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Cheong K, Gibson P, Burns R. P.10 Management and investigation pathway for suspected ACS in pregnancy. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kim KKB, Gibson P. 756 ORTHOPAEDIC SURGEONS CAN PRESCRIBE LAXATIVES & ANALGESICS TOO - A QUALITY IMPROVEMENT PROJECT SPANNING 7 YEARS. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.756] [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] Open
Abstract
Abstract
Background
Patients admitted with age 60 years and over with a hip fracture admitted to a District General Hospital.
Introduction
The aim was to improve the prescribing of regular laxatives and analgesia at the time of admission to hospital.
Methods
There were repeated PDSA cycles. Data was collected on consecutive patients (by admission date) identified from the National Hip Fracture Database. Data was collected at baseline (10 patients in November 2013) and after Phase 1 intervention (20 patients, December 2013—January 2014), after Phase 2 (20 patients, February 2014), after Phase 3 (39 patients, April—June 2017) and after Phase 4 (September—October 2020). The interventions were as follows: Phase 1: Prompts at new doctor induction (‘Induction’) + prompts in hip fracture admission document. Phase2: Phase 1 intervention + flow diagram in fracture admission document. Phase 3: Prompts at Induction + electronic prescribing protocol (including laxatives and analgesics) + removal of flow diagram from admission document. Phase 4: Phase 3 intervention + more effort to explain to new locum doctors.
Results
Laxative prescribing: Baseline = 40%, Phase 1 = 80%, Phase 2 = 80%, Phase 3 = 56%, Phase 4 = 74% (24 hours post-admission = 90%). Paracetamol prescribing: Baseline 100%, Phase 1,100%, Phase 2,100%, Phase 3 64%, Phase 4 82% (24 h post-admission = 90%). Regular strong opioid prescribing: Admission: Baseline 60%, Phase 1 90%, Phase 2,100%, Phase 3 44%, Phase 4 80% (24 h post-admission = 90%).
Conclusion
1. Orthopaedic Surgeons can prescribe laxatives and analgesia well—given sufficient prompts 2. The electronic solution is not always sufficient—locum doctors may not be aware of it. 3. Do not assume continued success Future Plans Re-introduce flow diagram to admission document. Acknowledgements Many people have helped with previous phases & will be acknowledged.
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Affiliation(s)
- K K B Kim
- The Royal Oldham Hospital; North Manchester General Hospital
| | - P Gibson
- The Royal Oldham Hospital; North Manchester General Hospital
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Tuck CJ, De Palma G, Takami K, Brant BJ, Caminero Fernandez A, Reed DE, Muir J, Gibson P, Winterborn A, Bercik P, Verdu E, Vanner S. A55 LACK OF EXPERIMENTAL REPRODUCIBILITY IN PRECLINICAL RESEARCH IS INFLUENCED BY THE NUTRITIONAL PROFILE OF STANDARD RODENT CHOWS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.054] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lack of experimental reproducibility, particularly in studies investigating the microbiota, is of growing concern to the scientific community. Factors such as environment, stress, and sex have been identified as contributors, whereas dietary composition has received less attention.
Aims
To profile the use of standard rodent chows in research institutions, analyze the nutrient content of common rodent chows, and assess the impact of different chows on microbiota profiles.
Methods
A survey was conducted to evaluate which rodent chows are used by research institutions worldwide. Seven standard rodent chows were selected for analysis of ingredients, fermentable carbohydrate (FODMAP) and gluten content. FODMAP content was measured by high-performance liquid-chromatography and enzymatic assays, and gluten content was assessed by a commercial kit using G12 antibody. Forty C57BL/6 mice were randomized to 4 groups of 10 mice (5 male, 5 female). Group A was euthanized at baseline. Group B received the breeding institution chow (LabDiet 5066). Group C received ResearchDiets AIN93G (low FODMAP and gluten content). Group D received LabDiet 5001 (high FODMAP and gluten content). After 3 weeks, cecal contents were collected and analyzed by 16S rRNA gene sequencing; short- and branched-chain fatty acids (SCFA, BCFAs) content was also determined.
Results
Twenty-eight different types of rodent chows were reported to be used by 45 international survey respondents. Ingredient composition of the standard chows varied widely, resulting in differences in FODMAP and gluten content. Microbiota analysis of cecal contents revealed that gut microbiota composition was altered by the standard chows, as reflected by significantly different clusters in β-diversity analysis as well as by altered α-diversity. Microbiota diversity was also influenced by sex in Groups A and B (p<0.01). Total SCFA levels were lower (p=0.03) and BCFA levels were higher (p=0.01) in Group C compared to Group B.
Conclusions
Our results suggest that the composition of the diet not only significantly impacts gut microbiota profiles and fermentation patterns but may also emphasize sex differences in preclinical studies, with major implications for the reproducibility of results across laboratories.
