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Glass B, Bergman D, Parro V, Kobayashi L, Stoker C, Quinn R, Davila A, Willis P, Brinckerhoff W, Warren-Rhodes K, Wilhelm M, Caceres L, DiRuggiero J, Zacny K, Moreno-Paz M, Dave A, Seitz S, Grubisic A, Castillo M, Bonaccorsi R. The Atacama Rover Astrobiology Drilling Studies (ARADS) Project. Astrobiology 2023; 23:1245-1258. [PMID: 38054949 PMCID: PMC10750311 DOI: 10.1089/ast.2022.0126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/01/2023] [Indexed: 12/07/2023]
Abstract
With advances in commercial space launch capabilities and reduced costs to orbit, humans may arrive on Mars within a decade. Both to preserve any signs of past (and extant) martian life and to protect the health of human crews (and Earth's biosphere), it will be necessary to assess the risk of cross-contamination on the surface, in blown dust, and into the near-subsurface (where exploration and resource-harvesting can be reasonably anticipated). Thus, evaluating for the presence of life and biosignatures may become a critical-path Mars exploration precursor in the not-so-far future, circa 2030. This Special Collection of papers from the Atacama Rover Astrobiology Drilling Studies (ARADS) project describes many of the scientific, technological, and operational issues associated with searching for and identifying biosignatures in an extreme hyperarid region in Chile's Atacama Desert, a well-studied terrestrial Mars analog environment. This paper provides an overview of the ARADS project and discusses in context the five other papers in the ARADS Special Collection, as well as prior ARADS project results.
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Affiliation(s)
- B. Glass
- NASA Ames Research Center, Moffett Field, California, USA
| | - D. Bergman
- Honeybee Robotics, Pasadena, California, USA
| | - V. Parro
- Centro de Astrobiología (CAB), CSIC-INTA, Torrejon de Ardoz, Spain
| | - L. Kobayashi
- NASA Ames Research Center, Moffett Field, California, USA
| | - C. Stoker
- NASA Ames Research Center, Moffett Field, California, USA
| | - R. Quinn
- NASA Ames Research Center, Moffett Field, California, USA
| | - A. Davila
- NASA Ames Research Center, Moffett Field, California, USA
| | - P. Willis
- NASA Jet Propulsion Laboratory, Pasadena, California, USA
| | | | - K. Warren-Rhodes
- NASA Ames Research Center, Moffett Field, California, USA
- SETI Institute, Carl Sagan Center, Mountain View, California, USA
| | - M.B. Wilhelm
- NASA Ames Research Center, Moffett Field, California, USA
| | - L. Caceres
- University of Antofagasta, Antofagasta, Chile
| | | | - K. Zacny
- Honeybee Robotics, Pasadena, California, USA
| | - M. Moreno-Paz
- Centro de Astrobiología (CAB), CSIC-INTA, Torrejon de Ardoz, Spain
| | - A. Dave
- NASA Ames Research Center, Moffett Field, California, USA
| | - S. Seitz
- NASA Ames Research Center, Moffett Field, California, USA
| | - A. Grubisic
- NASA Goddard Space Flight Center, Greenbelt, Maryland, USA
| | - M. Castillo
- NASA Goddard Space Flight Center, Greenbelt, Maryland, USA
| | - R. Bonaccorsi
- NASA Ames Research Center, Moffett Field, California, USA
- SETI Institute, Carl Sagan Center, Mountain View, California, USA
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Carvalho G, Quinn R, Luedtke K. Migraine patients' experiences with and expectations from physiotherapy. Musculoskelet Sci Pract 2023; 66:102803. [PMID: 37331925 DOI: 10.1016/j.msksp.2023.102803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/01/2023] [Accepted: 06/10/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Neck pain is prevalent in migraine and a common reason to receive physiotherapy. There is no information as to the type of modalities patients receive and whether these are perceived as effective and matching expectations. METHODS A survey was designed with closed and open-ended questions allowing for quantitative evaluation and qualitative insights into experiences and expectations. The survey was available online from June-November 2021 and was disseminated in the German migraine league (patient organization) and via social media. Open questions were summarized using qualitative content analysis. Differences between receiving and not receiving physiotherapy were analyzed through Chi2 or Fisher's Test. Categories within groups through Chi2-goodness-of-fit-test and multivariate logistic regression indicated perceived clinical improvement. RESULTS 149 (123 received physiotherapy) patients completed the questionnaire. Patients receiving physiotherapy had higher pain intensity (p < 0.001) and migraine frequency (p = 0.017). Most participants received 6 sessions or less (38%) (past 12 months) of manual therapy (82%) and soft-tissue techniques (61%). 63% perceived benefits after manual therapy, and 50% after soft-tissue techniques. Logistic regression revealed that ictal and interictal neck pain (OR: 9.12 and 6.41, respectively) and receiving manual therapy (OR: 5.52) are associated with improvement. Mat exercises and higher migraine frequency increased the odds for no improvement or worsening (OR: 0.25 and 0.65, respectively). Expectations included individualized and targeted treatment from a specialized physiotherapist (39%), easier access, more and longer sessions (28%), manual therapy (78%), soft-tissue techniques (72%) and education (26%). CONCLUSION sThis first study on migraine patients' views on physiotherapy can serve as insight for researchers for future studies and clinicians to improve future care.
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Affiliation(s)
- Gabriela Carvalho
- Institute of Health Sciences, Department of Physiotherapy, Universität zu Lübeck, Lübeck, Germany
| | - Rebecca Quinn
- Institute of Health Sciences, Department of Physiotherapy, Universität zu Lübeck, Lübeck, Germany
| | - Kerstin Luedtke
- Institute of Health Sciences, Department of Physiotherapy, Universität zu Lübeck, Lübeck, Germany.
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Quinn R. Housing letters: the dilemma. Br J Gen Pract 2023; 73:318. [PMID: 37385768 DOI: 10.3399/bjgp23x733389] [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: 07/01/2023] Open
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Quinn R. Health warning to a young clinician. Br J Gen Pract 2023; 73:278. [PMID: 37230778 DOI: 10.3399/bjgp23x733149] [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: 05/27/2023] Open
Affiliation(s)
- Rebecca Quinn
- Rebecca is an inner-city GP, who occasionally encounters the sublime among the daily grind of people that she has the privilege of calling her patients.
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Moorthy G, Craig J, Quinn R, Chittams J, Stavropoulos S, Trerotola S. Abstract No. 588 Supply Costs in Complex and Routine Inferior Vena Cava Filter Retrieval (IVCFR): Ten Years’ Data from a Single Center. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Guillaumin J, DeFrancesco TC, Scansen BA, Quinn R, Whelan M, Hanel R, Goy-Thollot I, Bublot I, Robertson JB, Bonagura JD. Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism. J Feline Med Surg 2022; 24:e535-e545. [PMID: 36350753 PMCID: PMC10812363 DOI: 10.1177/1098612x221135105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the impact of tissue plasminogen activator (TPA) on the treatment of feline aortic thromboembolism (FATE). METHODS Cats diagnosed with FATE involving ⩾2 limbs were enrolled in a prospective, multicenter, double-blinded, randomized, placebo-controlled study within 6 h of an event. Diagnosis was made by clinical findings and one confirmatory criterion. Cats received placebo or TPA (1 mg/kg/h with the first 10% by bolus). All cats received pain control and thromboprophylaxis. The primary outcome was a change from baseline in a published limb score at 48 h. Secondary outcomes included 48 h survival, survival to discharge and complication proportions. Statistical analyses included pattern-mixture models, logistic regression and Fisher's exact, Student's t- and Mann-Whitney-Wilcoxon tests. RESULTS Based on a power analysis, 40 cats were enrolled; however, only 20 survived to 48 h (TPA, n = 12; placebo, n = 8 [P = 0.34]). There was a statistically significant improvement in limb scores compared with baseline for both groups (P <0.001). Limb score at 48 h was 1 point lower (better) in the TPA group (P = 0.19). Thrombolysis had no statistically significant effect on 48 h survival (P = 0.22). Lower affected limb lactate was associated with better 48 h survival (odds ratio 1.53, 95% confidence interval 1.08-2.17; P = 0.02). The survival to discharge rates were 45% (TPA) and 30% (placebo; P = 0.51). Complications in the TPA and placebo groups included acute kidney injury (22% and 19%, respectively; P = 1.00) and/or reperfusion injuries (33% and 19%, respectively; P = 0.45). CONCLUSIONS AND RELEVANCE Survival and complication rates of acute FATE were not different with or without thrombolysis. High in-hospital mortality decreased the statistical power to detect a statistically significant difference between treatments with regard to our primary outcome.
