1
|
Bundred N, Dixon M, Acuthan R, Barrett E, Benson J, Courtney C, Skene A, Hoar F, Bhaskar P, Todd C, Macmillan D, Watterston D, Barnes N. Does the use of an Intraoperative device to assess margins reduce need for reexcison after breast conserving surgery: Multicentre Randomised Controlled Trial. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01358-2] [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: 11/19/2022]
|
2
|
Ali B, Nazar Z, Barnes N, Rutter P. The impact of religious beliefs on adherence to medication in the Muslim population: a systematic scoping review. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac019.035] [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: 11/12/2022]
Abstract
Abstract
Introduction
Factors influencing medication adherence are well-established, however, how religious beliefs influence medication adherence is less well researched. In the Islamic faith, strict dietary laws exist. It arguably prohibits certain animal derived, and alcohol-based foodstuff both in the diet as well as in medicines. Religiously Prohibited Medicines (RPMs) are medicines that contain ingredients, active or otherwise, proscribed by Islam’s canonical texts (1). Potential circumstances exist where Muslim patients avoid RPMs thus presenting a possible dilemma for patients and healthcare professionals involved in their care.
Aim
To scope the literature and summarise the reported influence of religious beliefs on adherence to RPMs in the Muslim population and highlight gaps for further research.
Methods
A systematic scoping review methodology advocated by the Joanna Briggs Institute was employed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (2). The protocol was registered with the Open Science Framework. Boolean operators AND and OR combined with truncation and phrase searches were used to search PubMed, Medline, Scopus and EBSCO (CINAHL, IPA, PsycINFO). MeSH terms were used where appropriate. Filters included, studies published in English from inception until November 2020. Grey literature sources included OpenGrey, EThOS and ZETOC. Reference lists from included studies were also hand-searched. All study designs were considered for inclusion. Eligible studies included investigations involving any stakeholder regarding the influence of RPMs on medication adherence amongst Muslims. Two reviewers independently screened the titles, abstracts and full papers, with a third reviewer consulted in cases of non-agreement. Two reviewers independently performed data extraction. A narrative approach to data synthesis was employed, in which two reviewers independently identified themes that aligned with the research question.
Results
15 articles were included, published between 2001-2019, 13 of which were conducted in the UK. Studies included seven cross-sectional surveys, one qualitative study, four practice papers, three case reports and one unpublished report. Most studies investigated healthcare practitioners’ awareness and knowledge of religious-factors influencing medication-adherence (n=13). These studies revealed that level of exposure to diverse populations and cultural competence training were of most significance. Some studies explored market availability of RPM alternatives with recommendations for clearer labelling on packaging and reference sources (n=2). Two case reports detailed accounts where Muslim patients prescribed RPMs resulted in non-adherence. Key themes identified that addressed the research question included: 1) ethical dilemmas; 2) sources of information; 3) cultural competence; 4) biological to synthetic sourcing.
Conclusion
The strength of this review is that it is the first to explore the influence of religious beliefs on adherence to RPMs and provides an overview of the existing literature. The review identified two case reports demonstrating the possible risks RPMs pose to medication-adherence, however, the lack of studies exploring this field restricts the understanding of the topic, limiting the research. Furthermore, only English published articles were included. Studies provided evidence that further training of healthcare professionals in cultural competence and awareness of RPMs, may facilitate the necessary support to deliver culturally-sensitive care to Muslim patients. However, multi-stakeholder perspectives of RPMs, and evidence-based strategies to address their potential negative implications, remains largely unexplored and warrants further research.
References
(1) Sattar SP, Ahmed MS, Madison J, Olsen DR, Bhatia SC, Ellahi S, et al. Patient and physician attitudes to using medications with religiously forbidden ingredients. Ann Pharmacother. 2004;38(11):1830–5.
(2) Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73.
Collapse
Affiliation(s)
- B Ali
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - Z Nazar
- College of Pharmacy, Qatar University, Doha, Qatar
| | - N Barnes
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - P Rutter
- School of Pharmacy and Biomedical Science, University of Portsmouth, Portsmouth, UK
| |
Collapse
|
3
|
Sewart E, Turner N, Conroy EJ, Cutress R, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. O77: DOES MESH IMPROVE PATIENT SATISFACTION AND HEALTH-RELATED QUALITY OF LIFE AFTER IMPLANT-BASED BREAST RECONSTRUCTION? A MULTICENTRE PROSPECTIVE COHORT STUDY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Biological and synthetic meshes may improve outcomes of immediate IBBR by facilitating single-stage direct-to-implant procedures. However, high-quality supporting evidence is limited, particularly regarding PROs.
Method
2108 consecutive women undergoing IBBR at 81 centres were prospectively recruited between 2014-2016. Demographic, operative, oncological and 3-month complication data were collected. An 18-month questionnaire assessed PROs using the validated BREAST-Q and a five-point Likert scale rating of overall reconstructive outcome.
The impacts of different IBBR techniques on PROs were explored using mixed-effects regression models adjusted for clinically-relevant confounders and including a random effect to account for clustering by centre. The reference group was two- stage submuscular reconstruction without mesh.
Result
1470 participants consented to receive the questionnaire and 891 completed it. 67 patients underwent two-stage submuscular reconstruction; 764 patients received subpectoral reconstructions with biological mesh (n=495) synthetic mesh (n=95) or dermal sling (n=174). 14 patients underwent prepectoral reconstructions (introduced late in the study).
Compared with two-stage reconstructions, no differences in PROs were seen in biological or synthetic mesh-assisted or dermal sling procedures (p>0.05). However, prepectoral IBBR patients reported better satisfaction with breasts (difference=6.63, 95% confidence interval[1.65–11.61], p=0.009). Outcomes were similar to those in the NMBRA 2008/9 cohort, which included submuscular procedures only.
Conclusion
This study does not suggest that mesh improves PROs of IBBR. It provides early data supporting improved satisfaction with breasts following prepectoral reconstructions. Future trials are needed to robustly evaluate prepectoral techniques.
Abbrev
IBBR: implant-based breast reconstruction, PRO: patient-reported outcome, NMBRA: National Mastectomy and Breast Reconstruction Audit
Take-home message
Although mesh-assisted techniques have become widely adopted, this large, prospective, multicentre cohort study does not suggest that mesh improves patient-reported outcomes of implant-based breast reconstruction compared with standard submuscular techniques. However, it provides early data to support improved satisfaction with breasts in the prepectoral setting, which now requires robust evaluation.
