott
- Department of Neurology; University of Rochester; Rochester New York USA
- Department of Biostatistics and Computational Biology; University of Rochester; New York USA
| | - Heather Szelag Fournier
- Department of Neurology, Boston Children's Hospital; Harvard Medical School; Boston Massachusetts USA
| | - Lavanya Madabusi
- Department of Neurology, Boston Children's Hospital; Harvard Medical School; Boston Massachusetts USA
| | - Timothy Harrington
- Department of Neurology, Boston Children's Hospital; Harvard Medical School; Boston Massachusetts USA
| | - Rosangel E. Cruz
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Nicole M. LaMarca
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Nancy M. Videon
- Department of Neurology; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
- Department of Pediatrics; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
| | - Darryl C. De Vivo
- Department of Neurology; Columbia University Medical Center; New York New York USA
| | - Basil T. Darras
- Department of Neurology, Boston Children's Hospital; Harvard Medical School; Boston Massachusetts USA
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11
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Connolly AM, Florence JM, Zaidman CM, Golumbek PT, Mendell JR, Flanigan KM, Karachunski PI, Day JW, McDonald CM, Darras BT, Kang PB, Siener CA, Gadeken RK, Anand P, Schierbecker JR, Malkus EC, Lowes LP, Alfano LN, Johnson L, Nicorici A, Kelecic JM, Quigley J, Pasternak AE, Miller JP. Clinical trial readiness in non-ambulatory boys and men with duchenne muscular dystrophy: MDA-DMD network follow-up. Muscle Nerve 2016; 54:681-9. [DOI: 10.1002/mus.25089] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/16/2016] [Accepted: 02/23/2016] [Indexed: 01/14/2023]
Affiliation(s)
- Anne M. Connolly
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
- Department of Pediatrics; Washington University School of Medicine; Saint Louis Missouri USA
| | - Julaine M. Florence
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
| | - Craig M. Zaidman
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
- Department of Pediatrics; Washington University School of Medicine; Saint Louis Missouri USA
| | - Paul T. Golumbek
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
- Department of Pediatrics; Washington University School of Medicine; Saint Louis Missouri USA
| | - Jerry R. Mendell
- Department of Pediatrics; Ohio State University, and the Center for Gene Therapy, Nationwide Children's Hospital; Columbus Ohio USA
| | - Kevin M. Flanigan
- Department of Pediatrics; Ohio State University, and the Center for Gene Therapy, Nationwide Children's Hospital; Columbus Ohio USA
| | | | - John W. Day
- Department of Neurology; Stanford University; Stanford California USA
| | - Craig M. McDonald
- Department Physical Medicine and Rehabilitation; University of California, Davis Medical Center; Sacramento California USA
| | - Basil T. Darras
- Department of Neurology; Harvard University, Boston Children's Hospital; Boston Massachusetts USA
| | - Peter B. Kang
- Division of Pediatric Neurology; University of Florida College of Medicine; Gainesville Florida USA
| | - Catherine A. Siener
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
| | - Rebecca K. Gadeken
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
| | - Pallavi Anand
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
| | | | - Elizabeth C. Malkus
- Department of Neurology; Washington University School of Medicine; Saint Louis Missouri USA
| | - Linda P. Lowes
- Department of Pediatrics; Ohio State University, and the Center for Gene Therapy, Nationwide Children's Hospital; Columbus Ohio USA
| | - Lindsay N. Alfano
- Department of Pediatrics; Ohio State University, and the Center for Gene Therapy, Nationwide Children's Hospital; Columbus Ohio USA
| | - Linda Johnson
- Department Physical Medicine and Rehabilitation; University of California, Davis Medical Center; Sacramento California USA
| | - Alina Nicorici
- Department Physical Medicine and Rehabilitation; University of California, Davis Medical Center; Sacramento California USA
| | - Jason M. Kelecic
- Department of Neurology; University of Minnesota; Minneapolis Minnesota USA
| | - Janet Quigley
- Department of Neurology; Harvard University, Boston Children's Hospital; Boston Massachusetts USA
| | - Amy E. Pasternak
- Department of Neurology; Harvard University, Boston Children's Hospital; Boston Massachusetts USA
| | - J. Philip Miller
- Division of Biostatistics; Washington University School of Medicine; Saint Louis Missouri USA
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12
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Montes J, Glanzman AM, Mazzone ES, Martens WB, Dunaway S, Pasternak A, Riley SO, Quigley J, Pandya S, De Vivo DC, Kaufmann P, Chiriboga CA, Finkel RS, Tennekoon GI, Darras BT, Pane M, Mercuri E, Mcdermott MP. Spinal muscular atrophy functional composite score: A functional measure in spinal muscular atrophy. Muscle Nerve 2015; 52:942-7. [PMID: 25846132 DOI: 10.1002/mus.24670] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/06/2015] [Accepted: 03/25/2015] [Indexed: 01/30/2023]
Abstract
INTRODUCTION With clinical trials underway, our objective was to construct a composite score of global function that could discriminate among people with spinal muscular atrophy (SMA). METHODS Data were collected from 126 participants with SMA types 2 and 3. Scores from the Hammersmith Functional Motor Scale-Expanded and Upper Limb Module were expressed as a percentage of the maximum score and 6-minute walk test as percent of predicted normal distance. A principal component analysis was performed on the correlation matrix for the 3 percentage scores. RESULTS The first principal component yielded a composite score with approximately equal weighting of the 3 components and accounted for 82% of the total variability. The SMA functional composite score, an unweighted average of the 3 individual percentage scores, correlated almost perfectly with the first principal component. CONCLUSIONS This combination of measures broadens the spectrum of ability that can be quantified in type 2 and 3 SMA patients.
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Affiliation(s)
- Jacqueline Montes
- Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York, 10032, USA.,Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, New York, USA
| | - Allan M Glanzman
- Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elena S Mazzone
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - William B Martens
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Sally Dunaway
- Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York, 10032, USA
| | - Amy Pasternak
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Susan O Riley
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Janet Quigley
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shree Pandya
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Darryl C De Vivo
- Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York, 10032, USA
| | - Petra Kaufmann
- Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York, 10032, USA
| | - Claudia A Chiriboga
- Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York, 10032, USA
| | - Richard S Finkel
- Division of Neurology, Nemours Children's Hospital, Orlando, Florida, USA
| | - Gihan I Tennekoon
- Division of Neurology, Children's Hospital of Philadelphia and Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Basil T Darras
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marika Pane
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Eugenio Mercuri
- Department of Paediatric Neurology, Catholic University, Rome, Italy
| | - Michael P Mcdermott
- Department of Neurology, University of Rochester, Rochester, New York, USA.,Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
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Mone F, Quigley J, Doyle B, Lambert M, Woolfson M, Downey P, Carroll S, Higgins S, Mahony R, Mcauliffe FM, Fitzgerald J, Mcparland P. Clinical disparity of haemolytic disease of the fetus and newborn in twin pregnancy. Transfus Med 2015; 25:345-6. [DOI: 10.1111/tme.12230] [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] [Received: 05/17/2015] [Revised: 07/15/2015] [Accepted: 07/16/2015] [Indexed: 11/30/2022]
Affiliation(s)
- F. Mone
- Department of Fetal Medicine; National Maternity Hospital; Dublin
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science; University College Dublin
| | - J. Quigley
- Department of Pathology and Laboratory Medicine; National Maternity Hospital; Dublin
| | - B. Doyle
- Irish Blood Transfusion Service; National Blood Centre; Dublin
| | - M. Lambert
- Irish Blood Transfusion Service; National Blood Centre; Dublin
| | - M. Woolfson
- Irish Blood Transfusion Service; National Blood Centre; Dublin