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Affiliation(s)
- Julien Guillaumin
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Teresa C DeFrancesco
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, USA
| | - Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Rebecca Quinn
- Cape Cod Veterinary Specialists, Buzzards Bay, MA, USA
| | | | - Rita Hanel
- Veterinary Emergency Group, New York, NY, USA
| | - Isabelle Goy-Thollot
- Reconciliation Projet of ENV Françaises, VetAgro Sup, 69280 Marcy l’Etoile, France
| | | | - James B Robertson
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - John D Bonagura
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, USA
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
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Pepe P, Moore J, Bachista K, Debaty G, Lurie K, Salverda B, Emanuelson L, Parquette B, Quinn R, Labarère J, Lick C. 3 Clinical Confirmation of Improved Likelihood of Survival Associated With the Use of the Head-Up CPR Bundle for Non-Shockable Cardiac Arrest Presentations. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.025] [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: 11/01/2022]
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Curnes N, Hung M, DePietro D, Ferrari V, Drivas T, Chittams J, Quinn R, Trerotola S. Abstract No. 390 Comparison of graded transthoracic contrast echocardiography and high resolution chest CT for pulmonary arteriovenous malformation follow-up in the early post-embolization period. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.471] [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: 10/18/2022] Open
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Kiwalkar S, Bhalerao S, Phung Nguyen K, Quinn R, Perham D, Malatestinic W, Bolce R, Hunter T, Khurana P, Deodhar A. POS0984 PREVALENCE OF axSpA IN PATIENTS TREATED FOR CHRONIC BACK PAIN IN CHIROPRACTIC CLINICS: THE OREGON CHIROPRACTIC AXIAL SPONDYLOARTHRITIS STUDY (ORCAS) – AN INTERIM ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundNon-rheumatology settings such as chiropractor clinics, where chronic back pain (CBP; including chronic back, buttock, or hip pain) patients are first seen, lack consistency in referral of patients to rheumatologists where the underlying cause may be axial spondyloarthritis (axSpA).ObjectivesPrimary objective was to estimate the prevalence of axSpA in CBP patients attending four chiropractic clinics in Portland, Oregon, referred to a rheumatology clinic using a referral strategy identifying features of spondyloarthritis (SpA).MethodsAdults attending one of four chiropractor clinics between Nov 2020 and Nov 2021 for CBP starting before age of 45, without prior diagnosis of SpA were eligible for inclusion. Patients were referred to rheumatologist for diagnostic assessment via phone consultation, if they had inflammatory back pain (IBP) and/or ≥1 of the following features: a family history of SpA, inflammatory bowel disease (IBD), psoriasis, good response to non-steroidal anti-inflammatory drugs, history of heel pain, uveitis, or joint swelling. The subsequent rheumatology assessment included history, C-reactive protein, HLA-B27, x-ray and MRI of the sacroiliac joints. Based on the assessment, patients were categorized as radiographic axSpA, non-radiographic axSpA, peripheral SpA, or no SpA. Endpoints were summarized using descriptive statistics.ResultsA total of 3,103 visits were recorded at four chiropractic offices between Nov 2020 and Nov 2021. Top ten chief complaints are presented in Figure 1. In total, 115 patients were referred by the chiropractors and 84 patients were confirmed to be eligible. Of the 74 patients who provided consent, 59 (79.7%) had IBP, and 66 (89.2%) had at least one clinical SpA feature. At interim data lock, 63 patients were fully assessed by a rheumatologist, of which 7 (11.1%) were HLA-B27 positive and 24 (38.1%) had rheumatologist-evaluated IBP. Eight (12.7%) patients had SpA, 6 (9.5%) were diagnosed as axSpA and fulfilled Assessment of Spondyloarthritis International Society (ASAS) classification criteria, 1 (1.6%) patient was diagnosed as psoriatic arthritis without imaging evidence of axial involvement and fulfilled Classification Criteria for Psoriatic Arthritis, and 1 (1.6%) had undifferentiated peripheral SpA and fulfilled ASAS Classification Criteria.Figure 1.Chief complaints reported by patients at chiropractor visits (n=3103)ConclusionMore than 10% of patients attending chiropractic clinics for musculoskeletal complaints had undiagnosed SpA conditions, with axSpA being the most common. Educational efforts targeted at chiropractors to suspect and refer appropriate cases to rheumatologists are needed.Table 1.Demographic and clinical characteristics stratified by diagnosis as confirmed by RheumatologistRadiographic axSpA (N = 1)Non-radiographic axSpA (N = 5)Peripheral SpA Including PsA (N= 2)No SpA (N = 55)Age, years (Mean; SD)73 (-)36.8 (6.4)46 (1.4)45.1 (12.1)Sex, Female – n (%)04 (80.0)2 (100)32 (58.2)Family history of spondyloarthritis, Yes – n (%)01 (20.0)1 (50.0)9 (16.4)Chronic back pain duration, years (Mean; SD)49 (-)12.4 (6.0)11 (7.0)15 (10.8)Confirmed during rheumatology visit – n (%) IBP* (4 out of 5 criteria as checked by patient)1 (100)3 (60.0)1 (50.0)27 (49.1) IBP* (4 out of 5 criteria per rheumatologist’s opinion)02 (40.0)022 (40.0) History of plantar fasciitis or Achilles tendinitis04 (80.0)2 (100)14 (25.5) History of peripheral joint swelling001 (50.0)8 (14.6) Positive response to NSAIDs1 (100)1 (20.0)2 (100)21 (38.2) Psoriasis1 (100)01 (50.0)2 (3.6) Inflammatory bowel disease0001 (1.9) Uveitis0001 (1.8) HLA-B27 positive02 (40.0)1 (50.0)4 (7.3) CRP, Above 10.0 mg/L02 (40.0)1 (50.0)1 (1.8) SI Joints X-ray positive for sacroiliitis (modified New York criteria)1 (100)001 (1.8) SI Joints MRI positive for active inflammation1 (100)3 (60.0)00*According to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpADisclosure of InterestsSonam Kiwalkar: None declared, Shireesh Bhalerao Consultant of: Eli Lilly and Company, Kim Phung Nguyen: None declared, Rose Quinn: None declared, Dave Perham: None declared, William Malatestinic Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Rebecca Bolce Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Theresa Hunter Employee of: Eli Lilly and Company, Pragya Khurana Consultant of: Eli Lilly and Company; ICON plc has received funding from several pharmaceutical companies involved in the marketing products for treatment of spondyloarthritis., Atul Deodhar Speakers bureau: Janssen, Novartis, Pfizer, UCB, Consultant of: AbbVie, Amgen, Aurinia, Bristol Myers Squibb, Celgene, Eli Lilly, Glaxo Smith & Kline, Janssen, MoonLake, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Bristol Myers Squibb, Celgene, Eli Lilly, Glaxo Smith & Kline, Novartis, Pfizer, UCB
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Mills L, Kholia K, Quinn R. Assessing the impact of prophylactic versus perioperative feeding jejunostomies on postoperative weight loss in oesophageal cancer patients. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ghuneim L, Raghuvanshi R, Schena B, Feiner J, Castillo-Bahena A, Jentz C, Mielke J, McClelland M, Conrad D, Klapper I, Zhang T, Quinn R. 487: Predicting and testing the complex outcomes of antibiotic treatment against the CF lung microbiome. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01911-1] [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]
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Quinn R, Sosinski L, Quinn R, Neugebauer K, Ghuneim L, Guzior D, Castillo-Bahena A, Mielke J, McClelland M, Thomas R, Conrad D. 525: Elexacaftor/tezacaftor/ivacaftor therapy alters the CF lung mucus metabolome, reshaping microbiome niche space. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01949-4] [Citation(s) in RCA: 1] [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: 10/20/2022]
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Garg A, Rao-Melacini P, Quinn R, Ainsworth C, Belley-Cote E, Cairns J, Cantor W, Dzavik V, Gomez RM, Kedev S, Lavi S, Stankovic G, Jolly S. TOTAL risk score for predicting safe very early discharge in patients with ST-elevation myocardial infarction (STEMI). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1472] [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: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Previously validated risk scores for identifying low-risk patients after ST-segment elevation myocardial infarction (STEMI) have led to acceptance of the safety and feasibility of discharge after 48–72 hours of hospitalization, reducing hospital length of stay and costs. With ongoing improvements in outcomes, it may be possible to select patients who are safe to discharge very early (24–48 hours) but this has never been evaluated.