Collapse
Affiliation(s)
| | | | | | | | - J Skillman
- University Hospitals Coventry and Warwickshire NHS Trust
| | - L Whisker
- Nottingham University Hospitals NHS Trust
| | | | - N Barnes
- Manchester University NHS Foundation Trust
| | - C Holcombe
- Royal Liverpool and Broadgreen University Hospital
| | - S Potter
- University of Bristol
- North Bristol NHS Trust
| |
Collapse
|
4
|
Sewart E, Turner N, Conroy EJ, Cutress R, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. O58: THE IMPACT OF RADIOTHERAPY ON PATIENT-REPORTED OUTCOMES OF IMMEDIATE IMPLANT-BASED BREAST RECONSTRUCTION: RESULTS OF A PROSPECTIVE MULTICENTRE COHORT STUDY. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.058] [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: 11/13/2022]
Abstract
Abstract
Introduction
Post-mastectomy radiotherapy (PMRT) is increasing given to improve breast cancer outcomes but can increase complication rates following implant-based breast reconstruction (IBBR). Little, however, is known about the impact of PMRT on patient-reported outcomes (PROs) of IBBR, especially in the context of mesh-assisted techniques.
Method
2108 consecutive women undergoing IBBR at 81 UK centres were prospectively recruited between 2014 and 2016. Demographic, operative, oncological and 3-month complication data were collected, and patients who consented received post-operative questionnaires. An 18-month questionnaire assessed PROs using the validated BREAST-Q. The effect of IBBR on PROs was investigated using mixed-effects regression models adjusted for clinically relevant confounders and including a random effect to account for potential clustering by centre.
Result
1693 iBRA participants underwent mastectomy for malignancy, of whom 1187 (70%) consented to receive the 18-month questionnaire and 732 (43%) completed it. Patients undergoing PMRT (n=214) reported significantly worse scores across 3 BREAST-Q domains: satisfaction with breasts (-6.27 points, p=0.008, 95% confidence interval (CI)[-10.91,-1.63]), satisfaction with outcome (-7.53 points, p=0.002, CI[-12.20,-2.85]) and physical well-being (-6.55 points, p<0.001, CI[-9.43,-3.67]). Overall satisfaction was worse in the PMRT group (OR 0.497, p=0.002, CI[0.32,0.77]). Use of biological mesh did not ameliorate the impact of PMRT on patient satisfaction (interaction term p-values [0.173 - 0.826]).
Conclusion:
PMRT adversely affects PROs of IBBR. This should be discussed with patients considering IBBR, especially if PMRT is anticipated or indications are borderline, to enable informed decisions regarding oncological and reconstructive options.
Abbrev
PMRT: post-mastectomy radiotherapy, PRO: patient-reported outcome
Take-home message
This multicentre, prospective cohort study of 732 patients undergoing implant-based breast reconstruction demonstrates worse 18-month patient-reported outcomes in women who received post-mastectomy radiotherapy than those who did not. These data should be discussed with patients to help them make informed decisions about reconstructive surgery.
Collapse
Affiliation(s)
| | | | | | | | - J Skillman
- University Hospitals Coventry and Warwickshire NHS Trust
| | - L Whisker
- Nottingham University Hospitals NHS Trust
| | | | - N Barnes
- Manchester University NHS Foundation Trust
| | - C Holcombe
- Royal Liverpool and Broadgreen University Hospital
| | - S Potter
- University of Bristol
- North Bristol NHS Trust
| |
Collapse
|
5
|
Sewart E, Turner NL, Conroy EJ, Cutress RI, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. Patient-reported outcomes of immediate implant-based breast reconstruction with and without biological or synthetic mesh. BJS Open 2021; 5:6145787. [PMID: 33609398 PMCID: PMC7896806 DOI: 10.1093/bjsopen/zraa063] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/02/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Biological and synthetic meshes may improve the outcomes of immediate implant-based breast reconstruction (IBBR) by facilitating single-stage procedures and improving cosmesis. Supporting evidence is, however, limited. The aim of this study was to explore the impact of biological and synthetic mesh on patient-reported outcomes (PROs) of IBBR 18 months after surgery. METHODS Consecutive women undergoing immediate IBBR between February 2014 and June 2016 were recruited to the study. Demographic, operative, oncological and 3-month complication data were collected, and patients received validated BREAST-Q questionnaires at 18 months. The impact of different IBBR techniques on PROs were explored using mixed-effects regression models adjusted for clinically relevant confounders, and including a random effect to account for clustering by centre. RESULTS A total of 1470 participants consented to receive the questionnaire and 891 completed it. Of these, 67 women underwent two-stage submuscular reconstructions. Some 764 patients had a submuscular reconstruction with biological mesh (495 women), synthetic mesh (95) or dermal sling (174). Fourteen patients had a prepectoral reconstruction. Compared with two-stage submuscular reconstructions, no significant differences in PROs were seen in biological or synthetic mesh-assisted or dermal sling procedures. However, patients undergoing prepectoral IBBR reported better satisfaction with breasts (adjusted mean difference +6.63, 95 per cent c.i. 1.65 to11.61; P = 0.009). PROs were similar to those in the National Mastectomy and Breast Reconstruction Audit 2008-2009 cohort, which included two-stage submuscular procedures only. CONCLUSION This study found no difference in PROs of subpectoral IBBR with or without biological or synthetic mesh, but provides early data to suggest improved satisfaction with breasts following prepectoral reconstruction. Robust evaluation is required before this approach can be adopted as standard practice.
