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Acuff J, Waterman K, Wu J, Murphy C, Gallagher D, Ponder M. Inactivation kinetics of a surrogate yield conservative predictions of foodborne pathogen reductions from low water activity foods of varying size and composition during low-temperature steam processing. Heliyon 2023; 9:e17893. [PMID: 37449168 PMCID: PMC10336792 DOI: 10.1016/j.heliyon.2023.e17893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/12/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
There is a growing interest in using models to predict foodborne pathogen inactivation as a way to validate or verify preventive controls. Unlike liquid foods, solid, low water activity foods (LWAF) are heterogenous in composition and structure and do not transfer heat uniformly. Using models constructed from one food to predict pathogen inactivation on another LWAF is complex and may not always be possible, even if the foods have similar composition. Using models constructed from inactivation kinetics of three foodborne pathogens and a surrogate from vacuum-steam-pasteurized (72 and 82 °C) whole macadamia nuts and dried apricot halves, 3-log reductions were predicted for the same pathogens and foods of reduced size. Model fits (First-order, Weibull, and Gompertz) were significantly impacted by the food type regardless of particle size. Despite the foods being identical in composition with particle size as the only altered characteristic, best-fit models accurately predicted the 3-log reductions only 50% of the time, but the surrogate inactivation models provided conservative predictions for pathogen reductions, highlighting that a surrogate's model may be a suitable tool for predicting pathogen reduction on LWAFs.
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Daly E, Collins G, Hall E, O'Dwyer J, Gallagher D, Kelly J. Telehealth Rehabilitation for the Management of Long Covid Symptoms. IRISH MEDICAL JOURNAL 2023; 115:677. [PMID: 36920416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Siddiqui F, Gallagher D, Shuster-Hyman H, Gauthier-Fisher A, Librach C. Mesenchymal Stem/Stromal Cells: FIRST TRIMESTER HUMAN UMBILICAL CORD PERIVASCULAR CELLS (HUCPVC) MODULATE THE KYNURENINE PATHWAY AND GLUTAMATE NEUROTRANSMISSION IN AN LPS-INDUCED MOUSE MODEL OF NEUROINFLAMMATION AND DEPRESSION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lopez L, Dviri M, Madjunkov M, Haham LM, Kuperman A, Mander P, Gallagher D, Gauthier-Fisher A, Librach C. Mesenchymal Stem/Stromal Cells: HUMAN UMBILICAL CORD PERIVASCULAR CELLS (HUCPVC) REDUCE OVARIAN FIBROSIS AND IMPROVE PREGNANCY RATE IN A MOUSE MODEL OF NATURAL OVARIAN AGING. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00183-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Penugonda M, Walsh J, Barry JJ, Govern RM, Bradley D, Bolger M, English G, Moore J, Nolan N, Treacy E, Burke J, Dwyer N, Gallagher D, Macken S, McCaffrey S, Moloney S, Murphy R, Murray M, Hanlon EO. 231 ESTABLISHING AN INTERVENTIONS BUNDLE TO IMPROVE INPATIENT CARE FOR PATIENTS WITH PARKINSON’S DISEASE: A MULTIDISCIPLINARY QUALITY IMPROVEMENT PROJECT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Patients with Parkinson’s (PwP) are at a higher risk of complications once admited to hospital compared to their age-matched peers. Medication mismanagement is a well-known obstacle, which puts PwP at risk of sub-optimal treatment leading to an unnecessary deterioration of baseline and potentially increases risk of adverse sequelae.
Methods
Retrospective electronic patient records (EPR)/chart review of 47 admissions was conducted, across three hospital sites.
Data attaining to correct prescribing of medication on admission and discharge, prescribing of contraindicated medications, reasons for medication lapses and complications of inpatient stay were collected. EPR of 17 patients’ were reviewed to assess if Parkinson’s disease (PD) medication administrations occurred within 30 minutes of patient schedule, as recommended by NICE guidelines. Key areas for improvement were identified based on the results.
Results
47 charts (30 Males, 17 Females) with mean age 72 (range:57–90), were reviewed. Average number of co-morbidities:4.5 and Clinical Frailty Scale ranged 5–9 (n = 30). LOS averaged 12.4 days and 43% of patients had ≥2 hospital admissions in the preceeding year.
38% (17/44) of admissions correctly documented patient specific medication times. Only 48% of patients (n = 638) received their medications within 30 minutes of the scheduled time. 47% (22/47) experienced complications attributable to PD. Contraindicated medications were noted in 5 cases. 84% of discharging prescriptions did not mention timing of PD medication and 3 prescriptions had errors with regards to dosage/omission of medication.
