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Fuller H, Race AD, Fenton H, Burke L, Downing A, Williams EA, Rees CJ, Brown LC, Loadman PM, Hull MA. Plasma and rectal mucosal oxylipin levels during aspirin and eicosapentaenoic acid treatment in the seAFOod polyp prevention trial. Prostaglandins Leukot Essent Fatty Acids 2023; 192:102570. [PMID: 37003144 DOI: 10.1016/j.plefa.2023.102570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Aspirin and eicosapentaenoic acid (EPA) have colorectal polyp prevention activity, alone and in combination. This study measured levels of plasma and rectal mucosal oxylipins in participants of the seAFOod 2 × 2 factorial, randomised, placebo-controlled trial, who received aspirin 300 mg daily and EPA 2000 mg free fatty acid, alone and in combination, for 12 months. METHODS Resolvin (Rv) E1, 15-epi-lipoxin (LX) A4 and respective precursors 18-HEPE and 15-HETE (with chiral separation) were measured by ultra-high performance liquid chromatography-tandem mass spectrometry in plasma taken at baseline, 6 months and 12 months, as well as rectal mucosa obtained at trial exit colonoscopy at 12 months, in 401 trial participants. RESULTS Despite detection of S- and R- enantiomers of 18-HEPE and 15-HETE in ng/ml concentrations, RvE1 or 15‑epi-LXA4 were not detected above a limit of detection of 20 pg/ml in plasma or rectal mucosa, even in individuals randomised to both aspirin and EPA. We have confirmed in a large clinical trial cohort that prolonged (12 months) treatment with EPA is associated with increased plasma 18-HEPE concentrations (median [inter-quartile range] total 18-HEPE 0.51 [0.21-1.95] ng/ml at baseline versus 0.95 [0.46-4.06] ng/ml at 6 months [P<0.0001] in those randomised to EPA alone), which correlate strongly with respective rectal mucosal 18-HEPE levels (r = 0.82; P<0.001), but which do not predict polyp prevention efficacy by EPA or aspirin. CONCLUSION Analysis of seAFOod trial plasma and rectal mucosal samples has not provided evidence of synthesis of the EPA-derived specialised pro-resolving mediator RvE1 or aspirin-trigged lipoxin 15‑epi-LXA4. We cannot rule out degradation of individual oxylipins during sample collection and storage but readily measurable precursor oxylipins argues against widespread degradation.
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Kelly JR, Baker A, Babiker M, Burke L, Brennan C, O'Keane V. The psychedelic renaissance: the next trip for psychiatry? Ir J Psychol Med 2022; 39:335-339. [PMID: 31543078 DOI: 10.1017/ipm.2019.39] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The psychedelic research renaissance is gaining traction. Preliminary clinical studies of the hallucinogenic fungi, psilocybin, with psychological support, have indicated improvements in mood, anxiety and quality of life. A seminal, open-label study demonstrated marked reductions in depression symptoms in participants with treatment-resistant depression (TRD). The associated neurobiological processes involve alterations in brain connectivity, together with altered amygdala and default mode network activity. At the cellular level, psychedelics promote synaptogenesis and neural plasticity. Prompted by the promising preliminary studies, a randomized, double-blind trial has recently been launched across Europe and North America to investigate the efficacy of psilocybin in TRD. One of these centres is based in Ireland - CHO Area 7 and Tallaght University Hospital. The outcome of this trial will determine whether psilocybin with psychological support will successfully translate into the psychiatric clinic for the benefit of patients.
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Young M, Thapa D, Moon A, Kim H, Beyer C, Sanders E, Wang K, McGinty K, Burke L, Altun E, Zhang X, Tan X, Tepper J, Yanagihara T. Disease Control and Hepatotoxicity Following Stereotactic Body Radiotherapy for Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hughes RK, Shiwani H, Rosmini S, Burke L, Pierce I, Castelletti S, Xue H, Kellman P, Lopes LR, Treibel T, Manisty C, Captur G, Davies R, Moon J. Improved diagnostic accuracy for apical hypertrophic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The diagnosis of apical hypertrophic cardiomyopathy (ApHCM) is contingent on demonstrating apical maximum wall thickness (MWT) of ≥15mm; the same threshold as other HCM subtypes. However, the myocardium naturally tapers towards the apex in healthy individuals, so ≥15mm MWT is proportionately higher in the apex than in naturally thicker basal segments. Using cardiac magnetic resonance (CMR), relative ApHCM has been described (typical ECG features, loss of apical tapering, cavity obliteration but hypertrophy <15mm). Wall thickness measurement using machine learning now exceeds human performance.
