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Oncocytic papillary cystadenoma. Br Dent J 2024; 236:187-188. [PMID: 38332080 DOI: 10.1038/s41415-024-7093-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
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Adaptations of an Effective Evidence-Based Pediatric Weight Management Intervention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023:10.1007/s11121-023-01557-7. [PMID: 37477808 DOI: 10.1007/s11121-023-01557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 07/22/2023]
Abstract
Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist-either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein's Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF. Participants included children aged 6-12 years with obesity (M = 9.46, SD = 1.74). The Framework for Reporting Adaptations and Modifications-Expanded guided our classification of modifications across BHF cohorts. Using the FRAME reporting structure, the changes that were documented were (1) planned and occurred pre-implementation, (2) based on decisions from local stakeholders (e.g., school administrator, members of the implementation team), and (3) specific to changes in content and context-with a focus on implementation and potential for local scale-up. The nature of the adaptations included adding elements (whole of family approach), removing elements (calorie counting), and substituting elements (steps for minutes of physical activity). Across 9 cohorts, 84 families initiated the BHF program, 69 families successfully completed the 12-week program, and 45 families returned for 6-month follow-up assessments. Results indicated that the BMI z score in children was reduced by 0.31 ± 0.17 at 6 months across all cohorts. Reduction in BMI z score ranged from 0.41 in cohort 4 to 0.13 in cohort 5. Iterative adaptations to BHF were completed to improve the fit of BHF to the setting and participants and have contributed to a sustained community PWMI that adheres to the underlying principles and core elements of other evidence-based PWMIs. Monitoring adaptations and related changes to outcomes can play a role in long-term sustainability and effectiveness.
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POS1106 MEDIATORS OF THE EFFECT OF THERAPEUTIC EXERCISE ON PAIN AND FUNCTION IN PATIENTS WITH KNEE AND HIP OSTEOARTHRITIS; AN INDIVIDUAL PATIENT DATA MEDIATION STUDY FROM THE OA TRIAL BANK. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundCurrently, there is no cure for osteoarthritis (OA). Therapeutic exercise is recommended in all international guidelines to improve pain and function (1). However, randomised controlled trials (RCTs) investigating therapeutic exercise showed that, on average, effect sizes are small to moderate compared to non-exercise controls (2-3). Better knowledge about how therapeutic exercise works to improve pain and function could help improve the design and delivery of future therapeutic exercise interventions and potentially improve patient outcomes.ObjectivesTo evaluate the mediating effects of 1) muscle strength, proprioception, and range of motion (ROM) among patients with knee OA, and 2) muscle strength among patients with hip OA, using the procedures established for Individual Participant Data (IPD) analyses by the OA Trial Bank.MethodsRelevant IPD were sought from all published RCTs comparing therapeutic exercise to a non-exercise control group among people with knee and/or hip OA, using previously published methods (4). For each potential mediator separately, the effect of exercise on the absolute change in pain/function directly after the intervention was determined, controlling for the relative change in mediator under investigation and potential mediator-outcome confounders, using the ‘counterfactual framework’ (5). Next, the effect of exercise on the relative change in the mediator was determined. The percentage mediated was calculated by dividing the natural indirect effect by the total effect.ResultsWe obtained IPD from 12 RCTs and 1407 participants (knee OA = 1113; hip OA n=294) that were eligible for inclusion in one or more mediation analyses. Therapeutic exercise showed a significant effect on the relative change in muscle strength in knee OA, but not for proprioception or ROM in knee OA, nor for muscle strength in hip OA. Of all mediators, only the change in muscle strength had a significant effect on the change in pain in knee OA, and on function in knee OA and in hip OA. The percentage mediated for each mediator and each outcome was small (5.3% or less, see Table 1).Table 1.Percentage mediated for all potential mediators, by outcome and joint.Knee OAPainKnee OAFunctionHip OAPainHip OAFunctionMuscle strength2.4%2.3%absentabsentProprioceptionabsent0.2%--Range of motion1.8%5.3%--‘absent’: no percentage mediated calculated, since direct and indirect effect had opposite directions.