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Abstract
INTRODUCTION The British Orthopaedic Association/British Association of Plastic, Reconstructive and Aesthetic Surgeons guidelines for the management of open tibial fractures recommend early senior combined orthopaedic and plastic surgical input with appropriate facilities to manage a high caseload. The aim of this study was to assess whether becoming a major trauma centre has affected the management of patients with open tibial fractures. METHODS Data were obtained prospectively on consecutive open tibial fractures during two eight-month periods: before and after becoming a trauma centre. RESULTS Overall, 29 open tibial fractures were admitted after designation as a major trauma centre compared with 15 previously. Of the 29 patients, 21 came directly or as transfers from another accident and emergency deparment (previously 8 of 15). The time to transfer patients admitted initially to local orthopaedic departments has fallen from 205.7 hours to 37.4 hours (p=0.084). Tertiary transferred patients had a longer hospital stay (16.3 vs 14.9 days) and had more operations (3.7 vs 2.6, p=0.08) than direct admissions. As a trauma centre, there were improvements in time to definitive skeletal stabilisation (4.7 vs 2.2 days, p=0.06), skin coverage (8.3 vs 3.7 days, p=0.06), average number of operations (4.2 vs 2.3, p=0.002) and average length of hospital admission (26.6 vs 15.3 days, p=0.05). CONCLUSIONS The volume and management of open tibial fractures, independent of fracture grade, has been directly affected by the introduction of a trauma centre enabling early combined senior orthopaedic and plastic surgical input. Our data strongly support the benefits of trauma centres and the continuing development of trauma networks in the management of open tibial fractures.
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Affiliation(s)
- J Stammers
- St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK.
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Ng WF, Lendrem D, Mitchell S, Bowman S, Price E, Pease C, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, Griffiths B. FRI0448 Evaluating health status of 620 patients with primary sjÖgren’s syndrome using EQ-5D. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ng WF, Miller A, Bowman S, Price E, Kitas G, Pease C, Emery P, Lanyon P, Hunter J, Gupta M, Giles I, Isenberg D, MaClaren J, Regan M, Cooper A, Young-Min S, Bombardieri M, Sutcliffe N, Pitzalis C, Vadivelu S, Coady D, MacKay K, Moots R, Mitchell S, Mchugh N, Dasgupta B, Trenell M. FRI0323 Level of physical activity in primary sjögren’s syndrome and its predictors. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tarn J, Mitchell S, Bowman S, Price E, Pease C, Sutcliffe N, Emery P, Andrews J, Bombardieri M, Pitzalis C, Lanyon P, Hunter J, Gupta M, Regan M, Cooper A, Giles I, Isenberg D, Young D, Lendrem D, McLaren J, Downie C, Foggo H, Stocks P, Edgar S, Ng WF. SAT0166 Serum cytokine and chemokine profiling in primary sjögren’s syndrome. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mehta P, Holder S, Fisher B, Vincent T, Nadesalingam K, Maciver H, Shingler W, Bakshi J, Hassan S, D'Cruz D, Chan A, Litwic AE, McCrae F, Seth R, McCrae F, Nandagudi A, Jury E, Isenberg D, Karjigi U, Paul A, Rees F, O'Dowd E, Kinnear W, Johnson S, Lanyon P, Bakshi J, Stevens R, Narayan N, Marguerie C, Robinson H, Ffolkes L, Worsnop F, Ostlere L, Kiely P, Dharmapalaiah C, Hassan N, Nandagudi A, Bharadwaj A, Skibinska M, Gendi N, Davies EJ, Akil M, Kilding R, Ramachandran Nair J, Walsh M, Farrar W, Thompson RN, Borukhson L, McFadyen C, Singh D, Rajagopal V, Chan AML, Wearn Koh L, Christie JD, Croot L, Gayed M, Disney B, Singhal S, Grindulis K, Reynolds TD, Conway K, Williams D, Quin J, Dean G, Churchill D, Walker-Bone KE, Goff I, Reynolds G, Grove M, Patel P, Lazarus MN, Roncaroli F, Gabriel C, Kinderlerer AR, Nikiphorou E, Hall FC, Bruce E, Gray L, Krutikov M, Wig S, Bruce I, D'Agostino MA, Wakefield R, Berner Hammer H, Vittecoq O, Galeazzi M, Balint P, Filippucci E, Moller I, Iagnocco A, Naredo E, Ostergaard M, Gaillez C, Kerselaers W, Van Holder K, Le Bars M, Stone MA, Williams F, Wolber L, Karppinen J, Maatta J, Thompson B, Atchia I, Lorenzi A, Raftery G, Platt P, Platt PN, Pratt A, Turmezei TD, Treece GM, Gee AH, Poole KE, Chandratre PN, Roddy E, Clarson L, Richardson J, Hider S, Mallen