| | - P. Downey
- Department of Pathology and Laboratory Medicine; National Maternity Hospital; Dublin
| | - S. Carroll
- Department of Fetal Medicine; National Maternity Hospital; Dublin
| | - S. Higgins
- Department of Fetal Medicine; National Maternity Hospital; Dublin
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science; University College Dublin
| | - R. Mahony
- Department of Fetal Medicine; National Maternity Hospital; Dublin
| | - F. M. Mcauliffe
- Department of Fetal Medicine; National Maternity Hospital; Dublin
- UCD Obstetrics and Gynaecology, School of Medicine and Medical Science; University College Dublin
| | - J. Fitzgerald
- Department of Pathology and Laboratory Medicine; National Maternity Hospital; Dublin
| | - P. Mcparland
- Department of Fetal Medicine; National Maternity Hospital; Dublin
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14
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Mazzone E, Montes J, Main M, Mayhew A, Ramsey D, Glanzman AM, Dunaway S, Salazar R, Pasternak A, Quigley J, Pane M, Pera MC, Scoto M, Messina S, Sframeli M, D'amico A, Van Den Hauwe M, Sivo S, Goemans N, Darras BT, Kaufmann P, Bertini E, De Vivo DC, Muntoni F, Finkel R, Mercuri E. Old measures and new scores in spinal muscular atrophy patients. Muscle Nerve 2015; 52:435-7. [DOI: 10.1002/mus.24748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Elena Mazzone
- Department of Paediatric Neurology; Catholic University; Largo Gemelli 8 00168 Rome Italy
| | - Jacqueline Montes
- Department of Neurology; Columbia University Medical Center; New York USA
| | - Marion Main
- Dubowitz Neuromuscular Centre; UCL Institute of Child Health & Great Ormond Street Hospital; London UK
| | - Anna Mayhew
- Institute of Genetic Medicine; Newcastle University; Newcastle UK
| | - Danielle Ramsey
- Dubowitz Neuromuscular Centre; UCL Institute of Child Health & Great Ormond Street Hospital; London UK
| | - Allan M. Glanzman
- Department of Physical Therapy; The Children's Hospital of Philadelphia; Philadelphia Pennsylvania USA
| | - Sally Dunaway
- Department of Neurology; Columbia University Medical Center; New York USA
| | - Rachel Salazar
- Department of Neurology; Columbia University Medical Center; New York USA
| | - Amy Pasternak
- Department of Neurology; Boston Children's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - Janet Quigley
- Department of Neurology; Boston Children's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - Marika Pane
- Department of Paediatric Neurology; Catholic University; Largo Gemelli 8 00168 Rome Italy
| | - Maria C. Pera
- Department of Paediatric Neurology; Catholic University; Largo Gemelli 8 00168 Rome Italy
| | - Mariacristina Scoto
- Dubowitz Neuromuscular Centre; UCL Institute of Child Health & Great Ormond Street Hospital; London UK
| | - Sonia Messina
- Department of Neurosciences; University of Messina; Messina Italy
| | - Maria Sframeli
- Department of Neurosciences; University of Messina; Messina Italy
| | - Adele D'amico
- Unit of Neuromuscular and Neurodegenerative Disorders; Department of Neurosciences; IRCCS Bambino Gesù Children's Hospital; Rome Italy
| | | | - Serena Sivo
- Department of Paediatric Neurology; Catholic University; Largo Gemelli 8 00168 Rome Italy
| | - Nathalie Goemans
- Department of Child Neurology; University Hospitals Leuven; Leuven Belgium
| | - Basil T. Darras
- Department of Neurology; Boston Children's Hospital, Harvard Medical School; Boston Massachusetts USA
| | - Petra Kaufmann
- Department of Neurology; Columbia University Medical Center; New York USA
| | - Enrico Bertini
- Unit of Neuromuscular and Neurodegenerative Disorders; Department of Neurosciences; IRCCS Bambino Gesù Children's Hospital; Rome Italy
| | - Darryl C. De Vivo
- Department of Neurology; Columbia University Medical Center; New York USA
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre; UCL Institute of Child Health & Great Ormond Street Hospital; London UK
| | - Richard Finkel
- Nemours Children's Hospital; University of Central Florida College of Medicine; Orlando Florida USA
| | - Eugenio Mercuri
- Department of Paediatric Neurology; Catholic University; Largo Gemelli 8 00168 Rome Italy
- Dubowitz Neuromuscular Centre; UCL Institute of Child Health & Great Ormond Street Hospital; London UK
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15
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Connolly AM, Malkus EC, Mendell JR, Flanigan KM, Miller JP, Schierbecker JR, Siener CA, Golumbek PT, Zaidman CM, Mcdonald CM, Johnson L, Nicorici A, Karachunski PI, Day JW, Kelecic JM, Lowes LP, Alfano LN, Darras BT, Kang PB, Quigley J, Pasternak AE, Florence JM. Outcome reliability in non-ambulatory boys/men with Duchenne muscular dystrophy. Muscle Nerve 2015; 51:522-32. [PMID: 25056178 DOI: 10.1002/mus.24346] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2014] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Therapeutic trials in Duchenne muscular dystrophy (DMD) often exclude non-ambulatory individuals. Here we establish optimal and reliable assessments in a multicenter trial. METHODS Non-ambulatory boys/men with DMD (N = 91; 16.7 ± 4.5 years of age) were assessed by trained clinical evaluators. Feasibility (percentage completing task) and reliability [intraclass correlation coefficients (ICCs) between morning and afternoon tests] were measured. RESULTS Forced vital capacity (FVC), assessed in all subjects, showed a mean of 47.8 ± 22% predicted (ICC 0.98). Brooke Upper Extremity Functional Rating (Brooke) and Egen Klassifikation (EK) scales in 100% of subjects showed ICCs ranging from 0.93 to 0.99. Manual muscle testing, range of motion, 9-hole peg test, and Jebsen-Taylor Hand Function Test (JHFT) demonstrated varied feasibility (99% to 70%), with ICCs ranging from 0.99 to 0.64. We found beneficial effects of different forms of corticosteroids for the Brooke scale, percent predicted FVC, and hand and finger strength. CONCLUSIONS Reliable assessment of non-ambulatory boys/men with DMD is possible. Clinical trials will have to consider corticosteroid use.
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Affiliation(s)
- Anne M Connolly
- Department of Neurology, Washington University School of Medicine in Saint Louis, St. Louis, Missouri, 63110, USA; Department of Pediatrics, Washington University School of Medicine in Saint Louis, St. Louis, Missouri, USA
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16
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Walsh CA, Doyle B, Quigley J, McAuliffe FM, Fitzgerald J, Mahony R, Higgins S, Carroll S, McParland P. Reassessing critical maternal antibody threshold in RhD alloimmunization: a 16-year retrospective cohort study. Ultrasound Obstet Gynecol 2014; 44:669-673. [PMID: 24706487 DOI: 10.1002/uog.13383] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 12/10/2013] [Revised: 03/02/2014] [Accepted: 03/26/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To determine the critical maternal antibody threshold for specialist referral in cases of RhD alloimmunization. METHODS This was a retrospective cohort study, covering a 16-year period at the national tertiary fetal medicine center for management of alloimmunization. Data concerning RhD alloimmunized pregnant women were extracted from an institutional database and maternal anti-D antibody levels were cross-checked with the national reference laboratory. Fetal hemoglobin (Hb) levels were determined only at the first intrauterine transfusion (IUT) and were compared with the pretransfusion maternal anti-D antibody level (IU/mL). Sensitivity, specificity and positive and negative predictive values of maternal antibody thresholds for detecting moderate to severe (Hb ≤ 0.64MoM) fetal anemia were calculated. RESULTS Between 1996 and 2011, 66 women underwent a first IUT for RhD alloimmunization at our institution. The highest serum anti-D antibody level was extracted for 208 RhD alloimmunized women who did not require IUT during the last 10 years of the study period. The traditional maternal antibody threshold of > 15 IU/mL failed to detect 20% of cases of moderate to severe fetal anemia. The ≥ 4 IU/mL threshold had 100% sensitivity but a 45% false-positive rate. The optimal anti-D antibody threshold for specialist referral in our population was ≥ 6 IU/mL; at this level, no case of moderate to severe anemia was missed and specificity was 61%. Use of this threshold would have eliminated 10% of referrals to our fetal medicine unit without compromising fetal outcomes. CONCLUSIONS Setting the critical maternal RhD antibody level at >15 IU/mL does not provide sufficient sensitivity. The lower threshold of ≥ 4 IU/mL, though sensitive, is associated with a 45% false-positive rate. In our population, a threshold of ≥ 6 IU/mL minimizes false-positive referrals while maintaining 100% sensitivity for moderate to severe fetal anemia.