Purpose
We aimed to redefine the optimal diagnostic threshold for ApHCM using segment-specific criteria based on a large cohort of healthy control subjects.
Methods
Segmental wall thickness was measured using healthy subjects from the UK Biobank using a clinically validated machine learning algorithm1,2. A normative reference range was established for all 16 segments, conditioned to body surface area (BSA), sex and age. Derived segment-specific wall thickness thresholds were used to define optimal disease thresholds for patients clinically managed with overt (MWT ≥15mm) and relative ApHCM (MWT <15mm, but typical ECG and imaging findings).
Results
4118 UK biobank subjects were used to define normal segmental thicknesses and reference ranges. These were applied to ApHCM (73 overt, 31 relative). There were no apical wall thickness age related differences. The upper limit of the 95% confidence interval corresponded to a combined maximum apical MWT for both males and females of 10.4mm using non-indexed measurement, or 5.6mm/m2 when indexed to BSA. Non-indexed segmental threshold identified 100% of ApHCM patients (true positives), 81% (25 of 31) relative ApHCM and 3% (115 of 4118) of healthy UK biobank subjects (false positives). Indexed segmental thresholds improved the diagnostic potential in relative ApHCM without an increase in false positives (100% of ApHCM patients, 84% (26 of 31) of relative ApHCM patients, and 3% healthy UK biobank (127 of 4118).
Conclusion
We propose new diagnostic criteria for ApHCM using segmental indexed apical wall thickness of >5.6 mm/m2 to better identify inappropriate apical hypertrophy in those whose wall thickness does not meet current criteria for diagnosis.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation
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Venkatesh A, Janke A, Koski-Vacirca R, Rothenberg C, Parwani V, Granovsky M, Burke L, Li SX, Pines J. 9 Nationwide Reimbursement Impact of COVID-19 to Emergency Physicians: $6.6 Billion Loss in 2020. Ann Emerg Med 2022. [PMCID: PMC9519215 DOI: 10.1016/j.annemergmed.2022.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lin M, Burke R, Goldberg E, Hwang U, Burke L. 136 Ambulatory Follow-up After Emergency Department Discharge and Association With Outcomes Among Older Adults With Alzheimer’s Disease and Related Dementia. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.160] [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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Shiwani H, Hughes RK, Camaioni C, Augusto JB, Knott K, Rosmini S, Burke L, Pierce I, Moon JC, Davies RH. Asymmetric septal thickening is observed in hypertrophic cardiomyopathy mutation carriers without left ventricular hypertrophy: insights from AI analysis. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeac141.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Dr Hughes is supported by the British Heart Foundation (grant number FS/17/82/33222).
Background
Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac disease characterised by left ventricular hypertrophy (LVH), often, with asymmetric septal thickening. Despite the prevalence of inherited mutations present in >50% of cases, there is variable phenotypic expression in those with abnormal sarcomere protein genes. In individuals with abnormal genes but without LVH, we hypothesised that there is subtle asymmetric septal hypertrophy, detectable by the increased precision offered by an artificial intelligence (AI) tool for measuring wall thickness.
Purpose
We explored the septal-lateral ratio measured by AI in individuals with an identified genotype but no left ventricular hypertrophy as a component of sub-clinical HCM.
Methods
43 individuals with identified genotype, but no left ventricular hypertrophy (G+LVH-) and 97 age-, sex- and disease-matched controls underwent CMR. Patients were excluded if they had a maximum wall thickness (MWT) of ≥13mm. A clinically validated AI tool was used to measure the MWT, for each segment in the 16-segment AHA model. The septal-lateral ratio was calculated using the septal segment with the largest MWT and the lateral segment with the largest MWT.