Collapse
Affiliation(s)
- E Sewart
- Population Health Sciences, Bristol Centre for Surgical Research, Bristol Medical School, Bristol, UK
| | - N L Turner
- Population Health Sciences, Bristol Centre for Surgical Research, Bristol Medical School, Bristol, UK
| | - E J Conroy
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - R I Cutress
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, UK
| | - J Skillman
- Department of Plastic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - L Whisker
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - S Thrush
- Breast Unit, Worcester Royal Hospital, Worcester, UK
| | - N Barnes
- Nightingale Breast Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - C Holcombe
- Linda McCartney Centre, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK
| | - S Potter
- Population Health Sciences, Bristol Centre for Surgical Research, Bristol Medical School, Bristol, UK.,Bristol Breast Care Centre, North Bristol NHS Trust, Bristol, UK
| | | |
Collapse
|
6
|
Hanania N, Bailes Z, Barnes N, Gardiner F, Lugogo N, Mannino D, Mehta V, Nyanjom D, Sitz K, Kerstjens H. P206 CAPTAIN STUDY: EFFECTS OF FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL ON FEV1 IMPROVEMENT IN ASTHMA ACCORDING TO AGE. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Apterbach W, Barnes N, David J, Apterbach G. 237 Do Sex and Racial Disparities Exist in Door-to-Drug Time on the Administration of TPA? Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.250] [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]
|
8
|
Sewart E, Turner N, Conroy E, Cutress R, Skillman J, Whisker L, Thrush S, Barnes N, Holcombe C, Potter S. The impact of radiotherapy on patient-reported outcomes of immediate implant-based breast reconstruction: Results of a prospective multicentre cohort study. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30614-6] [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]
|
9
|
Mahoney B, Walklet E, Bradley E, Thrush S, Skillman J, Whisker L, Barnes N, Holcombe C, Potter S. Experiences of implant loss after immediate implant-based breast reconstruction: qualitative study. BJS Open 2020; 4:380-390. [PMID: 32181587 PMCID: PMC7260419 DOI: 10.1002/bjs5.50275] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/13/2019] [Accepted: 02/06/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Immediate implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure in the UK, but almost one in ten women experience implant loss and reconstructive failure after this technique. Little is known about how implant loss impacts on patients' quality of life. The first phase of the Loss of implant Breast Reconstruction (LiBRA) study aimed to use qualitative methods to explore women's experiences of implant loss and develop recommendations to improve care. METHODS Semistructured interviews were conducted with a purposive sample of women who experienced implant loss after immediate IBBR, performed for malignancy or risk reduction across six centres. Interviews explored decision-making regarding IBBR, and experiences of implant loss and support received. Thematic analysis was used to explore the qualitative interview data. Sampling, data collection and analysis were undertaken concurrently and iteratively until data saturation was achieved. RESULTS Twenty-four women were interviewed; 19 had surgery for malignancy and five for risk reduction. The median time between implant loss and interview was 42 (range 22-74) months. Ten women had undergone secondary reconstruction, two were awaiting surgery, and 12 had declined further reconstruction. Three key themes were identified: the need for accurate information about the risks and benefits of IBBR; the need for more information about 'early-warning' signs of postoperative problems, to empower women to seek help; and better support following implant loss. CONCLUSION Implant loss is a devastating event for many women. Better preoperative information and support, along with holistic patient-centred care when complications occur, may significantly improve the experience and outcome of care.
Collapse
Affiliation(s)
- B. Mahoney
- School of Psychology, College of Business, Psychology and SportUniversity of WorcesterWorcesterUK
| | - E. Walklet
- School of Psychology, College of Business, Psychology and SportUniversity of WorcesterWorcesterUK
| | - E. Bradley
- College of Health, Life and Environmental SciencesUniversity of WorcesterWorcesterUK
| | - S. Thrush
- Breast UnitWorcester Royal HospitalWorcesterUK
| | - J. Skillman
- Department of Plastic SurgeryUniversity Hospitals Coventry and Warwickshire NHS Trust, Clifford Bridge RoadCoventryUK
| | - L. Whisker
- Nottingham Breast InstituteCity HospitalNottinghamUK
| | - N. Barnes
- Nightingale Breast UnitManchester University NHS Foundation TrustManchesterUK
| | - C. Holcombe
- Linda McCartney CentreRoyal Liverpool and Broadgreen University HospitalLiverpoolUK
| | - S. Potter
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical SchoolBristolUK
- Bristol Breast Care Centre, North Bristol NHS TrustSouthmead HospitalBristolUK
| |
Collapse
|
10
|
Jean SJ, Francart SJ, Eckel SF, Schenkat D, Eberwein S, Lamm M, Barnes N, Valgus JM, Amerine LB. Evaluation of telepharmacy and the use of a gravimetric technology–assisted workflow system for remote sterile product pharmacist checks. Am J Health Syst Pharm 2020; 77:560-567. [DOI: 10.1093/ajhp/zxaa015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
To evaluate the impact of remote sterile product pharmacist checks when used with a gravimetric-based technology-assisted workflow (TAWF) system on product checking accuracy, pharmacist review time, workload sharing, cost savings, and staff perceptions.
Methods
A double-arm, prospective study was conducted at 4 pharmacy locations for a 90-day period. Each compounded sterile product (CSP) checked by a remote pharmacist was also checked by a local pharmacist at the site of CSP preparation. An anonymous, online survey was emailed to staff before and after implementation to evaluate perceptions of the accuracy, timeliness, safety, potential impact, and value of the remote process.
Results
There was no statistically significant difference in the numbers of errors detected through the remote process and through the current, nonremote process (P = 0.177). The median pharmacist review time in the local process was significantly lower (P < 0.001). Remote pharmacists in the study workflow verified 30.4% of the total number of CSPs verified in the 90-day period. Annualized cost savings were calculated to be $23,770.08. Percent agreement increased from the preimplementation to the postimplementation period for survey questions about the safety of the remote process, opportunity for workload sharing, and optimization of current workflow. Percent agreement decreased for questions about the accuracy, timeliness, and value of the remote process and its impact on job security.
Conclusion
The study demonstrated that with use of a gravimetric-based TAWF system, there was no difference in the accuracy and safety of sterile product pharmacist checks performed remotely and those performed at the product preparation site. In addition, the remote process allows for opportunities for workload sharing and cost savings.