Funding Agencies
CIHRThe Canadian Nutrition Society
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Affiliation(s)
- C J Tuck
- Queen’s University, Kingston, ON, Canada
| | - G De Palma
- McMaster University, Hamilton, ON, Canada
| | - K Takami
- Queen’s University, Kingston, ON, Canada
| | - B J Brant
- Queen’s University, Kingston, ON, Canada
| | | | - D E Reed
- Queen’s University, Kingston, ON, Canada
| | - J Muir
- Monash University, Melbourne, Victoria, Australia
| | - P Gibson
- Monash University, Melbourne, Victoria, Australia
| | | | - P Bercik
- McMaster University, Hamilton, ON, Canada
| | - E Verdu
- McMaster University, Hamilton, ON, Canada
| | - S Vanner
- Queen’s University, Kingston, ON, Canada
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Okul Valentor A, Ochwo-Ssemakula M, Kaweesi T, Ozimati A, Mrema E, Mwale E, Gibson P, Achola E, Edema R, Baguma Y, Kawuki R. Plot based heritability estimates and categorization of cassava genotype response to cassava brown streak disease. Crop Prot 2018; 108:39-46. [PMID: 29861529 PMCID: PMC5890358 DOI: 10.1016/j.cropro.2018.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 01/23/2018] [Accepted: 02/07/2018] [Indexed: 05/21/2023]
Abstract
Cassava brown streak disease (CBSD) caused by Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) is a threat to food security in sub-Saharan Africa, where the disease persistently reduces overall root quality and quantity resulting in up to 100% yield losses. Complexities in CBSD symptom expression and the damage caused on leaves, stems and roots throughout the 12 months of cassava growth require that appropriate ways of categorizing genotype response and optimal stages of evaluation be identified. This study aimed at: 1) determining plot based heritability of CBSD based on symptom expression and 2) categorizing genotype resistance to CBSD based on symptom expression. Herein, 41 genotypes were evaluated for two years at Namulonge with an additional evaluation conducted across three locations. Evaluations were done at three, six, nine and twelve months after planting. Genotype responses to CBSD varied significantly. High broad sense heritability estimates of up to 0.81 (incidence) and 0.71 (severity) were obtained. Average disease severity scores had higher broad sense heritability estimates (0.53 and 0.65) than maximum disease severity scores (0.33 and 0.61) for root and foliar severities respectively. These findings are important in choosing an appropriate evaluation method for CBSD. Genotypes displayed differing CBSD responses in type, locality and severity of symptoms. This suggested that genotypes had differences in mechanisms of resistance that can be exploited in CBSD resistance breeding.
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Affiliation(s)
- A. Okul Valentor
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
- Corresponding author.
| | - M. Ochwo-Ssemakula
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
| | - T. Kaweesi
- National Crops Resources Research Institute, Root Crops Program, P.O. Box 7084, Kampala, Uganda
| | - A. Ozimati
- National Crops Resources Research Institute, Root Crops Program, P.O. Box 7084, Kampala, Uganda
| | - E. Mrema
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
| | - E.S. Mwale
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
| | - P. Gibson
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
| | - E. Achola
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
| | - R. Edema
- Makerere University, Department of Agricultural Production, P.O. Box 7062, Kampala, Uganda
| | - Y. Baguma
- National Crops Resources Research Institute, Root Crops Program, P.O. Box 7084, Kampala, Uganda
| | - R. Kawuki
- National Crops Resources Research Institute, Root Crops Program, P.O. Box 7084, Kampala, Uganda
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Tuck C, Ly E, Bogatyrev A, Costetsou I, Gibson P, Barrett J, Muir J. Fermentable short chain carbohydrate (FODMAP) content of common plant-based foods and processed foods suitable for vegetarian- and vegan-based eating patterns. J Hum Nutr Diet 2018; 31:422-435. [DOI: 10.1111/jhn.12546] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- C. Tuck
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - E. Ly
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - A. Bogatyrev
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - I. Costetsou
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - P. Gibson
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - J. Barrett
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
| | - J. Muir
- Department of Gastroenterology; Monash University; The Alfred Hospital; Melbourne VIC Australia
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Johannessen I, Danial J, Smith DB, Richards J, Imrie L, Rankin A, Willocks LJ, Evans C, Leen C, Gibson P, Simmonds P, Goldberg D, McCallum A, Roy K. Molecular and epidemiological evidence of patient-to-patient hepatitis C virus transmission in a Scottish emergency department. J Hosp Infect 2017; 98:412-418. [PMID: 29242141 DOI: 10.1016/j.jhin.2017.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/06/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Transmission of hepatitis C virus (HCV) in the healthcare setting is rare. Routine infection prevention and control measures mean that this should be a preventable 'never event'. AIM To investigate the diagnosis of acute healthcare-associated HCV infection. METHODS Epidemiological and molecular investigation of a case of acute HCV infection associated with nosocomial exposure. FINDINGS Detailed investigation of the treatment history of a patient with acute HCV infection identified transmission from a co-attending patient in an emergency department as the likely source; this possibility was confirmed by virus sequence analysis. The precise route of transmission was not identified, though both patient and source had minimally invasive healthcare interventions. Review of infection, prevention and control identified potentially contributory factors in the causal pathway including hand hygiene, inappropriate use of personal protective equipment, and blood contamination of the surface of the departmental blood gas analyser. CONCLUSION We provide molecular and epidemiological evidence of HCV transmission between patients in an emergency department that was made possible by environmental contamination. Patients with HCV infection are higher users of emergency care than the general population and a significant proportion of those affected remain unknown and/or infectious. Equipment, departmental design, staff behaviour, and patient risk require regular review to minimize the risk of nosocomial HCV transmission.