Conclusion
We implemented across two sites: 1) Care protocol flag in patient’s chart highlighting simple avoidable complications. 2) Laminated over the bed signpost alerting ‘time critical medication’. 3) ‘Time critical medication’ stickers in drug kardex 4) Education sessions for Medical, Nursing and Ward staff. 6) Establishing out of hours access to PD medications and protocols for NPO/poor swallow. We plan to reassess significance of efforts post intervention.
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Talbot A, McCabe M, Daly B, Gallagher D. Heart Rate Variability-Guided Exercise During Chemotherapy in Triathlete with Stage 1 BRCA1-Mutated Breast Cancer. IRISH MEDICAL JOURNAL 2021; 114:420. [PMID: 35476380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Lopez L, Shuster Hyman H, Gasner A, Khan H, Marco E, Mouazz S, Kauffman A, Gallagher D, Gauthier-Fisher A, Librach C. Systemically administered human umbilical cord perivascular cells (HUCPVC) prevent tumor growth in a human melanoma tumor-bearing mouse model. Cytotherapy 2021. [DOI: 10.1016/s1465324921003509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Power Foley M, Kelly ME, Kerr C, Kennedy C, Gallagher D, Gillham C, Mehigan BJ, McCormick PH, Bergin C, Larkin JO. Management of anal intraepithelial neoplasia and anal squamous cell carcinoma at a tertiary referral centre with a dedicated infectious diseases unit: an 18-year review. Int J Colorectal Dis 2020; 35:1855-1864. [PMID: 32500433 DOI: 10.1007/s00384-020-03640-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Anal squamous cell carcinoma (ASCC) is a rare malignancy with rising incidence rates. Risk factors include human immunodeficiency virus (HIV) infection, high-risk sexual activity and HPV-related genitourinary dysplasia/neoplasia. There is an overlap between high-risk patients and those attending HIV Medicine/Sexual Health (HMSH) services. We hypothesised that HMSH involvement may facilitate earlier referral to colorectal surgeons, with better outcomes. METHODS Retrospective review of all ASCC and anal intraepithelial neoplasia (AIN) treated at a tertiary-referral hospital with a dedicated HMSH clinic between 2000 and 2018. Comparative analysis was performed of demographics, management and outcomes between HMSH and non-HMSH patients. RESULTS One hundred and nine patients had anal pathology, eighty-five with ASCC (78%) and twenty-four with AIN (22%). Seventy (64%) were male. Median (range) age at ASCC diagnosis was 51 years (26-88). Thirty-six percent of all patients attended HMSH services, 28% were HIV positive, and 41% of males were men-who-have-sex-with-men (MSM). Eighty-one ASCC patients (97.5%) were treated with curative intent. Sixty-seven (80%) had primary chemoradiation therapy. Fifteen (17.5%) had primary surgical excision. Twelve (14%) developed recurrent disease. Ultimately, seven required salvage APR. Overall 3-year survival (3YS) was 76%. HMSH patients were significantly younger at ASCC diagnosis (p < 0.001), with a higher prevalence of HIV, HPV and MSM. HMSH attenders also tended to be diagnosed at earlier stages, were less likely to develop recurrence and achieved better overall outcomes, with a superior overall 3YS than non-HMSH patients (92% vs 72%, p = 0.037). CONCLUSION ASCC incidence is increasing worldwide. The HMSH cohort has emerged as a distinct subpopulation of younger, high-risk, male patients. Collaboration between HMSH and colorectal surgeons offers an opportunity for risk reduction strategies and earlier intervention.