C, Lieberman A, Prouse PJ, Mahendran P, Samarawickrama A, Churchill D, Walker-Bone KE, Ottery FD, Yood R, Wolfson M, Ang A, Riches P, Thomson J, Nuki G, Humphreys J, Verstappen SM, Chipping J, Hyrich K, Marshall T, Symmons DP, Roy M, Kirwan JR, Marshall RW, Matcham F, Scott IC, Rayner L, Hotopf M, Kingsley GH, Scott DL, Steer S, Ma MH, Dahanayake C, Scott IC, Kingsley G, Cope A, Scott DL, Dahanayake C, Ma MH, Scott IC, Kingsley GH, Cope A, Scott DL, Wernham A, Ward L, Carruthers D, Deeming A, Buckley C, Raza K, De Pablo P, Nikiphorou E, Carpenter L, Jayakumar K, Solymossy C, Dixey J, Young A, Singh A, Penn H, Ellerby N, Mattey DL, Packham J, Dawes P, Hider SL, Ng N, Humby F, Bombardieri M, Kelly S, Di Cicco M, Dadoun S, Hands R, Rocher V, Kidd B, Pyne D, Pitzalis C, Poore S, Hutchinson D, Low A, Lunt M, Mercer L, Galloway J, Davies R, Watson K, Dixon W, Symmons D, Hyrich K, Mercer L, Lunt M, Low A, Galloway J, Watson KD, Dixon WG, Symmons D, Hyrich KL, Low A, Lunt M, Mercer L, Bruce E, Dixon W, Hyrich K, Symmons D, Malik SP, Kelly C, Hamilton J, Heycock C, Saravanan V, Rynne M, Harris HE, Tweedie F, Skaparis Y, White M, Scott N, Samson K, Mercieca C, Clarke S, Warner AJ, Humphreys J, Lunt M, Marshall T, Symmons D, Verstappen S, Chan E, Kelly C, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Ahmad Y, Koduri G, Young A, Kelly C, Chan E, Ahmad Y, Woodhead FA, Nisar M, Arthanari S, Dawson J, Sathi N, Koduri G, Young A, Cumming J, Stannett P, Hull R, Metsios G, Stavropoulos Kalinoglou A, Veldhuijzen van Zanten JJ, Nightingale P, Koutedakis Y, Kitas GD, Nikiphorou E, Dixey J, Williams P, Kiely P, Walsh D, Carpenter L, Young A, Perry E, Kelly C, de-Soyza A, Moullaali T, Eggleton P, Hutchinson D, Veldhuijzen van Zanten JJ, Metsios G, Stavropoulos-Kalinoglou A, Sandoo A, Kitas GD, de Pablo P, Maggs F, Carruthers D, Faizal A, Pugh M, Jobanputra P, Kehoe O, Cartwright A, Askari A, El Haj A, Middleton J, Aynsley S, Hardy J, Veale D, Fearon U, Wilson G, Muthana M, Fossati G, Healy L, Nesbitt A, Becerra E, Leandro MJ, De La Torre I, Cambridge G, Nelson PN, Roden D, Shaw M, Davari Ejtehadi H, Nevill A, Freimanis G, Hooley P, Bowman S, Alavi A, Axford J, Veitch AM, Tugnet N, Rylance PB, Hawtree S, Muthana M, Aynsley S, Mark Wilkinson J, Wilson AG, Woon Kam N, Filter A, Buckley C, Pitzalis C, Bombardieri M, Croft AP, Naylor A, Zimmermann B, Hardie D, Desanti G, Jaurez M, Muller-Ladner U, Filer A, Neumann E, Buckley C, Movahedi M, Lunt M, Ray DW, Dixon WG, Burmester GR, Matucci-Cerinic M, Navarro-Blasco F, Kary S, Unnebrink K, Kupper H, Mukherjee S, Cornell P, Richards S, Rahmeh F, Thompson PW, Westlake SL, Javaid MK, Batra R, Chana J, Round G, Judge A, Taylor P, Patel S, Cooper C, Ravindran V, Bingham CO, Weinblatt ME, Mendelsohn A, Kim L, Mack M, Lu J, Baker D, Westhovens R, Hewitt J, Han C, Keystone EC, Fleischmann R, Smolen J, Emery P, Genovese M, Doyle M, Hsia EC, Hart JC, Lazarus MN, Kinderlerer AR, Harland D, Gibbons C, Pang H, Huertas C, Diamantopoulos A, Dejonckheere F, Clowse M, Wolf D, Stach C, Kosutic G, Williams S, Terpstra I, Mahadevan U, Smolen J, Emery P, Ferraccioli G, Samborski W, Berenbaum F, Davies O, Koetse W, Bennett B, Burkhardt H, Weinblatt ME, Fleischmann R, Davies O, Luijtens K, van der Heijde D, Mariette X, van Vollenhoven RF, Bykerk V, de Longueville M, Arendt C, Luijtens K, Cush J, Khan A, Maclaren Z, Dubash S, Chalam VC, Sheeran T, Price T, Baskar S, Mulherin D, Molloy C, Keay F, Heritage C, Douglas B, Fleischmann R, Weinblatt ME, Schiff MH, Khanna D, Furst DE, Maldonado MA, Li W, Sasso EH, Emerling D, Cavet G, Ford K, Mackenzie-Green B, Collins D, Price E, Williamson L, Golla J, Vagadia V, Morrison E, Tierney A, Wilson H, Hunter J, Ma MH, Scott DL, Reddy V, Moore S, Ehrenstein M, Benson C, Wray M, Cairns A, Wright G, Pendleton A, McHenry M, Taggart A, Bell A, Bosworth A, Cox M, Johnston G, Shah P, O'Brien A, Jones P, Sargeant I, Bukhari M, Nusslein H, Alten R, Galeazzi M, Lorenz HM, Boumpas D, Nurmohamed MT, Bensen W, Burmester GR, Peter HH, Rainer F, Pavelka K, Chartier M, Poncet C, Rauch C, Le Bars M, Lempp H, Hofmann D, Adu A, Congreve C, Dobson J, Rose D, Simpson C, Wykes T, Cope A, Scott DL, Ibrahim F, Schiff M, Alten R, Weinblatt ME, Nash P, Fleischmann R, Durez P, Kaine J, Delaet I, Kelly S, Maldonado M, Patel S, Genovese M, Jones G, Sebba A, Lepley D, Devenport J, Bernasconi C, Smart D, Mpofu C, Gomez-Reino JJ, Verma I, Kaur J, Syngle A, Krishan P, Vohra K, Kaur L, Garg N, Chhabara M, Gibson K, Woodburn J, Telfer S, Buckley F, Finckh A, Huizinga TW, Dejonckheere F, Jansen JP, Genovese M, Sebba A, Rubbert-Roth A, Scali JJ, Alten R, Kremer JM, Pitts L, Vernon E, van Vollenhoven RF, Sharif MI, Das S, Emery P, Maciver H, Shingler W, Helliwell P, Sokoll K, Vital EM. Case Reports * 1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGF Receptor Mutations in Benign Joint Hypermobility. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tarn JR, Natasari A, Mitchell S, Bowman S, Price E, Pease C, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, McLaren J, Hunter J, Gupta M, Regan M, Cooper A, Giles I, Isenberg D, Young D, Lendrem D, Downie C, Foggo H, Stocks P, Edgar S, Ng WF. Soluble molecule profiling and network analysis of primary Sjögren's Syndrome patient serum. BMC Musculoskelet Disord 2013. [PMCID: PMC3582419 DOI: 10.1186/1471-2474-14-s1-a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Murdoch D, Hunter J, Incani A, Raffel O, Aroney C, Walters D. Percutaneous Balloon Aortic Valvuloplasty is a Safe and Effective Bridging Procedure to Transcatheter Aortic Valve Replacement. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chalmers AG, Hunter J, Lees CD, Millar JA, Brown JJ, Robertson JI. A comparison and an investigation of a potential synergistic effect of labetalol and bethanidine in patients with mild hypertension. Br J Clin Pharmacol 2012; 8 Suppl 2:183S-7S. [DOI: 10.1111/j.1365-2125.1979.tb04778.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Allexandre D, Neuman A, Hunter J, Morledge T, Roizen M. P02.63. Efficacy of an 8-week online mindfulness stress management program in a corporate call center. Altern Ther Health Med 2012. [PMCID: PMC3373580 DOI: 10.1186/1472-6882-12-s1-p119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Heathfield S, Parker B, Zeef L, Bruce I, Alexander Y, Collins F, Stone M, Wang E, Williams AS, Wright HL, Thomas HB, Moots RJ, Edwards SW, Bullock C, Chapman V, Walsh DA, Mobasheri A, Kendall D, Kelly S, Bayley R, Buckley CD, Young SP, Rump-Goodrich L, Middleton J, Chen L, Fisher R, Kollnberger S, Shastri N, Kessler BM, Bowness P, Nazeer Moideen A, Evans L, Osgood L, Williams AS, Jones SA, Nowell MA, Mahadik Y, Young S, Morgan M, Gordon C, Harper L, Giles JL, Paul Morgan B, Harris CL, Rysnik OJ, McHugh K, Kollnberger S, Payeli S, Marroquin O, Shaw J, Renner C, Bowness P, Nayar S, Cloake T, Bombardieri M, Pitzalis C, Buckley C, Barone F, Barone F, Nayar S, Cloake T, Lane P, Coles M, Buckley C, Williams EL, Edwards CJ, Cooper C, Oreffo RO, Dunn S, Crawford A, Wilkinson M, Le Maitre C, Bunning R, Daniels J, Phillips KLE, Chiverton N, Le Maitre CL, Kollnberger S, Shaw J, Ridley A, Wong-Baeza I, McHugh K, Keidel S, Chan A, Bowness P, Gullick NJ, Abozaid HS, Jayaraj DM, Evans HG, Scott DL, Choy EH, Taams LS, Hickling M, Golor G, Jullion A, Shaw S, Kretsos K, Bari SF, Rhys-Dillon B, Amos N, Siebert S, Phillips KLE, Chiverton N, Bunning RD, Haddock G, Cross AK, Le Maitre CL, Kate I, Phillips E, Cross A, Chiverton N, Haddock G, Bunning RAD, Le Maitre CL, Ceeraz S, Spencer J, Choy E, Corrigall V, Crilly A, Palmer H, Lockhart J, Plevin R, Ferrell WR, McInnes I, Hutchinson D, Perry L, DiCicco M, Humby F, Kelly S, Hands R, Buckley C, McInnes I, Taylor P, Bombardieri M, Pitzalis C, Mehta P, Mitchell A, Tysoe C, Caswell R, Owens M, Vincent T, Hashmi TM, Price-Forbes A, Sharp CA, Murphy H, Wood EF, Doherty T, Sheldon J, Sofat N, Goff I, Platt PN, Abdulkader R, Clunie G, Ismajli M, Nikiphorou E, Young A, Tugnet N, Dixey J, Banik S, Alcorn D, Hunter J, Win Maw W, Patil P, Hayes F, Main Wong W, Borg FA, Dasgupta B, Malaviya AP, Ostor AJ, Chana JK, Ahmed AA, Edmonds S, Hayes F, Coward L, Borg F, Heaney J, Amft N, Simpson J, Dhillon V, Ayalew Y, Khattak F, Gayed M, Amarasena RI, McKenna F, Amarasena RI, McKenna F, Mc Laughlin M, Baburaj K, Fattah Z, Ng N, Wilson J, Colaco B, Williams MR, Adizie T, Dasgupta B, Casey M, Lip S, Tan S, Anderson D, Robertson C, Devanny I, Field M, Walker D, Robinson S, Ryan S, Hassell A, Bateman J, Allen M, Davies D, Crouch C, Walker-Bone K, Gainsborough N, Gullick NJ, Lutalo PM, Davies UM, Walker-Bone K, Mckew JR, Millar AM, Wright SA, Bell AL, Thapper M, Roussou T, Cumming J, Hull RG, Thapper M, Roussou T, McKeogh J, O'Connor MB, Hassan AI, Bond U, Swan J, Phelan MJ, Coady D, Kumar N, Farrow L, Bukhari