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Affiliation(s)
- I Johannessen
- NHS Lothian Laboratory Medicine (Virology), Royal Infirmary of Edinburgh, Edinburgh, UK.
| | - J Danial
- NHS Lothian Infection Prevention and Control Service, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - D B Smith
- Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK
| | - J Richards
- NHS Lothian Infection Prevention and Control Service, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - L Imrie
- Infection Prevention and Control Group, Health Protection Scotland, Glasgow, UK
| | - A Rankin
- Infection Prevention and Control Group, Health Protection Scotland, Glasgow, UK
| | - L J Willocks
- NHS Lothian Public Health and Health Policy, Waverley Gate, Edinburgh, UK
| | - C Evans
- NHS Lothian Public Health and Health Policy, Waverley Gate, Edinburgh, UK
| | - C Leen
- NHS Lothian Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK
| | - P Gibson
- NHS Lothian Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - P Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - D Goldberg
- Blood-Borne Virus Group, Health Protection Scotland, Glasgow, UK
| | - A McCallum
- NHS Lothian Public Health and Health Policy, Waverley Gate, Edinburgh, UK
| | - K Roy
- Blood-Borne Virus Group, Health Protection Scotland, Glasgow, UK
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Affiliation(s)
- A Kolb
- Department of Renal Medicine, Royal Infirmary of Edinburgh, UK
| | - P Gibson
- Department of Renal Medicine, Royal Infirmary of Edinburgh, UK
| | - E D O'Sullivan
- Department of Renal Medicine, Royal Infirmary of Edinburgh, UK
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Abstract
The 2017 Faraday Discussion on the topic of "Catalysis for Fuels" was unique in the sense that it was the first Faraday Discussion to be held on the continent of Africa. "Catalysis" and "Fuels" are both topics that could be widely interpreted and the session topics proved to be a relevant spread of old and new i.e. Fischer-Tropsch chemistry, biomass refining, zeolite conversions and photocatalysis. Most of the papers were underpinned by fundamental studies, catalyst design approaches, reports of in operando characterization and detailed speciation and micro kinetic analyses. Examples of commercial application were offered under the headings of biomass conversion, Fischer-Tropsch and to some extent photocatalysis. Cognisance was given to the increasingly important role of catalytic metals in terms of scarcity, cost and environmental impact. The potential role of novel alloys in addressing some of the catalytic mechanistic challenges turned out to be one of the central themes during the discussions. The following remarks are an attempt to draw parallels between the topics under discussion and the author's subjective view of current universal questions that could/should be highlighted under the "Catalysis for Fuels" heading.
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Affiliation(s)
- P Gibson
- Group Technology, Sasol South Africa (Pty) Ltd, South Africa.
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Iacovou M, Yelland G, Gibson P, Muir J. Dietary modifications of the maternal diet among breast-feeding mothers. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yao C, Tuck C, Barrett J, Canale K, Philpott H, Gibson P. Reproducibility of lactulose and fructose breath hydrogen testing and impact on clinical utility. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Malakar S, Gibson P, Muir J. CD63 upregulation on basophils is not a predictor of salicylate sensitivity. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Gibson P, Boyd P. Optimal electrode design: Straight versus perimodiolar. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S63-5. [DOI: 10.1016/j.anorl.2016.04.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/28/2016] [Indexed: 11/29/2022]
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13
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Elnawsra O, Fok I, Sparrow M, Gibson P, Andrews J, Connor S. Faecal calprotectin: current usage and perceived beneficial effects of third-party funding on rates of colonoscopy by Australian gastroenterologists. Intern Med J 2016; 46:590-5. [DOI: 10.1111/imj.13056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 12/23/2015] [Accepted: 02/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- O. Elnawsra
- Department of Gastroenterology and Hepatology; Liverpool Hospital; Sydney New South Wales Australia
| | - I. Fok
- Department of Gastroenterology; Royal North Shore Hospital; Sydney New South Wales Australia
| | - M. Sparrow
- Department of Gastroenterology; The Alfred Hospital; Melbourne Victoria Australia
| | - P. Gibson
- Department of Gastroenterology; The Alfred Hospital; Melbourne Victoria Australia
- Faculty of Medicine; Monash University; Melbourne Victoria Australia
| | - J. Andrews
- Department of Gastroenterology; Royal Adelaide Hospital; Adelaide South Australia Australia
- School of Medicine, Faculty of Health Science; University of Adelaide; Adelaide South Australia Australia
| | - S. Connor
- Department of Gastroenterology and Hepatology; Liverpool Hospital; Sydney New South Wales Australia
- Faculty of Medicine; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital; Sydney New South Wales Australia