Collapse
Affiliation(s)
- Stephanie J Jean
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Suzanne J Francart
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Stephen F Eckel
- UNC Eshelman School of Pharmacy, Chapel Hill, NC, and Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Daniel Schenkat
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Samuel Eberwein
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Matthew Lamm
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Nathan Barnes
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - John M Valgus
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC
| | - Lindsey B Amerine
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC
| |
Collapse
|
11
|
Roberts PA, Willoughby IR, Barnes N, Eckel SF, Paruscio A, Valgus JM, Amerine LB. Evaluation of a gravimetric-based technology-assisted workflow system on hazardous sterile product preparation. Am J Health Syst Pharm 2018; 75:1286-1292. [DOI: 10.2146/ajhp170564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | | | - Nathan Barnes
- University of North Carolina Medical Center, Chapel Hill, NC
| | - Stephen F. Eckel
- UNC Eshelman School of Pharmacy, Chapel Hill, NC, and University of North Carolina Medical Center, Chapel Hill, NC
| | - Ashley Paruscio
- University of North Carolina Medical Center, Chapel Hill, NC
| | - John M. Valgus
- University of North Carolina Medical Center, Chapel Hill, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC
| | - Lindsey B. Amerine
- University of North Carolina Medical Center, Chapel Hill, NC, and UNC Eshelman School of Pharmacy, Chapel Hill, NC
| |
Collapse
|
12
|
Barnes N, Yates L, Gibbs MR, Forth R. P158 Fluticasone furoate(FF)/vilanterol (VI) once daily improves night-time awakenings in asthma. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.301] [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]
|
13
|
Hilton E, Compton C, Midwinter D, Barnes N. P142 The distribution of blood eosinophil count in a copd clinical trials database: comparing the uk with the rest of the world. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
14
|
Durward-Akhurst SA, Finno CJ, Barnes N, Shivers J, Guo LT, Shelton GD, Valberg SJ. Major Histocompatibility Complex I and II Expression and Lymphocytic Subtypes in Muscle of Horses with Immune-Mediated Myositis. J Vet Intern Med 2016; 30:1313-21. [PMID: 27352021 PMCID: PMC5094553 DOI: 10.1111/jvim.14371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/25/2016] [Accepted: 06/11/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Major histocompatibility complex (MHC) I and II expression is not normally detected on sarcolemma, but is detected with lymphocytic infiltrates in immune-mediated myositis (IMM) of humans and dogs and in dysferlin-deficient muscular dystrophy. HYPOTHESIS/OBJECTIVES To determine if sarcolemmal MHC is expressed in active IMM in horses, if MHC expression is associated with lymphocytic subtype, and if dysferlin is expressed in IMM. ANIMALS Twenty-one IMM horses of Quarter Horse-related breeds, 3 healthy and 6 disease controls (3 pasture myopathy, 3 amylase-resistant polysaccharide storage myopathy [PSSM]). METHODS Immunohistochemical staining for MHC I, II, and CD4+, CD8+, CD20+ lymphocytes was performed on archived muscle of IMM and control horses. Scores were given for MHC I, II, and lymphocytic subtypes. Immunofluorescent staining for dysferlin, dystrophin, and a-sarcoglycan was performed. RESULTS Sarcolemmal MHC I and II expression was detected in 17/21 and 15/21 of IMM horses, respectively, and in specific fibers of PSSM horses, but not healthy or pasture myopathy controls. The CD4+, CD8+, and CD20+ cells were present in 20/21 IMM muscles with CD4+ predominance in 10/21 and CD8+ predominance in 6/21 of IMM horses. Dysferlin, dystrophin, and a-sarcoglycan staining were similar in IMM and control muscles. CONCLUSIONS AND CLINICAL IMPORTANCE Deficiencies of dysferlin, dystrophin, and a-sarcoglycan are not associated with IMM. Sarcolemmal MHC I and II expression in a proportion of myofibers of IMM horses in conjunction with lymphocytic infiltration supports an immune-mediated etiology for IMM. The MHC expression also occured in specific myofibers in PSSM horses in the absence of lymphocytic infiltrates.
Collapse
Affiliation(s)
- S A Durward-Akhurst
- Department of Veterinary Population Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - C J Finno
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA
| | - N Barnes
- Department of Veterinary Population Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - J Shivers
- Department of Veterinary Population Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - L T Guo
- Department of Pathology, University of California, San Diego, La Jolla, CA
| | - G D Shelton
- Department of Pathology, University of California, San Diego, La Jolla, CA
| | - S J Valberg
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI
| |
Collapse
|
15
|
Suarez E, Fang S, Abraham J, DiSantostefano R, Stempel D, Frith L, Barnes N. P239 Effect Of Inhaled Corticosteroid (ics) Particle Size On Asthma Efficacy And Safety Outcomes: A Systematic Literature Review. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
16
|
Martineau A, James W, Hooper R, Barnes N, Jolliffe D, Bhowmik A, Rajakulasingam R, Choudhury A, Simcock D, Corrigan C, Hawrylowicz C, Griffiths C. S104 Double-blind Multi-centre Randomised Controlled Trial Of Vitamin D3 Supplementation In Copd (vidico). Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
17
|
Martineau A, MacLaughlin B, Hooper R, Barnes N, Jolliffe D, Choudhury A, Rajakulasingam R, Bhowmik A, Simcock D, Grigg J, Corrigan C, Hawrylowicz C, Griffiths C. S95 Double-blind Multi-centre Randomised Controlled Trial Of Vitamin D3 Supplementation In Adults With Inhaled Corticosteroid-treated Asthma (vidias). Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
18
|
Prazma CM, Wenzel S, Barnes N, Douglass JA, Hartley BF, Ortega H. Characterisation of an OCS-dependent severe asthma population treated with mepolizumab. Thorax 2014; 69:1141-2. [PMID: 24834924 DOI: 10.1136/thoraxjnl-2014-205581] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
UNLABELLED A subpopulation of patients with asthma treated with maximal inhaled treatments is unable to maintain asthma control and requires additional therapy with oral corticosteroids (OCS); a subset of this population continues to have frequent exacerbations. Alternate treatment options are needed as daily use of OCS is associated with significant systemic adverse effects that affect many body systems and have a direct association with the dose and duration of OCS use. We compared the population demographics, medical conditions and efficacy responses of the OCS-dependent group from the DREAM study of mepolizumab with the group not managed with daily OCS. TRIAL REGISTRATION NUMBER NCT01000506.
Collapse
Affiliation(s)
- C M Prazma
- GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - S Wenzel
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - N Barnes
- Respiratory Medical Franchise, GSK, Uxbridge, UK The William Harvey Research Institute, Barts, London, UK The London School of Medicine and Dentistry, London, UK
| | - J A Douglass
- Department of Allergy and Immunology, The Royal Melbourne Hospital and The University of Melbourne, Parkville, Victoria, Australia
| | | | - H Ortega
- GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| |
Collapse
|
19
|
Barnes N, Calverley PMA, Kaplan A, Rabe KF. Chronic obstructive pulmonary disease and exacerbations: clinician insights from the global Hidden Depths of COPD survey. Curr Med Res Opin 2014; 30:667-84. [PMID: 24256026 DOI: 10.1185/03007995.2013.867842] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This real-life, global study aimed to investigate current views of and clinical practice in the management of COPD and its exacerbations, among clinicians from both the primary and secondary care settings. METHODOLOGY We devised an online questionnaire about COPD management and invited 13,613 general practitioners (GPs) and respiratory specialists to respond. Participating clinicians, recruited from an established research panel, treated a minimum of 10 (GPs) or 20 (respiratory specialists) patients with COPD per month. Completed responses were collected from 1400 clinicians from 14 countries. RESULTS A third of GPs and respiratory specialists reported that the main goal of COPD management was to improve patients' quality of life; only 14% of GPs thought that the prevention of exacerbations was a priority. The study showed a strong preference for inhaled corticosteroids in combination with other treatments, rather than as sole therapy, in line with global guidelines. Fewer GPs than respiratory specialists routinely recommended anticholinergics, pulmonary rehabilitation or oxygen therapy. Clinicians reported that 55% (GPs) and 57% (respiratory specialists) of their COPD patients had experienced an exacerbation in the previous 12 months. Although higher than those reported in clinical trials, these rates were lower than patients' own estimates from a corresponding patient survey, even in mild COPD patients (62%; 80% in severe patients). Despite this, 74% of GPs and 67% of respiratory physicians reported satisfaction with therapies to prevent exacerbations. CONCLUSIONS This global survey revealed that clinicians' main goal when managing COPD was to improve the lives of their patients, and that few viewed reducing exacerbations as a priority. Despite a relatively high level of adherence to treatment recommendations, it appears that clinicians, particularly GPs, underestimate the frequency and impact of exacerbations. These results suggest a need to raise awareness of exacerbations among both GPs and respiratory specialists.