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Affiliation(s)
- C A Walsh
- Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland
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17
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Doyle B, Quigley J, Lambert M, Crumlish J, Walsh C, Adshead S, Woolfson M, McParland P, Culliton M, Fitzgerald J. Red cell alloimmunisation following intrauterine transfusion and the feasibility of providing extended phenotype-matched red cell units. Transfus Med 2014; 24:311-5. [DOI: 10.1111/tme.12145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 06/10/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022]
Affiliation(s)
- B. Doyle
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service
| | - J. Quigley
- Department of Transfusion Medicine; National Maternity Hospital
| | - M. Lambert
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service
| | - J. Crumlish
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service
| | - C. Walsh
- Department of Fetal Medicine; National Maternity Hospital
| | - S. Adshead
- Automated Donor Grouping Laboratory; Irish Blood Transfusion Service; Dublin Ireland
| | - M. Woolfson
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service
| | - P. McParland
- Department of Fetal Medicine; National Maternity Hospital
| | - M. Culliton
- Department of Transfusion Medicine; National Maternity Hospital
| | - J. Fitzgerald
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service
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18
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Finkel RS, McDermott MP, Kaufmann P, Darras BT, Chung WK, Sproule DM, Kang PB, Foley AR, Yang ML, Martens WB, Oskoui M, Glanzman AM, Flickinger J, Montes J, Dunaway S, O'Hagen J, Quigley J, Riley S, Benton M, Ryan PA, Montgomery M, Marra J, Gooch C, De Vivo DC. Observational study of spinal muscular atrophy type I and implications for clinical trials. Neurology 2014; 83:810-7. [PMID: 25080519 DOI: 10.1212/wnl.0000000000000741] [Citation(s) in RCA: 316] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Prospective cohort study to characterize the clinical features and course of spinal muscular atrophy type I (SMA-I). METHODS Patients were enrolled at 3 study sites and followed for up to 36 months with serial clinical, motor function, laboratory, and electrophysiologic outcome assessments. Intervention was determined by published standard of care guidelines. Palliative care options were offered. RESULTS Thirty-four of 54 eligible subjects with SMA-I (63%) enrolled and 50% of these completed at least 12 months of follow-up. The median age at reaching the combined endpoint of death or requiring at least 16 hours/day of ventilation support was 13.5 months (interquartile range 8.1-22.0 months). Requirement for nutritional support preceded that for ventilation support. The distribution of age at reaching the combined endpoint was similar for subjects with SMA-I who had symptom onset before 3 months and after 3 months of age (p=0.58). Having 2 SMN2 copies was associated with greater morbidity and mortality than having 3 copies. Baseline electrophysiologic measures indicated substantial motor neuron loss. By comparison, subjects with SMA-II who lost sitting ability (n=10) had higher motor function, motor unit number estimate and compound motor action potential, longer survival, and later age when feeding or ventilation support was required. The mean rate of decline in The Children's Hospital of Philadelphia Infant Test for Neuromuscular Disorders motor function scale was 1.27 points/year (95% confidence interval 0.21-2.33, p=0.02). CONCLUSIONS Infants with SMA-I can be effectively enrolled and retained in a 12-month natural history study until a majority reach the combined endpoint. These outcome data can be used for clinical trial design.
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Affiliation(s)
- Richard S Finkel
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL.
| | - Michael P McDermott
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Petra Kaufmann
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Basil T Darras
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Wendy K Chung
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Douglas M Sproule
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Peter B Kang
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - A Reghan Foley
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Michelle L Yang
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - William B Martens
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Maryam Oskoui
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Allan M Glanzman
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Jean Flickinger
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Jacqueline Montes
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Sally Dunaway
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Jessica O'Hagen
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Janet Quigley
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Susan Riley
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Maryjane Benton
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Patricia A Ryan
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Megan Montgomery
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Jonathan Marra
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Clifton Gooch
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
| | - Darryl C De Vivo
- From the Departments of Neurology (R.S.F., A.R.F., M.L.Y.), Pediatrics (R.S.F., A. R.F., M.L.Y., M.B.), and Physical Therapy (A.M.G., J.F.),The Children's Hospital of Philadelphia, and Perelman School of Medicine at the University of Pennsylvania (R.S.F., A.R.F., M.L.Y.), Philadelphia; Departments of Biostatistics and Computational Biology (M.P.M.) and Neurology (M.P.M., W.B.M.), University of Rochester, NY; Departments of Neurology (P.K., D.M.S., J. Montes, S.D., J.O., M.M., J. Marra, D.C.D.V.) and Pediatrics (W.K.C., D.M.S., P.A.R., D.C.D.V.), Columbia University, New York, NY; Departments of Neurology (B.T.D., P.B.K.) and Physical Therapy (J.Q., S.R.), Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Neurology (C.G.), University of South Florida, Tampa; and Departments of Neurology & Neurosurgery (M.O.) and Pediatrics (M.O.), McGill University, Montreal, Canada. R.S.F. is currently with the Division of Neurology, Nemours Children's Hospital, Orlando, FL. P.B.K. is currently with the Division of Pediatric Neurology, University of Florida College of Medicine, Gainesville, FL
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Doyle B, Quigley J, Lambert M, Crumlish J, Walsh C, McParland P, Culliton M, Murphy K, Fitzgerald J. A correlation between severe haemolytic disease of the fetus and newborn and maternal ABO blood group. Transfus Med 2014; 24:239-43. [PMID: 24975587 DOI: 10.1111/tme.12132] [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: 02/12/2014] [Revised: 05/24/2014] [Accepted: 05/26/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyse anti-D quantification levels and frequency of intrauterine transfusion (IUT), per maternal ABO blood group. BACKGROUND Maternally derived red cell allo-antibodies can target fetal red cell antigens in utero leading to haemolytic disease and fetal anaemia. When a clinically significant allo-antibody is formed the priority is ascertaining the risk to the fetus and maternal ABO blood groups are not considered relevant. MATERIALS AND METHODS This was a 10-year retrospective, observational study carried out on women referred for anti-D quantification (n = 1106), and women whose fetuses required an IUT to treat fetal anaemia (n = 62) due to anti-D, in the Republic of Ireland. RESULTS Relative to the overall incidence of RhD allo-immunisation by blood group, women of blood group A were more likely to require IUT compared with those who were blood group O (P = 0.002). CONCLUSION It is known that ABO feto-maternal compatibility can influence the incidence and level of red cell allo-antibodies in pregnancy; however, it does not account for the significantly high rate of severe haemolytic disease requiring IUT seen in blood group A women.
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Affiliation(s)
- B Doyle
- Red Cell Immunohaematology Laboratory, Irish Blood Transfusion Service, Dublin, Ireland
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Doyle B, Quigley J, Allen C, Fitzgerald J. Homozygous expression of fetal red cell antigen in donor oocyte pregnancy complicated by allo-immunisation: are current antibody thresholds to trigger increased monitoring relevant? Transfus Med 2014; 24:182-3. [DOI: 10.1111/tme.12117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/08/2014] [Accepted: 02/22/2014] [Indexed: 11/29/2022]
Affiliation(s)
- B. Doyle
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service; Dublin Ireland
| | - J. Quigley
- Department of Transfusion Medicine; National Maternity Hospital; Dublin Ireland
| | - C. Allen
- Merrion Fertility Clinic; Dublin Ireland
- Department of Obstetrics and Gynaecology; National Maternity Hospital; Dublin Ireland
| | - J. Fitzgerald
- Red Cell Immunohaematology Laboratory; Irish Blood Transfusion Service; Dublin Ireland
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Kumar G, Quigley J, Singh M, Keeping S, Pitman R, Carroll S. Do local enhanced services in primary care improve outcomes? Results from a literature review. Qual Prim Care 2014; 22:157-169. [PMID: 24865343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This paper aims to examine the role of local enhanced services (LES) as a financial incentive in improving clinical and process outcomes in primary care with a view to discussing their future in light of the Health and Social Care Act. METHODS A literature review was conducted to identify LES commissioned in the UK in any disease area and to evaluate common themes relating to their impact on outcomes. The literature review consisted of two stages: an initial reference database search (MEDLINE, MEDLINE IN-PROCESS and EMBASE) and a more general internet search. The internet search used free text augmented by a targeted search of key health organisations' websites. Data were extracted from the LES to provide information on the background and context of the LES before going on to describe the incentive structure, health and economic outcomes and limitations of the LES. RESULTS Although a number of LES were identified in the online search, only 14 reported any data on outcomes. These LES programmes related to 10 different disease areas, with cancer, alcohol dependence and chronic obstructive pulmonary disease (COPD) being the most common health needs. Three common factors between the selected LES emerged that appear to influence the extent of the impact on local health or economic outcomes: (1) a national framework supporting the LES, (2) existing service provision, and (3) the size of the financial incentives. CONCLUSION The common themes emerging from the literature review suggest that, following the Health and Social Care Act 2012 and newly established national standards, given sufficient attention to planning service specifications, LES could continue to be important in reducing health inequalities and preparing poorly performing general practices for longer term changes directed at improving outcomes and standards in healthcare.