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Porsbjerg C, Baines K, Gibson P, Bergqvist A, Erjefält JS, Sverrild A, Backer V. IL-33 is related to innate immune activation and sensitization to HDM in mild steroid-free asthma. Clin Exp Allergy 2016; 46:564-74. [DOI: 10.1111/cea.12702] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 11/24/2015] [Accepted: 12/18/2015] [Indexed: 01/03/2023]
Affiliation(s)
- C. Porsbjerg
- Respiratory Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - K. Baines
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - P. Gibson
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - A. Bergqvist
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - J. S. Erjefält
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - A. Sverrild
- Respiratory Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - V. Backer
- Respiratory Research Unit; Bispebjerg Hospital; Copenhagen Denmark
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Sverrild A, Bergqvist A, Baines KJ, Porsbjerg C, Andersson CK, Thomsen SF, Hoffmann HJ, Gibson P, Erjefält JS, Backer V. Airway responsiveness to mannitol in asthma is associated with chymase-positive mast cells and eosinophilic airway inflammation. Clin Exp Allergy 2016; 46:288-97. [DOI: 10.1111/cea.12609] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/16/2015] [Accepted: 07/24/2015] [Indexed: 12/23/2022]
Affiliation(s)
- A. Sverrild
- University Hospital Bispebjerg; Copenhagen Denmark
| | - A. Bergqvist
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - K. J. Baines
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - C. Porsbjerg
- University Hospital Bispebjerg; Copenhagen Denmark
| | - C. K. Andersson
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - S. F. Thomsen
- Department of Dermatology; Bispebjerg Hospital; Copenhagen Denmark
| | - H. J. Hoffmann
- Department of Pulmonary Medicine B; Institute for Clinical Medicine; Aarhus University; Aarhus Denmark
| | - P. Gibson
- Centre for Asthma and Respiratory Disease; The University of Newcastle; Newcastle NSW Australia
| | - J. S. Erjefält
- Respiratory Medicine and Allergology and Experimental Medical Science; Lund University; Lund Sweden
| | - V. Backer
- University Hospital Bispebjerg; Copenhagen Denmark
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Tilley S, Alghamdi F, Anderson T, Chow K, Choy J, Dyck J, Ezekowitz J, Gibson P, Kaul P, Narine K, Pagano J, Paterson I, Savu A, Thompson R, Becher H. DETERMINATION OF NORMAL LV VOLUME AND EF BY CONTRAST ECHO AND COMPARISON WITH CARDIAC MRI. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.161] [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] Open
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Miall A, Khoo A, Rauch C, Gibson P, Costa R. Repetitive gut challenge reduces gastro-intestinal symptoms and malabsorption of carbohydrates during exertional stress. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Iacovou M, Ralston R, Walker K, Truby H, Gibson P, Muir J. Dietary management for infantile colic: A systematic review. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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19
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Tuck C, Barrett J, Gibson P, Muir J. Utilising cooking methods can reduce the fodmap content of legumes to assist in increasing fibre intake. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Peters S, Yao C, Shepherd S, Philpott H, Yelland G, Muir J, Gibson P. The low fodmap diet and gut-directed hypnotherapy are equally efficacious in patients with irritable bowel sydnrome. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.163] [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] Open
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Douglas K, Hillis G, Croal B, Gibson P, Cuthbertson B. B-type natriuretic peptide and echocardiographic indices of left ventricular filling in critically ill patients with severe sepsis: a cohort study. Br J Anaesth 2014; 113:884-5. [DOI: 10.1093/bja/aeu354] [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: 11/13/2022] Open
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22
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Lees JS, Church N, Langdale-Brown B, Bellamy C, Gibson P, Watson S. IgG4-related disease: a novel, important but easily missed condition. J R Coll Physicians Edinb 2014; 43:126-33. [PMID: 23734354 DOI: 10.4997/jrcpe.2013.208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a multisystem, fibroinflammatory condition unrecognised in medical science until the last decade. It is characterised by progressive scarring and dysfunction of affected organs and tissues including the pancreas, hepatobiliary tree, kidneys, salivary glands, retroperitoneum and lungs. The diagnosis is made with the presence of numerous IgG4 positive plasma cells within a histologically-distinct chronic inflammatory process; most patients also have elevated serum IgG4. Though early cases were all identified in Japan, subsequent reports clearly demonstrate that IgG4-RD exists worldwide. There are no data confirming the prevalence of IgG4-RD in the West but it is thought to be very rare. Limited awareness of the condition and its heterogeneous presentation frequently results in misdiagnosis. Prompt and correct diagnosis is critical, as a rapid reversal of even advanced disease is often seen with corticosteroid therapy. We present three cases that illustrate some of the typical features of this condition.