Collapse
Affiliation(s)
- N Barnes
- GSK Stockley Park, West Uxbridge , Middlesex , United Kingdom
| | | | | | | |
Collapse
|
20
|
Irons J, McKone E, Dumbleton R, Barnes N, He X, Provis J, Ivanovici C, Kwa A. A new theoretical approach to improving face recognition in disorders of central vision: Face caricaturing. J Vis 2014; 14:14.2.12. [DOI: 10.1167/14.2.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
21
|
Martineau AR, Hanifa Y, Hooper RL, Witt KD, Patel M, Syed A, Jolliffe DA, Timms PM, Balayah Z, Stevens N, Clark DA, Eldridge S, Barnes N, Griffiths CJ. S123 Increased risk of upper respiratory infection with addition of intermittent bolus-dose vitamin D supplementation to a daily low-dose regimen. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
22
|
McKone E, Irons J, He X, Barnes N, Provis J, Dumbleton R, Ivanovici C, Kwa A. Caricaturing improves face recognition in simulated age-related macular degeneration. J Vis 2013. [DOI: 10.1167/13.9.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
23
|
Welte T, Bateman E, Ferguson GT, Barnes N, Gallagher N, Green Y, Horton R, Henley M, Banerji D. Vorteile einer dualen Bronchodilatation mit QVA149 einmal täglich versus Placebo, Indacaterol, NVA237 und Tiotropium bei Patienten mit COPD: die SHINE Studie. Pneumologie 2013. [DOI: 10.1055/s-0033-1334779] [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: 10/27/2022]
|
24
|
Barnes N, Bateman E, Gallagher N, Green Y, Horton R, Henley M, Banerji D. P192 QVA149 once daily provides superior bronchodilation versus indacaterol, glycopyrronium, tiotropium and placebo: the SHINE study: Abstract P192 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
25
|
Barnes N, Radwan A, Percival F. S12 Unscheduled healthcare resource utilisation and health-related quality of life before and after omalizumab initiation in UK clinical practice: the apex study. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.12] [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]
|
26
|
Barnes N, Lieby P, Dennet H, Walker J, McCarthy C, Liu N, Li Y. Investigating the role of single-viewpoint depth data in visually-guided mobility. J Vis 2011. [DOI: 10.1167/11.11.926] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
27
|
Taylor S, Bremner S, Choudhury A, Cook V, Devine A, Eldridge S, Feder G, Foster G, Islam K, Sohanpal R, Spencer A, Griffiths C, Barnes N. OEDIPUS: A cluster randomised trial of education for South Asians with asthma, and their primary and secondary care physicians, to reduce unscheduled care. J Epidemiol Community Health 2011. [DOI: 10.1136/jech.2011.143586.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
28
|
Barnes N, Pavord I, Chuchalin A, Bell J, Hunter M, Lewis T, Parker D, Payton M, Collins LP, Pettipher R, Steiner J, Perkins CM. A randomized, double-blind, placebo-controlled study of the CRTH2 antagonist OC000459 in moderate persistent asthma. Clin Exp Allergy 2011; 42:38-48. [DOI: 10.1111/j.1365-2222.2011.03813.x] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
29
|
Barnes N, Price D, Colice G, Chisholm A, Dorinsky P, Hillyer EV, Burden A, Lee AJ, Martin RJ, Roche N, von Ziegenweidt J, Israel E. Asthma control with extrafine-particle hydrofluoroalkane-beclometasone vs. large-particle chlorofluorocarbon-beclometasone: a real-world observational study. Clin Exp Allergy 2011; 41:1521-32. [PMID: 21752116 DOI: 10.1111/j.1365-2222.2011.03820.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The extrafine-particle formulation of hydrofluoroalkane-beclometasone (EF HFA-BDP; Qvar®) demonstrates improved total and small airway deposition compared with large-particle chlorofluorocarbon (CFC)-BDP. In some short-term studies, EF HFA-BDP provides greater effects on lung function than CFC-BDP, and hence is recommended to be prescribed at a lower dose, but whether there are differences in asthma outcomes during long-term treatment is unknown. OBJECTIVE To compare the effectiveness of EF HFA-BDP vs. CFC-BDP over 1 year. METHODS This retrospective matched cohort study examined outcomes in a large primary care database for patients aged 5-60 years with asthma receiving their first inhaled corticosteroid (ICS) prescription (initiation population) or first ICS dose increase (step-up population) by a pressurized metered-dose inhaler (pMDI) as EF HFA-BDP or CFC-BDP. Patients were matched on baseline demographic and asthma severity measures in EF HFA-BDP:CFC-BDP ratios of 1:3 and 1:2 for initiation and step-up populations, respectively. Step-up patients were matched also on ICS dose during a baseline year. Co-primary endpoints were asthma control (composite measure comprising no recorded hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and exacerbation rate during the outcome year. RESULTS For the initiation population (EF HFA-BDP n=2882; CFC-BDP n=8646), adjusted odds of achieving asthma control with EF HFA-BDP vs. CFC-BDP was 1.15 (95% CI 1.02-1.28). For the step-up population (n=258 and 516), adjusted odds of asthma control with EF HFA-BDP was 1.72 (95% CI 1.14-2.56). EF HFA-BDP was prescribed at a median dose half that of CFC-BDP. CONCLUSION AND CLINICAL RELEVANCE During 1 year after initiating or stepping up ICS therapy by pMDI, patients who received EF HFA-BDP were more likely to achieve asthma control than those receiving CFC-BDP. These findings suggest that ICS formulation, particle size, and deposition characteristics play important roles in real-life effectiveness of asthma therapy. This study shows that an EF-particle formulation of beclometasone can be used at half the dose of the large-particle formulation with at least as good clinical outcomes.