Results
The mean septal-lateral ratio of the G+LVH- patients was 1.22 (SD 0.22) and the mean septal-lateral ratio of the matched controls was 1.14 (SD 0.15) with a statistically significant mean difference of 0.08 (p=0.01). There was no significant difference between the MWT of the G+LVH- patients at 10.3mm (SD 2.2) and healthy volunteers at 10.1mm (SD 1.8) (p = 0.61).
Conclusion
G+LVH- patients have a 7% increase in their septal-lateral ratio compared with age-matched controls despite the lack of difference in the MWT. Using increased precision offered by AI, early features of HCM can be observed in patients without overt LVH.
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Shiwani H, Hughes RK, Camaioni C, Augusto JB, Knott K, Rosmini S, Khoury S, Malcolmson J, Kellman P, Xue H, Burke L, Pierce I, Moon JC, Davies RH. Improving the diagnostic accuracy of apical hypertrophic cardiomyopathy using machine learning. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeac141.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Dr Hughes is supported by the British Heart Foundation (grant number FS/17/82/33222).
Introduction
The imaging criteria for diagnosis of apical hypertrophic cardiomyopathy (ApHCM) is a maximum wall thickness (MWT) ≥15mm. CMR enables detection of subtle phenotypic features (e.g. loss of apical tapering, cavity obliteration) and coupled with characteristic electrocardiogram changes, ApHCM can be diagnosed without overt hypertrophy. However, these patients are not captured by current diagnostic criteria.
Purpose
We sought to use a machine learning tool to quantify wall thickness and identify patients with ‘relative’ ApHCM that do not reach current diagnostic thresholds.
Methods
CMR images from 4118 healthy participants from the UK Biobank were segmented automatically with a clinically validated machine learning algorithm and wall thickness measured at all point in the myocardium by solving a solution to Laplace’s equation. MWT were pooled into 16 AHA segments and indexed to body surface area (BSA). The non-indexed and indexed segmental upper limit of normal was calculated as the mean + 3 standard deviations (the equivalent of 95% confidence interval after correcting for multiple [16] comparisons using the Bonferroni method).
Results
73 overt ApHCM subjects (MWT>15mm) and 31 relative ApHCM subjects underwent CMR scanning. In healthy controls, the non-indexed (and indexed) upper limits were calculated for the apical-anterior 10.2mm (5.2 mm/m2), apical-septal 11.1mm (5.6 mm/m2), apical-inferior 10.5mm (5.3 mm/m2) and apical-lateral 10.1mm (5.2 mm/m2) segments. With a non-indexed cut-off, all (73 of 73) overt ApHCM and 84% (26 of 31) relative ApHCM were classified as having an abnormally thick apex. 3% (127 of 4118) of the healthy UK Biobank cohort were classified as abnormal, as expected. Using an indexed cut-off, all overt ApHCM and 87% (27/31) relative ApHCM were classified as abnormal, and 3% (123 of 4118) of the healthy UK Biobank cohort were misclassified.