Purpose
We sought to develop and validate a novel risk score for identifying low-risk patients suitable for very early discharge (≤48 hours of hospitalization) post-STEMI.
Methods
We derived a novel risk score using data from patients enrolled in the Trial of Routine Aspiration Thrombectomy with PCI versus PCI alone in Patients with STEMI (TOTAL). The TOTAL database was randomly divided into a derivation cohort with 2/3 of the composite events and non-events and remaining 1/3 as the internal validation cohort. Using the derivation cohort, we identified risk factors for cardiovascular death (CV) or non-fatal cardiac arrest by performing a univariate and multivariable stepwise regression analysis of baseline clinical and angiographic characteristics. Each co-variate was assigned an integer score based on regression coefficients and the novel TOTAL risk score was developed by adding points from each risk factor profile. We externally validated the TOTAL score using data from the Radial versus Femoral Access for Coronary Intervention (RIVAL) trial.
Results
The TOTAL derivation cohort included 6331 participants with 287 events (CV death/cardiac arrest). Twelve independent risk-factors associated with risk of CV death and non-fatal cardiac arrest at 1 year were selected and weighted for the TOTAL risk score (Table 1). In the TOTAL validation cohort (n=3166), patients with a TOTAL score of 0–4 points (n=779 (24.6%)) were categorized as very low risk with only a 0.1% risk of CV death/cardiac arrest observed within 24 hours of hospitalization, and no further events observed between 24 hours and 30 days post-STEMI. In the RIVAL validation dataset (n=1451), patients with a TOTAL score of 0–4 points (n=737 (50.7%)) had a 0.3% risk of CV death/cardiac arrest within 24 hours, with no further events observed between 24 hours and 72 hours of hospitalization.
Conclusion
The TOTAL risk score identified a very low risk subset of patients for whom early discharge, 24–48 hours post-STEMI, is likely safe. These findings have the potential to change practice and support early discharge after STEMI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Garg
- McMaster University, Hamilton, Canada
| | | | - R Quinn
- McMaster University, Hamilton, Canada
| | | | - E Belley-Cote
- Population Health Research Institute, Hamilton, Canada
| | - J Cairns
- University of British Columbia, Vancouver, Canada
| | - W Cantor
- Southlake Regional Health Centre, Newmarket, Canada
| | - V Dzavik
- Peter Munk Cardiac Centre, Toronto, Canada
| | | | - S Kedev
- University of St Cyril and Methodius, Skopje, North Macedonia
| | - S Lavi
- Western University, London, Canada
| | - G Stankovic
- University Clinical Center of Serbia, Belgrade, Serbia
| | - S Jolly
- Population Health Research Institute, Hamilton, Canada
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Kelly D, Quinn R. Non-inflammatory joint effusions as a presenting sign of hypothyroidism in a dog. J Small Anim Pract 2021; 63:159-162. [PMID: 34585404 DOI: 10.1111/jsap.13431] [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] [Received: 07/19/2021] [Revised: 08/20/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022]
Abstract
Non-inflammatory joint effusion with characteristically increased synovial fluid viscosity is a rare but well-recognised rheumatic manifestation of hypothyroidism in people and based on the literature search, this is the first report of the condition in dogs. A 2-year-old Pyrenean Mountain dog presented for lameness and multiple joint effusions. CT confirmed effusions affecting multiple limb joints along with delayed closure of multiple physes. Synovial fluid analysis from the effused joints showed no evidence of inflammation but the fluid viscosity was markedly increased. Serum total thyroxine concentration was decreased, thyroid-stimulating hormone concentration was increased and antithyroglobulin autoantibody measurement returned a positive result. Oral levothyroxine supplementation resulted in relatively rapid and complete resolution of the clinical signs, in association with attaining a euthyroid state. Follow-up examination and CT six months later confirmed resolution of the joint effusions and significant improvement or resolution of the other documented skeletal changes.
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Affiliation(s)
- D Kelly
- Southern Counties Veterinary Specialists, Ringwood, UK
| | - R Quinn
- Southern Counties Veterinary Specialists, Ringwood, UK
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Finn GM, Quinn R, Sanders K, Ballard W, Balogun-Katung A, Dueñas AN. Pandemics, Protests, and Pronouns: The Changing Landscape of Biomedical Visualisation and Education. Adv Exp Med Biol 2021; 1334:39-53. [PMID: 34476744 DOI: 10.1007/978-3-030-76951-2_3] [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] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Events in early 2020 changed the landscape of education for the foreseeable future, perhaps permanently. Three events had a significant impact; (1) the Coronavirus disease 2019 (COVID-19) pandemic, (2) the death of George Floyd, which resulted in the most recent Black Lives Matter (BLM) protests, and (3) the Twitter storm, the resultant societal fallout and freedom of speech campaigns, following comments made by author JK Rowling which many deemed transphobic. These events had a differential impact on biomedical sciences, when compared to other sectors. COVID-19 resulted in a global lockdown, with higher education institutions closing campuses and moving to online-only delivery. This rapid change required radical shifts in the use of technology, with mass delivery of teaching at short notice. The BLM protests further raised awareness of the inequalities within society, particularly those experienced by Black people and other oppressed groups. As a result, there have been calls for the decolonisation of the curriculum. The implications of these three key events have led institutions to rethink their policies, teaching delivery, assessment, curricula, and physical environments. This chapter considers (1) the implications of a swift change in the primary mode of curriculum delivery within Higher Education to online formats and (2) how recent adverse events have resulted in calls for much-needed changes in visual representations within biomedical sciences. Finally, we consider (3) the role of the hidden curriculum and the potential impact of visual representations in curricula on the delivery of healthcare and the fight against health inequalities, which are often as a result of implicit biases. The year 2020 has proven timely in presenting the opportunity for change, provided through the power of imagery.
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Affiliation(s)
- Gabrielle M Finn
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Rebecca Quinn
- Hull York Medical School, University of Hull, Hull, UK
| | - Katherine Sanders
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Hull, UK
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Chinedozi I, Zarin J, Quinn R, Rowin E, Cobey FC, Trzcinka A. Two Tales of Cardiomyopathy: Underscore for One Health Initiative. J Cardiothorac Vasc Anesth 2021; 35:2811-2814. [PMID: 33781670 DOI: 10.1053/j.jvca.2021.02.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 11/11/2022]
Abstract
Hypertrophic cardiomyopathy, a common cause of sudden cardiac death, results from mutations in the cardiac sarcomere. Although there has been much scientific exploration regarding this disease, there is still much to be elucidated. This E-challenge highlights two cases of cardiomyopathy and underscores the need for future multidisciplinary collaboration as outlined by the One Health Initiative.
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Affiliation(s)
- Imaobong Chinedozi
- Tufts Medical Center, Department of Anesthesiology and Perioperative Medicine, Boston, MA
| | - Joseph Zarin
- Angell Animal Medical Center, Department of Cardiology, Boston, MA
| | - Rebecca Quinn
- Angell Animal Medical Center, Department of Cardiology, Boston, MA
| | - Ethan Rowin
- Tufts Medical Center, Department of Medicine, Division of Cardiology, Boston, MA
| | - Frederick C Cobey
- Tufts Medical Center, Department of Anesthesiology and Perioperative Medicine, Boston, MA
| | - Agnieszka Trzcinka
- Tufts Medical Center, Department of Anesthesiology and Perioperative Medicine, Boston, MA.