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Affiliation(s)
- J S Lees
- Department of Renal Medicine, Royal Infirmary of Edinburgh, UK
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Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, Adcock IM, Bateman ED, Bel EH, Bleecker ER, Boulet LP, Brightling C, Chanez P, Dahlen SE, Djukanovic R, Frey U, Gaga M, Gibson P, Hamid Q, Jajour NN, Mauad T, Sorkness RL, Teague WG. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2013; 43:343-73. [DOI: 10.1183/09031936.00202013] [Citation(s) in RCA: 2274] [Impact Index Per Article: 206.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Gibson P, Becher H, Choy J. Differences in classification of left ventricular size measured by diameter and volume with contrast echocardiography. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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De Cruz P, Kamm M, Hamilton A, Ritchie K, Gorelik A, Liew D, Prideaux L, Lawrance I, Andrews J, Bampton P, Sparrow M, Jakobovits S, Florin T, Gibson P, Debinski H, Gearry R, Macrae F, Leong R, Kronborg I, Connor S, Pavli P, Smith GR, Selby W, Johnston M, Brouwer R, Keck J, Woods R, Connell W, Brown S, Bell S, Lust M, Elliott R, Desmond P. P342 Adalimumab prevents post-operative Crohn's disease recurrence and is superior to thiopurines: Early results from the prospective POCER study. J Crohns Colitis 2012. [DOI: 10.1016/s1873-9946(12)60361-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Schechter T, Teuffel O, Gibson P, Sung L, Seto W, Gassas A, Doyle J, Dupuis L. Cyclosporine Area Under the Curve in Children Undergoing Haematopoietic Stem Cell Transplantation: Limited Sampling Strategy at Steady-State. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vertigan A, Gibson P. Development of a Brief Speech Pathology Intervention for Chronic Refractory Cough. Pulm Pharmacol Ther 2011. [DOI: 10.1016/j.pupt.2011.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schechter T, Teuffel O, Gibson P, Sung L, Seto W, Gassas A, Doyle J, Dupuis L. Cyclosporine Area Under The Curve (AUC) In Children Undergoing Haematopoietic Stem Cell Transplantation (HSCT): Limited Sampling Strategy (LSS). Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.315] [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: 11/26/2022]
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Moore JE, Buckley TC, Millar BC, Gibson P, Cannon G, Egan C, Cosgrove H, Stanbridge S, Anzai T, Matsuda M, Murphy PG. Molecular surveillance of the incidence of Taylorella equigenitalis and Pseudomonas aeruginosa from horses in Ireland by sequence-specific PCR [SS-PCR]. Equine Vet J 2010; 33:319-22. [PMID: 11352356 DOI: 10.2746/042516401776249750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- J E Moore
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Belfast
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Gibson P. Book Review: SAQs for the Final FRCA. Anaesth Intensive Care 2010. [DOI: 10.1177/0310057x1003800142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Geary M, Gibson P, Wilkins R, Lamont R. Novel treatment of extensive thrombo-embolic disease in pregnancy with a temporary vena cava filter. J OBSTET GYNAECOL 2009; 17:282-3. [PMID: 15511853 DOI: 10.1080/01443619750113302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- M Geary
- Northwick Park Hospital and St Mark's NHS Trust, Harrow, UK
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Spicer K, Gibson P, Bloe C, Cross SJ, Leslie SJ. Weight assessment in cardiac patients: implications for prescription of low molecular weight heparin. Postgrad Med J 2009; 85:124-7. [DOI: 10.1136/pgmj.2008.071100] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald JM, Gibson P, Ohta K, O'Byrne P, Pedersen SE, Pizzichini E, Sullivan SD, Wenzel SE, Zar HJ. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008; 31:143-78. [PMID: 18166595 DOI: 10.1183/09031936.00138707] [Citation(s) in RCA: 1960] [Impact Index Per Article: 122.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled "A Global Strategy for Asthma Management and Prevention", first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that "it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained," and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.
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Affiliation(s)
- E D Bateman
- University of Cape Town Lung Institute, PO Box 34560, Groote School, 7700 Mowbray, Cape Town, South Africa.
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Abstract
A prospective, multi-centre study was carried out on 1421 total hip replacements between January 1999 and July 2007 to examine if obesity has an effect on clinical outcomes. The patients were categorised into three groups: non-obese (body mass index (BMI) < 30 kg/m2), obese (BMI 30 to 40 kg/m2) and morbidly obese (BMI > 40 kg/m2). The primary outcome measure was the change in Oxford hip score at five years. Secondary outcome measures included dislocation and revision rates, increased haemorrhage, deep infection, deep-vein thrombosis and pulmonary embolism, mean operating time and length of hospital stay. Radiological analysis assessing heterotopic ossification, femoral osteolysis and femoral stem positioning was performed. Data were incomplete for 362 hips (25.5%) There was no difference in the change in the Oxford hip score, complication rates or radiological changes at five years between the groups. The morbidly obese group was significantly younger and required a significantly longer operating time. Obese and morbidly obese patients have as much to gain from total hip replacement as non-obese patients.
