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Hughes L, Swain PM, Lai T, McEwen JA. It's time to regulate - The importance of accurate surgical-grade tourniquet autoregulation in blood flow restriction exercise applications. Phys Ther Sport 2024; 67:41-46. [PMID: 38508000 DOI: 10.1016/j.ptsp.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Evaluate the efficacy of five common blood flow restriction (BFR) systems to accurately maintain and autoregulate BFR pressure in the tourniquet cuff near target pressure throughout exercise. DESIGN Randomised crossover design. SETTING Laboratory. PARTICIPANTS 15 healthy individuals. OUTCOME MEASURES 1) Percentage of total BFR time that surgical-grade tourniquet autoregulation, defined as automatic and rapid self-regulation of cuff pressure to within ±15 mmHg of initial target pressure within 1 s in the presence of transient pressure changes associated with exercise, was provided; 2) pressure change in the BFR cuff throughout exercise, by comparing the initial target pressure to the measured pressure at completion of BFR exercise. RESULTS One BFR system could provide surgical-grade tourniquet autoregulation for the whole duration (100 ± 0%) of the BFR exercise in all subjects. In two of the five BFR systems evaluated, measured cuff pressure at the end of exercise was not different (p < 0.05) to the initial target pressure. CONCLUSIONS Surgical-grade tourniquet autoregulation is important to consistently and reliably apply a targeted BFR pressure stimulus. This may allow BFR methodology and protocols to be accurately implemented and controlled so that the results can be more meaningfully compared, leading to the potential optimization of applications.
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Langbaum JB, Zissimopoulos J, Au R, Bose N, Edgar CJ, Ehrenberg E, Fillit H, Hill CV, Hughes L, Irizarry M, Kremen S, Lakdawalla D, Lynn N, Malzbender K, Maruyama T, Massett HA, Patel D, Peneva D, Reiman EM, Romero K, Routledge C, Weiner MW, Weninger S, Aisen PS. Recommendations to address key recruitment challenges of Alzheimer's disease clinical trials. Alzheimers Dement 2023; 19:696-707. [PMID: 35946590 PMCID: PMC9911558 DOI: 10.1002/alz.12737] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 05/26/2022] [Accepted: 06/14/2022] [Indexed: 11/10/2022]
Abstract
Clinical trials for Alzheimer's disease (AD) are slower to enroll study participants, take longer to complete, and are more expensive than trials in most other therapeutic areas. The recruitment and retention of a large number of qualified, diverse volunteers to participate in clinical research studies remain among the key barriers to the successful completion of AD clinical trials. An advisory panel of experts from academia, patient-advocacy organizations, philanthropy, non-profit, government, and industry convened in 2020 to assess the critical challenges facing recruitment in Alzheimer's clinical trials and develop a set of recommendations to overcome them. This paper briefly reviews existing challenges in AD clinical research and discusses the feasibility and implications of the panel's recommendations for actionable and inclusive solutions to accelerate the development of novel therapies for AD.
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Paton B, Hughes L. Strength training with blood flow restriction in anterior cruciate ligament rehabilitation. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Langran C, Mantzourani E, Hughes L, Hall K, Willis S. “I'm at breaking point”; Exploring pharmacists' resilience, coping and burnout during the COVID-19 pandemic. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100104. [PMID: 35072149 PMCID: PMC8760739 DOI: 10.1016/j.rcsop.2022.100104] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/15/2021] [Accepted: 01/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background There is a lack of evidence on how the multimodal dynamic process of resilience has impacted personal adaptation of frontline healthcare professionals, working under extreme pressure during the COVID-19 global pandemic. Objectives To explore resilience, burnout and wellbeing for UK pharmacists in patient-facing roles, including individual and organisational factors that align to the ABC-X theoretical model of the dynamic process of resilience. Methods A non-experimental pragmatist research design was adopted, with a cross-sectional online survey distributed via social media and professional networks between June and July 2020. Quantitative data aligned to a positivist research paradigm was collected using validated scores, to statistically analyse wellbeing, burnout and resilience. Qualitative textual data, consistent with an interpretivist research paradigm, were analysed following an inductive thematic approach. Results A total of 199 surveys from pharmacists working within community, hospital and GP sectors were analysed. Wellbeing scores were strongly correlated to resilience scores. Wellbeing and resilience scores were both inversely correlated with burnout scores. Two-thirds of participants were classified as high-risk within the burnout scales. Key stressors were highlighted by participants, who described how individual resources and perceptions shaped their experience, which overall contributed to their burnout. Organisations that supported pharmacists embraced change and quickly adopted new ways of working, such as teleconsultations, flexible and remote working, redesign of workflow, alongside clear guidance. However, there was also reported frustration at lack of, slow or conflicting guidance from employers. Conclusions This study adds to the growing evidence base for how individuals are affected by adverse events in a dynamic environment, alongside the role that employers can play in supporting individual and organisational resilience. It provides an opportunity to learn from pharmacists' responses to the COVID-19 pandemic, and a call to action for healthcare organisations to rebuild and invest resources into sustained support for staff wellbeing.