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Danisavich T, Destro C, Diaz B, Fitzgerald S, Gallagher D, Franke W, Freshly J, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Maki G, McDonagh S, McKee B, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Trottier Y, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Visual Immunoprecipitate Assay (VIP) for Listeria monocytogenes and Related Listeria Species Detection in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.791] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Destro C, Diaz B, Franke W, Gallagher D, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Trottier YL, Maki G, McDonagh S, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Assurance Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria Species in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.775] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Kasper JC, Bale SD, Belcher JW, Berthomier M, Case AW, Chandran BDG, Curtis DW, Gallagher D, Gary SP, Golub L, Halekas JS, Ho GC, Horbury TS, Hu Q, Huang J, Klein KG, Korreck KE, Larson DE, Livi R, Maruca B, Lavraud B, Louarn P, Maksimovic M, Martinovic M, McGinnis D, Pogorelov NV, Richardson JD, Skoug RM, Steinberg JT, Stevens ML, Szabo A, Velli M, Whittlesey PL, Wright KH, Zank GP, MacDowall RJ, McComas DJ, McNutt RL, Pulupa M, Raouafi NE, Schwadron NA. Alfvénic velocity spikes and rotational flows in the near-Sun solar wind. Nature 2019; 576:228-231. [PMID: 31802006 DOI: 10.1038/s41586-019-1813-z] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/17/2019] [Indexed: 11/09/2022]
Abstract
The prediction of a supersonic solar wind1 was first confirmed by spacecraft near Earth2,3 and later by spacecraft at heliocentric distances as small as 62 solar radii4. These missions showed that plasma accelerates as it emerges from the corona, aided by unidentified processes that transport energy outwards from the Sun before depositing it in the wind. Alfvénic fluctuations are a promising candidate for such a process because they are seen in the corona and solar wind and contain considerable energy5-7. Magnetic tension forces the corona to co-rotate with the Sun, but any residual rotation far from the Sun reported until now has been much smaller than the amplitude of waves and deflections from interacting wind streams8. Here we report observations of solar-wind plasma at heliocentric distances of about 35 solar radii9-11, well within the distance at which stream interactions become important. We find that Alfvén waves organize into structured velocity spikes with duration of up to minutes, which are associated with propagating S-like bends in the magnetic-field lines. We detect an increasing rotational component to the flow velocity of the solar wind around the Sun, peaking at 35 to 50 kilometres per second-considerably above the amplitude of the waves. These flows exceed classical velocity predictions of a few kilometres per second, challenging models of circulation in the corona and calling into question our understanding of how stars lose angular momentum and spin down as they age12-14.
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aharchi J, Aldridge I, Arling V, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Rucker C, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 996.14 Assurance® Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Assurance®Listeria Polyclonal Enzyme Immunoassay (EIA) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 23 collaborators, representing government agencies, as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 550 test portions and controls was analyzed and confirmed, of which 207 were positive and 336 were negative by both methods. Six test portions were positive by culture, but negative by the EIA. Three test portions were negative by culture, but positive by the EIA. Two test portions were negative by EIA and by culture, but confirmed positive when EIA enrichment broths were subcultured to selective agars. The data reported here indicate that the Assurance®Listeria EIA method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aguilar G, Aharchi J, Aldridge I, Arling V, Bitner B, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Dombroski P, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, Martensen D, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Robertson M, Rogers P, Rucker C, Sacca J, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, Vess R, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 997.03 Visual Immunoprecipitate Assay (VIP®) for Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Visual Immunoprecipitate assay (VIP®) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 27 laboratories, representing government agencies as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 615 test portions and controls was analyzed and confirmed, of which 227 were positive and 378 were negative by both methods. Nine test portions were positive by culture, but negative by the VIP. Five test portions were negative by culture, but positive by the VIP. Four test portions were negative by VIP and by culture, but confirmed positive when VIP enrichment broths were subcultured to selective agars. The data reported here indicate that the VIP method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Liu C, Herrmann N, Gallagher D, Rajji T, Oh P, Marzolini S, Banks L, Vieira D, Lanctot K. Designing a randomized, sham-controlled, parallel-design trial to investigate the effects of a combined exercise priming and transcranial direct current stimulation intervention in mild cognitive impairment and alzheimer’s disease. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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O'Donovan EM, Farrell M, Gallagher D. Abstract P5-09-19: The complexity of germline panel testing: Cost, access and variant interpretation in an Irish context. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-09-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives
Diagnostic germline genetic testing of single or multiple cancer predisposition genes is increasingly central to the care of women with breast cancer. Testing for mutations in BRCA1/2 has therapeutic relevance in perioperative and metastatic settings. Variants of uncertain significance (VUS) are identified in approximately 5-20% of tests. Single gene testing in the Rep. of Ireland occurs through 3 clinics using laboratories in England. Panel testing is offered through Color Genomics and Myriad Genetics. Color genomics offers a less expansive panel test. Panels have made variant interpretation a common clinical challenge. We investigated interpretation of 10 VUS in 3 laboratories.
Methods
We selected 10 patients who had VUS reported in BRCA1/2 in NHS laboratories. Further diagnostic testing for mutations in BRCA1/2 was subsequently completed using BRACAnalysis on stored DNA from these individuals. Patients were re-contacted and offered Color panel testing for mutations in 30 genes. Previous test reports were not provided to either company. A review of all 10 BRCA1/2 VUS was performed on ClinVar database.