Conclusion
We can successfully classify 87% of relative ApHCM patients from a normative reference range derived from a large cohort of healthy patients – a significant improvement on existing methods. We show that the specificity and sensitivity is increased when MWT is indexed to BSA. For practical clinical application, we recommend a cut-off of 10mm or an indexed cut-off of 5mm/m2 in any apical segment to diagnose apical LVH. Overt and relative apical HCM examplesHealthy controls AHA maps (non-indexed)
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Appaneal R, Burke L, Drew M, Hughes D, Lovell G, Lundy B, Rogers M, Vlahovich N, Waddington G. The diagnostic performance of the Low Energy Availability in Females Questionnaire (LEAF-Q) in a mixed-sport cohort. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.082] [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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10
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Lin M, Burke R, Orav E, Burke L. Ambulatory Care Access and Postdischarge Adverse Events after Emergency Department Visits Among Medicare Beneficiaries. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13448] [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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Chique C, Hynds PD, Andrade L, Burke L, Morris D, Ryan MP, O'Dwyer J. Cryptosporidium spp. in groundwater supplies intended for human consumption - A descriptive review of global prevalence, risk factors and knowledge gaps. WATER RESEARCH 2020; 176:115726. [PMID: 32247994 DOI: 10.1016/j.watres.2020.115726] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/05/2020] [Accepted: 03/15/2020] [Indexed: 06/11/2023]
Abstract
Cryptosporidiosis is one of the leading causes of diarrhoeal illness and mortality induced by protozoan pathogens worldwide. As a largely waterborne disease, emphasis has been given to the study of Cryptosporidium spp. in surface waters, readily susceptible to pathogenic contamination. Conversely, the status of Cryptosporidium in potable groundwater sources, generally regarded as a pristine and "safe" drinking-water supply owing to (sub)-soil protection, remains largely unknown. As such, this investigation presents the first literature review aimed to ascertain the global prevalence of Cryptosporidium in groundwater supply sources intended for human consumption. Thirty-seven peer-reviewed studies were identified and included in the review. Groundwater sample and supply detection rates (estimated 10-20%) indicate Cryptosporidium is frequently present in domestic groundwater sources, representing a latent health concern for groundwater consumers. Specifically, sample (10.4%) and source (19.1%) detection rates deriving from comprehensive "temporal" investigations are put forward as representative of a contamination 'baseline' for Cryptosporidium in 'domestic' groundwater supplies. Proposed 'baseline' prevalence figures are largely applicable in preventive risk-based catchment and groundwater quality management including the formulation of Quantitative Microbial Risk Assessment (QMRA). Notwithstanding, a large geographical disparity in available investigations and lack of standardized reporting restrict the transferability of research findings. Overall, the mechanisms responsible for Cryptosporidium transport and ingress into groundwater supplies remain ambiguous, representing a critical knowledge gap, and denoting a distinctive lack of integration between groundwater and public-health sub-disciplines among investigations. Key recommendations and guidelines are provided for prospective studies directed at more integrative and multi-disciplinary research.
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Chasens ER, Sereika SM, Kortykowski M, Stansbury R, Burke L, Strollo PJ, Bizhanova Z, Atwood CW. 0686 Diabetes Sleep Treatment Trial: The Effect Of Treatment Of OSA With CPAP On Glycemic Control In Type 2 Diabetes. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Evidence remains unclear whether treatment of OSA with CPAP results in improved glycemic control. This study evaluated if CPAP improved glucose control compared to sham-CPAP and the effect of adherence to active CPAP on glucose control after 6 and 12 weeks of treatment.
Methods
This was a multi-center, double-blind clinical trial. Participants were adults with type 2 diabetes (T2D), A1C≥6.5%, apnea + hypopnea index (AHI)≥10, and naïve to CPAP. All participants received diabetes education. Glucose control was evaluated with frucostamine and A1C levels; CPAP adherence with a wireless modem system. Statistical analysis followed an “intent-to-treat” approach with linear mixed modeling. The dose of active CPAP was calculated as the percentage of days with active CPAP use≥4 hours and the average adherence of active CPAP with sham coded as “0”dose”.
Results
Randomized participants (N=98, CPAP=50; sham-CPAP=48) were primarily middle-aged (age=58.7±9.8 years), White (75%), males (57%) obese (BMI=36.2±6.6), suboptimal glucose control (A1C=7.9%±0.9) and OSA (AHI=23.9±14.4). There were no significant baseline differences except in A1C (Active CPAP=7.7%±0.8; sham-CPAP=8.1%±1.0). There was no significant difference in use of their devices at 6 or 12 weeks. Based on linear mixed modeling, participants on active CPAP had improved A1C (b (SE): -.76 (.24), P<.01) and frucostamine (-21.8 (10.5), P=.04) at 6 weeks with A1C trending to significance at 12 weeks (p=0.10). Both the % of cumulative days of active CPAP usage (≥4 hours/day) (.002 (.003), P=.09) and cumulative hours of active CPAP use (.03 (.03), P=.08) showed a trend being associated with greater change in A1C but not in frucostamine (P=.61, P=.51). The rate of change in A1C varied by time, increasing the % of cumulative days of CPAP use (≥4 hours/day) at week 6 predicted greater change in A1C (.006 (.002), P=.01) than week 12 (.002 (.003), P=.38). Higher average hours of CPAP usage were associated with greater change in A1C (.08 (.03), P=.01) at week 6 compared to week 12 (.03 (.03), P=.47).