M, Oldroyd AG, Greenbank C, McBeth J, Duncan R, Brown D, Horan M, Pendleton N, Littlewood A, Cordingley L, Mulvey M, Curtis EM, Cole ZA, Crozier SR, Georgia N, Robinson SM, Godfrey KM, Sayer AA, Inskip HM, Cooper C, Harvey NC, Davies R, Mercer L, Galloway J, Low A, Watson K, Lunt M, Symmons D, Hyrich K, Chitale S, Estrach C, Moots RJ, Goodson NJ, Rankin E, Jiang CQ, Cheng KK, Lam TH, Adab P, Ling S, Chitale S, Moots RJ, Estrach C, Goodson NJ, Humphreys J, Ellis C, Bunn D, Verstappen SM, Symmons D, Fluess E, Macfarlane GJ, Bond C, Jones GT, Scott IC, Steer S, Lewis CM, Cope A, Mulvey MR, Macfarlane GJ, Symmons D, Lovell K, Keeley P, Woby S, Beasley M, McBeth J, Viatte S, Plant D, Lunt M, Fu B, Parker B, Galloway J, Solymossy C, Worthington J, Symmons D, Dixey J, Young A, Barton A, Williams FM, Osei-Bordom DC, Popham M, MacGregor A, Spector T, Little J, Herrick A, Pushpakom S, Ennis H, McBurney H, Worthington J, Newman W, Ibrahim I, Plant D, Hyrich K, Morgan A, Wilson A, Isaacs J, Barton A, Sanderson T, Hewlett S, Calnan M, Morris M, Raza K, Kumar K, Cardy CM, Pauling JD, Jenkins J, Brown SJ, McHugh N, Nikiphorou E, Mugford M, Davies C, Cooper N, Brooksby A, Bunn D, Symmons D, MacGregor A, Dures E, Ambler N, Fletcher D, Pope D, Robinson F, Rooke R, Hewlett S, Gorman CL, Reynolds P, Hakim AJ, Bosworth A, Weaver D, Kiely PD, Skeoch S, Jani M, Amarasena R, Rao C, Macphie E, McLoughlin Y, Shah P, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Patel Y, Baguley E, Jani M, Halsey J, Severn A, Bukhari M, Selvan S, Price E, Husain MJ, Brophy S, Phillips CJ, Cooksey R, Irvine E, Siebert S, Lendrem D, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Griffiths B, Foggo H, Edgar S, Vadivelu S, Coady D, McHugh N, Ng WF, Dasgupta B, Taylor P, Iqbal I, Heron L, Pilling C, Marks J, Hull R, Ledingham J, Han C, Gathany T, Tandon N, Hsia E, Taylor P, Strand V, Sensky T, Harta N, Fleming S, Kay L, Rutherford M, Nicholl K, Kay L, Rutherford M, Nicholl K, Eyre T, Wilson G, Johnson P, Russell M, Timoshanko J, Duncan G, Spandley A, Roskell S, Coady D, West L, Adshead R, Donnelly SP, Ashton S, Tahir H, Patel D, Darroch J, Goodson NJ, Boulton J, Ellis B, Finlay R, Lendrem D, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, McHugh N, Griffiths B, Foggo H, Edgar S, Ng WF, Murray-Brown W, Priori R, Tappuni T, Vartoukian S, Seoudi N, Picarelli G, Fortune F, Valesini G, Pitzalis C, Bombardieri M, Ball E, Rooney M, Bell A, Merida AA, Isenberg D, Tarelli E, Axford J, Giles I, Pericleous C, Pierangeli SS, Ioannou J, Rahman A, Alavi A, Hughes M, Evans B, Bukhari M, Parker B, Zaki A, Alexander Y, Bruce I, Hui M, Garner R, Rees F, Bavakunji R, Daniel P, Varughese S, Srikanth A, Andres M, Pearce F, Leung J, Lim K, Regan M, Lanyon P, Oomatia A, Petri M, Fang H, Birnbaum J, Amissah-Arthur M, Gayed M, Stewart K, Jennens H, Braude S, Gordon C, Sutton EJ, Watson KD, Gordon C, Yee CS, Lanyon P, Jayne D, Isenberg D, Rahman A, Akil M, McHugh N, Ahmad Y, Amft N, D'Cruz D, Edwards CJ, Griffiths B, Khamashta M, Teh LS, Zoma A, Bruce I, Dey ID, Kenu E, Isenberg D, Pericleous C, Garza-Garcia A, Murfitt L, Driscoll PC, Isenberg D, Pierangeli S, Giles I, Ioannou Y, Rahman A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Segeda I, Shevchuk S, Kuvikova I, Brown N, Bruce I, Venning M, Mehta P, Dhanjal M, Mason J, Nelson-Piercy C, Basu N, Paudyal P, Stockton M, Lawton S, Dent C, Kindness K, Meldrum G, John E, Arthur C, West L, Macfarlane MV, Reid DM, Jones GT, Macfarlane GJ, Yates M, Loke Y, Watts R, MacGregor A, Adizie T, Christidis D, Dasgupta B, Williams M, Sivakumar R, Misra R, Danda D, Mahendranath KM, Bacon PA, Mackie SL, Pease CT. Basic science * 232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Nikiphorou E, Carpenter L, Kiely P, Walsh D, Dixey J, Young A, Kapoor SR, Filer A, Fitzpatrick M, Fisher BA, Taylor PC, Buckley C, McInnes I, Raza K, Young SP, Dougados M, Kissel K, Amital H, Conaghan P, Martin-Mola E, Nasonov E, Schett G, Troum O, Veldi T, Bernasconi C, Huizinga T, Durez P, Genovese MC, Richards HB, Supronik J, Dokoupilova E, Aelion JA, Lee SH, Codding CE, Kellner H, Ikawa T, Hugot S, Ligozio G, Mpofu S, Kavanaugh A, Emery P, Fleischmann R, Van Vollenhoven R, Pavelka K, Durez P, Guerette B, Santra S, Redden L, Kupper H, Smolen JS, Wilkie R, Tajar A, McBeth J, Hooper LS, Bowen CJ, Gates L, Culliford D, Edwards CJ, Arden NK, Adams J, Ryan S, Haywood H, Pain H, Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, Helliwell PS, Norton S, Kiely P, Walsh D, Williams R, Young A, Halls S, Law RJ, Jones J, Markland D, Maddison P, Thom J, Parker B, Urowitz MB, Gladman DD, Bruce I, Croca SC, Pericleous C, Yong H, Isenberg D, Giles I, Rahman A, Ioannou Y, Warrell CE, Dobarro D, Handler C, Denton CP, Schreiber BE, Coghlan JG, Betteridge ZE, Woodhead F, Bunn C, Denton CP, Abraham D, Desai S, du Bois R, Wells A, McHugh N, Abignano G, Aydin S, Castillo-Gallego C, Woods D, Meekings A, McGonagle D, Emery P, Del Galdo F, Vila J, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, Griffiths B, Lendrem D, Foggo H, Tarn J, Ng WF, Goodhead C, Shekar P, Kelly C, Francis G, Bailey AM, Thompson L, Hamilton J, Salisbury C, Foster NE, Bishop A, Coast J, Franchini A, Hall J, Hollinghurst S, Hopper C, Grove S, Kaur S, Montgomery A, Paskins Z, Sanders T, Croft PR, Hassell AB, Coxon DE, Frisher M, Jordan KP, Jinks C, Peat G, Monk HL, Muller S, Mallen C, Hider SL, Roddy E, Muller S, Hayward R, Mallen C. Oral abstracts 3: RA Treatment and outcomes * O13. Validation of jadas in all subtypes of juvenile idiopathic arthritis in a clinical setting. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maraveyas A, Palmer J, Avery G, Stephens A, Elliot M, Hunter J, Dean S, Bozas G. Outcome and characteristics of cancer patients with unsuspected PE managed under a specialised care pathway protocol – updated results. Thromb Res 2012. [DOI: 10.1016/s0049-3848(12)70110-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Roher A, Bowers W, Hunter J, Maarouf C, Daugs I, Valla J, Kokjohn T, Beach T. P3‐036: Morphological and biochemical analysis of the 3xTg‐Alzheimer's disease mouse model: Implications for sporadic Alzheimer's disease and the amyloid cascade hypothesis. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.1475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alex Roher
- Banner Sun Health Research InstituteSun CityArizonaUnited States
| | - William Bowers
- University of Rochester Medical CenterRochesterNew YorkUnited States
| | - Jesse Hunter
- Banner Sun Health Research InstituteSun CityArizonaUnited States
| | - Chera Maarouf
- Banner Sun Health Research InstituteSun CityArizonaUnited States
| | - Ian Daugs
- Banner Sun Health Research InstituteSun CityArizonaUnited States
| | - Jon Valla
- Midwestern UniversityGlendaleArizonaUnited States
| | | | - Thomas Beach
- Banner Sun Health Research InstituteSun CityArizonaUnited States
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Affiliation(s)
- J Hunter
- Gartnavel General Hospital, Glasgow, UK
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Abstract
AIM The NHS Bowel Cancer Screening Programme is currently being introduced following three rounds of pilot screening. The study outlines the important characteristics of polyps detected by pilot screening and compares the location of polyps with those of symptomatic cancers to challenge the circumstantial evidence for the adenoma carcinoma pathway. METHOD The first 100 patients with screen-detected polyps from University Hospitals Coventry and Warwickshire (UHCW) were identified from the colorectal cancer screening database. Important characteristics of the polyps were identified from the endoscopy reporting system and entered into a database. Polyp location was compared with the location of symptomatic cancers detected in the UHCW colorectal cancer database. RESULTS One hundred patients were selected for investigation and 202 polyps were detected. The average age of the patients with polyps was 61 years, 35% were under the age of 60. There were 67% male subjects. The average size of the largest polyp in each of the different patients was 13.5 mm. Eighty-five per cent of polyps were excised. Histology was available for 181 polyps of which 40% were tubulovillous, 33% tubular, 14% metaplastic and 1% villous. Eighty-eight per cent showed low-grade dysplasia and 8% high-grade one. The location of screen-detected polyps was significantly different from that of symptomatic cancers in our database, with proportionally more sigmoid and proportionally less rectal and caecal polyps detected. CONCLUSION The study outlines the important characteristics of screen-detected polyps. The significant difference in location of polyps from that of cancer suggests a variation in the malignancy potential of polyps depending on the location.