Results
Two VUS in BRCA1 and 8 VUS in BRCA2 were included in the study. Retesting was completed at a median time of 20mths (14-70mths) after the original testing. All 10 individuals underwent BRCAnalysis testing, only 7 had panel testing (2 did not make contact following calls/ letters, 1 had left Ireland). ClinVar classified 3 variants as benign, 2 likely benign, 2 VUS and 2 pathogenic (1not on ClinVar). All 10 VUS were re-classified by Myriad and Color. One result was deemed 'pathogenic' by Color and 'suspected deleterious' by Myriad (pt 9, table 1). Panel testing identified two additional VUS: an MSH6 and a RAD51.
Interpretation of testing CliniVarNHS laboratory testingMyriadColor GenomicsPtDatabase ReviewGeneexon BRACAnalysis30 gene panel test1Benign (2018)BRCA111c.3708T>G, p.(Asn1236Lys)No deleterious mutationMSH6 VUS c.2585T>A (p.Leu862Gln)2Benign (2015)BRCA111c.4910C>T, p.(Pro1637Leu)No deleterious mutationNo mutations identified3Not on ClinVarBRCA211c.3037A>G, p.(Lys1025Glu)No deleterious mutationNo mutations identified4Pathogenic (2016)BRCA23c.316+5G>CDeleterious MutationNo sample submitted5VUS (2016)BRCA24c.343A>G , p.(Lys115Glu)No deleterious mutationNo mutations identified6Likely benign (2016)BRCA211c.5635G>A, p.(Glu1879Lys)No deleterious mutationRAD51D VUS c.26G>C (p.Cys9Ser)7Benign (2017)BRCA211c.6821G>T, p.(Gly2274Val)No deleterious mutationNo sample submitted8Likely Benign (2018)BRCA215c.7601C>T, p.(Ala2534Val)No deleterious mutationvNo mutations identified9Pathogenic (2017)BRCA217c.7958T>C, p.(Leu2653Pro)Suspected deleterious mutationBRCA2, c.7958T>C, p.(Leu2653Pro) PATHOGENIC10VUS (2016)BRCA219c.8351G>A, p.(Arg2784Gln)No deleterious mutationNo sample submitted
Conclusions
All 10 VUS in BRCA1/2 were reclassified with additional testing by two commercial laboratories at a later date. The results of this testing by two different companies are clinically concordant. Panel testing identified 2 additional VUS in potentially clinically relevant genes. Less expansive testing increases access to germline genetic testing but requires responsible interpretation.
Citation Format: O'Donovan EM, Farrell M, Gallagher D. The complexity of germline panel testing: Cost, access and variant interpretation in an Irish context [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-09-19.
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Prior L, Teo M, Greally M, Ward C, O'Leary C, Aslam R, Darwish W, Ahmed N, Watson G, Kelly D, Kiely L, Hassan A, Gleeson J, Featherstone H, Lim M, Murray H, Gallagher D, Westrup J, Hennessy B, Leonard G, Grogan L, Breathnach O, Horgan A, Coate L, O'Mahony D, Coate L, O'Reilly S, Gupta R, Keane M, Duffy K, O'Connor M, Kennedy J, McCaffrey J, Higgins M, Kelly C, Carney D, Gullo G, Crown J, Walshe J. Abstract P6-08-17: Pregnancy associated breast cancer: Evaluating maternal outcomes. A multicentre study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-08-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Pregnancy associated breast cancer (PABC) is defined as breast cancer (BC) diagnosed during the gestational period (GP) or in the first year postpartum (PP). Despite its infrequent occurrence, the incidence of PABC appears to be rising due to the increasing propensity for women to delay childbirth. We have established the first combined prospective and retrospective registry study of PABC in Ireland to examine specific clinicopathological characteristics, treatments and maternal outcomes. We present the retrospective findings to date.
Methods
We performed a retrospective multicentre observational study of patients (pts) with PABC treated in the eight Irish cancer centres from August 2001 to March 2017. Data extracted included information on pt demographics, tumour biology, staging, treatment administered and maternal outcomes. Standard biostatistical methods were used for analysis.