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Liu J, Tayob N, Campos S, Wright A, Krasner C, Schumer S, Horowitz N, Veneris J, Xiong N, West G, Quinn R, Matulonis U, Konstantinopoulos P. A phase II trial of the Wee1 inhibitor adavosertib (AZD1775) in recurrent uterine serous carcinoma. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.009] [Citation(s) in RCA: 1] [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: 10/23/2022]
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Konstantinopoulos P, Wahner Hendrickson A, Penson R, Doyle A, Kohn E, Duska L, Crispens M, Olawaiye A, Winer I, Barroilhet L, Fu S, McHale M, Schilder R, Farkkila A, Curtis J, Quinn R, Whalen C, Shapiro G, Matulonis U. Randomized phase II (RP2) study of ATR inhibitor M6620 in combination with gemcitabine versus gemcitabine alone in platinum-resistant high grade serous ovarian cancer (HGSOC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tam-Tham H, King-Shier K, Thomas C, Quinn R, Fruetel K, Hemmelgarn B. CHRONIC KIDNEY FAILURE AND CONSERVATIVE (NON-DIALYSIS) CARE AMONG OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1418] [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: 11/12/2022] Open
Affiliation(s)
- H. Tam-Tham
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - K. King-Shier
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - C. Thomas
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - R. Quinn
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - K. Fruetel
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - B. Hemmelgarn
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Xu X, Abdalla T, Bratcher PE, Jackson PL, Sabbatini G, Wells JM, Lou XY, Quinn R, Blalock JE, Clancy JP, Gaggar A. Doxycycline improves clinical outcomes during cystic fibrosis exacerbations. Eur Respir J 2017; 49:49/4/1601102. [PMID: 28381428 DOI: 10.1183/13993003.01102-2016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 12/19/2016] [Indexed: 11/05/2022]
Abstract
Matrix metalloprotease-9 (MMP-9) plays a role in progression of cystic fibrosis, and doxycycline can reduce MMP-9 in vitro Here, we explore the effect of doxycycline during cystic fibrosis exacerbation treatment on MMP-9 related readouts and clinical end-points.This randomised, double-blind, placebo-controlled study enrolled hospitalised patients with cystic fibrosis undergoing exacerbation. In total, 20 participants were given doxycycline and 19 participants were given placebo over an 8-day period during hospitalisation. Biospecimens were collected at the beginning and the end of the study period. Primary end-points were total MMP-9 levels in the sputum and safety/tolerability. Secondary end-points included change in lung function, time to next exacerbation, and markers of MMP-9-related protease activity (active MMP-9 and TIMP-1). Nonparametric testing was used for within-group and between-group analyses.Doxycycline was well tolerated, with no treatment discontinuations or serious adverse events. Doxycycline reduced total sputum MMP-9 levels by 63.2% (p<0.05), and was also associated with a 56.5% reduction in active MMP-9 levels (p<0.05), a 1.6-fold increase in sputum TIMP-1 (p<0.05), improvement in forced expiratory volume in 1 s (p<0.05), and an increase in time to next exacerbation (p<0.01).Adjunctive use of doxycycline improved dysregulated MMP-9 levels in sputum, along with biomarkers consistent with a reduced proteolytic pulmonary environment. Improvement in clinical outcome measures suggests an important therapeutic benefit of doxycycline for individuals with cystic fibrosis.
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Affiliation(s)
- Xin Xu
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Gregory Fleming James Cystic Fibrosis Research Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Lung Health Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, AL, USA
| | - Tarek Abdalla
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Preston E Bratcher
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patricia L Jackson
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Gregory Fleming James Cystic Fibrosis Research Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Lung Health Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, AL, USA
| | - Gina Sabbatini
- Physician Assistant Studies Program, Christian Brothers University, Memphis, TN, USA
| | - J Michael Wells
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Gregory Fleming James Cystic Fibrosis Research Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Lung Health Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, AL, USA
| | - Xiang-Yang Lou
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rebecca Quinn
- Dept of Pharmacy, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Edwin Blalock
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA.,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Gregory Fleming James Cystic Fibrosis Research Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Lung Health Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Dept of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - J P Clancy
- Cincinnati Children's Hospital Medical Center and The University of Cincinnati, Cincinnati, OH, USA
| | - Amit Gaggar
- Dept of Medicine, Division of Pulmonary, Allergy, and Critical Care, The University of Alabama at Birmingham, Birmingham, AL, USA .,Program in Protease and Matrix Biology, The University of Alabama at Birmingham, Birmingham, AL, USA.,Gregory Fleming James Cystic Fibrosis Research Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Lung Health Center, The University of Alabama at Birmingham, Birmingham, AL, USA.,Medical Service at Birmingham VA Medical Center, Birmingham, AL, USA.,Dept of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, AL, USA
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Russo J, Nery P, Ha A, Healey J, Rivard L, Friedrich M, Gula L, Wisenberg G, deKemp R, Chakraborty S, Hruczkowski T, Quinn R, Dwivedi G, Beanlands R, Birnie D. SENSITIVITY AND SPECIFICITY OF CHEST IMAGING FOR SCREENING OF SARCOIDOSIS IN PATIENTS WITH CARDIAC PRESENTATIONS: INSIGHTS FROM THE CHASM-CS REGISTRY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.147] [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
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Roderick KV, Abelson AL, Nielsen L, Price LL, Quinn R. Evaluation of red blood cell distribution width as a prognostic indicator in cats with acquired heart disease, with and without congestive heart failure. J Feline Med Surg 2016; 19:648-656. [PMID: 27225272 DOI: 10.1177/1098612x16649988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Congestive heart failure secondary to cardiomyopathy is a common manifestation of cardiac disease in cats, carrying a variable prognosis. The objective of this retrospective study was to evaluate the relationship between red blood cell distribution width (RDW) and survival time in feline patients with acquired heart disease with and without congestive heart failure (CHF). Methods Three hundred and forty-nine client-owned cats with echocardiograms and complete blood count, including RDW measurement, performed between March 2006 and December 2011, were included in the study. Patient characteristics, including signalment, hematocrit, RDW, echocardiographic parameters and survival, were recorded. Comparisons between RDW in cats with asymptomatic acquired heart disease and those with CHF were made. Survival was documented and compared at 30 days and 6 months. Results CHF was present in 80 cats and absent in 269 cats. Cats with CHF had an increase in mortality compared with cats without CHF at 30 days and 6 months ( P = 0.007 and P = 0.04, respectively). RDW was not significantly associated with survival in cats with or without CHF at 30 days or 6 months. A significant difference was found between median RDW values in cats with CHF vs cats without CHF (16.3% vs 15.8%; P = 0.02). The median RDW value was significantly higher in cats with unclassified cardiomyopathy compared with cats with other types of cardiomyopathy (16.3% vs 15.8%; P = 0.03). Conclusions and relevance Single RDW values did not predict mortality in cats with acquired heart disease but may be useful in determining if cats have decompensated heart disease and CHF. Human studies indicate that incremental increases in serial RDW measurements are associated with decreased survival; serial RDW measurements in cats may be an area of future study.
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Affiliation(s)
- Kursten V Roderick
- 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, USA.,2 Angell Animal Medical Center, MA, USA
| | - Amanda L Abelson
- 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, USA
| | - Lindsey Nielsen
- 2 Angell Animal Medical Center, MA, USA.,3 SAGE Centers, CA, USA
| | - Lori Lyn Price
- 4 The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, MA, USA.,5 Tufts Clinical and Translational Science Institute, Tufts University, MA, USA
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Foley EK, Caldwell K, Triplett NT, Bergquist J, Quinn R, Pressley AK, Collier SR. Tai Chi Chaun Improves Autonomic Function in College Aged Students That Suffer From High Anxiety. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478606.11282.7d] [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: 11/21/2022]
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Pressley AK, Caldwell K, Triplett NT, Bergquist J, Bergman S, Quinn R, Foley EK, Collier SR. The Effects of Tai Chi Chuan on Sleep Architecture in Young Adults Suffering From Anxiety. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477479.51877.92] [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: 11/21/2022]
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25
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Collier SR, Caldwell K, Triplett NT, Bergquist J, Bergman S, Quinn R. Sex Differences in Sleep Architecture in Anxious Young Adults Following Tai Chi Chaun Training. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477480.59500.0e] [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: 11/21/2022]
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26
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Wong JA, Chen G, Burland L, Arnburg B, Quinn R, Gillis AM, Wyse G, Wilton SB. Temporal Patterns and Predictors of Rate Versus Rhythm Control in Patients With Atrial Fibrillation - Results From a Multidisciplinary Atrial Fibrillation Clinic. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.130] [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: 11/17/2022] Open
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27
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Verschraegen CF, Arias-Pulido H, Lee SJ, Movva S, Cerilli LA, Eberhardt S, Schmit B, Quinn R, Muller CY, Rabinowitz I, Purdy M, Snyder D, Bocklage T. Phase IB study of the combination of docetaxel, gemcitabine, and bevacizumab in patients with advanced or recurrent soft tissue sarcoma: the Axtell regimen. Ann Oncol 2012; 23:785-790. [PMID: 21746804 DOI: 10.1093/annonc/mdr299] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND To assess the response of patients with soft tissue sarcoma (STS) to the combination of docetaxel, bevacizumab, and gemcitabine. Vascular endothelial growth factor (VEGF)-A levels and expression of VEGF-A and VEGF receptors 1 and 2 were evaluated. PATIENTS AND METHODS Thirty-eight chemotherapy-naive patients with STS were enrolled. A dose-finding study for gemcitabine from 1000, 1250, then 1500 mg/m(2) was done in nine patients (three cohorts), followed by an expansion cohort of 27 patients. Dose of docetaxel was 50 mg/m(2), bevacizumab was 5 mg/kg, and gemcitabine was 1500 mg/m(2), every 2 weeks. Serum VEGF-A was measured by enzyme-linked immunosorbent assay and tissue VEGF-A and its receptors by immunohistochemistry. RESULTS The median follow-up was 36 months. The overall response rate observed was 31.4%, with 5 complete and 6 partial responses, and 18 stable diseases lasting for a median of 6 months. There was no significant hematologic toxicity. The adverse events with the highest grade were attributed to bevacizumab. There was no correlation of VEGF pathway biomarkers with outcome. CONCLUSIONS The combination of gemcitabine, docetaxel, and bevacizumab is safe and effective in patients with STS. The most concerning adverse events were consequences of bevacizumab administration. The benefit of bevacizumab in this patient population remains unclear.