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Affiliation(s)
- J Hunter
- ST3 General Surgery, Northampton General Hospital NHS Trust, Cliftonville, Northampton, UK
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Mullen W, Nemzer B, Ou B, Stalmach A, Hunter J, Clifford MN, Combet E. The antioxidant and chlorogenic acid profiles of whole coffee fruits are influenced by the extraction procedures. J Agric Food Chem 2011; 59:3754-3762. [PMID: 21401105 DOI: 10.1021/jf200122m] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Commercial whole coffee fruit extracts and powder samples were analyzed for chlorogenic acids (CGA), caffeine and antioxidant activities. CGA and caffeine were characterized by LC-MS(n) and HPLC accordingly, and quantified by UV absorbance. ORAC, HORAC, NORAC, SORAC and SOAC (antioxidant capacities) were assessed. Three caffeoylquinic acids, three feruloylquinic acids, three dicaffeoylquinic acids, one p-coumaroylquinic acid, two caffeoylferuloylquinic acids and three putative chlorogenic lactones were quantified, along with a methyl ester of 5-caffeoylquinic acid (detected in one sample, the first such report in any coffee material). Multistep whole coffee fruit extracts displayed higher CGA content than single-step extracts, freeze-dried, or air-dried whole raw fruits. Caffeine in multistep extracts was lower than in the single-step extracts and powders. Antioxidant activity in whole coffee fruit extracts was up to 25-fold higher than in powders dependent upon the radical. Total antioxidant activity of samples displayed strong correlation to CGA content.
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Affiliation(s)
- W Mullen
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Bayraktar A, Hudson S, Watson A, Fraser S, Hunter J. Does social environment affect arthritis patients' ability to remain on methotrexate treatment? International Journal of Pharmacy Practice 2011. [DOI: 10.1111/j.2042-7174.2001.tb01135.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Focal points
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Affiliation(s)
- A Bayraktar
- Pharmaceutical Care Health Service Unit, Department of Pharmaceutical Sciences, University of Strathclyde
| | - S Hudson
- Pharmaceutical Care Health Service Unit, Department of Pharmaceutical Sciences, University of Strathclyde
| | - A Watson
- Glasgow Pharmacy Practice Unit and Southern General Hospital
| | | | - J Hunter
- Gartnavel General Hospital, Glasgow
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Hunter J, Hammett C, Cullen L, Greenslade J, Brown A, Chu K, Parsonage W. Indeterminate Troponin Elevations Have Poor Positive Predictive Value for Acute Coronary Syndrome in an Emergency Department population. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chambers D, Paulden M, Paton F, Heirs M, Duffy S, Craig D, Hunter J, Wilson J, Sculpher M, Woolacott N. Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment. Health Technol Assess 2010; 14:1-211. [PMID: 20688009 DOI: 10.3310/hta14390] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Sugammadex (Bridion) is a newly developed agent for the reversal of neuromuscular blockade (NMB) induced by rocuronium or vecuronium. Sugammadex can reverse profound blockade and can be given for immediate reversal and its use would avoid the potentially serious adverse effects of the currently used agent, succinylcholine. Also, sugammadex can reverse NMB more quickly and predictably than existing agents. OBJECTIVES To determine the clinical effectiveness and cost-effectiveness of sugammadex for the reversal of muscle relaxation after general anaesthesia in UK practice following routine or rapid induction of NMB. DATA SOURCES Medical databases [including MEDLINE, EMBASE, CINAHL, Science Citation Index, BIOSIS and Cochrane Central Register of Controlled Trials (CENTRAL), conference proceedings, internet sites and clinical trials registers] were searched to identify published and unpublished studies. The main searches were carried out in May 2008 and supplemented by current awareness updates up until November 2008. REVIEW METHODS For the clinical effectiveness review, randomised controlled trials of sugammadex against placebo or an active comparator (neostigmine + glycopyrrolate) for the reversal of moderate or profound NMB and for immediate reversal (spontaneous recovery from succinylcholine-induced blockade) were included. The primary effectiveness outcome was speed of recovery from NMB, as measured by objective monitoring of neuromuscular function. For the cost-effectiveness review, a de novo economic assessment considered the routine induction of NMB and the rapid induction and/or reversal of NMB, and threshold analyses were carried out on a series of pairwise comparisons to establish how effective sugammadex needs to be to justify its cost. RESULTS The review of clinical effectiveness included four randomised active-control trials of sugammadex, nine randomised placebo-controlled trials and five studies in special populations. A total of 2132 titles and abstracts and 265 full-text publications were screened. The included trials indicated that sugammadex produces more rapid recovery from moderate or profound NMB than placebo or neostigmine. Median time to recovery from moderate blockade was 1.3-1.7 minutes for rocuronium + sugammadex, 21-86 minutes for rocuronium + placebo and 17.6 minutes for rocuronium + neostigmine. In profound blockade, median time to recovery was 2.7 minutes for rocuronium + sugammadex, 30 to > 90 minutes for rocuronium + placebo, and 49 minutes for rocuronium + neostigmine. Results for vecuronium were similar. In addition, recovery from NMB was faster with rocuronium reversed by sugammadex 16 mg/kg after 3 minutes (immediate reversal) than with succinylcholine followed by spontaneous recovery (median time to primary outcome 4.2 versus 7.1 minutes). The evidence base for modelling cost-effectiveness is very limited. However, assuming that the reductions in recovery times seen in the trials can be achieved in routine practice and can be used productively, sugammadex [2 mg/kg (4 mg/kg)] is potentially cost-effective at its current list price for the routine reversal of rocuronium-induced moderate (profound) blockade, if each minute of recovery time saved can be valued at approximately 2.40 pounds (1.75 pounds) or more. This is more likely to be achieved if any reductions in recovery time are in the operating room (estimated value of 4.44 pounds per minute saved) rather than the recovery room (estimated value of 0.33 pounds per minute saved). The results were broadly similar for rocuronium- and vecuronium-induced blockade. For rapid reversal of NMB it appeared that any reduction in morbidity from adopting sugammadex is unlikely to result in significant cost savings. LIMITATIONS The evidence base was not large and many of the published trials were dose-finding and safety studies with very small sample sizes. Also, some relevant outcomes, in particular patient experience/quality of life and resources/costs used, were either not investigated or not reported. In addition, it is likely that the patients included in the efficacy trials were relatively young and in good general health compared with the overall surgical population. Regarding the economic evaluation, there appears to be no evidence linking measures of clinical efficacy to patients' health-related quality of life and mortality risks. CONCLUSIONS Sugammadex may be a cost-effective option compared with neostigmine + glycopyrrolate for reversal of moderate NMB and also provides the facility to recover patients from profound blockade. Rocuronium + sugammadex could be considered as a replacement for succinylcholine for rapid induction (and reversal) of NMB, although this may not be a cost-effective option in some types of patient at current list prices for sugammadex. Considerable uncertainties remain about whether the full benefits of sugammadex can be realised in clinical practice.