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Affiliation(s)
- G Kumar
- ICON Health Economics, ICON Health Economics, Seacourt Tower, West Way, Oxford OX2 0JJ, UK.
| | | | - M Singh
- ICON Health Economics, Oxford, UK
| | | | - R Pitman
- ICON Health Economics, Oxford, UK
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Quigley J, Hernandez RK, Pirolli M, Quach D, Liede A. Abstract P3-06-12: Estimating prevalence of stage II-III breast cancer in the United States by treatment and biologic subtypes using oncology clinic data. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-06-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Breast cancer (BC) is the most common malignancy and the second most common cause of cancer death among women in the US, and the main cause of death in women ages 40 to 49 years. Stage II and III BC are diverse diseases represented by several biologic subtypes with distinct behaviors, which have not been quantified outside of clinical trials or SEER using observational data. Additionally, although guidelines address the use of adjuvant treatment (tx) based on tumor grade, lymph node involvement, tumor size, and whether the tumor expression pattern is consistent with estrogen receptor (ER), progesterone receptor (PR), or Her2 receptor over-expression, there is considerable heterogeneity in clinical practice with respect to the types of tx used for patients with early stage BC. The objective of this study was to estimate the number of women (prevalence) with Stage II and III BC in the US by year, as well as the proportion of patients treated with chemotherapy or biologic tx, stratified by subtype and age using electronic medical record (EMR) data from oncology clinics.
Methods:
The Oncology Services Comprehensive Electronic Records (OSCER) database was used to identify women with early stage BC and ≥1 visit to a clinic in each year, 2009-2012. OSCER captures EMR data on >500,000 cancer patients since 2004 from outpatient community and hospital-affiliated oncology practices across the US. Women with a diagnosis of BC (ICD-9 174) were identified using a 4-year look-back period. Women with stage I disease were excluded due to variability in the use of adjuvant tx. Treated patients were defined as receiving any chemotherapy or biologic tx during the year of interest. Raw counts from OSCER were projected nationally with 95% confidence intervals through direct estimation methods utilizing claims data.
Results: When projected to the US population, the prevalence of women with Stage II or III BC was estimated at 316,827 (311,040 - 322,614), 308,792 (303,267 - 314,317), 317,691 (311,543 - 323,839), and 321,281 (315,470 - 327,092) from 2009-2012, respectively. In 2012, 65% of these women had Stage II disease, 76% were over the age of 50, 30% were Her2 positive (+ve), and 63% were ER/PR +ve (17% were Her2/ER/PR +ve). Approximately 46% of Stage II-III BC patients received treatment in an outpatient oncology clinic (45% of Stage II and 48% of Stage III). The proportion of early-stage BC patients receiving tx was very similar across biologic subtypes. Women 65 years or older were least likely to receive tx (42%) of all strata examined.
2012 Patients Prevalence% treatedBC Stage II-III32128146Stage II20932745Stage III11195448Her2 Status Her2 +ve9677451Her2 -ve22450744ER, PR Status ER, PR +ve20328644ER -ve, PR +ve498952ER +ve, PR -ve3339145ER, PR -ve7961552Age Group <507608152≥5024520045<6521016948≥6511111242
Conclusions:
This is the first study to estimate diagnosed and treated prevalence of women with Stage II or III BC by hormonal and Her2 status in the US using real-world EMR data. These data suggest that adjuvant chemotherapy or biologic tx is used in approximately 46% of women after BC diagnosis, and women age 65 years or older are less likely to receive adjuvant tx.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-06-12.
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Affiliation(s)
- J Quigley
- IMS Health, Plymouth Meeting, PA; Center for Observational Research, Amgen, Inc., Thousand Oaks, CA; Center for Observational Research, Amgen, Inc., South San Francisco, CA
| | - RK Hernandez
- IMS Health, Plymouth Meeting, PA; Center for Observational Research, Amgen, Inc., Thousand Oaks, CA; Center for Observational Research, Amgen, Inc., South San Francisco, CA
| | - M Pirolli
- IMS Health, Plymouth Meeting, PA; Center for Observational Research, Amgen, Inc., Thousand Oaks, CA; Center for Observational Research, Amgen, Inc., South San Francisco, CA
| | - D Quach
- IMS Health, Plymouth Meeting, PA; Center for Observational Research, Amgen, Inc., Thousand Oaks, CA; Center for Observational Research, Amgen, Inc., South San Francisco, CA
| | - A Liede
- IMS Health, Plymouth Meeting, PA; Center for Observational Research, Amgen, Inc., Thousand Oaks, CA; Center for Observational Research, Amgen, Inc., South San Francisco, CA
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Morrill KM, Polo J, Lago A, Campbell J, Quigley J, Tyler H. Estimate of serum immunoglobulin G concentration using refractometry with or without caprylic acid fractionation. J Dairy Sci 2013; 96:4535-41. [PMID: 23664346 DOI: 10.3168/jds.2012-5843] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 03/26/2013] [Indexed: 11/19/2022]
Abstract
Objectives of this study were to develop a rapid calf-side test to determine serum IgG concentrations using caprylic acid (CA) fractionation, followed by refractometry of the IgG-rich supernatant and compare the accuracy of this method with results obtained using refractometry using raw serum. Serum samples (n=200) were obtained from 1-d-old calves, frozen (-20°C), and shipped to the laboratory. Samples were allowed to thaw for 1h at room temperature. Fractionation with CA was conducted by adding 1mL of serum to a tube containing 45, 60, or 75µL of CA and 0.5, 1.0, or 1.5mL of 0.06 M acetic acid. The tube contents were mixed well, allowed to react for 1 min, and then centrifuged at 3,300 × g for 0, 10, or 20 min at 25°C. The %Brix and refractive index of the fractionated supernatant were determined using a digital refractometer. Nonfractionated serum was analyzed for %Brix (BRn), refractive index (nDn), and IgG concentration by radial immunodiffusion. The mean serum IgG concentration was 19.0 mg/mL [standard deviation (SD)=9.7], with a range of 3.5 to 47.0 mg/mL. The mean serum BRn was 8.6 (SD=0.91), with a range of 6.8 to 11.0. The mean serum nDn was 1.34566 (SD=0.00140), with a range of 1.34300 to 1.34930. Serum nDn was positively correlated with IgG concentration (correlation coefficient=0.86; n=185). Fractionated samples treated with 1mL 0.6 M acetic acid and 60µL of CA and not centrifuged before analysis resulted in a strong relationship between the refractive index of the fractionated supernatant and IgG (correlation coefficient=0.80; n=45). Regression was used to determine cut points indicative of 10, 12, and 14 mg of IgG/mL to determine the sensitivity and specificity of refractometry to identify failure of passive transfer (serum IgG <10 mg/mL at 24 h old). The nDn were 1.34414, 1.34448, and 1.34480 to predict 10, 12, and 14 mg of IgG/mL of serum, respectively. The BRn cut points were 7.6, 7.8, and 8.0, respectively. The nDn cut points of 1.34448 and 1.34480 resulted in similar specificities (82.9%), whereas the 1.34414 cut point had a specificity of 60.0%. The BRn cut point of 7.6 and 7.8%Brix resulted in a similar percentage of correctly classified samples (89.7 and 90.8%, respectively); however, the 7.8% Brix cut point resulted in fewer false positives. These results suggest that Brix refractometry of nonfractionated calf serum provides a strong estimate of IgG concentration and 7.8% Brix may be used as the cut point to identify failure of passive transfer in 1-d-old calves.
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Affiliation(s)
- K M Morrill
- Department of Animal Science, Iowa State University, Ames Iowa, 50014, USA.
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Morrill KM, Conrad E, Lago A, Campbell J, Quigley J, Tyler H. Nationwide evaluation of quality and composition of colostrum on dairy farms in the United States. J Dairy Sci 2012; 95:3997-4005. [PMID: 22720954 DOI: 10.3168/jds.2011-5174] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 03/13/2012] [Indexed: 11/19/2022]
Abstract
The objective of this study was to characterize the quality of maternal colostrum (MC) fed to newborn dairy calves in the United States and identify the proportion of MC that meets industry standards for IgG concentration and total plate count (TPC). Samples of MC (n=827) were collected from 67 farms in 12 states between June and October 2010. Samples were collected from Holsteins (n=494), Jerseys (n=87), crossbred (n=7), and unidentified dairy cattle (n=239) from first (n=49), second (n=174), third or greater (n=128), and unknown (n=476) lactations. Samples were identified as fresh (n=196), refrigerated (n=152), or frozen (n=479) before collection, as well as whether the sample was from an individual cow (n=734) or pooled (n=93). Concentration of IgG in MC ranged from <1 to 200mg/mL, with a mean IgG concentration of 68.8 mg/mL (SD=32.8). Almost 30% of MC contained <50 mg of IgG/mL. The IgG concentration increased with parity (42.4, 68.6, and 95.9 mg/mL in first, second, and third and later lactations, respectively). No differences in IgG concentration were observed among breeds or storage method; however, IgG was highest in samples collected in the Midwest and lowest in samples collected in the Southwest (79.7 vs. 64.3 mg/mL). Total plate count of samples ranged from 3.0 to 6.8 log(10) cfu/mL, with a mean of 4.9 log(10) cfu/mL (SD=0.9) and was greater in samples collected in the Southeast compared with other regions of the country. Pooled samples had greater TPC than individual samples and refrigerated samples had greater TPC than frozen and fresh samples. Almost 43% of samples collected had TPC >100,000 cfu/mL, 16.9% of the samples had >1 million cfu/mL. Only 39.4% of the samples collected met industry recommendations for both IgG concentration and TPC. Almost 60% of MC on dairy farms is inadequate, and a large number of calves are at risk of failure of passive transfer or bacterial infections, or both. Also, the data indicate that regional differences exist in colostrum quality.