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Affiliation(s)
| | | | - S-J Lee
- Departments of Hematology/Oncology
| | - S Movva
- Departments of Hematology/Oncology
| | | | | | | | - R Quinn
- Departments of Surgery, The University of New Mexico Cancer Center, Albuquerque
| | - C Y Muller
- Departments of Surgery, The University of New Mexico Cancer Center, Albuquerque
| | | | - M Purdy
- Department of Oncology, New Mexico Cancer Care Alliance, Albuquerque, USA
| | - D Snyder
- Department of Oncology, New Mexico Cancer Care Alliance, Albuquerque, USA
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Tita ATN, Szychowski JM, Rouse DJ, Bean CM, Chapman V, Nothern A, Figueroa D, Quinn R, Andrews WW, Hauth JC. Higher-dose oxytocin and hemorrhage after vaginal delivery: a randomized controlled trial. Obstet Gynecol 2012; 119:293-300. [PMID: 22227638 PMCID: PMC3282278 DOI: 10.1097/aog.0b013e318242da74] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Higher-dose oxytocin is more effective than lower-dose regimens to prevent postpartum hemorrhage after cesarean delivery. We compared two higher-dose regimens (80 units and 40 units) to our routine regimen (10 units) among women who delivered vaginally. METHODS In a double-masked randomized trial, oxytocin (80 units, 40 units, or 10 units) was administered in 500 mL over 1 hour after placental delivery. The primary outcome was a composite of any treatment of uterine atony or hemorrhage. Prespecified secondary outcomes included outcomes in the primary composite and a decline of 6% or more in hematocrit. A sample size of 600 per group (N=1,800) was planned to compare each of the 80-unit and 40-unit groups to the 10-unit group. At planned interim review (n=1,201), enrollment in the 40-unit group was stopped for futility and enrollment continued in the other groups. RESULTS Of 2,869 women, 1,798 were randomized as follows: 658 to 80 units; 481 to 40 units; and 659 to 10 units. Most characteristics were similar across groups. The risk of the primary outcome in the 80-unit group (6%; relative risk [RR] 0.93, 95% confidence interval [CI] 0.62-1.40) or the 40-unit group (6%; RR 0.94, 95% CI 0.61-1.47) was not different compared with the 10-unit group (7%). Treatment with additional oxytocin after the first hour was less frequent with 80 units compared with 10 units (RR 0.41, 95% CI 0.19-0.88), as was a 6% or more decline in hematocrit (RR 0.83, 95% CI 0.69-0.99); both outcomes declined with increasing oxytocin dose. Outcomes were similar between the 40-unit and 10-unit groups. CONCLUSION Compared with 10 units, 80 units or 40 units of prophylactic oxytocin did not reduce overall postpartum hemorrhage treatment when administered in 500 mL over 1 hour for vaginal delivery. Eighty units decreased the need for additional oxytocin and the risk of a decline in hematocrit of 6% or more. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, www.clinicaltrials.gov, NCT00790062. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Alan T N Tita
- Center for Women's Reproductive Health and Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, University Hospital, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Pacciani R, Torres J, Solsona P, Coe C, Quinn R, Hufton J, Golden T, Vega LF. Influence of the concentration of CO2 and SO2 on the absorption of CO2 by a lithium orthosilicate-based absorbent. Environ Sci Technol 2011; 45:7083-7088. [PMID: 21756001 DOI: 10.1021/es201269j] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A novel, high temperature solid absorbent based on lithium orthosilicate (Li(4)SiO(4)) has shown promise for postcombustion CO(2) capture. Previous studies utilizing a clean, synthetic flue gas have shown that the absorbent has a high CO(2) capacity, >25 wt %, along with high absorption rates, lower heat of absorption and lower regeneration temperature than other solids such as calcium oxide. The current effort was aimed at evaluating the Li(4)SiO(4) based absorbent in the presence of contaminants found in typical flue gas, specifically SO(2), by cyclic exposure to gas mixtures containing CO(2), H(2)O (up to 25 vol. %), and SO(2) (up to 0.95 vol. %). In the absence of SO(2), a stable CO(2) capacity of ∼ 25 wt % over 25 cycles at 550 °C was achieved. The presence of SO(2), even at concentrations as low as 0.002 vol. %, resulted in an irreversible reaction with the absorbent and a decrease in CO(2) capacity. Analysis of SO(2)-exposed samples revealed that the absorbent reacted chemically and irreversibly with SO(2) at 550 °C forming Li(2)SO(4). Thus, industrial application would require desulfurization of flue gas prior to contacting the absorbent. Reactivity with SO(2) is not unique to the lithium orthosilicate material, so similar steps would be required for other absorbents that chemically react with SO(2).