‘-‘: factors not considered a potential mediator for therapeutic exercise in hip OA.ConclusionIn the first IPD mediation analysis to our knowledge of this scale, muscle strength, proprioception and ROM did mediate the effect of therapeutic exercise for pain and function in knee OA, but only to a very small degree. We observed no such mediating effect of muscle strength for therapeutic exercise in patients with hip OA. The challenge remains to better understand the key mechanisms of action of therapeutic exercise for knee and hip OA, so that exercise interventions can be designed and delivered to target these and therewith optimise the effects for patients.References[1]Bierma-Zeinstra S, et al. Nonpharmacological and nonsurgical approaches in OA. Best Pract Res Clin Rheumatol. 2020 Apr;34(2):101564.[2]Fransen M, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015 Jan 9;1:CD004376.[3]Fransen M, et al. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev. 2014 Apr 22(4):CD007912.[4]Holden MA, et al. Subgrouping and TargetEd Exercise pRogrammes for knee and hip OsteoArthritis (STEER OA): a systematic review update and individual participant data meta-analysis protocol. BMJ Open. 2017 Dec 22;7(12):e018971.[5]VanderWeele TJ, Vansteelandt S. Mediation Analysis with Multiple Mediators. Epidemiol Methods. 2014 Jan;2(1):95-115.AcknowledgementsWe thank all members of the OA Trial Bank Exercise Collaborative, who shared IPD with the OA Trial Bank/STEER OA for making this study possible.Disclosure of InterestsJos Runhaar Grant/research support from: Fellowship from the Foundation for Research in Rheumatology (FOREUM), Melanie Holden Grant/research support from: Grant from the Chartered Society of Physiotherapy Charitable Trust (grant no PRF/16/A07), and the National Institute for Health Research (NIHR) School of Primary Care Research (grant no 531), Miriam Hattle: None declared, Johny Quicke Grant/research support from: JQ is part-funded by an NIHR CRN West Midlands Research Scholarship and part funded by the Haywood Foundation, Richard Riley: None declared, Emma Healey Grant/research support from: part funded by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands., Danielle van der Windt: None declared, Krysia Dziedzic: None declared, Marienke Van Middelkoop: None declared, S.M.A. Bierma-Zeinstra Grant/research support from: OA Trial Bank received long-term funding by the Dutch Arthritis Association, Nadine Foster: None declared
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Computer-based stratified care in general practice for common musculoskeletal consultations: Results of the STarT MSK cluster randomised controlled trial (ISRCTN15366334). Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rehabilitation following rotator cuff repair: Multi-centre pilot and feasibility randomised controlled trial (RaCeR). Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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The development of individualised work absence prediction models in patients with neck and/or low back pain. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Evaluation of the First Contact Physiotherapy (FCP) model of primary care: Patient characteristics and outcomes. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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IL-1 Signal Inhibition In Alcoholic Hepatitis (ISAIAH): a study protocol for a multicentre, randomised, placebo-controlled trial to explore the potential benefits of canakinumab in the treatment of alcoholic hepatitis. Trials 2021; 22:792. [PMID: 34763711 PMCID: PMC8581959 DOI: 10.1186/s13063-021-05719-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/12/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Alcohol consumption causes a spectrum of liver abnormalities and leads to over 3 million deaths per year. Alcoholic hepatitis (AH) is a florid presentation of alcoholic liver disease characterized by liver failure in the context of recent and heavy alcohol consumption. The aim of this study is to explore the potential benefits of the IL-1β antibody, canakinumab, in the treatment of AH. METHODS This is a multicentre, double-blind, randomised placebo-controlled trial. Participants will be diagnosed with AH using clinical criteria. Liver biopsy will then confirm that all histological features of AH are present. Up to 58 participants will be recruited into two groups from 15 centres in the UK. Patients will receive an infusion of Canakinumab or matched placebo by random 1:1 allocation. The primary outcome is the difference between groups in the proportion of patients demonstrating histological improvement and will compare histological appearances at baseline with appearances at 28 days to assign a category of "improved" or "not improved". Patients with evidence of ongoing disease activity will receive a second infusion of canakinumab or placebo. Participants will be followed up for 90 days. Secondary outcomes include mortality and change in MELD score at 90 days. DISCUSSION This phase II study will explore the benefits of the IL-1β antibody, canakinumab, in the treatment of AH to provide proof of concept that inhibition of IL-1β signalling may improve histology and survival for patients with AH. TRIAL REGISTRATION EudraCT 2017-003724-79 . Prospectively registered on 13 April 2018.