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Affiliation(s)
- D Chambers
- Centre for Reviews and Dissemination, University of York, York, UK
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Sulaiman L, Hunter J, Farquharson F, Reddy H. Mechanical thrombectomy of an infected deep venous thrombosis: a novel technique of source control in sepsis. Br J Anaesth 2010; 106:65-8. [PMID: 20952425 DOI: 10.1093/bja/aeq276] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
A young i.v. drug abuser presented with an extensive iliofemoral deep vein thrombosis and signs of severe sepsis. Subsequent investigations revealed multiple septic emboli in his lungs originating from infected thrombus in his leg. Despite systemic anti-coagulation and appropriate parenteral antibiotics, he continued to show signs of worsening acute infection. Percutaneous mechanical thrombectomy was performed successfully and resulted in an immediate improvement in his condition. In this report, we discuss the novel use of this technique for source control in a patient with septic shock secondary to infected thrombus.
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Affiliation(s)
- L Sulaiman
- East Cheshire NHS Trust, Macclesfield, UK.
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Gilhooly K, McGeorge P, Hunter J, Rawles J, Kirby I, Green C, Wynn V. Biomedical Knowledge in Diagnostic Thinking: The Case of Electrocardiogram (ECG) Interpretation. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/713752555] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Laser vaporization of graphite generates C(60)(+) cluster ions that are fullerenes and a mixture of roughly planar polycyclic polyyne ring isomers. Experimental studies of the annealing of the non-fullerene C(60)(+) ions indicate that they can be converted (in the gas phase) into the fullerene and an isomer that appears to be a large monocyclic ring. Some fragmentation is associated with conversion to the fullerene geometry, but the majority of the non-fullerene C(60)(+) isomers are cleanly converted into an intact fullerene. The emergence of the monocyclic ring (as the clusters are annealed) suggests that this is a relatively stable non-spheroidal form of these all carbon molecules. The estimated activation energies for the observed structural interconversions are relatively low, suggesting that these processes may play an important role in the synthesis of spheroidal fullerenes.
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Shaikh MF, Shenker NG, Dale J, Else S, Stirling A, France J, Gordon MM, Hunter J, Porter D, Smith R, Khan J, Chan A, Paskins Z, John H, Hassell A, Rowe IF, Al-Mossawi MH, Chambers T, Greenbank C, Bronwen E, Halsey J, Bukhari M, Pearce FA, Lanyon P, Zakout S, Clarke L, Kirwan J, Marie Smith A, Lingard L, Heslop P, Walker DJ, Miller A, Johnston M, Timms A, Misbah S, Luqmani R, Bamji A, Lane J, Donnelly AA, Halsey JP, Bukhari MA, van Vollenhoven R, Cifaldi M, Roy S, Chen N, Gotlieb L, Malaise M, Ara R, Rafia R, Packham J, Haywood K, Healey E, Jones EA, Jones GT, Hannaford PC, Keeley P, Lovell K, McBeth J, McNamee P, Prescott GJ, Woby S, Macfarlane GJ, Munir M, Joshi AR, Johnson H, Smith EC, Poole CD, Lebmeier M, Currie CJ, Clark H, Rome K, Atkinson I, Plant M, Dixon J, Baskar S, Erb N, Whallett AJ, Arhinful-Adjapong A, Hawksley J, Tillett W, Green S, Tan WS, Pauling J, Michell L, Russell J, Derham S, Korendowych E, Bojke C, Cifaldi M, Ray S, Van Hout B, Grigor C, Porter D, Toner V, Stirling A, McEntegart A, Seng Edwin Lim C, Low ST, Joshi N, Walton T, Sanderson T, Morris M, Calnan M, Richards P, Hewlett S, Waller RD, Collins DA, Williamson LJ, Price EJ, Judge A, Dieppe PA, Arden NK, Cooper C, Carr A, Javaid K, Field R, Rafia R, Ara R, Lebmeier M. Health Services Research, Economics and Outcomes Research [86-113]: 86. What Happens to Patients with Complex Regional Pain Syndrome of Greater than 12 Months' Duration? Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
OBJECTIVE It is important that screening detects cancers regardless of their location within the colon. The aim of this study was to see if the location of cancers detected by the pilot screening programme differs from that of unscreened cancers. METHOD The colorectal cancer dataset of University Hospital Coventry was analysed retrospectively. A 7-year period was used to include all three rounds of the pilot screening. Two groups of patients were selected, those with colorectal cancers detected by the screening programme and those detected outside of screening. The tumour location was compared in the two groups statistically (chi-squared test). RESULTS One thousand four hundred-ninety patients were included, 100 of whom were in the screened population and 1390 were in the unscreened population. There was no significant difference in tumour location between the two groups (P = 0.49). CONCLUSION This study showed that screen-detected cancers do not differ in their location from unscreened cancers and suggests that faecal occult blood testscreening detects cancer irrespective of location within the colon.
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Affiliation(s)
- C Harmston
- University Hospital Coventry and Warwickshire, Coventry, UK.