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Affiliation(s)
- K M Morrill
- Cornell Cooperative Extension, Cornell University, Ithaca 14853, USA.
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Kaufmann P, McDermott MP, Darras BT, Finkel RS, Sproule DM, Kang PB, Oskoui M, Constantinescu A, Gooch CL, Foley AR, Yang ML, Tawil R, Chung WK, Martens WB, Montes J, Battista V, O'Hagen J, Dunaway S, Flickinger J, Quigley J, Riley S, Glanzman AM, Benton M, Ryan PA, Punyanitya M, Montgomery MJ, Marra J, Koo B, De Vivo DC. Prospective cohort study of spinal muscular atrophy types 2 and 3. Neurology 2012; 79:1889-97. [PMID: 23077013 PMCID: PMC3525313 DOI: 10.1212/wnl.0b013e318271f7e4] [Citation(s) in RCA: 182] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 06/25/2012] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To characterize the natural history of spinal muscular atrophy type 2 and type 3 (SMA 2/3) beyond 1 year and to report data on clinical and biological outcomes for use in trial planning. METHODS We conducted a prospective observational cohort study of 79 children and young adults with SMA 2/3 who participated in evaluations for up to 48 months. Clinically, we evaluated motor and pulmonary function, quality of life, and muscle strength. We also measured SMN2 copy number, hematologic and biochemical profiles, muscle mass by dual x-ray absorptiometry (DXA), and the compound motor action potential (CMAP) in a hand muscle. Data were analyzed for associations between clinical and biological/laboratory characteristics cross-sectionally, and for change over time in outcomes using all available data. RESULTS In cross-sectional analyses, certain biological measures (specifically, CMAP, DXA fat-free mass index, and SMN2 copy number) and muscle strength measures were associated with motor function. Motor and pulmonary function declined over time, particularly at time points beyond 12 months of follow-up. CONCLUSION The intermediate and mild phenotypes of SMA show slow functional declines when observation periods exceed 1 year. Whole body muscle mass, hand muscle compound motor action potentials, and muscle strength are associated with clinical measures of motor function. The data from this study will be useful for clinical trial planning and suggest that CMAP and DXA warrant further evaluation as potential biomarkers.
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Affiliation(s)
- Petra Kaufmann
- Department of Neurology, Columbia University, New York, USA
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Morrill K, Conrad E, Polo J, Lago A, Campbell J, Quigley J, Tyler H. Estimate of colostral immunoglobulin G concentration using refractometry without or with caprylic acid fractionation. J Dairy Sci 2012; 95:3987-96. [DOI: 10.3168/jds.2011-5104] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 02/28/2012] [Indexed: 11/19/2022]
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Florence J, Connolly A, Miller JP, Malkus E, Schierbecker J, Siener C, Wulf C, Anand P, McDonald C, Goude E, Johnson L, Nicorici A, Day J, Karachunski P, Dalton J, Kelecic J, Paulson K, Naughton C, Lowes L, Alfano L, Viollet-Callendret L, Flanigan K, Mendell J, Darras B, Quigley J, Pasternak A, Shriber E, Parad R, MDA DMD Clinical Research Network. Outcomes Measure Reliability in Non Ambulatory Boys and Men with Duchenne Muscular Dystrophy (DMD): Results from the Muscular Dystrophy Association DMD Clinical Research Network (P04.085). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.085] [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: 11/15/2022] Open
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Saraf S, Patel P, Ozer H, Peace D, Quigley J, Mahmud N, Rondelli D. Improved Outcome of African American Multiple Myeloma Patients with Novel Agents and Autologous Stem Cell Transplant. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.238] [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: 10/14/2022]
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Glanzman AM, O'Hagen JM, McDermott MP, Martens WB, Flickinger J, Riley S, Quigley J, Montes J, Dunaway S, Deng L, Chung WK, Tawil R, Darras BT, De Vivo DC, Kaufmann P, Finkel RS. Validation of the Expanded Hammersmith Functional Motor Scale in spinal muscular atrophy type II and III. J Child Neurol 2011; 26:1499-507. [PMID: 21940700 DOI: 10.1177/0883073811420294] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The relationships between the Expanded Hammersmith Functional Motor Scale (HFMSE) and genotype and motor and respiratory outcomes were examined in patients with spinal muscular atrophy types II and III (n = 70). The correlation between the HFMSE and Gross Motor Function Measure was r = 0.98. Correlations between HFMSE and forced vital capacity (percentage of predicted normal) (n = 56) and a functional rating (n = 57) were r = 0.87 and r = 0.92, respectively. Correlations with strength were as follows: knee extension, r = 0.74 (n = 60); elbow flexion, r = 0.77 (n = 61); and knee flexion, r = 0.74 (n = 58). The HFMSE differentiated patients by SMN2 copy number (P = .0007); bi-level positive airway pressure use, <8 versus ≥8 hours/day (P < .0001); ambulatory status (P < .0001); and spinal muscular atrophy type (P < .0001). The HFMSE demonstrates significant associations with established measures of function, strength, and genotype, and discriminates patients based on function, diagnostic category, and bi-level positive airway pressure need. Time of administration averaged 12 minutes. The HFMSE is a valid, time-efficient outcome measure for clinical trials in spinal muscular atrophy types II and III.
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Affiliation(s)
- Allan M Glanzman
- Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
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Pirolli M, Collins H, Quigley J, Hulnick S. 4026 POSTER Rate of Hemoglobin (Hb) Decline by Age and Tumour Type in Patients (pts) Receiving Chemotherapy (CT) Without an Erythropoiesis-stimulating Agent (ESA) in the United States Community Setting. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Pirolli M, Collins H, Hulnick SA, Quigley J. Rate of hemoglobin (Hb) decline from less than 10 g/dl to less than 9 g/dl by electronic medical-record (EMR) evaluation in community oncology patients (pts) receiving chemotherapy in the absence of erythropoiesis-stimulating agents (ESAs). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kaufmann P, McDermott MP, Darras BT, Finkel R, Kang P, Oskoui M, Constantinescu A, Sproule DM, Foley AR, Yang M, Tawil R, Chung W, Martens B, Montes J, O'Hagen J, Dunaway S, Flickinger JM, Quigley J, Riley S, Glanzman AM, Benton M, Ryan PA, Irvine C, Annis CL, Butler H, Caracciolo J, Montgomery M, Marra J, Koo B, De Vivo DC. Observational study of spinal muscular atrophy type 2 and 3: functional outcomes over 1 year. ACTA ACUST UNITED AC 2011; 68:779-86. [PMID: 21320981 DOI: 10.1001/archneurol.2010.373] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To characterize the short-term course of spinal muscular atrophy (SMA) in a genetically and clinically well-defined cohort of patients with SMA. DESIGN A comprehensive multicenter, longitudinal, observational study. SETTING The Pediatric Neuromuscular Clinical Research Network for SMA, a consortium of clinical investigators at 3 clinical sites. PARTICIPANTS Sixty-five participants with SMA types 2 and 3, aged 20 months to 45 years, were prospectively evaluated. INTERVENTION We collected demographic and medical history information and determined the SMN 2 copy number. MAIN OUTCOME MEASURES Clinical outcomes included measures of motor function (Gross Motor Function Measure and expanded Hammersmith Functional Motor Scale), pulmonary function (forced vital capacity), and muscle strength (myometry). Participants were evaluated every 2 months for the initial 6 months and every 3 months for the subsequent 6 months. We evaluated change over 12 months for all clinical outcomes and examined potential correlates of change over time including age, sex, SMA type, ambulatory status, SMN2 copy number, medication use, and baseline function. RESULTS There were no significant changes over 12 months in motor function, pulmonary function, and muscle strength measures. There was evidence of motor function gain in ambulatory patients, especially in those children younger than 5 years. Scoliosis surgery during the observation period led to a subsequent decline in motor function. CONCLUSIONS Our results confirm previous clinical reports suggesting that SMA types 2 and 3 represent chronic phenotypes that have relatively stable clinical courses. We did not detect any measurable clinical disease progression in SMA types 2 and 3 over 12 months, suggesting that clinical trials will have to be designed to measure improvement rather than stabilization of disease progression.