Conclusion
In our study, individuals with T2D and OSA, adherence to active CPAP use improved glycemic control over 6 weeks.
Support
NIDDK grant R01DK096028; CTRI grant UL1TR001857 and UL1TR000005.
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Burke L, Androutsos C, Jogia J, Byrne P, Frangou S. The Maudsley Early Onset Schizophrenia Study: The effect of age of onset and illness duration on fronto-parietal gray matter. Eur Psychiatry 2020; 23:233-6. [DOI: 10.1016/j.eurpsy.2008.03.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Revised: 12/14/2007] [Accepted: 01/07/2008] [Indexed: 11/28/2022] Open
Abstract
AbstractObjectiveIn Early Onset Schizophrenia (EOS; onset before the 18th birthday) late brain maturational changes may interact with disease mechanisms leading to a wave of back to front structural changes during adolescence. To further explore this effect we examined the relationship between age of onset and duration of illness on brain morphology in adolescents with EOS.Subjects and methodsStructural brain magnetic resonance imaging scans were obtained from 40 adolescents with EOS. We used Voxel Based Morphometry and multiple regressions analyses, implemented in SPM, to examine the relationship between gray matter volume with age of onset and illness duration.ResultsAge of onset showed a positive correlation with regional gray matter volume in the right superior parietal lobule (Brodmann Area 7). Duration of illness was inversely related to regional gray matter volume in the left inferior frontal gyrus (BA 11/47).ConclusionsParietal gray matter loss may contribute to the onset of schizophrenia while orbitofrontal gray matter loss is associated with illness duration.
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Rogers M, Burke L, Vlahovich N, Lovell G, Pyne D, Lundy B, Appaneal R, Halson S, West N, Welvaert M, Hughes D, Waddington G, Drew M. Prevalence of variables related to RED-S in Australian elite and pre-elite female athletes. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hart A, Bonner G, Suarez M, Roberson T, Burke L, Steffen A. FINDINGS FROM AN END-OF-LIFE EDUCATION INTERVENTION FOR AFRICAN AMERICAN CAREGIVERS OF RELATIVES WITH DEMENTIA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1558] [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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16
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Lorenzi J, Cohen Y, Burke L, Caskey M, Nussenzweig M. A phase 2 trial to evaluate the effects of 3BNC117 in addition to antiretroviral therapy on the latent reservoir and viral rebound. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30556-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Burke L, Brown W. Weighty Issues Symposium. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.09.375] [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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18
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Burke L. Low carb high fat (LCHF) diets for athletes – Third time lucky? J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.09.369] [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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19
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Morris JL, Atwood C, Burke L, Baniak L, Korytkowski M, Sereika S, Strollo PJ, Chasens E. 1063 THE EFFECT OF SLEEP QUALITY ON INTIMATE RELATIONSHIPS AND SEXUAL ACTIVITY IN MEN AND WOMEN WITH TYPE 2 DIABETES. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1062] [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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20
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Kelly D, Mc Sorley L, O'Shea E, Mc Carthy E, Bowe S, Brady C, Sui J, Dawod MA, O'Brien O, Graham D, McCarthy J, Burke L, Power D, O'Reilly S, Bambury RM, Mahony DO. A regional analysis of epidermal growth factor receptor (EGFR) mutated lung cancer for HSE South. Ir J Med Sci 2017; 186:855-857. [PMID: 28185061 DOI: 10.1007/s11845-017-1579-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/05/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND EGFR mutated lung cancer represents a subgroup with distinct clinical presentations, prognosis, and management requirements. We investigated the survival, prognostic factors, and real-world treatment of NSCLC patients with EGFR mutation in clinical practice. METHODS A retrospective review of all specimens sent for EGFR analysis from December 2009 to September 2015 was performed. Patient demographics, specimen type, EGFR mutation status/type, stage at diagnosis, treatment, response rate, and survival data were recorded. RESULTS 27/334 (8%) patient specimens sent for EGFR testing tested positive for a sensitising EGFR mutation. The median age was 65 years (40-85 years). Exon 19 deletion represented the most commonly detected alteration, accounting for 39% (n = 11). First-line treatment for those with Exon 18, 19, or 21 alterations (n = 24) was with an EGFR tyrosine kinase inhibitor (TKI) in 79% (n = 19). Objective response rate among these patients was 74% and median duration of response was 13 months (range 7-35 months). CONCLUSION The incidence of EGFR mutation in our cohort of NSCLC is 9% which is consistent with mutation incidence reported in other countries. The rate of EGFR mutation in our population is slightly below that reported internationally, but treatment outcomes are consistent with published data. Real-world patient data have important contributions to make with regard to quality measurement, incorporating patient experience into guidelines and identifying safety signals.