Collapse
Affiliation(s)
- N Barnes
- Department of Respiratory Medicine, London Chest Hospital, Barts and The London NHS Trust, London, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Mittapalli D, Sebastian BJ, Leung E, Barnes N, Senapati PSP. Adhesive bowel obstruction? Not always. J Emerg Trauma Shock 2011; 4:135-6. [PMID: 21633584 PMCID: PMC3097565 DOI: 10.4103/0974-2700.76826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 09/15/2010] [Indexed: 11/04/2022] Open
Abstract
A 58-year-old man presented acutely with features of post-surgical adhesive small bowel obstruction. Following an unsuccessful trial of conservative management, computed tomography (CT) of the abdomen was performed. This revealed a mass in the ileocaecal region, for which he underwent a subsequent right hemicolectomy. Histology revealed diffuse B-cell Non-Hodgkin's lymphoma of the terminal ileum. Confounding obstructive lesion of the intestine in patients with a history of previous laparotomy is extremely uncommon. Early high resolution imaging may predict diagnosis and consolidate clinical management plans.
Collapse
Affiliation(s)
- D Mittapalli
- Department of Surgery, Rochdale Infirmary, Whitehall Street, Rochdale, OL12 0NB, UK
| | | | | | | | | |
Collapse
|
31
|
Ball SV, Maxwell JL, Cruikshank MK, Douglas S, Price V, Davidson JE, Hanna L, Brown L, Watson L, Kelly J, Baildam EM, Cleary AG, McCann LM, Beresford MW, Hawley DP, Baildam EM, Amin TS, Cruikshank MK, Davidson J, Dixon J, Ennals G, Gulati R, Ohlsson V, Rangaraj S, Riley P, Sundaramoorthy C, Walsh J, Foster HE, Hendry GJ, Gardner-Medwin J, Turner DE, Woodburn J, Lorgelly PK, Hendry GJ, Steultjens MPM, Gardner-Medwin J, Woodburn J, Turner DE, Jandial S, Stewart J, Kay L, Foster HE, Leone V, McDonagh J, Pilkington C, Rangaraj S, Tizard EJ, Beresford MW, McErlane F, Kulkani P, Nicholl K, Foster HE, McErlane F, Foster HE, Symmons D, Hyrich K, Midgley A, Beresford MW, Pain CE, McCann LJ, Cleary AG, Beresford MW, Barnes N, Landes C, Baildam EM, Pain CE, Gargh K, McCann LJ, Rapley T, Heaven B, May C, Kay L, Foster H, Rapley T, Avery P, May C, Beresford M, Foster H, Rapley TR, May C, Foster HE, Sen ES, Mandal K, Hinchcliffe A, Dick AD, Ramanan AV, Thorbinson C, Midgley A, Beresford MW, Watson L, Midgley A, Hanna L, Jones C, Holt R, Pilkington C, Tullus K, Beresford MW, Wyllie R, Craig L. BSPAR ANNUAL CONFERENCE ABSTRACTS (presented in alphabetical order of first author). Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/keq394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
32
|
Serra E, Spaeth M, Carbonell J, Arnould B, Benmedjahed K, Barnes N, Le Lay K, Taïeb C. Development of the Fibromyalgia Burden Assessment: measuring the multifaceted burden of fibromyalgia. Clin Exp Rheumatol 2010; 28:S87-S93. [PMID: 21176427] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 12/01/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To develop a questionnaire assessing the burden of fibromyalgia's impacts on patients' lives. METHODS A literature review was conducted to identify impacts of fibromyalgia and their consequences on patients' lives. Exploratory interviews were performed with 15 fibromyalgia patients in France, Germany and Spain. Using patients' wording, items were generated simultaneously in French, German, Spanish, and UK English. Relevance and comprehension of the resulting questionnaire versions were tested with 21 additional fibromyalgia patients; questionnaires were revised accordingly. RESULTS Three domains, Burden associated with the impacts of fibromyalgia, Symptoms and Influencing factors, were identified from the literature review. Following patient interviews, the burden domain was further divided based on the nature of the impact: Pain, Physical impact (including tiredness, sleep problems and other symptoms), Activities of Daily Living impact (including autonomy and coping), Social and Family Life impact, Work, Studies and Personal Finances impact, Psychological impact (including cognitive impact), and Relationship to Medicine and Disease. The resulting test versions of the questionnaire contained 79 items. Comprehension tests identified problematic items and cultural differences and suggested deletions or rewording. After revision and linguistic harmonization, the pilot version of the questionnaire contained 62 items divided into 7 sections, and was named Fibromyalgia Burden Assessment (FMBA©). CONCLUSIONS The FMBA is a self-reported questionnaire allowing the assessment and a better understanding of the impacts of fibromyalgia and the burden associated with these on patients' daily lives. It is available in UK English, French, German and Spanish. Its scoring and validation remain to be undertaken.
Collapse
Affiliation(s)
- E Serra
- Amiens University Hospital, Amiens, France
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Gawne S, Barnes N, Kordzadeh A, Koussa F, Prasad R, Todd J. 282 Early complications of mastectomy. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70308-6] [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: 10/19/2022] Open
|
34
|
Barnes N, Gawne S, Harland R. 141 ‘Triple negative’ receptor status as a risk factor for recurrence and death in cancer of the breast. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70172-5] [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: 10/19/2022] Open
|
35
|
Cherbuin N, Lieby P, Barnes N, Réglade-Meslin C, Maller JJ, Sachdev PS, Anstey KJ. A new measure of hippocampal surface (W-index) is a better predictor of memory change in young-old adults than raw volume. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
36
|
Uberoi R, Roberts P, Barnes N, Wilson N. Transcatheter closure of total cavopulmonary connection lateral tunnel dehiscence and fenestration using a custom-made, self-expanding stent graft. Cardiovasc Intervent Radiol 2008; 32:385-7. [PMID: 18830742 DOI: 10.1007/s00270-008-9448-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 08/13/2008] [Accepted: 09/03/2008] [Indexed: 10/21/2022]
|
37
|
|
38
|
Miller WA, Miller MA, Gardner IA, Atwill ER, Harris M, Ames J, Jessup D, Melli A, Paradies D, Worcester K, Olin P, Barnes N, Conrad PA. New genotypes and factors associated with Cryptosporidium detection in mussels (Mytilus spp.) along the California coast. Int J Parasitol 2006; 35:1103-13. [PMID: 15993883 DOI: 10.1016/j.ijpara.2005.04.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Revised: 04/12/2005] [Accepted: 04/15/2005] [Indexed: 11/24/2022]
Abstract
A 3 year study was conducted to evaluate mussels as bioindicators of faecal contamination in coastal ecosystems of California. Haemolymph samples from 4680 mussels (Mytilus spp.) were tested for Cryptosporidium genotypes using PCR amplification and DNA sequence analysis. Our hypotheses were that mussels collected from sites near livestock runoff or human sewage outflow would be more likely to contain the faecal pathogen Cryptosporidium than mussels collected distant to these sites, and that the prevalence would be greatest during the wet season when runoff into the nearshore marine environment was highest. To test these hypotheses, 156 batches of sentinel mussels were collected quarterly at nearshore marine sites considered at higher risk for exposure to livestock runoff, higher risk for exposure to human sewage, or lower risk for exposure to both faecal sources. Cryptosporidium genotypes detected in Haemolymph samples from individual mussels included Cryptosporidium parvum, Cryptosporidium felis, Cryptosporidium andersoni, and two novel Cryptosporidium spp. Factors significantly associated with detection of Cryptosporidium spp. in mussel batches were exposure to freshwater outflow and mussel collection within a week following a precipitation event. Detection of Cryptosporidium spp. was not associated with higher or lower risk status for exposure to livestock faeces or human sewage sources. This study showed that mussels can be used to monitor water quality in California and suggests that humans and animals ingesting faecal-contaminated water and shellfish may be exposed to both host-specific and anthropozoonotic Cryptosporidium genotypes of public health significance.