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Affiliation(s)
- R Pacciani
- Air Products and Chemicals Inc., Allentown, Pennsylvania 18195, USA
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Bolignano D, Zanoli L, Rastelli S, Marcantoni C, Coppolino G, Lucisano G, Tamburino C, Battaglia E, Castellino P, Coppolino G, Lucisano G, Presta P, Battaglia E, Pedrelli L, Bolignano D, Rastelli S, Zanoli L, Marcantoni C, Bolignano D, Coppolino G, Battaglia E, Tamburino C, Castellino P, Bolignano D, Zanoli L, Rastelli S, Marcantoni C, Coppolino G, Lucisano G, Battaglia E, Tamburino C, Castellino P, Iiadis F, Ntemka A, Didangelos T, Makedou A, Divani M, Moralidis E, Makedou K, Gotzamani-Psarakou A, Grekas D, Selistre L, Souza V, Domanova O, Cochat P, Ranchin B, Varennes A, Dubourg L, Hadj-Aissa A, Leonardis D, Mallamaci F, Enia G, Postorino M, Tripepi G, Zoccali C, MAURO Working Group, Donadio C, Kanaki A, Caprio F, Donadio E, Tognotti D, Olivieri L, Eloot S, Schepers E, Barreto D, Barreto F, Liabeuf S, Van Biesen W, Verbeke F, Glorieux G, Choukroun G, Massy Z, Vanholder R, Chaaban A, Torab F, Abouchacra S, Bernieh B, Hussein Q, Osman M, Gebran N, Kayyal Y, Al Omary H, Nagelkerke N, Horio M, Imai E, Yasuda Y, Takahara S, Watanabe T, Matsuo S, Fujimi A, Ueda S, Fukami K, Obara N, Okuda S, Pecchini P, Mieth M, Mass R, Tripepi G, Malberti F, Mallamaci F, Quinn R, Zoccali C, Ravani P, Fujii H, Kono K, Nakai K, Goto S, Fukagawa M, Nishi S, Havrda M, Granatova J, Vernerova Z, Vranova J, Hornova L, Zabka J, Rychlik I, Kratka K, De Nicola L, Zamboli P, Mascia S, Calabria M, Grimaldi M, Conte G, Minutolo R, Gluhovschi G, Modilca M, Kaycsa A, Velciov S, Gluhovschi C, Bob F, Petrica L, Bozdog G, Methven S, Traynor J, Deighan C, O'Reilly D, MacGregor M, Szotowska M, Chudek J, Adamczak M, Wiecek A, Dudar I, Shifris I, Loboda O, Yanagisawa N, Ando M, Tsuchiya K, Nitta K, Heguilen R, Liste A, Canteli M, Muguerza G, Cohen L, Ortemberg M, Hermes R, Bernasconi A, Galli D, Miani N, Staffolani E, Nicolais R, Borzacchi MS, Tozzo C, Manca di Villahermosa S, Di Daniele N, Musial K, Zwolinska D, Loriga G, Carru C, Zinellu A, Milia A, Satta AE, Frolova I, Kuryata A, Koppe L, Kalabacher E, Pelletier C, Geloen A, Fouque D, Soulage C, Feriozzi S, Torras J, Cybulla M, Nicholls K, Sunder-Plassmann G, West M. Progression & risk factors CKD 1-5 (1). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.30] [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: 11/14/2022] Open
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Movva S, Bocklage T, Schmit B, Quinn R, Liem BJ, Verschraegen CF. Phase I study of irinotecan and temsirolimus in patients with refractory sarcomas. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10027] [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: 11/20/2022] Open
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Byrne MK, Willis A, Deane FP, Hawkins B, Quinn R. Training inpatient mental health staff how to enhance patient engagement with medications: Medication Alliance training and dissemination outcomes in a large US mental health hospital. J Eval Clin Pract 2010; 16:114-20. [PMID: 20367823 DOI: 10.1111/j.1365-2753.2009.01126.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 12/25/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES The Medication Alliance training programme has previously been shown to be effective in enhancing clinician knowledge, attitudes and skills in regard to non-adherent individuals in a community-based psychiatric setting. The current study attempts to replicate these findings in an inpatient setting and assess the feasibility of dissemination using a train-the-trainer model. METHOD One hundred and thirteen staff from four wards at an inpatient psychiatric facility attended Medication Alliance training workshops over 3 days. Two wards comprised an expert trained group (n = 67); and the remaining two wards made up a novice trained group (n = 46). The novice trained group attended training 6 months after the expert group, and were trained by selected trainees from the expert group. Participants completed a package of questionnaires both before and after their training to determine if Medication Alliance resulted in any changes in knowledge, attitudes and skills. RESULTS Paired t-tests showed significant improvements across both groups for knowledge, attitudes and one skill domain following training in Medication Alliance. There were no differences at baseline between groups and analysis of post-test scores yielded no significant difference between the groups in terms of training effect for knowledge, attitudes or skills. CONCLUSIONS Medication Alliance can be successfully implemented in an inpatient setting, enhancing knowledge, attitudes and at least some skill domains of staff in dealing with non-adherent patients. The equivalence of results between the expert and novice trained training groups suggests that Medication Alliance may be more broadly disseminated using a cost-effective train-the-trainer model.
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Affiliation(s)
- Mitchell K Byrne
- Clinical Psychology, Illawarra Institute for Mental Health and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
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Byrne MK, Deane FP, Willis A, Hawkins B, Quinn R. Preliminary reliability of an observer rating scale for assessing medication adherence on psychiatric wards. J Eval Clin Pract 2009; 15:246-51. [PMID: 19335480 DOI: 10.1111/j.1365-2753.2008.00989.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Medication non-adherence is a major contributor to poor outcomes following discharge from psychiatric hospitals. It is therefore imperative that staff are able to accurately assess the extent to which patients have engaged with treatment. This study presents data on a new observer rating instrument of patient medication adherence. METHODS Staff participating in a medication adherence training programme ('Medication Alliance') were given a brief overview of the Observer Rating of Medication Taking (ORMT) scale. Participants then watched six video vignettes of patient adherence behaviour and provided a rating on their scale for each vignette. Participant ratings were then compared with 'expert' ratings. RESULTS Percentage agreement between 'experts' and participants ranged from a low of 68% through to 98% agreement. Only one vignette was rated significantly differently [Mdiff = 0.33, t(49) = 2.08, P = 0.007], with 32% of people falling outside the expert rating range (all of those ratings being higher). This difference was attributed to between group differences, [F(2,47) = 3.49, P < 0.05] and post hoc assessment suggested that the differences between expert and trainee ratings for the vignette may be explained by trainee characteristics, as distinct from inherent characteristics of the rating scale. CONCLUSION The ORMT can help mental health professionals identify particular non-adherent behaviours thus facilitating identification and treatment of likely non-adherence before discharge. The scale appears to be accessible to a variety of professions with a range of experience and requires minimum training in order to be used reliably.
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Affiliation(s)
- Mitchell K Byrne
- Department of Clinical Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
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Abstract
AIMS Cerebrovascular disease (CVD) is a major risk factor for cognitive decline associated with progression to Alzheimer's disease (AD) and dementia. The objective of this study was to retrospectively assess the prevalence of CVD and its cognitive impact in patients with AD in everyday clinical practice. METHODS Medical notes were retrospectively reviewed for all individuals who presented at East Sussex Memory Clinic (2004-2008) for investigation of cognitive impairment and had brain magnetic resonance imaging (MRI) as part of their clinical work-up. Global cognitive status was assessed with Mini-Mental State Examination (MMSE) and Cambridge Cognitive Examination. The extent of cerebrovascular abnormalities was qualitatively evaluated with MRI. RESULTS Notes were reviewed for 232 patients (109 males, 123 females), mean age 76 years (range 62-93), who underwent MRI. Of these, 167 (72%) patients were diagnosed with AD. CVD was present in 89% of AD patients and 47% of patients had moderate to severe cerebrovascular abnormalities. The majority of patients (57%) had MMSE scores in the 21-26 range, indicative of mild AD. There was a trend towards worse cognitive status in patients with more severe CVD, which did not reach significance. Hachinski Ischaemic score indicated these patients did not have vascular dementia (VaD) (mean +/- standard deviation 1.1 +/- 1.3). CONCLUSION These findings, based on qualitative MRI, indicate that cerebrovascular pathology is a very common associated feature in patients with mild to moderate AD, without VaD. Although the study suggests that CVD does not contribute to cognitive decline, and is not associated with the development of VaD, a non-significant trend was observed towards worsening cognitive status with increasing severity of CVD. The finding of this trend suggests a need for additional research, especially a prospective quantitative method of assessing CVD, to improve our understanding of how CVD contributes to cognitive impairment in AD.
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Affiliation(s)
- N Tabet
- Institute of Postgraduate Medicine, Brighton & Sussex Medical School, University of Sussex, Brighton, East Sussex, UK.
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Abstract
BACKGROUND Vitamin E is a dietary compound that functions as an antioxidant scavenging toxic free radicals. Evidence that free radicals may contribute to the pathological processes of cognitive impairment including Alzheimer's disease (AD) has led to interest in the use of Vitamin E in the treatment of Alzheimer's disease and Mild Cognitivie Impairment (MCI). OBJECTIVES To assess the efficacy of Vitamin E in the treatment of Alzheimer's disease and prevention of progression of Mild Cognitive Impairment to Alzheimer's disease. SEARCH STRATEGY The Cochrane Dementia and Cognitive Improvement's Specialized Register was searched on 8 January 2007 using the following terms: "Vitamin E", vitamin-E, alpha-tocopherol. The CDCIG Registers contains records from major health care databases and ongoing trial databases and is updated regularly. SELECTION CRITERIA All unconfounded, double blind, randomized trials in which treatment with Vitamin E at any dose was compared with placebo for patients with Alzheimer's disease or Mild Cognitive Impairment. DATA COLLECTION AND ANALYSIS Two reviewers independently applied the selection criteria and assessed study quality and extracted and analysed the data. For each outcome measure data were sought on every patient randomized. Where such data were not available an analysis of patients who completed treatment was conducted. MAIN RESULTS Only 2 studies met the inclusion criteria. The primary outcome used in the AD study was survival time to the first of 4 endpoints: death, institutionalisation, loss of 2 out of 3 basic activities of daily living and severe dementia (defined as a global Clinical Dementia Rating of 3). The investigators reported the total numbers in each group who reached the primary endpoint within two years for participants completing the study ("completers"). There appeared to be some benefit from Vitamin E with fewer participants reaching endpoint - 58% (45/77) of completers compared with 74% (58/78) - a Peto odds ratio of 0.49, 95% confidence interval 0.25 to 0.96.However, more participants taking Vitamin E suffered a fall (12/77 compared with 4/78; odds ratio 3.07, 95% CI 1.09 to 8.62). It was not possible to interpret the reported results for specific endpoints or for secondary outcomes of cognition, dependence, behavioural disturbance and activities of daily living.The primary outcome used in the MCI study which had 769 participants (257 in the Vitamin E group and 259 in the placebo group; a third Donepezil group of 253 was not included in this review) was the time to progression from MCI to possible or probable AD. A total of 214 of the 769 participants had progression to dementia, with 212 being classified as having possible or probable AD. There was no significant difference in the probability of progression from MCI to AD between the Vitamin E group and the placebo group. There was no significant difference between the placebo group and the Vitamin E group in adverse events. Five subjects died in each group and 72 discontinued treatment in the Vitamin E group and 66 in the placebo group. AUTHORS' CONCLUSIONS There is no evidence of efficacy of Vitamin E in the prevention or treatment of people with AD or MCI. More research is needed to identify the role of Vitamin E, if any, in the management of cognitive impairment.