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Wolz R, Bork J, Cordell C, Hughes L, Bullock RA, Cerroni G, Dwyer J, Mohs R. An investigation of HCV as a predictor of cognitive decline: The Bio‐Hermes protocol. Alzheimers Dement 2021. [DOI: 10.1002/alz.053737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gómez Fernández L, Niimura Del Barrio MC, Huuskonen V, Fernandez Perez C, Brama P, Hughes L. Lithium dilution cardiac output measurements in isoflurane-anaesthetised goats: Jugular versus cephalic lithium chloride administration. Res Vet Sci 2021; 141:95-102. [PMID: 34706305 DOI: 10.1016/j.rvsc.2021.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 12/26/2022]
Abstract
The administration of lithium chloride (LiCl) for cardiac output (CO) measurement via a peripheral instead of a central vein has been described previously as a valid alternative route in pigs and dogs. The aim of the study was to compare CO measurements after administration of LiCl using two peripheral veins, cephalic or jugular, in goats. Ten adult, female, experimental goats undergoing bilateral stifle arthrotomy were recruited for the study. Paired CO measurements were taken two minutes apart during stable conditions in isoflurane-anaesthetised goats. Forty-two paired CO measurements were taken in total, and the median (range) of paired CO measurement per goat were 4.5 (3-6). The mean (SD) CO using the cephalic and jugular vein for injection of LiCl was 5.28 (1.29) L min-1 and 5.20 (1.24) L min-1 respectively. The Bland-Altman analysis showed an acceptable agreement with a mean bias of 1.33% with limits of agreement (LoA) of -18.43 to 21.09%. The percentage of error was 25%. The four-quadrant plot analysis showed a poor agreement (71%) between the two routes. The polar plot showed a poor trending ability. An 86% inclusion rate (18/21 points) was reached with a ± 35° radial sector size. The findings revealed that the agreement between the two routes is not as precise as the authors expected, however the results are comparable with studies published previously.
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Hughes L, O'Flaherty D, O'Byrne JJ, Donnelly J, O'Shaughnessy F, Doherty A. A case report of anaesthetic considerations for maple syrup urine disease during pregnancy and delivery. Int J Obstet Anesth 2021; 48:103208. [PMID: 34391024 DOI: 10.1016/j.ijoa.2021.103208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
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Nugent C, Rosato M, Hughes L, Leavey G. Risk factors associated with experienced stigma among people diagnosed with mental ill-health: a cross-sectional study. Psychiatr Q 2021; 92:633-643. [PMID: 32857285 PMCID: PMC8110482 DOI: 10.1007/s11126-020-09827-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE to examine the relationship between religiosity, social support, trauma, quality of life and experienced stigma of mental illness amongst a population diagnosed with mental ill-health. METHODS A cross-sectional survey of day service users in Northern Ireland (n = 295) covering a range of issues including religiosity, social support, quality of life and prior experience of trauma. Stigma was measured using a recognised stigma scale. We used multinomial logistic regression to examine risk factors associated with experienced stigma. RESULTS Univariate analysis showed significant associations between stigma and age, number of friends, social support, quality of life and prior experience of trauma. Age, quality of life, and trauma remained independently associated with stigma in a multivariate logistic regression model (x2(12) = 98.40, p < 0.001). CONCLUSION Younger people, those with less social support, prior experience of trauma and with poorer quality of life are at increased risk of experiencing stigma related to their diagnosis of mental illness. The findings provide further understanding of stigma and are useful for those overseeing programmes to improve access to mental health treatment.