Results
111 PABC patients were identified. Sixty pts (54%) were diagnosed during the GP and 51 (46%) within 1 year PP. Median age at diagnosis was 36 years (yrs). Table 1 illustrates baseline characteristics. Two thirds of pts were node positive and a similar proportion had grade 3 pathology. Seventy pts (63%) were estrogen receptor (ER) positive, 36 (32%) HER2 positive, 25 (22%) triple negative. Twenty-two pts (20%) were metastatic at presentation. Seven pts (6%) had a known BRCA 1/2 mutation. The median OS (overall survival) and DFS (disease free survival) for the entire cohort was 107.4 and 94.2 months respectively (resp). There was no survival difference between those diagnosed during the GP versus PP. 5 yr DFS and OS was 68.6% and 69.2% resp. This compares unfavourably to results reported by the National Cancer Registry of Ireland in a similar age-matched BC population between 2000-2012 where the 5 yr OS was 86.5%. Variables in our study associated with poorer outcomes included younger age, tumour size, node positivity and lack of estrogen expression.
Baseline characteristics PABC patients (n=11) %(n)Diagnosed in GP (n=60) %(n)Diagnosed 1yr PP (n=51) %(n)p valueDemographic Age at diagnosis3636(25-49)36(21-44)0.31Stage I-II54(60)55(33)53(27)0.85III23(26)23(14)23(12)1IV20(22)18(11)22(11)0.81Unknown3(3)3(2)2(1)1Pathology Grade 366(74)70(42)63(32)0.43Node positive66(73)68(41)63(32)0.55ER+/HER2-41(45)38(23)43(22)0.69ER+/HER2+23(25)28(17)16(8)0.17ER-/HER2+14(16)17(10)12(6)0.59Triple negative22(25)17(10)29(15)0.11Surgery Breast conservation23(26)25(15)21(11)0.82Mastectomy56(63)57(34)59(30)0.84Adjuavnt/Neoadjuvant treatment Chemotherapy73(81)77(46)69(35)0.39Anthracycline68(55)78(36)54(19)0.03Taxane89(72)93(43)83(29)0.16Anti HER2 agent21(23)18(11)24(12)0.63Endocrine therapy64(52)63(29)66(23)0.84Radiotherapy79(64)74(34)86(30)0.85Relapse in Stage I-III Local relapse15(13)12(6)18(7)0.55Distant relapse24(21)22(11)25(10)0.80
Conclusions
PABC patients may have a poorer outcome. Our study reported higher rates of triple negative and HER2 positive breast cancer which are associated with more aggressive biology. Prospective evaluation of clinicopathological features, pharmacokinetics of treatments selected and maternal and fetal outcomes is imperative in this distinct pt group.
Citation Format: Prior L, Teo M, Greally M, Ward C, O'Leary C, Aslam R, Darwish W, Ahmed N, Watson G, Kelly D, Kiely L, Hassan A, Gleeson J, Featherstone H, Lim M, Murray H, Gallagher D, Westrup J, Hennessy B, Leonard G, Grogan L, Breathnach O, Horgan A, Coate L, O'Mahony D, Coate L, O'Reilly S, Gupta R, Keane M, Duffy K, O'Connor M, Kennedy J, McCaffrey J, Higgins M, Kelly C, Carney D, Gullo G, Crown J, Walshe J. Pregnancy associated breast cancer: Evaluating maternal outcomes. A multicentre study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-08-17.
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Townson J, Gregory JW, Cowley L, Gallagher D, Channon S, Robling M, Williams D, Hughes C, Murphy S, Lowes L. Establishing the feasibility of a community and primary health care intervention to raise awareness of symptoms of Type 1 Diabetes-The Early Detection of Type 1 Diabetes in Youth (EDDY) study. Pediatr Diabetes 2017; 18:955-963. [PMID: 28261940 DOI: 10.1111/pedi.12516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/17/2017] [Accepted: 02/06/2017] [Indexed: 11/29/2022] Open
Abstract
AIMS To design, develop, and evaluate the feasibility of delivering a multi-component community based intervention to parents and primary health care professionals to raise awareness of the symptoms of Type 1 diabetes (T1D) in childhood in 3 adjoining borough counties of South Wales. MATERIALS AND METHODS Parent and primary health care advisory groups were established to design the intervention. Qualitative interviews with stakeholders and parents assessed the acceptability, feasibility and any potential impact of the intervention. RESULTS The parent component of the intervention developed was a re-useable shopping bag with the 4 main symptoms of T1D illustrated on the side, based on the road traffic system of red warning triangles and an octagon "stop" sign stating "Seek Medical Help". Accompanying the bag was an A5 leaflet giving further information. Both were overwrapped with clear plastic and delivered to 98% (323/329) schools, equating to 101 371 children. The primary health care professional component was a dual glucose/ketone meter, single use lancets, stickers, the A5 parent leaflet displayed as a poster and an educational visit from a Community Diabetes Liaison Nurse. 87% (73/84) of GP practices received the intervention, 100% received the materials. The intervention was delivered within Cardiff, the Vale of Glamorgan and Bridgend. Qualitative analyses suggest that the intervention raised awareness and had some impact. CONCLUSION This study showed that it is feasible and acceptable to design, develop and deliver a community based intervention to raise awareness of T1D. There is some suggestion of impact but a definitive evaluation of effectiveness is still required.