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Affiliation(s)
- J. G. Andrew
- Department of Orthopaedics Ysbyty Gwynedd, Bangor LL57 2PW, UK
| | - J. Palan
- Nuffield Department of Orthopaedic Surgery Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford OX3 7LD, UK
| | - H. V. Kurup
- Mayday University Hospital, 530 London Road, Croydon CR7 7YE, UK
| | - P. Gibson
- Woodend Hospital, Eday Road, Woodend, Aberdeen AB15 6XS, UK
| | - D. W. Murray
- Nuffield Department of Orthopaedic Surgery Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford OX3 7LD, UK
| | - D. J. Beard
- Nuffield Department of Orthopaedic Surgery Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford OX3 7LD, UK
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Abstract
INTRODUCTION This prospective, cohort study compares child protection outcomes over the first 5 years of life in a group of children born to self-declared drug-using mothers recruited during pregnancy (cases) and a group of children matched for gestational age, chronological age, maternal neighbourhood and place of delivery whose mothers made no such declaration of problematic drug use (controls). METHODOLOGY We monitored local child protection registers to identify cohort members who came to the attention of the local authority. RESULTS Of the 71 original cases and 142 original controls, 55 (77%) and 96 (68%) remained in the area enrolled in local schools at 5 years of age. In total, 26 (47.3%) of the case children were subject to child protection procedures compared with 18 (18.8%) of the control children. This risk difference of 28.5% (95% CI 13.2% to 43.9%) has increased marginally since our previous report in this journal of child protection outcomes at 18 months of age (32% vs. 7%). However, the level of intervention deemed necessary to protect the child has increased significantly with six cases (compared with one control child) taken into the care of the local authority. CONCLUSIONS Despite early maternal intentions and multiple supportive interventions, 27% of children born to women with significant substance abuse problems in our area required child protection during the pre-school years. Child protection risk assessment procedures need to weigh problematic maternal drug use heavily. Intervention studies with child welfare outcomes are needed to identify the most effective harm reduction strategies and inform public debate on how we can minimize child abuse related to substance misuse.
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Affiliation(s)
- K Street
- Centre for Child and Adolescent Health, Hampton House, Cotham Hill, Bristol, UK.
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Abstract
INTRODUCTION Injection of steroid and local anaesthetic into hip and knee joints has been a recommended treatment for osteoarthritic pain for decades. There have been recent studies showing a higher incidence of infection leading to early revision of joint prostheses in patients who have had corticosteroid injections prior to joint replacement surgery. OBJECTIVE The aim of our study was to determine if there is any risk of infection in patients undergoing total hip arthroplasty (THA) after a hip joint injection. PATIENTS AND METHODS A retrospective search was conducted using the hospital computer database to identify patients who underwent hip injection and subsequent THA between 2000 and 2004. The study included a review all case notes to specifically identify prosthetic infection or early joint replacement surgery. RESULTS One hundred and twenty-eight patients had hip joint injections and subsequently underwent successful total hip replacement. In this study there was no evidence of associated risk of prosthetic infection or early revision of total hip arthroplasty after hip joint injection with corticosteroids (average time of follow-up 3.2 years). CONCLUSIONS Hip injection is safe provided a strict aseptic protocol is maintained. The time period of pain relief with hip injection is limited (average 2 months). For diagnostic purposes injections with local anaesthetic only is recommended. A large randomised control study would probably further substantiate these findings.
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Affiliation(s)
- S V Karuppiah
- Grampian University Hospital, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
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Roland JT, Shevla M, Gibson P, Treaba C. Electrode insertion mechanics and outer wall forces with the Nucleus 24 Contour Advance™ electrode. Cochlear Implants Int 2006. [DOI: 10.1002/cii.270] [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: 11/08/2022]
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Noursadeghi M, Aqel N, Gibson P, Pasvol G. Successful treatment of severe Kikuchi's disease with intravenous immunoglobulin. Rheumatology (Oxford) 2005; 45:235-7. [PMID: 16352644 DOI: 10.1093/rheumatology/kei074] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Roland JT, Shevla M, Gibson P, Treaba C. Electrode insertion mechanics and outer wall forces with the Nucleus 24 Contour Advance TMelectrode. Cochlear Implants Int 2005; 6 Suppl 1:5-8. [DOI: 10.1179/cim.2005.6.supplement-1.5] [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] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kneif D, Downing M, Ashcroft GP, Gibson P, Knight D, Ledingham W, Hutchison J. Peri-acetabular radiolucent lines: inter- and intra-observer agreement on post-operative radiographs. Int Orthop 2005; 29:152-5. [PMID: 15806358 PMCID: PMC3456885 DOI: 10.1007/s00264-005-0644-8] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 12/14/2004] [Accepted: 01/21/2005] [Indexed: 11/30/2022]
Abstract
Peri-acetabular radiolucent lines (RLLs) seen on "early" post-operative radiographs have been identified as a potential predictor of long-term implant performance. This study examines the inter- and intra-observer variation encountered when assessing such radiographs. Four consultant orthopaedic surgeons assessed the presence, extent and width of RLLs in 220 radiographs performed on 50 patients taken one to two weeks, six weeks, six months and one year following surgery. Inter-observer agreement was fair at 7-14 days but improved to moderate to good in films at six and 12 months. Intra-observer agreement was moderate to good at 7-10 days but again improved to good at 6 and 12 months. When only the presence or absence of RLLs was considered, both inter-observer and intra-observer agreement improved for both the six-month and one-year radiographs. This experiment shows that caution must be used for the interpretation of RLLs on hip radiographs taken during the very early post-operative period. We recommend that films taken at least six weeks to six months following surgery should be used for assessment to reduce observer variation. For optimum results, a single experienced observer should do the assessment with a simple classification.