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Hoyle A, Iqbal K, Henry J, Hughes L, Johnson D. 649 COVID BOAST In Practice: Our Experience Implementing BOA Recommendations During the UK Coronavirus Pandemic Peak. Br J Surg 2021. [PMCID: PMC8135759 DOI: 10.1093/bjs/znab134.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background
In anticipation of the UK coronavirus pandemic peak, BOA published new pandemic-specific guidance (“COVID BOAST”) in April 2020. We describe our experience implementing this restructured T&O service in a busy DGH setting during the pandemic peak.
Method
A rapid retrospective audit was conducted of all patients presenting to our T&O service in April 2020, with particular emphasis compliance with COVID BOAST.
Results
Our service conducted 511 outpatient reviews, and 95 operative procedures. 94% of outpatients were treated non-operatively. We provided telephone appointments to 12.8% of follow-up patients, and 39% of new patients. 82% of patients were treated with removable casts/splints/boots. 23% of patients were discharged direct from VFC or after one face-to-face fracture clinic review. Residual deformity was consciously accepted in 13% of patients. Theatre throughput fell significantly due to pandemic precautions however, femoral neck fracture volumes remained constant.
Conclusions
We demonstrate broad compliance with COVID BOAST guidance. The majority of patients were treated non-operatively, including conscious acceptance of residual deformity. Our pre-existing VFC allowed us to provide a significant number of telephone consultations, although despite the practice shift towards removable splintage, face-to-face consultations were required for clinical and/or radiological assessment. The impact of increased conservative management on patients’ long-term outcomes needs further evaluation.
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Langran C, Willis S, Hughes L, Mantzourani E, Hall K. Intra and Inter-professional working: how have pharmacists’ working practices changed during the COVID-19 pandemic? INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021. [PMCID: PMC8083675 DOI: 10.1093/ijpp/riab015.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction COVID-19 has acted as a catalyst for radical changes in the working practices of pharmacists. While there is emerging evidence of adaptability mitigating burnout amongst pharmacists in other countries (1), what has yet to be established is the extent to which the well-being and resilience of pharmacists in the UK may be supported through changes in intra and inter-professional working practices. Aim As part of a wider project aiming to explore the impact of COVID-19 on pharmacists’ wellbeing and resilience, in this abstract we present findings exploring the impact on working relationships within pharmacy and multidisciplinary teams. Methods An online questionnaire containing validated measures of wellbeing and resilience and free-text open questions exploring the impact of COVID-19 on working practices was piloted on five practising pharmacists. This questionnaire was subsequently distributed via social media and professional networks in June 2020. Convenience sampling was used whereby any UK-registered pharmacist in a patient-facing role was eligible to take part. Inductive thematic analysis of the free text responses was conducted. This abstract presents one key theme; intra and inter-professional relationships. Results A total of 202 questionnaires were completed (Table 1), with 192 participants entering free-text responses. Participants reported pharmacy teams becoming closer, supporting one another and working more cohesively. Work redesign and staff upskilling were given as positive examples of practice change in response to the pandemic. Reported challenges included managing conflict within a team due to heightened stress, sustaining staff morale, exhaustion, and prioritising others to the detriment of their own wellbeing: “I have no time for myself as I'm too busy keeping the day to day working and supporting my team emotionally. I'm emotionally exhausted and at home I withdraw and ignore the outside world as I'm at breaking point but don’t want my colleagues to see this.” Inter-professional relationships sometimes improved as a result of more effective communication, extended networking and pharmacists feeling valued and recognised as integral to multidisciplinary working. Supportive inter-professional working was described as a “Great sense of comradery - we're in this together”. Yet for others, inter-professional working proved challenging, with non-engagement of clinicians, frequently changing guidance from senior management, and restricted staff interaction due to remote or shift working. Conclusions Whilst for some the pandemic facilitated improved inter- and intra- professional interactions, for others this was viewed as challenges of daily practice. Due to recruiting via social media, this study is limited by the response numbers and is therefore not representative of all UK registered pharmacists. However, a key strength is that pharmacists from all sectors of practice responded, in comparison to other studies which have focused solely on community pharmacists. Results from this study can be used to support sustainable change in fostering collaborative working within pharmacy and multi-professional healthcare teams. References 1. Austin, Z., & Gregory, P. (2020). Resilience in the time of pandemic: The experience of community pharmacists in Ontario during COVID-19. Research in Social and Administrative Pharmacy.