Collapse
Affiliation(s)
- W A Miller
- School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Barnes N, Haywood P, Flint P, Knox WF, Bundred NJ. Survivin expression in in situ and invasive breast cancer relates to COX-2 expression and DCIS recurrence. Br J Cancer 2006; 94:253-8. [PMID: 16421596 PMCID: PMC2361101 DOI: 10.1038/sj.bjc.6602932] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In lung cancer cyclooxygenase-2 (COX-2) expression has been reported to stabilise survivin, an inhibitor of apoptosis (IAP) which prevents cell death by blocking activated caspases. COX-2 expression limits the ubiquitination of survivin, protecting it from degradation. To determine if COX-2 expression in breast cancer showed an association with survivin expression, we assessed the levels of each protein in ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC); relating expression patterns to recurrence of DCIS after surgery. Patterns of COX-2 and survivin expression were determined by intensity-graded immunohistochemistry of the primary tumours. Patients with DCIS (n=161) which had either recurred (n=47) or shown no evidence of recurrence (n=114) 5 years following primary surgery were studied. These were compared to 58 cases of IBC. Survivin was expressed in the cytoplasm of 59% of DCIS and 17% of IBC. High levels of both cytoplasmic survivin and COX-2 expression significantly correlated to DCIS recurrence. COX-2 expression was present in 72% of DCIS, and levels of expression positively correlated with cytoplasmic survivin expression in DCIS and invasive disease. The majority of DCIS that recurred expressed both proteins (69%) vs 39% nonrecurrent. Recurrence was not seen in DCIS lacking both proteins at 5 years (P=0.001). Expression of the IAP survivin is increased in DCIS and correlates closely with COX-2 expression. Increased expression of IAP, (leading to reduced apoptosis) may explain the effect of COX-2 in increasing recurrence of DCIS after surgical treatment.
Collapse
Affiliation(s)
- N Barnes
- Department of Academic Surgery, South Manchester University Hospital, Manchester, UK
| | - P Haywood
- Department of Academic Surgery, South Manchester University Hospital, Manchester, UK
| | - P Flint
- Department of Academic Surgery, South Manchester University Hospital, Manchester, UK
| | - W F Knox
- Department of Pathology, South Manchester University Hospital, Manchester, UK
| | - N J Bundred
- Department of Academic Surgery, South Manchester University Hospital, Manchester, UK
- Department of Academic Surgery, Research and Education Building 2nd Floor, South Manchester University Hospital, Southmoor Road, Wythenshawe, Manchester, M23 9LT, United Kingdom; E-mail:
| |
Collapse
|
40
|
Abstract
The recovery of heat from the mass incineration of solid waste can make a useful contribution to the nation's energy needs. Whilst we have been slow to exploit fully this resource in Great Britain, there are some notable plants both here and abroad which have demonstrated commercial success over a number of years. When operated with engineering judgement they are reliable and dispose of waste economically in urban areas.
Collapse
Affiliation(s)
- N Barnes
- Consultant to Kennedy and Donkin Consulting Engineers
| |
Collapse
|
41
|
Affiliation(s)
- N Barnes
- John Radcliffe Hospital, Oxford, UK.
| | | |
Collapse
|
42
|
Barnes N, Boland G, Khavari S, Cramer A, Knox W, Bundred N. Predicting recurrence risk in DCIS: The role of Type 1 tyrosine kinase receptor co-expression. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)91068-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
43
|
Abstract
AIM The benefit of anti-reflux surgery for gastro-oesophageal reflux (GOR) in early infancy is uncertain. The aim of this study was to assess the value of Nissen fundoplication in a group of infants with severe GOR. METHODS 10 infants underwent Nissen fundoplication for gastro-oesophageal reflux following a failure of medical management. All had suffered life-threatening respiratory episodes as a consequence of gastro-oesophageal reflux, and were neonatal intensive care-dependent. Median (range) birth weight was 1.26 kg (0.48-3.8 kg), gestation 30 weeks (25-38 weeks); at surgery, weight was 3.25 kg (2.5-6.1 kg) at a corrected age of 11.5 weeks (term-22) weeks. For each infant, the success of enteral feeding and the level of support required pre- and post-operatively was compared, and where appropriate, the facilitation of palliative feeding was assessed. Median follow-up was 14 (3-36) months. RESULTS No infant suffered intra-operative morbidity or mortality. One infant died within 1 month of surgery from a collapse unrelated to surgery. Eight of nine surviving infants were discharged from intensive care following extubation and the establishment of enteral feeding. One patient died of severe bronchopulmonary dysplasia 3 months post-surgery. One infant developed a gastrostomy site infection, and two required gastrostomy tube replacement within 6 months of surgery. All were thriving at follow-up. Two infants with a congenital myopathy died as a result of their muscle disease at 9 and 11 months post-operatively. CONCLUSIONS Nissen fundoplication is a feasible, effective and safe operation in severe gastro-oesophageal reflux unresponsive to medical treatment in term and pre-term infants. It has an additional important role in facilitating safe palliative enteral feeding in infants with a diagnosis incompatible with survival into adulthood.