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Affiliation(s)
- D. Kneif
- Department of Orthopaedics, Aberdeen University, Aberdeen, UK
| | - M. Downing
- Department of Orthopaedics, Aberdeen University, Aberdeen, UK
| | - G. P. Ashcroft
- Department of Orthopaedics, Aberdeen University, Aberdeen, UK
- Department of Orthopaedics, Aberdeen Medical School, Foresterhill, Aberdeen, AB25 2ZD Scotland UK
| | - P. Gibson
- Department of Orthopaedics, Aberdeen University Hospital Trust, Aberdeen, UK
| | - D. Knight
- Department of Orthopaedics, Aberdeen University Hospital Trust, Aberdeen, UK
| | - W. Ledingham
- Department of Orthopaedics, Aberdeen University Hospital Trust, Aberdeen, UK
| | - J. Hutchison
- Department of Orthopaedics, Aberdeen University, Aberdeen, UK
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Mawdsley JED, Gibson P, Forbes A, Gabe SM. Technical report: per-oral image-guided insertion of a jejunostomy feeding tube. Clin Radiol 2004; 59:951-3. [PMID: 15451358 DOI: 10.1016/j.crad.2004.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2004] [Revised: 03/30/2004] [Accepted: 04/05/2004] [Indexed: 10/26/2022]
Affiliation(s)
- J E D Mawdsley
- Digestive Disease Research Centre, Royal London Hospital, Turner Street, Whitechapel, London, UK.
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Gibson P. Spinal cord damage following thoracic epidural anaesthesia. Anaesth Intensive Care 2004; 32:596-7; author reply 597. [PMID: 15675229] [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: 05/01/2023]
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Gibson P. Anaesthesia for spinal surgery in adults. Br J Anaesth 2004; 92:770; author reply 771-2. [PMID: 15113767 DOI: 10.1093/bja/aeh557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
BACKGROUND Anticholinergic agents such as ipratropium bromide are sometimes used in the treatment of chronic asthma. They effect bronchodilation and have also been used in combination with beta2-agonists in the management of chronic asthma. OBJECTIVES To examine the effectiveness of anticholinergic agents versus placebo and in comparison with beta2-agonists or as adjunctive therapy to beta2-agonists. SEARCH STRATEGY The Cochrane Airways Group asthma and wheeze database was searched with a pre-defined search strategy. Searches were current as of August 2003. Reference lists of articles were also examined. SELECTION CRITERIA Randomised trials or quasi-randomised trials were considered for inclusion. Studies assessing an anticholinergic agent versus placebo or in combination/comparison with beta2-agonists were included. In practice, all beta2-agonists were short acting. Short-term (less than 24 hours duration) and longer-term studies were separated; the latter are reported in this review and the former in the review, "Anticholinergic agents for chronic asthma in adults short term". DATA COLLECTION AND ANALYSIS Two reviewers independently assessed abstracts for retrieval of full text articles. Papers were then assessed for suitability for inclusion in the review. Data from included studies were extracted by two reviewers and entered into the software package (RevMan 4.2). We contacted authors for missing data and some responded. Adverse effect data were analysed if reported in the included studies. MAIN RESULTS The studies analysed were in two groups: those comparing anticholinergics with placebo and those comparing the combination of anticholinergics with short acting beta2-agonists versus short acting beta2-agonists alone. The former group had 13 studies involving 205 participants included in this review, and the latter 9 studies involving 440 patients. Generally methodological quality was poorly reported, and there were some reservations with respect to the quality of the studies. Despite the limited number of studies that could be combined, anticholinergic agents in comparison with placebo resulted in more favourable symptom scores particularly in respect of daytime dyspnoea (WMD -0.09 (95%CI -0.14, -0.04, 3 studies, 59 patients). Daily peak flow measurements also showed a statistically significant improvement for the anticholinergic (e.g. morning PEF: WMD =14.38 litres/min (95%CI 7.69, 21.08; 3 studies, 59 patients). However the clinical significance is small and in terms of peak flow measurements equates to approximately a 7% increase over placebo. The more clinically relevant comparison of a combination of anticholinergic plus short acting beta2-agonist versus short acting beta2-agonist alone gave no evidence in respect of symptom scores or peak flow rates of any significant differences between the two regimes. Again there are reservations with respect to the quality of the information from which these conclusions are drawn. REVIEWERS' CONCLUSIONS Overall this review provides no justification for routinely introducing anticholinergics as part of add-on treatment for patients whose asthma is not well controlled on standard therapies. This does not exclude the possibility that there may be a sub-group of patients who derive some benefit and a trial of treatment in individual patients may still be justified. The role of long term anticholinergics such as tiotropium bromide has yet to be established in patients with asthma and any future trials might draw on the messages derived from this review.