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Digital adherence technology for TB: focus on livelihoods as well as lives. Int J Tuberc Lung Dis 2021; 25:416-417. [PMID: 33977914 DOI: 10.5588/ijtld.21.0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Opioid shock. Br Dent J 2021; 230:6. [PMID: 33420437 DOI: 10.1038/s41415-020-2563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Moderators of the effects of therapeutic exercise for people with knee and hip osteoarthritis: A systematic review of sub-group analyses from randomised controlled trials. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100113. [DOI: 10.1016/j.ocarto.2020.100113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022] Open
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1917P Pembrolizumab salvage add-on therapy in patients with radioiodine-refractory (RAIR), progressive differentiated thyroid cancer (DTC) progressing on lenvatinib: Results of a multicenter phase II International Thyroid Oncology Group Trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Achieving consensus on the treatment targets of exercise in persistent non-specific low back pain: a modified nominal group workshop process. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Stratified care for patients consulting with suspected sciatica in primary care: the SCOPiC RCT (ISRCTN75449581). Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Patients’ and general practitioners’ views of stratified care for musculoskeletal pain: qualitative findings from the STarT MSK pilot trial. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
The purpose of this article is to give a preliminary econometric analysis of earnings inflation based on the disaggregation of aggregate earnings into four sectors: private manufacturing; private non-manufacturing; public corporations; and central and local government. In the introduction we discuss some of our objectives in analysing wage movements in this way. The second section presents the data. The third section describes the alternative hypotheses to be tested and the research methodology used. The fourth section describes the results of the econometric analysis and in the fifth section we draw tentative conclusions. The data series used are described in more detail in the appendix.
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ZEBRA: an ACCRU/IRCI multicenter phase 2 study of pembrolizumab in patients with advanced small bowel adenocarcinoma (SBA). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Prevalence, characteristics and clinical course of neuropathic pain in primary care patients consulting with low back-related leg pain. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Treatments of exercise and orthotic devices for plantar heel pain: The TREADON feasibility and pilot study. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Clinical course and prognostic factors across different musculoskeletal pain sites: A secondary analysis of individual patient data from randomised clinical trials. Eur J Pain 2018; 22:1057-1070. [DOI: 10.1002/ejp.1190] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 12/19/2022]
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Factors associated with physiotherapists’ preference for MRI in patients with back and leg pain. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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FIRST-YEAR OUTCOMES OF THE MOHLTC-FUNDED COMMUNITY PARAMEDICINE DEMONSTRATION PROJECTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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ESTABLISHING THE EFFECTIVENESS OF THE INDEPENDENCE AT HOME COMMUNITY PARAMEDICINE MODEL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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INSIGHTS GAINED FROM THE DEVELOPMENT OF COMMUNITY PARAMEDICINE PROGRAMS IN CANADA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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ACEING THE CARE OF OLDER ADULTS IN HOSPITALS THROUGH INNOVATIVE MODELS OF ACUTE CARE FOR ELDERS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC). J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis. BMC Infect Dis 2016; 16:726. [PMID: 27905897 PMCID: PMC5131398 DOI: 10.1186/s12879-016-2064-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 11/08/2016] [Indexed: 12/05/2022] Open
Abstract
Background Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. Methods We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered ‘real world’ constraints such as sub-optimal guideline adherence. Results From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating ‘real world’ constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries’ GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh. Conclusion Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-2064-3) contains supplementary material, which is available to authorized users.
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Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC). Eur J Vasc Endovasc Surg 2016; 52:758-763. [DOI: 10.1016/j.ejvs.2016.09.007] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/16/2016] [Indexed: 10/20/2022]
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Abstract
IL-18 is a pro-inflammatory cytokine that is important in the regulation of T-cells and is elevated in inflammatory disorders such as periodontal disease. Vasoactive intestinal peptide (VIP) modulates immune responses to the periodontal pathogen Porphyromonas gingivalis ( Pg). Our objective was to investigate the effect of Pg LPS on IL-18 and its natural inhibitor, IL-18 binding protein (IL-18BPa), in human monocytes, and the effect of VIP on this system. We demonstrated that Pg LPS induced both IL-18 and IL-18BPa secretion in cultures of the human monocytic cell line THP-1, as measured by specific ELISA. The addition of antibodies to IL-18BPa to the stimulated THP-1 cultures resulted in increased levels of free IL-18, indicating a specific interaction between IL18 and IL-18BPa in this system. VIP (10−8M) inhibited both IL-18 and IL-18Bpa secretion by stimulated monocytes. We conclude that IL-18 and IL-18BPa secretion by monocytes is part of the immune response to Pg, and that VIP can inhibit this process.