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Boulogne C, Gillet C, Hughes L, LE Bars R, Canette A, Hawes CR, Satiat-Jeunemaitre B. Functional organisation of the endomembrane network in the digestive gland of the Venus flytrap: revisiting an old story with a new microscopy toolbox. J Microsc 2020; 280:86-103. [PMID: 32844427 DOI: 10.1111/jmi.12957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 01/10/2023]
Abstract
Up-to-date imaging approaches were used to address the spatiotemporal organisation of the endomembrane system in secretory cells of Dionaea muscipula. Different 'slice and view' methodologies were performed on resin-embedded samples to finally achieve a 3D reconstruction of the cell architecture, using ultrastructural tomography, array tomography, serial block face-scanning electron microscopy (SBF-SEM), correlation, and volume rendering at the light microscopy level. Observations of cryo-fixed samples by high-pressure freezing revealed changes of the endomembrane system that occur after trap activation and prey digestion. They provide evidence for an original strategy that adapts the secretory machinery to a specific and unique case of stimulated exocytosis in plant cells. A first secretion peak is part of a rapid response to deliver digestive fluids to the cell surface, which delivers the needed stock of digestive materials 'on site'. The second peak of activity could then be associated with the reconstruction of the Golgi apparatus (GA), endoplasmic reticulum (ER) and vacuolar machinery, in order to prepare for a subsequent round of prey capture. Tubular continuum between ER and Golgi stacks observed on ZIO-impregnated tissues may correspond to an efficient transfer mechanism for lipids and/or proteins, especially for use in rapidly resetting the molecular GA machinery. The occurrence of one vacuolar continuum may permit continuous adjustment of cell homeostasy. The subcellular features of the secretory cells of Dionaea muscipula outline key innovations in the organisation of plant cell compartmentalisation that are used to cope with specific cell needs such as the full use of the GA as a protein factory, and the ability to create protein reservoirs in the periplasmic space. Shape-derived forces of the pleiomorphic vacuole may act as signals to accompany the sorting and entering flows of the cell.
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Pullan J, Sheikh G, Hughes L. An audit of audits - A never ending loop. J Healthc Qual Res 2020; 35:265-267. [PMID: 32505749 DOI: 10.1016/j.jhqr.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 06/11/2023]
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Hayward L, Moses R, Hughes L, Forster E, Saul N. Tracheostomy weaning in community and the importance of the Multi-Disciplinary Team (MDT) to optimise outcomes - a case report. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.041] [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]
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Hughes L, Rudler D, Perks K, Richman T, Kusnetsova I, Ermer J, Shearwood A, Viola H, Hool L, Siira S, Rackham O, Filipovska A. Misregulation of Mitochondrial Protein Synthesis Leads to Cardiomyopathy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Popat S, Januszewski A, Hughes L, O'Brien M, Ahmad T, Lewanski C, Dernedde U, Jankowska P, Mulatero C, Shah R, Hicks J, Geldart T, Cominos M, Gray G, Spicer J, Bell K, Roitt S, Howarth K, Cinelli M, Green E, Morris C, Ngai Y, Hackshaw A. P1.13-17 Multicentre Phase II Trial of First-Line Afatinib in Patients with Suspected/Confirmed EGFR Mutant NSCLC: ctDNA and Long-Term Efficacy. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.874] [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]
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Blom J, Tan L, Hughes L, Tekpetey F, Abu Rafea B. Serum estradiol level on the fifth day of ovarian stimulation in a GnRH antagonist protocol can predict pregnancy outcomes in IVF/ICSI. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hughes L, Rosenblatt B, Gissane C, Paton B, Patterson SD. Interface pressure, perceptual, and mean arterial pressure responses to different blood flow restriction systems. Scand J Med Sci Sports 2018; 28:1757-1765. [DOI: 10.1111/sms.13092] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 12/16/2022]