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Affiliation(s)
- M Westby
- UK Cochrane Centre, Summertown Pavilion, Middle Way, Oxford, Oxfordshire, UK, OX2 7LG.
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Paasche G, Gibson P, Averbeck T, Becker H, Lenarz T, Stöver T. Technical report: modification of a cochlear implant electrode for drug delivery to the inner ear. Otol Neurotol 2003; 24:222-7. [PMID: 12621336 DOI: 10.1097/00129492-200303000-00016] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [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: 11/26/2022]
Abstract
OBJECTIVE To investigate the possibility of modifying a cochlear implant electrode for the purpose of drug delivery to the cochlea. BACKGROUND Animal experiments suggest that local therapy of the inner ear could be a promising new approach to the interventional treatment of inner ear disease, and that pharmacologic intervention could possibly enhance cochlear implant performance. One of the key aspects is the deployment of a means of drug delivery to the human inner ear. METHODS The tip of the Contour electrode array was cut to open the lumen of the array, and a connecting piece was developed to connect the electrode to a pump. The feasibility of using the array for drug delivery was tested using both an Alzet mini-osmotic pump and a mechanical pump. The connection was tested for its stability in terms of leakage and resistance to tractive forces. The system was also applied to temporal bones to evaluate its applicability to the human cochlea. RESULTS The modified Contour electrode is easy to handle in temporal bones and can be used to simulate drug delivery to the inner ear. The connection to the pump was sealed for all tested pump rates and resisted tractive forces up to 50 N. CONCLUSIONS The described modified electrode could provide a safe and easy-to-handle means of combining electrical stimulation with the beneficial effects of a local drug therapy applied to the inner ear.
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Affiliation(s)
- G Paasche
- Department of Otorhinolaryngology, Medical University of Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
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Abstract
There is increasing evidence that inflammatory mechanisms other than eosinophilic inflammation may be involved in producing the final common pathway of enhanced bronchial reactivity and reversible airflow obstruction that characterises asthma. A review of the literature has shown that, at most, only 50% of asthma cases are attributable to eosinophilic airway inflammation. It is hypothesised that a major proportion of asthma is based on neutrophilic airway inflammation, possibly triggered by environmental exposure to bacterial endotoxin, particulate air pollution, and ozone, as well as viral infections. If there are indeed two (or more) subtypes of asthma, and if non-eosinophilic (neutrophil mediated) asthma is relatively common, this would have major consequences for the treatment and prevention of asthma since most treatment and prevention strategies are now almost entirely focused on allergic/eosinophilic asthma and allergen avoidance measures, respectively. It is therefore important to study the aetiology of asthma further, including the underlying inflammatory profiles.
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Affiliation(s)
- J Douwes
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental and Occupational Health, Utrecht University, The Netherlands.
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Abstract
BACKGROUND Humidity control measures in the home environment of patients with asthma have been recommended, however there is no consensus about the usefulness of these measures. OBJECTIVES To study the effect of dehumidification of the home environment on asthma control. SEARCH STRATEGY A search of the clinical trials registers of the Cochrane Collaboration and Cochrane Airways Group using search terms for asthma and [humid* OR water vapour OR water vapor* OR water-vapour* OR water-vapor*]. SELECTION CRITERIA Randomized controlled trials on the use of humidity control measures in the home environment of patients with asthma were evaluated for inclusion. Only one trial could be included. DATA COLLECTION AND ANALYSIS Data was extracted using a predesigned data extraction form. No data was available for entering into RevMan for analysis. MAIN RESULTS The included trial using mechanical ventilation with or without high efficiency vacuum cleaners did not show any clinical benefit to asthma patients. There was a decline in the house dust mite count and the antigen level. This open trial had a low sample size. REVIEWER'S CONCLUSIONS There is a need for studying the health benefits of dehumidification by a double blind randomized controlled trial with adequate sample size measuring clinical outcomes in patients of asthma.
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Affiliation(s)
- M Singh
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India, 160 012.
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