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Verschraegen CF, Quinn R, Rabinowitz I, Arias-Pulido H, Muller C. Phase I/II study of docetaxel (D), gemcitabine (G), and bevacizumab (B) in patients (pts) with advanced or recurrent soft tissue sarcoma (STS). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10534] [Citation(s) in RCA: 8] [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: 11/20/2022] Open
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King J, Glenn D, Quinn R, Janssen J, Liauw W, Morris DL. Radioactive microspheres in liver metastases from neuroendocrine cancer (NETLM). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15541] [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: 11/20/2022] Open
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Verschraegen CF, Fekrazad HM, Rabinowitz I, Quinn R, Snyder D, Judson P, Purdy M, Lee FC. Phase I/II study of docetaxel (D), gemcitabine (G), and bevacizumab (B) in patients (pts) with advanced or recurrent soft tissue sarcoma (STS). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10056 Background: The combination of G and D has shown efficacy against refractory STS (Hensley, JCO 2002). STS have a high content of VEGF, which is associated with poor prognosis. This phase I/II study assesses the safety, tolerability, efficacy, and pharmacodynamics (PD) of B in combination with G+D, given on a two-weekly schedule to minimize adverse events (AEs). We are reporting the phase I results. Methods: Untreated pts with advanced or recurrent STS and ECOG PS =2 were eligible. Some pts were treated in a neoadjuvant setting, when surgically appropriate. Planned doses were G 1,000, 1,250, and 1,500 mg/m2, D 50 mg/m2, and B 5 mg/kg iv, every 2 wks. G doses were escalated in serial pt cohorts to determine the maximum tolerated dose (MTD) of G with fixed doses of D and B. MTD was assessed on the first 2 cycles (1 cycle = 2 wks). Treatment was continued until progression or unacceptable toxicity. For neoadjuvant therapy, B was given only for 4 cycles, followed by 4 cycles without B in anticipation of surgery and pts came off study at that point. PD and antitumor efficacy were also assessed. Results: Nine pts have been treated on the phase I escalation arm, including 3 in the neoadjuvant setting. There were no dose limiting toxicities. After 4 cycles with G at 1,500 mg/m2, there was 1 asymptomatic grade 4 bowel perforation at the site of the tumor in a pt with initially inoperable leiomyosarcoma (LMS). After emergency surgery, the pt is free of disease. Observed grade 1 and 2 AEs include alopecia, diarrhea, fatigue (5 each), rigors (4), nausea, dyspnea, headaches (3 each), chest pain, epistaxis, stomatitis, anemia (2 each), rash, hypertension, neuropathy, leukopenia (1 each). There were 1 CR (angiosarcoma), 2 PR, (myxoid sarcoma, undifferentiated sarcoma), 4 NC (2 LMS, liposarcoma, PNST), and 2 PD (myxoid sarcoma, PNST). Necrosis was observed, including in NC disease. Three pts are free of disease after surgery. Conclusions: The combination of G, D, and B given every 2 weeks is safe and has demonstrated some activity in pts with advanced or recurrent STS. The phase II arm is ongoing at G 1,500 mg/m2 with 4 pts already enrolled. Mature data including PD will be reported at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- C. F. Verschraegen
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - H. M. Fekrazad
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - I. Rabinowitz
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - R. Quinn
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - D. Snyder
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - P. Judson
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - M. Purdy
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
| | - F. C. Lee
- Univ of New Mexico, Albuquerque, NM; New Mexico Cancer Care Associates, Santa Fe, NM; Hematology Oncology Associates, Albuquerque, NM
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King J, Quinn R, Glenn D, Liauw W, Janssen J, Morris D. Pilot study of selective internal radiation therapy (SIRT) for patients with unresectable neuroendocrine liver metastases (NETLM). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15096 Background: Few effective treatment options exist for inoperable NETLM. A prospective single-unit study assessed safety and efficacy of radioactive yttrium90 resin (SIR) in 34 patients with unresectable (NETLM). Method: Microspheres were administered via temporary percutaneous hepatic artery catheter with concomitant 7day 5-flurouracil infusion. Patients were monitored prospectively and treatment response measured by CT imaging and chromogranin A (CgA). Results: 34 patients (22 male), mean age 61 years (range 32–79) were treated with SIRT from December 2003 to December 2005. Mean follow-up 28.9 months, (95% CI 23.4 to 32.3). Complications were: post-embolitic pain and lethargy 1 week-1 month; 3 radiation gastritis, 2 of whom developed a duodenal ulcer. RECIST response on CT scan of 34 patients at 1 month: PR 9 (26%); SD 22 (65%); PD 3 (9%); 32 at 6 months, PR 7 (22%); SD 19 (59%); PD 6 (19%); 29 at 12 months CR 2 (7%); PR 3 (10%); SD 16 (55%); PD 8 (28%); 16 at 18 months, CR 4(25%); PR 1 (6%); SD 8 (50%); PD =3 (19%); 8 at 24 months, CR 4 (50%);SD 2 (25%),PD 2 (25%); 6 at 30 months, CR 2 (33%); SD 2 (33%); PD 2 (33%). CgA U/L fall from entry was: 19 (26%) at one month; 15 (43%) at 6 months; 15 (52%) at 9 months; 11 (57%) at 12 months; 8 (38%) at 24 months and 4 (80%) at 30 months. At 36 months from entry 11 (32%) have died; 8 (24%) have PD; 9 (26%) have SD and 6 (18%), (15 to 30 months) have CR on CT scan. Conclusion: SIRT is a promising treatment option for patients with in-operable NETLM. No significant financial relationships to disclose.