Collapse
Affiliation(s)
- N Barnes
- Department of Neonatology, Imperial College School of Medicine, Hammersmith Campus, London W12 0HS, UK
| | | | | |
Collapse
|
44
|
Affiliation(s)
- F Serracino-Inglott
- Department of Cascular Surgey, North Manchester General Hospital, Manchester, England
| | | | | |
Collapse
|
45
|
Phipps S, Flood-Page P, Menzies-Gow A, Wangoo A, Barnes N, Barkans J, Robinson D, Kay A. Anti-IL-5 (Mepolizumab) reduces the expression of tenascin, procollagen III and lumican in the reticular basement membrane of human atopic asthmatics. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80998-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
46
|
Gowardman J, Sleigh J, Barnes N, Smith A, Havill J. Intermittent enteral nutrition--a comparative study examining the effect on gastric pH and microbial colonization rates. Anaesth Intensive Care 2003; 31:28-33. [PMID: 12635391 DOI: 10.1177/0310057x0303100105] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 11/15/2022]
Abstract
In a prospective randomized study we aimed to examine the effect on gastric pH and microbial colonization of enteral nutrition (EN) delivered both by intermittent and continual infusion. Forty-three mechanically ventilated patients were randomized to receive EN by one of three methods, intermittent or continual gastric or continual jejunal. We sampled gastric aspirate for pH and culture in all patients at 0600 hours and pH in gastric intermittent feeders at 2200 hours daily. Patients were studied for 12 days or until extubated. Data was obtained on 41 patients, of whom 73% had a diagnosis of trauma. Median APACHE II score was 17 and ventilation time 11 days. Twelve patients received gastric continuous, 15 gastric intermittent and 14 jejunal nutrition. No significant difference was observed between the three groups with regard to median 0600 pH (P = 0.16). This was lowest in the jejunal group (3.2) followed by the gastric intermittent group (4.0) and then gastric continuous group (5.0). With overnight cessation of EN in the gastric intermittent group, the median pH fell from 5.2 at 2200 to 4.0 at 0600 (P = 0.01) with no effect on gastric colonization. The probability of gastric colonization over time however was significantly lower in the jejunal group compared with the two gastric groups (Log rank test, P = 0.02). These results demonstrate that in a patient population consisting predominantly of trauma, overnight cessation of EN made no overall difference to 0600 gastric pH or colonization rates. The preservation of pH and lowered colonization in those given jejunal feeding may have implications in the pathogenesis of ventilator-associated infection and may warrant further study using larger patient numbers.
Collapse
|
47
|
Abstract
This review explores the health and social burden of some of the main respiratory diseases (asthma, chronic obstructive pulmonary disease, cryptogenic fibrosing alveolitis, cystic fibrosis, lung cancer, mesothelioma, obstructive sleep apnoea and tuberculosis) in order to increase awareness of these diseases and highlight areas where improvements in care are required. The overall impact of respiratory diseases in the U.K. in terms of prevalence, mortality, morbidity and economic costs, with particular reference to secondary care has been considered and comparisons made with the rest of Europe where data are available. Respiratory diseases are responsible for a significant proportion of serious morbidity and premature death among the population of the U.K. and they will continue to present a growing challenge; special support is needed to tackle this burden.
Collapse
Affiliation(s)
- F Chung
- Royal Brompton & Harefield NHS Trust, London, U.K.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Gizycki MJ, Hattotuwa KL, Barnes N, Jeffery PK. Effects of fluticasone propionate on inflammatory cells in COPD: an ultrastructural examination of endobronchial biopsy tissue. Thorax 2002; 57:799-803. [PMID: 12200525 PMCID: PMC1746422 DOI: 10.1136/thorax.57.9.799] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [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: 11/03/2022]
Abstract
BACKGROUND Inhaled corticosteroids (ICS) markedly reduce bronchial mucosal inflammation in asthma but whether they have an anti-inflammatory effect in airway tissue in chronic obstructive pulmonary disease (COPD) is unknown. METHODS A study of endobronchial biopsy samples was conducted as part of a double blind, placebo controlled, randomised trial of parallel design. Patients had mild to moderately severe COPD (FEV(1) 25-80% of predicted) and were given 3 months treatment with ICS, fluticasone propionate (FP; 500 micro g twice daily, n=14) or placebo (n=10). Biopsy tissue taken at baseline and after treatment was examined by transmission electron microscopy to count the numbers of all ultrastructurally distinct inflammatory cells. RESULTS Compared with their baseline values, FP resulted in a significant decrease (on average 65%) in the numbers of mucosal mast cells (median 7.8 (range 1-33) v 2.8 (1-14), p<0.05). The reductive effect of FP held true when the post-treatment values of the placebo and FP groups were compared: 8.8 (1-24) v 2.8 (1-14) (p<0.05). Unexpectedly, there were significantly more neutrophils in the FP than in the placebo group: 4.0 (0-23) v 1.7 (0-8), respectively (p<0.05). There were no alterations to other cell types including mononuclear cells. Symptoms markedly improved in the patients treated with FP for 3 months. CONCLUSION Fluticasone propionate given for 3 months to patients with COPD has selective effects on the inflammatory cells in the bronchial mucosa: the reduction in mast cell numbers may account for the improvement in symptoms over this time.
Collapse
Affiliation(s)
- M J Gizycki
- Lung Pathology Unit, Imperial College School of Medicine at the Royal Brompton Hospital, London, UK London Chest Hospital, London, UK
| | | | | | | |
Collapse
|
49
|
Birchenough AC, Barnes N, Evans SM, Hinz H, Krönke I, Moss C. A review and assessment of tributyltin contamination in the North Sea, based on surveys of butyltin tissue burdens and imposex/intersex in four species of neogastropods. Mar Pollut Bull 2002; 44:534-543. [PMID: 12146836 DOI: 10.1016/s0025-326x(01)00275-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
It is evident from measures of butyltin tissue burdens and imposex or intersex in neogastropods that tributyltin (TBT) contamination of coastal waters and open parts of the North Sea is now low. It has been declining for at least the past decade. This is probably due to two measures. First, regulations prohibiting the use of TBT-based paints on small boats and fish farms have reduced inputs of TBT from these sources so that they are now negligible (except possibly where the regulations are flaunted). Second, there is evidence from sites, where commercial vessels are the sole source of TBT, that the adoption of TBT SPC paints has been effective in reducing environmental levels of these contaminants. However, poor dockyard practices, allowing TBT-contaminated wastes, including paint flakes, to accumulate in sediments have left a legacy of hot-spots of contamination in some ports. The impact is localised so that TBT contamination is low in coastal areas immediately adjacent to ports.
Collapse
Affiliation(s)
- A C Birchenough
- Department of Marine Sciences and Coastal Management, Newcastle University, Cullercoats, Tyne and Wear, UK.
| | | | | | | | | | | |
Collapse
|
50
|
Grayling M, Barnes N. 'Tears at bedtime' and how to avoid them. Br J Anaesth 2002; 88:745-6. [PMID: 12067027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
|