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Isaacson A, Commander C, Burke L. Visibility of gadolinium enhancement adjacent to radiopaque polyvinyl alcohol beads in a liver phantom. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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22
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Khanna D, Denton C, Jahreis A, van Laar J, Burke L, Spotswood H, Lin C, Pope J, Allanore Y, Müller-Ladner U, Siegel J, Furst D. FRI0268 Safety and Efficacy of Subcutaneous Tocilizumab in Early Systemic Sclerosis: Results from The Open-Label Period of The Fasscinate Trial. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ryan C, Barbour A, Burke L, Sheppard MN. Non-infectious aortitis of the ascending aorta: a histological and clinical correlation of 71 cases including overlap with medial degeneration and atheroma—a challenge for the pathologist. J Clin Pathol 2015; 68:898-904. [DOI: 10.1136/jclinpath-2015-203061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/11/2015] [Indexed: 12/15/2022]
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Cort M, White G, Harcourt P, Burke L. Supplements in sport – To be or not to be – That is the question. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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25
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Moloney F, Ryan D, McCarthy L, McCarthy J, Burke L, Henry MT, Kennedy MP, Hinchion J, McSweeney S, Maher MM, O'Regan K. Increasing the accuracy of 18F-FDG PET/CT interpretation of "mildly positive" mediastinal nodes in the staging of non-small cell lung cancer. Eur J Radiol 2014; 83:843-7. [PMID: 24581594 DOI: 10.1016/j.ejrad.2014.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 01/20/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The aim of this study was to identify radiological factors that may reduce false-positive results and increase diagnostic accuracy when staging the mediastinum of patients with non-small cell lung carcinoma (NSCLC). METHODS This was a retrospective, interdisciplinary, per-node analysis study. We included patients with NSCLC and mediastinal nodes with an SUV max in the range of 2.5-4.0 on PET-CT. We hypothesized that the greatest number of false positive cases would occur in this cohort of patients. RESULTS A total of 92 mediastinal lymph nodes were analyzed in 44 patients. Mediastinal disease (N2/N3) was histologically confirmed in 15 of 44 patients and in 34 of 92 lymph nodes; positive predictive value of 37% and false positive rate of 63%. Lymph node SUV max, tumor size, ratio of node SUV max to tumor SUV max (SUVn/SUVp), and ratio of node SUV max to node size (SUV n/SADn) were significantly higher in true positive cases. Using a threshold of 0.3 for SUV node/tumor and 3 for SUV node/size yielded sensitivities of 91% and 71% and specificities of 71% and 69% respectively for the detection of mediastinal disease. Using both ratios in combination resulted in a sensitivity of 65% and a specificity of 88%. Concurrent benign lung disease was observed significantly more frequently in false-positive cases. CONCLUSION SUVn/SUVpt and SUVn/SADn may be complimentary to conventional visual interpretation and SUV max measurement in the assessment of mediastinal disease in patients with NSCLC.
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