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Gasparini M, Bombardieri E, Tondini C, Maffioli L, Hughes L, Burraggi GL, Goldenberg DM. Clinical Utility of Radioimmunoscintigraphy of Non-Hodgkin's Lymphoma with Radiolabelled LL2 Monoclonal Antibody., Lymphoscan™: Preliminary Results. TUMORI JOURNAL 2018; 81:173-8. [PMID: 7571023 DOI: 10.1177/030089169508100304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background Adequate clinical staging of non-Hodgkin's lymphoma patients is essential because only localized disease can be treated satisfactorily. Many imaging procedures are necessary to stage the disease accurately. The objective of this study was to evaluate the efficacy of an anti-lymphoma antibody in the Fab’ fragment form, labelled with 99mTc, to detect malignant lesions. Methods Radioimmunodetection (RAID) with 99mTc-labelled B-cell lymphoma monoclonal antibody IMMU-LL2-Fab’ (LymphoSCAN™; Immunomedics, Morris Plain, NJ, USA) was investigated in 10 patients (5 females and 5 males; age range, 20-72 years) with histologically proved non-Hodgkin's lymphoma. Of the 10 lymphomas, 7 were intermediate grade and 3 were low grade. Whole body images with multiple planar views were obtained at 30 min, 4-6 and 24 h after i.v. injection of 1 mg LL2-Fab’ labelled with 740-925 MBq of 99mTc. SPET of the chest or abdomen was performed in all patients 5-8 h after the immunoreagent injection. Results No adverse reactions were observed in any patient after Mab infusion, and no appreciable changes were seen in the blood counts, renal or liver function tests. A total of 18 of 21 (85.7%) lymphoma lesions were detected by RAID. All the tumor localizations were confirmed by clinical examination and with other imaging techniques, such as CT scan, MRI or gallium scan. In this series of patients no false-positive results were noted. As regards the biodistribution of the immunoreagent, no appreciable bone marrow activity was seen; splenic targeting was demonstrated in all patients; the tumor-to-non-tumor ratios ranged from 1.2 to 2.8 ad measured by the ROI technique; no difference in uptake was noted for different tumor grades. The images obtained 24 h after injection did not reveal new lesions, but areas of doubtful uptake were seen as positive focal areas in the delayed scan. Conclusions LymphoSCAN™ seems to be useful for detection, staging and follow-up of non-Hodgkin's lymphoma patients.
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Hughes L, Perks K, Rossetti G, Ermer J, Viola H, Hool L, Filipovska A. Loss of Mitochondrial RNA Binding Protein PTCD1 Leads to Cardiomyopathy. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.018] [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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Sclafani F, Gollins S, Cunningham D, Hulkki Wilson S, Kouvelakis K, Lopes A, West N, Quirke P, Begum R, Valeri N, Beare S, Hughes L, Gonzalez De Castro D, Chau I. FCγRIIa and FCγRIIIa single nucleotide polymorphisms (SNPs) and cetuximab benefit in the EXCITE trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.046] [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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van Andel L, Rosing H, Zhang Z, Hughes L, Kansra V, Sanghvi M, Tibben MM, Gebretensae A, Schellens JHM, Beijnen JH. Determination of the absolute oral bioavailability of niraparib by simultaneous administration of a 14C-microtracer and therapeutic dose in cancer patients. Cancer Chemother Pharmacol 2017; 81:39-46. [PMID: 29043410 PMCID: PMC5754411 DOI: 10.1007/s00280-017-3455-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/11/2017] [Indexed: 02/07/2023]
Abstract
Introduction Niraparib (Zejula™) is a poly(ADP-ribose) polymerase inhibitor recently approved by the US Food and Drug Administration for the maintenance treatment of patients with recurrent platinum-sensitive epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy. The pivotal phase III clinical trial has shown improved progression-free survival in patients receiving niraparib compared with those receiving placebo. Purpose Since niraparib is administered orally, it is of interest to investigate the oral bioavailability (Fpo) of this novel compound, which is the aim of this study. Methods Six patients received an oral therapeutic dose of 300 mg niraparib, followed by a 15-min intravenous infusion of 100 µg 14C-niraparib with a radioactivity of approximately 100 nCi. The niraparib therapeutic dose was measured in plasma using a validated liquid chromatography–tandem mass spectrometry method, whereas the total 14C-radioactivity and 14C-niraparib plasma levels were measured by accelerator mass spectrometry and a validated high performance liquid chromatography assay with AMS. Results The Fpo of niraparib was determined to be 72.7% in humans.