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Affiliation(s)
- Petra Kaufmann
- Department of Neurology, Columbia University, 710 W 168th St, 2nd Floor, New York, NY 10032, USA
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Glanzman AM, McDermott MP, Montes J, Martens WB, Flickinger J, Riley S, Quigley J, Dunaway S, O'Hagen J, Deng L, Chung WK, Tawil R, Darras BT, Yang M, Sproule D, De Vivo DC, Kaufmann P, Finkel RS. Validation of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND). Pediatr Phys Ther 2011; 23:322-6. [PMID: 22090068 DOI: 10.1097/pep.0b013e3182351f04] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Preliminary validation of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) for motor skill assessment in spinal muscular atrophy type I. METHODS A total of 27 subjects 3 to 260 months old (mean = 49, SD = 69) with spinal muscular atrophy-I were evaluated with the CHOP INTEND. Subjects were evaluated as part of a multicenter natural history study. RESULTS CHOP INTEND scores and age were significantly correlated (r = -0.51, P = .007; 2 survival of the motor neuron [SMN] 2 gene copies, n = 16, r = -0.60, 3 SMN2 gene copies, n = 9, r = -0.83). Respiratory support and CHOP INTEND scores were correlated (r = -0.74, P < .0001, n = 26). The CHOP INTEND and age regression in patients with 2 copies versus 3 copies of SMN2 approached significance (P = .0711, n = 25). Subjects who required respiratory support scored significantly lower (mean = 15.5, SD = 10.2 vs mean = 31.2, SD = 4.2, P < .0001, n = 27). Correlation with motor unit number estimation and combined motor unit activation were not significant. CONCLUSION The CHOP INTEND reflects measures of disease severity and supports continued exploration of the CHOP INTEND.
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Affiliation(s)
- Allan M Glanzman
- Department of Physical Therapy, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
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Watson P, van Langen F, Quigley J, Maughan RJ. Systematic examination of the influence of carbohydrate supplementation on physical and mental performance in warm conditions. Br J Sports Med 2010. [DOI: 10.1136/bjsm.2010.078972.62] [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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Montes J, McDermott MP, Martens WB, Dunaway S, Glanzman AM, Riley S, Quigley J, Montgomery MJ, Sproule D, Tawil R, Chung WK, Darras BT, De Vivo DC, Kaufmann P, Finkel RS. Six-Minute Walk Test demonstrates motor fatigue in spinal muscular atrophy. Neurology 2010; 74:833-8. [PMID: 20211907 DOI: 10.1212/wnl.0b013e3181d3e308] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In spinal muscular atrophy (SMA), weakness, decreased endurance, and fatigue limit mobility. Scales have been developed to measure function across the wide spectrum of disease severity. However, these scales typically are observer dependent, and scores are based on sums across Likert-scaled items. The Six-Minute Walk Test (6MWT) is an objective, easily administered, and standardized evaluation of functional exercise capacity that has been proven reliable in other neurologic disorders and in children. METHODS To study the performance of the 6MWT in SMA, 18 ambulatory participants were evaluated in a cross-sectional study. Clinical measures were 6MWT, 10-m walk/run, Hammersmith Functional Motor Scale-Expanded (HFMSE), forced vital capacity, and handheld dynamometry. Associations between the 6MWT total distance and other outcomes were analyzed using Spearman correlation coefficients. A paired t test was used to compare the mean distance walked in the first and sixth minutes. RESULTS The 6MWT was associated with the HFMSE score (r = 0.83, p < 0.0001), 10-m walk/run (r = -0.87, p < 0.0001), and knee flexor strength (r = 0.62, p = 0.01). Gait velocity decreased during successive minutes in nearly all participants. The average first minute distance (57.5 m) was significantly more than the sixth minute distance (48 m) (p = 0.0003). CONCLUSION The Six-Minute Walk Test (6MWT) can be safely performed in ambulatory patients with spinal muscular atrophy (SMA), correlates with established outcome measures, and is sensitive to fatigue-related changes. The 6MWT is a promising candidate outcome measure for clinical trials in ambulatory subjects with SMA.
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Affiliation(s)
- J Montes
- SMA Clinical Research Center, Department of Neurology, Columbia University, 180 Ft. Washington Ave., 5th Floor, New York, NY 10032, USA.
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Nimmagadda S, Sweiss K, Chunduri S, Beri R, Peace D, Quigley J, Dobogai L, Mahmud N, Rondelli D. Increased Mucositis in Patients Receiving Targeted Vs Non-Targeted IV Busulfan Prior to Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.344] [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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Gao J, Zhang HJ, Yu SH, Wu SG, Yoon I, Quigley J, Gao YP, Qi GH. Effects of yeast culture in broiler diets on performance and immunomodulatory functions. Poult Sci 2008; 87:1377-84. [PMID: 18577619 DOI: 10.3382/ps.2007-00418] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A study was conducted to evaluate the effect of supplemental yeast culture (Diamond V XP Yeast Culture; YC) in broiler diets on performance, digestibility, mucosal development, and immunomodulatory functions. One-day-old Arbor Acres chicks (n = 960) were randomly assigned to 1 of 4 dietary treatments based on corn and soybean meal and containing 0, 2.5, 5.0, and 7.5 g/kg of YC in the diet for 42 d. Each treatment consisted of 12 replicates of 20 broilers each. Nutrient digestibility was determined on d 15 and 35 by total fecal collection. On d 21 and 42, 12 birds per treatment were sacrificed to evaluate gut morphology and secretory IgA. Broilers were vaccinated with Newcastle disease vaccine by eye drop on d 7 and 28 and antibody titer was determined on d 14, 21, 35, and 42. Dietary supplemental YC at 2.5 g/kg improved average daily gain and feed conversion during grower and overall periods (P <or= 0.05). Yeast culture supplementation increased digestibility of Ca (linear and quadratic, P = 0.01) and P (linear, P = 0.01) on d 35, but did not affect (P > 0.05) protein retention and energy digestibility. Villus height to crypt depth ratios in the duodenum and jejunum (d 42) and ileum (d 21) were increased (P <or= 0.05) in broilers fed 2.5 g/kg of YC. Yeast culture increased antibody titers to Newcastle disease virus (linear, P <or= 0.05), serum lysozyme activity (linear and cubic, P <or= 0.05), and IgM (linear, P <or= 0.05) and secretary IgA concentrations in the duodenum (linear, P = 0.01). Results of this study indicate that dietary supplemental YC at 2.5 g/kg improved growth performance. Dietary YC affected immune functions, digestibility of Ca and P, and intestinal mucosal morphology of broilers. Growth performance was optimized at 2.5 g/kg of YC in the present study. Immune function could be modified with dietary YC supplementation.
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Affiliation(s)
- J Gao
- Feed Research Institute, Chinese Academy of Agricultural Sciences, Beijing, China
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O'Hagen JM, Glanzman AM, McDermott MP, Ryan PA, Flickinger J, Quigley J, Riley S, Sanborn E, Irvine C, Martens WB, Annis C, Tawil R, Oskoui M, Darras BT, Finkel RS, De Vivo DC. An expanded version of the Hammersmith Functional Motor Scale for SMA II and III patients. Neuromuscul Disord 2007; 17:693-7. [PMID: 17658255 DOI: 10.1016/j.nmd.2007.05.009] [Citation(s) in RCA: 217] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 04/20/2007] [Accepted: 05/25/2007] [Indexed: 01/23/2023]
Abstract
PURPOSE To develop and evaluate an expanded version of the Hammersmith Functional Motor Scale allowing for evaluation of ambulatory SMA patients. PROCEDURES Thirty-eight patients with SMA type II or III were evaluated using the Gross Motor Function Measure and the Hammersmith Functional Motor Scale. Based on statistical and clinical criteria, we selected 13 Gross Motor Function Measure items to develop an expanded HFMS. The expanded Hammersmith Functional Motor Scale was validated by comparison with the Gross Motor Function Measure minus the 13 items (GMFM-75) and an assessment of clinical function. The reliability of the expanded Hammersmith Functional Motor Scale in 36 patients was established. FINDINGS The expanded Hammersmith Functional Motor Scale was highly correlated with the GMFM-75 and the clinical function assessment (p=0.97, and p=0.90). The expanded Hammersmith Functional Motor Scale showed excellent test-retest reliability (International Coordinating Committee = 0.99). CONCLUSIONS The expanded Hammersmith Functional Motor Scale allows assessment of high functioning SMA type II and III patients. Ease of administration and correlation with established motor function measures justify use in future SMA clinical trials.