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Affiliation(s)
- J. King
- UNSW/St George Hospital, Sydney, Australia
| | - R. Quinn
- UNSW/St George Hospital, Sydney, Australia
| | - D. Glenn
- UNSW/St George Hospital, Sydney, Australia
| | - W. Liauw
- UNSW/St George Hospital, Sydney, Australia
| | - J. Janssen
- UNSW/St George Hospital, Sydney, Australia
| | - D. Morris
- UNSW/St George Hospital, Sydney, Australia
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Quinn R, Appleby JB, Pez GP. Hydrogen sulfide separation from gas streams using salt hydrate chemical absorbents and immobilized liquid membranes. SEP SCI TECHNOL 2007. [DOI: 10.1081/ss-120001451] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Xu Y, Ohinata K, Meguid MM, Marx W, Tada T, Chen C, Quinn R, Inui A. Gastric bypass model in the obese rat to study metabolic mechanisms of weight loss. J Surg Res 2002; 107:56-63. [PMID: 12384065 DOI: 10.1006/jsre.2002.6508] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [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: 11/22/2022]
Abstract
A rat model replicating gastric bypass with Roux-en-Y (GB) as used in morbidly obese patients, evolved in our laboratory in stages, using the Zucker rat as an obese model (GB) is presented. In the final model, a 20% gastric fundic pouch to limit the gastric reservoir was created using two staple lines (Ethicon). A 4- to 5-mm end-to-side gastrojejunostomy and a 6- to 8-mm jejunojejunostomy, at 10 cm length of the Roux-en-Y limb, placed 16 cm below the ligament of Treitz, was hand sewn to create a limited area of nutrient digestion and absorption. Controls underwent sham operation. Rats were divided into: (i) sham-op ad lib-fed (Control); (ii) GB; and (iii) sham-op pair fed (PF) in two experiments. In Experiment 1, 24 Zuckers (control n = 8; GB n = 8; PF n = 8) were studied to assess the effectiveness of the model for weight loss. In Experiment 2, 24 Zuckers (8/group) were studied to confirm the effects of the operation on weight loss and on metabolic parameters. Boost was given for 4 days starting 24 h postop and then ground chow was given. Daily food intake (FI), meal size (MZ), meal number (MN), and body weight (BW) were measured. Rats were sacrificed on Day 20 in Experiment 1 and on Day 10 in Experiment 2. Serum metabolites and body fat weight were measured. Data were evaluated using Student's t test. Controls steadily gained BW (5.2-6.1 g/day), reaching approximately 500 g. In GB: FI, MZ, MN, BW, glucose, free fatty acids, insulin, and body fat decreased (P < 0.05). In PF: BW, insulin, triglycerides, and body fat decreased. A dependable, reproducible gastric bypass with Roux-en-Y obesity model was developed. This permits the study of biochemical and eventually molecular mechanism(s) of weight loss resulting from the operation.
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Affiliation(s)
- Y Xu
- Second Department of Internal Medicine, Kobe School of Medicine, Japan
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Groom R, Tryzelaar J, Forest R, Niimi K, Cecere G, Donegan D, Katz S, Weldner P, Quinn R, Braxton J, Blank S, Kramer R, Morton J. Intra-operative quality assessment of coronary artery bypass grafts. Perfusion 2001; 16:511-8. [PMID: 11761091 DOI: 10.1177/026765910101600611] [Citation(s) in RCA: 10] [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: 11/16/2022]
Abstract
Early coronary artery bypass graft (CABG) failure is a troubling complication that may result in a wide range of problems, including refractory angina, myocardial infarction, low cardiac output, arrhythmia, and fatal heart failure. Early graft failures are related to poor quality and size of the distal native vascular bed, coagulation abnormalities, or technical problems involving the graft conduits and anastomoses. Unfortunately, graft failure is difficult to detect during surgery by visual assessment, palpation, or conventional monitoring. We evaluated the accuracy and utility of a transit-time, ultrasonic flow measurement system for measurement of CABGs. There were no differences between transit-time measurements and volumetric-time collected samples in an in vitro circuit over a range of flows from 10 to 100ml/min (Bland and Altman Plot, 1.96 SD). Two hundred and ninety-eight CABGs were examined in 125 patients. Graft flow rate was proportional to the target vessel diameter. Nine technical errors were detected and corrected. Flow waveform morphology provided valuable information related to the quality of the anastamosis, which led to the immediate correction of technical problems at the time of surgery.
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Affiliation(s)
- R Groom
- Cardiac Surgery Department, Maine Medical Center, Portland 04102, USA.
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Herzig S, Long F, Jhala US, Hedrick S, Quinn R, Bauer A, Rudolph D, Schutz G, Yoon C, Puigserver P, Spiegelman B, Montminy M. Erratum: correction: CREB regulates hepatic gluconeogenesis through the coactivator PGC-1. Nature 2001. [DOI: 10.1038/35098123] [Citation(s) in RCA: 6] [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: 11/09/2022]
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Magill MK, Quinn R, Babitz M, Saffel-Shrier S, Shomaker S. Integrating public health into medical education: community health projects in a Primary Care Preceptorship. Acad Med 2001; 76:1076-1079. [PMID: 11597854 DOI: 10.1097/00001888-200110000-00022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Physicians must integrate care of populations with the care of individual patients to function optimally in today's health care environment. With this understanding, medical school curricula are increasingly addressing the skills and knowledge of public health along with those of clinical medicine. The University of Utah School of Medicine in 1997 revised its four-year curriculum to increase the teaching of topics needed by future physicians, including public health. This report describes one course in the curriculum, the Primary Care Preceptorship (PCP), a fourth-year, six-week required rotation that assists students in learning about the health needs of a community along with providing primary care for its individual residents. Students in the PCP spend approximately 60% of their time in clinical primary care and 40% completing a community health project. In the first year of the PCP, 32 students completed projects on clinical problems, 27 on community health needs assessment, 26 on patient education, and 15 on epidemiology.
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Affiliation(s)
- M K Magill
- Department of Family and Preventive Medicine and Utah Area Health Education Centers Program, University of Utah School of Medicine, Salt Lake City, 84132-2118, USA.
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Herzig S, Long F, Jhala US, Hedrick S, Quinn R, Bauer A, Rudolph D, Schutz G, Yoon C, Puigserver P, Spiegelman B, Montminy M. CREB regulates hepatic gluconeogenesis through the coactivator PGC-1. Nature 2001; 413:179-83. [PMID: 11557984 DOI: 10.1038/35093131] [Citation(s) in RCA: 1072] [Impact Index Per Article: 46.6] [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: 12/19/2022]
Abstract
When mammals fast, glucose homeostasis is achieved by triggering expression of gluconeogenic genes in response to glucagon and glucocorticoids. The pathways act synergistically to induce gluconeogenesis (glucose synthesis), although the underlying mechanism has not been determined. Here we show that mice carrying a targeted disruption of the cyclic AMP (cAMP) response element binding (CREB) protein gene, or overexpressing a dominant-negative CREB inhibitor, exhibit fasting hypoglycaemia [corrected] and reduced expression of gluconeogenic enzymes. CREB was found to induce expression of the gluconeogenic programme through the nuclear receptor coactivator PGC-1, which is shown here to be a direct target for CREB regulation in vivo. Overexpression of PGC-1 in CREB-deficient mice restored glucose homeostasis and rescued expression of gluconeogenic genes. In transient assays, PGC-1 potentiated glucocorticoid induction of the gene for phosphoenolpyruvate carboxykinase (PEPCK), the rate-limiting enzyme in gluconeogenesis. PGC-1 promotes cooperativity between cyclic AMP and glucocorticoid signalling pathways during hepatic gluconeogenesis. Fasting hyperglycaemia is strongly correlated with type II diabetes, so our results suggest that the activation of PGC-1 by CREB in liver contributes importantly to the pathogenesis of this disease.
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Affiliation(s)
- S Herzig
- Peptide Biology Laboratories, Salk Institute for Biological Studies, 10010 N Torrey Pines Road, La Jolla, California 92037-1002, USA
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Surgenor SD, O'Connor GT, Lahey SJ, Quinn R, Charlesworth DC, Dacey LJ, Clough RA, Leavitt BJ, Defoe GR, Fillinger M, Nugent WC. Predicting the risk of death from heart failure after coronary artery bypass graft surgery. Anesth Analg 2001; 92:596-601. [PMID: 11226084 DOI: 10.1097/00000539-200103000-00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED Heart failure is the most common cause of death among coronary artery bypass graft (CABG) patients. In addition, most variation in observed mortality rates for CABG surgery is explained by fatal heart failure. The purpose of this study was to develop a clinical risk assessment tool so that clinicians can rapidly and easily assess the risk of fatal heart failure while caring for individual patients. Using prospective data for 8,641 CABG patients, we used logistic regression analysis to predict the risk of fatal heart failure. In multivariate analysis, female sex, prior CABG surgery, ejection fraction <40%, urgent or emergency surgery, advanced age (70-79 yr and >80 yr), peripheral vascular disease, diabetes, dialysis-dependent renal failure and three-vessel coronary disease were significant predictors of fatal postoperative heart failure. A clinical risk assessment tool was developed from this logistic regression model, which had good discriminating characteristics (receiver operating characteristic clinical source = 0.75, 95% confidence interval: 0.71, 0.78). IMPLICATIONS In contrast to previous cardiac surgical scoring systems that predicted total mortality, we developed a clinical risk assessment tool that evaluates risk of fatal heart failure. This distinction is relevant for quality improvement initiatives, because most of the variation in CABG mortality rates is explained by postoperative heart failure.
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Affiliation(s)
- S D Surgenor
- Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
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