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The feasibility of conducting a randomised controlled trial comparing arthroscopic hip surgery to conservative care for patients with femoroacetabular impingement syndrome: the FASHIoN feasibility study. J Hip Preserv Surg 2016; 3:304-311. [PMID: 29632690 PMCID: PMC5883184 DOI: 10.1093/jhps/hnw026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/24/2016] [Indexed: 11/13/2022] Open
Abstract
To determine whether it was feasible to perform a randomized controlled trial (RCT) comparing arthroscopic hip surgery to conservative care in patients with femoroacetabular impingement (FAI). This study had two phases: a pre-pilot and pilot RCT. In the pre-pilot, we conducted interviews with clinicians who treated FAI and with FAI patients to determine their views about an RCT. We developed protocols for operative and conservative care. In the pilot RCT, we determined the rates of patient eligibility, recruitment and retention, to investigate the feasibility of the protocol and we established methods to assess treatment fidelity. In the pre-pilot phase, 32 clinicians were interviewed, of which 26 reported theoretical equipoise, but in example scenarios 7 failed to show clinical equipoise. Eighteen patients treated for FAI were also interviewed, the majority of whom felt that surgery and conservative care were acceptable treatments. Surgery was viewed by patients as a 'definitive solution'. Patients were motivated to participate in research but were uncomfortable about randomization. Randomization was more acceptable if the alternative was available at the end of the trial. In the pilot phase, 151 patients were assessed for eligibility. Sixty were eligible and invited to take part in the pilot RCT; 42 consented to randomization. Follow-up was 100% at 12 months. Assessments of treatment fidelity were satisfactory. An RCT to compare arthroscopic hip surgery with conservative care in patients with FAI is challenging but feasible. Recruitment has started for a full RCT.
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Development of a new conceptual framework for the biopsychosocial clinical approach using concept mapping methodology. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.math.2016.05.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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P-100 Phase IB study of sorafenib + evofosfamide in patients (pts) with advanced hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC): NCCTG N1153 (Alliance). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Patients' costs associated with seeking and accessing treatment for drug-resistant tuberculosis in South Africa. Int J Tuberc Lung Dis 2015; 19:1513-9. [PMID: 26614194 PMCID: PMC6548556 DOI: 10.5588/ijtld.15.0341] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING South Africa is one of the world's 22 high tuberculosis (TB) burden countries, with the second highest number of notified rifampicin-resistant TB (R(R)-TB) and multidrug-resistant TB (MDR-TB) cases. OBJECTIVE To estimate patient costs associated with the diagnosis and treatment of R(R)-TB/MDR-TB in South Africa. DESIGN Patients diagnosed with R(R)-TB/MDR-TB and accessing care at government health care facilities were surveyed using a structured questionnaire. Direct and indirect costs associated with accessing R(R)-TB/MDR-TB care were estimated at different treatment durations for each patient. RESULTS A total of 134 patients were surveyed: 84 in the intensive phase and 50 in the continuation phase of treatment, 82 in-patients and 52 out-patients. The mean monthly patient costs associated with the diagnosis and treatment of R(R)-TB/MDR-TB were higher during the intensive phase than the continuation phase (US$235 vs. US$188) and among in-patients than among out-patients (US$269 vs. US$122). Patients in the continuation phase and those accessing care as out-patients reported higher out-of-pocket costs than other patients. Most patients did not access social protection for costs associated with R(R)-TB/MDR-TB illness. CONCLUSION Despite free health care, patients bear high costs when accessing diagnosis and treatment services for R(R)-TB/MDR-TB; appropriate social protection mechanisms should be provided to assist them in coping with these costs.