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Chunduri S, Dobogai L, Peace D, Saunthararajah Y, Quigley J, Chen YH, Boccuni P, Hoffman R, Mahmud N, Beri R, Hurter E, Rondelli D. 230: Fludarabine/full dose I.V. busulfan conditioning regimen in allogeneic PBSC transplantation for high risk patients. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Madsen M, Deryugina E, Niessen S, Cravatt B, Quigley J. ID: 303 Activity Based Protein Profiling of HT-1080 Variants Identifies uPA Activation as a Key Regulator of Tumor Cell Intravasation. J Thromb Haemost 2006. [DOI: 10.1111/j.1538-7836.2006.00303.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Deryugina E, Madsen M, Partridge J, Papagiannakopoulos T, Ardi V, Quigley J. ID: 305 Gene and protein expression profiling of human MMPs and TIMPs in primary tumors derived from high and low disseminating variants of HT-1080 fibrosarcoma. J Thromb Haemost 2006. [DOI: 10.1111/j.1538-7836.2006.00305.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hooper J, Ramsay A, Quigley J, Reid J, Hunt M. ID: 368 Serine proteases as initiators of intracellular signalling. J Thromb Haemost 2006. [DOI: 10.1111/j.1538-7836.2006.00368.x] [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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Chunduri S, Dobogai LC, Peace D, Saunthararajah Y, Chen HY, Mahmud N, Quigley J, Hoffman R, Jessop E, Beri R, Rondelli D. Comparable kinetics of myeloablation between fludarabine/full-dose busulfan and fludarabine/melphalan conditioning regimens in allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 2006; 38:477-82. [PMID: 16980995 DOI: 10.1038/sj.bmt.1705480] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fludarabine was utilized in the conditioning regimen of 30 adult patients undergoing an allogeneic hematopoietic stem cell transplant. In 18 patients it was combined with full-dose busulfan (FluBu) as a myeloablative regimen and in 12 cases with melphalan (FluMel) as a reduced intensity conditioning (RIC) regimen. Patients in the FluBu group were younger than in the FluMel group (P=0.03). Of 30 patients, 24 received peripheral blood stem cells (PBSC) whereas six patients in the FluBu group received bone marrow cells. The hematological toxicity of each regimen was evaluated by analyzing the kinetics of the neutropenia induced by preparative regimens and the time to recovery of the absolute neutrophils count (ANC) and platelets post transplantation. In PBSC transplants, the median day of severe neutropenia (<500 ANC/microl) occurred on day +6 after the FluBu regimen and on day +3 after FluMel (P=ns), whereas both groups had a duration of severe neutropenia of 9 days and a comparable time for ANC and platelet engraftment. Extra-hematological toxicities were also comparable in the two groups. These findings suggest that the hematological and extra-hematological toxicities induced by fludarabine/full-dose i.v. busulfan are similar to those induced by a standard RIC regimen such as fludarabine/melphalan.
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Affiliation(s)
- S Chunduri
- Section of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL 60607-7171, USA
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Noiri E, Lee E, Testa J, Quigley J, Colflesh D, Keese CR, Giaever I, Goligorsky MS. Podokinesis in endothelial cell migration: role of nitric oxide. Am J Physiol 1998; 274:C236-44. [PMID: 9458733 DOI: 10.1152/ajpcell.1998.274.1.c236] [Citation(s) in RCA: 138] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Previously, we demonstrated the role of nitric oxide (NO) in transforming epithelial cells from a stationary to locomoting phenotype [E. Noiri, T. Peresleni, N. Srivastava, P. Weber, W.F. Bahou, N. Peunova, and M. S. Goligorsky. Am. J. Physiol. 270 (Cell Physiol. 39): C794-C802, 1996] and its permissive function in endothelin-1-stimulated endothelial cell migration (E. Noiri, Y. Hu, W. F. Bahou; C. Keese, I. Giaever, and M. S. Goligorsky, J. Biol: Chem. 272: 1747-1753, 1997). In the present study, the role of functional NO synthase in executing the vascular endothelial growth factor (VEGF)-guided program of endothelial cell migration and angiogenesis was studied in two independent experimental settings. First, VEGF, shown to stimulate NO release from simian virus 40-immortalized microvascular endothelial cells, induced endothelial cell transwell migration, whereas NG-nitro-L-arginine methyl ester (L-NAME) or antisense oligonucleotides to endothelial NO synthase suppressed this effect of VEGF. Second, in a series of experiments on endothelial cell wound healing, the rate of VEGF-stimulated cell migration was significantly blunted by the inhibition of NO synthesis. To gain insight into the possible mode of NO action, we next addressed the possibility that NO modulates cell matrix adhesion by performing impedance analysis of endothelial cell monolayers subjected to NO. The data showed the presence of spontaneous fluctuations of the resistance in ostensibly stationary endothelial cells. Spontaneous oscillations were induced by NO, which also inhibited cell matrix adhesion. This process we propose to term "podokinesis" to emphasize a scalar from of micromotion that, in the presence of guidance cues, e.g., VEGF, is transformed to a vectorial movement. In conclusion, execution of the program for directional endothelial cell migration requires two coexisting messages: NO-induced podokinesis (scalar motion) and guidance cues, e.g., VEGF, which imparts a vectorial component to the movement. Such a requirement for the dual signaling may explain a mismatch in the demand and supply with newly formed vessels in different pathological states accompanied by the inhibition of NO synthase.
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Affiliation(s)
- E Noiri
- Department of Medicine, State University of New York, Stony Brook 11794-8152, USA
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Abstract
OBJECTIVE To investigate the "toxic" total (potential for) hostility component of the type A behavior pattern (assessed by means of the structured interview) as it relates to prediction of restenosis after percutaneous transluminal coronary angioplasty (PTCA). DESIGN Patients with single vessel or multivessel coronary artery disease in whom PTCA had been scheduled or done were administered the structured interview by one trained interviewer prospectively or retrospectively (blinded to angiographic endpoints). MATERIAL AND METHODS A total of 41 patients underwent 53 initial balloon dilations on native arteries by 1 of 5 participating cardiologists. Inclusion criteria for this study were a successful initial PTCA and post-PTCA recatheterization if a patient complained of ischemic symptoms possibly related to restenosis. RESULTS Of the 41 patients, 15 (36.6%) had restenoses at a total of 18 previous angioplasty sites. Patients with high total (potential for) hostility ratings were almost 2.5 times more likely to have restenosis than those with low total (potential for) hostility scores (95% confidence interval = 1.03 to 5.32). Logistic regression revealed that total (potential for) hostility scores predicted post-PTCA restenosis overall as well as when adjusted for gender and race. Total (potential for) hostility scores were also positively associated with the number of arteries restenosed (P = 0.01). CONCLUSION This is the first report of type A total (potential for) hostility behavior conferring an increased risk for restenosis after PTCA. Its modification may be effective in reducing recurrent cardiac events. A coronary-prone behavior modification program for patients with persistent, same-site restenosis after PTCA has been initiated.