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Baird A, Keegan N, Barr M, Fishleder S, Idris A, Harrold E, O'Kelly P, Duff E, Lim S, O'Donnell M, Gallagher D, Grant C, Kennedy J, O'Donnell D, Sukor S, O'Brien C, Finn S, Cuffe S. MA 04.10 An Assessment of the Willingness to Provide Serial Bio-Specimens: Experience from an Irish Tertiary Cancer Centre. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Barretto T, Park E, Liu E, Gauthier-Fisher A, Gallagher D, Librach C, Baker A. Blood brain barrier integrity and edema formation after moderate traumatic brain injury is improved with human umbilical cord perivascular cell therapy. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Paley C, Hull H, Ji Y, Toro-Ramos T, Thornton J, Bauer J, Matthews P, Yu A, Navder K, Dorsey K, Gallagher D. Body fat differences by self-reported race/ethnicity in healthy term newborns. Pediatr Obes 2016; 11:361-8. [PMID: 26509351 PMCID: PMC4848178 DOI: 10.1111/ijpo.12072] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/24/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ethnic differences in total body fat (fat mass [FM]) have been reported in adults and children, but the timing of when these differences manifest and whether they are present at birth are unknown. OBJECTIVES This study aimed to assess whether ethnic differences in body fat are present at birth in healthy infants born at term, where body fat is measured using air displacement plethysmography and fat distribution by skin-fold thickness. METHODS Data were from a multiracial cross-sectional convenience sample of 332 term infants from four racial or ethnic groups based on maternal self-report (A, Asian; AA, non-Hispanic Black [African-American]; C, non-Hispanic White; and H, Hispanic). The main outcome measure was infant body fat at 1-3 days after birth, with age, birth weight, gestational age and maternal pre-pregnancy weight as covariates. RESULTS Significant effects for race (P = 0.0011), sex (P = 0.0051) and a race by sex interaction (P = 0.0236) were found. C females had higher FM than C males (P = 0.0001), and AA females had higher FM than AA males (P = 0.0205). C males had less FM than A males (P = 0.0353) and H males (P = 0.0001). CONCLUSION Race/ethnic and sex differences in FM are present in healthy term newborns. Although the implications of these differences are unclear, studies beginning in utero and birth set the stage for a life course approach to understanding disease later in life.
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Harrold E, Idris A, Keegan N, Corrigan L, Teo M, Lim S, Duff E, Donnell M, Kennedy J, O'Donnell D, Sukor S, Grant C, Gallagher D, Collier S, Kingston T, O'Dwyer A, Cuffe S. Insomnia prevalence in an oncology patient population: an Irish tertiary referral centre experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Karadawi N, O'Kane G, Gallagher D, Finn S, Muldoon C, Mulligan N. Cascade testing following universal immunohistochemistry for mismatch repair protiens. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Molloy C, Cahill R, Gallagher D, Murphy P, Quinn J. Early-onset chronic lymphocytic leukaemia in a young man with Cowden syndrome. Ann Hematol 2016; 95:1205-6. [PMID: 27165089 DOI: 10.1007/s00277-016-2677-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/14/2016] [Indexed: 11/29/2022]
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Gallagher D, Bramall A, Paquin A, Voronova A, Burns S, Neilsen P, Keller G, Kaplan D, Miller F. ISDN2014_0042: Autism‐associated Ankrd11 is a novel epigenetic regulator of neurogenesis. Int J Dev Neurosci 2015. [DOI: 10.1016/j.ijdevneu.2015.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Toro-Ramos T, Paley C, Pi-Sunyer FX, Gallagher D. Body composition during fetal development and infancy through the age of 5 years. Eur J Clin Nutr 2015; 69:1279-89. [PMID: 26242725 PMCID: PMC4680980 DOI: 10.1038/ejcn.2015.117] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 02/07/2023]
Abstract
Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life.
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