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Trad M, Boyer S, VanBelle C, Hughes L, Moody B. Advancing drug development in neuro-orphan indications. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vivekanandan S, Landau DB, Counsell N, Warren DR, Khwanda A, Rosen SD, Parsons E, Ngai Y, Farrelly L, Hughes L, Hawkins MA, Fenwick JD. The Impact of Cardiac Radiation Dosimetry on Survival After Radiation Therapy for Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2017; 99:51-60. [PMID: 28816160 PMCID: PMC5554783 DOI: 10.1016/j.ijrobp.2017.04.026] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 04/07/2017] [Accepted: 04/19/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE The heart receives high radiation doses during radiation therapy of advanced-stage lung cancer. We have explored associations between overall survival, cardiac radiation doses, and electrocardiographic (ECG) changes in patients treated in IDEAL-CRT, a trial of isotoxically escalated concurrent chemoradiation delivering tumor doses of 63 to 73 Gy. METHODS AND MATERIALS Dosimetric and survival data were analyzed for 78 patients. The whole heart, pericardium, AV node, and walls of left and right atria (LA/RA-Wall) and ventricles (LV/RV-Wall) were outlined on radiation therapy planning scans, and differential dose-volume histograms (dDVHs) were calculated. For each structure, dDVHs were approximated using the average dDVH and the 10 highest-ranked structure-specific principal components (PCs). ECGs at baseline and 6 months after radiation therapy were analyzed for 53 patients, dichotomizing patients according to presence or absence of "any ECG change" (conduction or ischemic/pericarditis-like change). All-cause death rate (DR) was analyzed from the start of treatment using Cox regression. RESULTS 38% of patients had ECG changes at 6 months. On univariable analysis, higher scores for LA-Wall-PC6, Heart-PC6, "any ECG change," and larger planning target volume (PTV) were significantly associated with higher DR (P=.003, .009, .029, and .037, respectively). Heart-PC6 and LA-Wall-PC6 represent larger volumes of whole heart and left atrial wall receiving 63 to 69 Gy. Cardiac doses ≥63 Gy were concentrated in the LA-Wall, and consequently Heart-PC6 was highly correlated with LA-Wall-PC6. "Any ECG change," LA-Wall-PC6 scores, and PTV size were retained in the multivariable model. CONCLUSIONS We found associations between higher DR and conduction or ischemic/pericarditis-like changes on ECG at 6 months, and between higher DR and higher Heart-PC6 or LA-Wall-PC6 scores, which are closely related to heart or left atrial wall volumes receiving 63 to 69 Gy in this small cohort of patients.
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Hughes L, Wilson K. The Role of Social Media Platforms and the Internet in Community Nutrition Education: Making the 21st Century a Healthier Place. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zhang ZY, Kansra V, van Andel L, Tibben M, Rosing H, Lu S, Agarwal S, Hughes L, Schellens J, Beijnen J. Characterization of Absorption, Metabolism, and Elimination of Niraparib, an Investigational Poly (ADP-Ribose) Polymerase Inhibitor, in Cancer Patients. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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