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Affiliation(s)
- M Goodman
- Department of Psychiatry and Behavioral Medicine, Union Memorial Hospital, Baltimore, Maryland, USA
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Bai JZ, Bardon O, Blum I, Breakstone A, Burnett T, Chen GP, Chen HF, Chen J, Chen SM, Chen Y, Chen YB, Chen YQ, Cheng BS, Cowan RF, Cui XZ, Ding HL, Du ZZ, Dunwoodie W, Fan XL, Fang J, Fero M, Gao CS, Gao ML, Gao SQ, Gratton P, Gu JH, Gu SD, Gu WX, Gu YF, Guo YN, Han SW, Han Y, Harris FA, Hatanaka M, He J, He M, Hitlin DG, Hu GY, Hu T, Hu XQ, Huang DQ, Huang YZ, Izen JM, Jia QP, Jiang CH, Jin S, Jin Y, Jones L, Kang SH, Ke ZJ, Kelsey MH, Kim BK, Kong D, Lai YF, Lan HB, Lang PF, Lankford A, Li F, Li J, Li PQ, Li Q, Li RB, Li W, Li WD, Li WG, Li XH, Li XN, Lin SZ, Liu HM, Liu J, Liu JH, Liu Q, Liu RG, Liu Y, Liu ZA, Lou XC, Lowery B, Lu JG, Luo SQ, Luo Y, Ma AM, Ma EC, Ma JM, Mao HS, Mao ZP, Malchow R, Mandelkern M, Meng XC, Ni HL, Nie J, Olsen SL, Oyang J, Paluselli D, Pan LJ, Panetta J, Porter F, Prabhakar E, Qi ND, Que YK, Quigley J, Rong G, Schernau M, Schmid B, Schultz J, Shao YY, Shen BW, Shen DL, Shen H, Shen XY, Sheng HY, Shi HZ, Shi XR, Smith A, Soderstrom E, Song XF, Standifird J, Stoker D, Sun F, Sun HS, Sun SJ, Synodinos J, Tan YP, Tang SQ, Toki W, Tong GL, Torrence E, Wang F, Wang LS, Wang LZ, Wang M, Wang P, Wang PL, Wang SM, Wang TJ, Wang YY, Wei CL, Whittaker S, Wilson R, Wisniewski WJ, Xi DM, Xia XM, Xie PP, Xiong WJ, Xu DZ, Xu RS, Xu ZQ, Xue ST, Yamamoto R, Yan J, Yan WG, Yang CM, Yang CY, Yang J, Yang W, Ye MH, Ye SW, Ye SZ, Young K, Yu CS, Yu CX, Yu ZQ, Yuan CZ, Zhang BY, Zhang CC, Zhang DH, Zhang HL, Zhang J, Zhang JW, Zhang LS, Zhang SQ, Zhang Y, Zhang YY, Zhao DX, Zhao HW, Zhao JW, Zhao M, Zhao PD, Zhao WR, Zheng JP, Zheng LS, Zheng ZP, Zhou GP, Zhou HS, Zhou L, Zhou XF, Zhou YH, Zhu QM, Zhu YC, Zhu YS, Zhuang BA, Zioulas G. Search for a vector glueball by a scan of the J/ psi resonance. Phys Rev D Part Fields 1996; 54:1221-1224. [PMID: 10020592 DOI: 10.1103/physrevd.54.1221] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Abe K, Abe K, Abt I, Akagi T, Allen NJ, Ash WW, Aston D, Baird KG, Baltay C, Band HR, Barakat MB, Baranko G, Bardon O, Barklow T, Bashindzhagyan GL, Bazarko AO, Ben-David R, Benvenuti AC, Bilei GM, Bisello D, Blaylock G, Bogart JR, Bolton T, Bower GR, Brau JE, Breidenbach M, Bugg WM, Burke D, Burnett TH, Burrows PN, Busza W, Calcaterra A, Caldwell DO, Calloway D, Camanzi B, Carpinelli M, Cassell R, Castaldi R, Castro A, Cavalli-Sforza M, Chou A, Church E, Cohn HO, Coller JA, Cook V, Cotton R, Cowan RF, Coyne DG, Crawford G, D'Oliveira A, Damerell CJS, Daoudi M, De Sangro R, De Simone P, Dell'Orso R, Dervan PJ, Dima M, Dong DN, Du PYC, Dubois R, Eisenstein BI, Elia R, Etzion E, Falciai D, Fan C, Fero MJ, Frey R, Furuno K, Gillman T, Gladding G, Gonzalez S, Hallewell GD, Hart EL, Hasan A, Hasegawa Y, Hasuko K, Hedges S, Hertzbach SS, Hildreth MD, Huber J, Huffer ME, Hughes EW, Hwang H, Iwasaki Y, Jackson DJ, Jacques P, Jaros J, Johnson AS, Johnson JR, Johnson RA, Junk T, Kajikawa R, Kalelkar M, Kang HJ, Karliner I, Kawahara H, Kendall HW, Kim Y, King ME, King R, Kofler RR, Krishna NM, Kroeger RS, Labs JF, Langston M, Lath A, Lauber JA, Leith DWGS, Lia V, Liu MX, Liu X, Loreti M, Lu A, Lynch HL, Ma J, Mancinelli G, Manly S, Mantovani G, Markiewicz TW, Maruyama T, Massetti R, Masuda H, Mazzucato E, McKemey AK, Meadows BT, Messner R, Mockett PM, Moffeit KC, Mours B, Muller D, Nagamine T, Narita S, Nauenberg U, Neal H, Nussbaum M, Ohnishi Y, Osborne LS, Panvini RS, Park H, Pavel TJ, Peruzzi I, Piccolo M, Piemontese L, Pieroni E, Pitts KT, Plano RJ, Prepost R, Prescott CY, Punkar GD, Quigley J, Ratcliff BN, Reeves TW, Reidy J, Rensing PE, Rochester LS, Rowson PC, Russell JJ, Saxton OH, Schalk T, Schindler RH, Schumm BA, Sen S, Serbo VV, Shaevitz MH, Shank JT, Shapiro G, Sherden DJ, Shmakov KD, Simopoulos C, Sinev NB, Smith SR, Snyder JA, Stamer P, Steiner H, Steiner R, Strauss MG, Su D, Suekane F, Sugiyama A, Suzuki S, Swartz M, Szumilo A, Takahashi T, Taylor FE, Torrence E, Trandafir AI, Turk JD, Usher T, Va'vra J, Vannini C, Vella E, Venuti JP, Verdier R, Verdini PG, Wagner SR, Waite AP, Watts SJ, Weidemann AW, Weiss ER, Whitaker JS, White SL, Wickens FJ, Williams DA, Williams DC, Williams SH, Willocq S, Wilson RJ, Wisniewski WJ, Woods M, Word GB, Wyss J, Yamamoto RK, Yamartino JM, Yang X, Yellin SJ, Young CC, Yuta H, Zapalac G, Zdarko RW, Zeitlin C, Zhou J. First Study of Rapidity Gaps in e+e- Annihilation. Phys Rev Lett 1996; 76:4886-4890. [PMID: 10061405 DOI: 10.1103/physrevlett.76.4886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Kameyama K, Sakai C, Kondoh S, Yonemoto K, Nishiyama S, Tagawa M, Murata T, Ohnuma T, Quigley J, Dorsky A, Bucks D, Blanock K. Inhibitory effect of magnesium L-ascorbyl-2-phosphate (VC-PMG) on melanogenesis in vitro and in vivo. J Am Acad Dermatol 1996; 34:29-33. [PMID: 8543691 DOI: 10.1016/s0190-9622(96)90830-0] [Citation(s) in RCA: 176] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND An inhibitory effect of ascorbic acid (AsA) on melanogenesis has been described. However, AsA is quickly oxidized and decomposed in aqueous solution and thus is not generally useful as a depigmenting agent. OBJECTIVE Our purpose was to examine the effect on pigmentation of magnesium-L-ascorbyl-2-phosphate (VC-PMG), a stable derivative of AsA. METHODS Percutaneous absorption of VC-PMG was examined in dermatomed human skin, and its effect on melanin production by mammalian tyrosinase and human melanoma cells in culture was also measured. A 10% VC-PMG cream was applied to the patients. RESULTS VC-PMG suppressed melanin formation by tyrosinase and melanoma cells. In situ experiments demonstrated that VC-PMG cream was absorbed into the epidermis and that 1.6% remained 48 hours after application. The lightening effect was significant in 19 of 34 patients with chloasma or senile freckles and in 3 of 25 patients with normal skin. CONCLUSION VC-PMG is effective in reducing skin hyperpigmentation in some patients.
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Affiliation(s)
- K Kameyama
- Department of Dermatology, Kitasato University School of Medicine, Sagamihara, Japan
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Quigley J, Misquith S, Surolia A, Srimal S, Armstrong P. Preliminary investigation of the molecular basis for the functional differences between the two pentraxins limulin and C-reactive protein from the plasma of the American horseshoe crab, Limulus polyphemus. Biol Bull 1994; 187:229-230. [PMID: 7811790 DOI: 10.1086/bblv187n2p229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- J Quigley
- Department of Pathology, Health Sciences Center, State University of New York, Stony Brook 11798-8691
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Gleeson N, Gaffney EF, Gonsalves R, Quigley J, Bonnar J. Sarcomas of the female genital tract and pelvic soft tissues. A cluster of 14 cases in one year. Ir Med J 1993; 86:196-8. [PMID: 8106227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report ten uterine and four extrauterine sarcomas encountered in a twelve month period (1989-90). The seven new cases of uterine sarcomas represent an estimated one third of all cases of malignancy of the corpus uteri, which were diagnosed at the gynaecology departments of St James's and Adelaide hospitals in one year. Overall, the prognosis was poor in the uterine sarcoma group-only one patient in clinically tumour free and five have succumbed to their disease. Delay in diagnosis especially in younger women with fibroid uterus contributed to this outcome.
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Affiliation(s)
- N Gleeson
- Trinity College Dept of Gynaecology, Dublin
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