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THU0457 Long Term Barriers and Facilitators to Exercise and Physical Activity in Older Adults with Knee Pain: The Beep Longitudinal Qualitative Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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OP0105 Improving the Effectiveness of Exercise Therapy for Older Adults with Knee Osteoarthritis: A Pragmatic Randomised Controlled Trial (The Beep Trial). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Improving the effectiveness of exercise therapy for older adults with knee pain: a pragmatic randomised controlled trial (the beep trial). Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Development of a new conceptual framework for the biopsychosocial clinical approach to musculoskeletal pain using concept mapping methodology. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Randomised controlled trial testing physiotherapy-led exercise and ultrasound-guided corticosteroid injection for subacromial impingement syndrome: the support trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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The relationship between attitudes, beliefs and physical activity behaviour in older adults with knee pain. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Physiotherapists’ perceptions of pregnancy-related low back pain and its management by acupuncture. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The redevelopment of the pain attitudes and beliefs scale: a measure of healthcare practitioners’ attitudes and beliefs about musculoskeletal pain. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Direct access to physiotherapy for musculoskeletal problems in primary care: the stems pilot cluster randomised trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vasoactive intestinal peptide inhibits the production of Salmonella-induced inflammatory cytokines by human monocytes. Crit Care 2014. [PMCID: PMC4273770 DOI: 10.1186/cc14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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OA03.01. Acupuncture for chronic pain: an individual patient data meta-analysis of randomized trials. Altern Ther Health Med 2012. [PMCID: PMC3373337 DOI: 10.1186/1472-6882-12-s1-o9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Proactive Dementia Care: A Five-Year Experience in Dementia Caregiver Counseling (P07.156). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Frequency of Frontal Hypometabolism in Autopsy Confirmed AD Subjects (S14.006). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s14.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Will shared decision making between patients with chronic musculoskeletal pain and physiotherapists, osteopaths and chiropractors improve patient care? Fam Pract 2012; 29:203-12. [PMID: 21982810 DOI: 10.1093/fampra/cmr083] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chronic musculoskeletal pain (CMP) is treated in primary care by a wide range of health professionals including chiropractors, osteopaths and physiotherapists. AIMS To explore patients and chiropractors, osteopaths and physiotherapists' beliefs about CMP and its treatment and how these beliefs influenced care seeking and ultimately the process of care. METHODS Depth interviews with a purposive sample of 13 CMP patients and 19 primary care health professionals (5 osteopaths, 4 chiropractors and 10 physiotherapists). RESULTS Patients' models of their CMP evolved throughout the course of their condition. Health professionals' models also evolved throughout the course of their treatment of patients. A key influence on patients' consulting behaviour appeared to be finding someone who would legitimate their suffering and their condition. Health professionals also recognized patients' need for legitimation but often found that attempts to explore psychological factors, which may be influencing their pain could be construed by patients as delegitimizing. Patients developed and tailored their consultation strategies throughout their illness career but not always in a strategic fashion. Health professionals also reflected on how patients' developing knowledge and changing beliefs altered their expectations. Therefore, overall within our analysis, we identified three themes: 'the evolving nature of patients and health professionals models of understanding CMP'; 'legitimating suffering' and 'development and tailoring of consultation and treatment strategies throughout patients' illness careers'. CONCLUSIONS Seeking care for any condition is not static but a process particularly for long-term conditions such as CMP. This may need to be taken into account by both CMP patients and their treating health professionals, in that both should not assume that their views about causation and treatment are static and that instead they should be revisited on a regular basis. Adopting a shared decision-making approach to treatment may be useful particularly for long-term conditions; however, in some cases, this may be easier said than done due to both patients' and health professionals' sometimes discomfort with adopting such an approach. Training and support for both health professionals and patients may be helpful in facilitating a shared decision-making approach.
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Integrative mRNA profiling comparing cultured primary cells with clinical samples reveals PLK1 and C20orf20 as therapeutic targets in cutaneous squamous cell carcinoma. Oncogene 2011; 30:4666-77. [PMID: 21602893 PMCID: PMC3219832 DOI: 10.1038/onc.2011.180] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 03/30/2011] [Accepted: 04/01/2011] [Indexed: 01/03/2023]
Abstract
Identifying therapeutic targets for cancer treatment relies on consistent changes within particular types or sub-types of malignancy. The ability to define either consistent changes or sub-types of malignancy is often masked by tumor heterogeneity. To elucidate therapeutic targets in cutaneous squamous cell carcinoma (cSCC), the most frequent skin neoplasm with malignant potential, we have developed an integrated approach to gene expression profiling beginning with primary keratinocytes in culture. Candidate drivers of cSCC development were derived by first defining a set of in vitro cancer genes and then comparing their expression in a range of clinical data sets containing normal skin, cSCC and the benign hyper-proliferative condition psoriasis. A small interfering RNA (siRNA) screen of the resulting 21 upregulated genes has yielded targets capable of reducing xenograft tumor volume in vivo. Small-molecule inhibitors for one target, Polo-like kinase-1 (PLK1), are already in clinical trials for other malignancies, and our data show efficacy in cSCC. Another target, C20orf20, is identified as being overexpressed in cSCC, and siRNA-mediated knockdown induces apoptosis in vitro and reduces tumor growth in vivo. Thus, our approach has shown established and uncharacterized drivers of tumorigenesis with potent efficacy as therapeutic targets for the treatment of cSCC.
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