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Kurowska-Stolarska M, Ballantine L, Stolarski B, Hunter J, Hueber A, Gracie JA, Liew FY, McInnes IB. miR-155 and miR-34a regulate proinflammatory cytokine production by human monocytes. Ann Rheum Dis 2010. [DOI: 10.1136/ard.2010.129619g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bristol E, Roth E, Hunter J. 219 THE IMMEDIATE EFFECTS OF RHYTHMIC AUDITORY STIMULATION (RAS) ON GAIT PARAMETERS AND SYNCHRONIZATION OF ADULTS WITH SEVERE TRAUMATIC BRAIN INJURY. Parkinsonism Relat Disord 2010. [DOI: 10.1016/s1353-8020(10)70220-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The purpose of this study was to measure the team skills of operational crime scene examiners (CSEs). The techniques used were based on established methods and helped to gain a greater understanding of the domain of forensic investigation. The research begins with a hierarchical task analysis and then adapts pre-established methods for measuring the performance of CSEs in four UK Police Forces. The process supports comparison between prescribed methods of 'good practice' and real world practice. This has allowed the identification of the distributed skills and tasks of the CSE. Using Annett et al.'s HTA(T), crime scene examination can be categorised and the communications and coordination structures occurring between teams investigating a burglary considered. This makes it possible to generalise the method to situations involving ad hoc teams.
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Affiliation(s)
- P A Smith
- Department of Electric, Electronic and Computer Engineering, University of Birmingham, Edgbaston, Birmingham, UK.
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Sanghvi P, Kalpathy-Cramer J, Holland J, Hunter J, Thomas C, Wang S. Pre-operative Radiation is Associated with Improved Survival Compared to Post-operative Radiation for Esophageal Cancer: A SEER Database Analysis. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Buckle A, Androulakis S, Schmidberger J, Bate M, DeGori R, Beitz A, McGowan S, Porter C, Harrison A, Hunter J, Kobe B, Dobson R, Parker M, Whisstock J, Gray J, Treloar A. Federated repositories of X-ray diffraction images. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308095056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
This article provides a step-by-step approach to the removal of chest drains and offers a rationale for practice. It also discusses indications for chest drain removal and potential complications associated with the procedure.
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Affiliation(s)
- J Hunter
- City Community and Health Sciences, St Bartholomew School of Nursing and Midwifery, City University, London.
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McKeon A, Lennon VA, Lotze T, Tenenbaum S, Ness JM, Rensel M, Kuntz NL, Fryer JP, Homburger H, Hunter J, Weinshenker BG, Krecke K, Lucchinetti CF, Pittock SJ. CNS aquaporin-4 autoimmunity in children. Neurology 2008; 71:93-100. [PMID: 18509092 DOI: 10.1212/01.wnl.0000314832.24682.c6] [Citation(s) in RCA: 212] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In adult patients, autoantibodies targeting the water channel aquaporin-4 (AQP4) are a biomarker for a spectrum of CNS inflammatory demyelinating disorders with predilection for optic nerves and spinal cord (neuromyelitis optica [NMO]). Here we describe the neurologic, serologic, and radiographic findings associated with CNS AQP4 autoimmunity in childhood. METHODS A total of 88 consecutive seropositive children were identified through service evaluation for NMO-IgG. Sera of 75 were tested for coexisting autoantibodies. Clinical information was available for 58. RESULTS Forty-two patients (73%) were non-Caucasian, and 20 (34%) had African ethnicity. Median age at symptom onset was 12 years (range 4-18). Fifty-seven (98%) had attacks of either optic neuritis (n = 48; 83%) or transverse myelitis (n = 45; 78%), or both. Twenty-six (45%) had episodic cerebral symptoms (encephalopathy, ophthalmoparesis, ataxia, seizures, intractable vomiting, or hiccups). Thirty-eight (68%) had brain MRI abnormalities, predominantly involving periventricular areas (in descending order of frequency): the medulla, supratentorial and infratentorial white matter, midbrain, cerebellum, thalamus, and hypothalamus. Additional autoantibodies were detected in 57 of 75 patients (76%), and 16 of 38 (42%) had a coexisting autoimmune disorder recorded (systemic lupus erythematosus, Sjögren syndrome, juvenile rheumatoid arthritis, Graves disease). Attacks were recurrent in 54 patients (93%; median follow-up, 12 months). Forty-three of 48 patients (90%) had residual disability: 26 (54%) visual impairment and 21 (44%) motor deficits (median Expanded Disability Status Scale 4.0 at 12 months). CONCLUSIONS Aquaporin-4 autoimmunity is a distinctive recurrent and widespread inflammatory CNS disease in children.
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Affiliation(s)
- A McKeon
- Departments of Neurology and Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Rawlings-Anderson K, Hunter J. Monitoring pulse rate. Nurs Stand 2008; 22:41-43. [PMID: 18426117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This article, part of Nursing Standards clinical skills series, illustrates the sites for palpating the pulse and outlines the correct procedure for monitoring and recording pulse rate. This information will assist nurses to perform the skill safely as part of cardiovascular assessment of the patient.
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Abstract
The administration of intramuscular (IM) injections is an important part of medication management and a common nursing intervention in clinical practice. A skilled injection technique can make the patient's experience less painful and avoid unnecessary complications.
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Affiliation(s)
- J Hunter
- St Bartholomew School of Nursing and Midwifery, City University, London.
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Rabius V, Pike KJ, Hunter J, Wiatrek D, McAlister AL. Effects of frequency and duration in telephone counselling for smoking cessation. Tob Control 2007; 16 Suppl 1:i71-4. [PMID: 18048636 DOI: 10.1136/tc.2007.019950] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study evaluates alternative protocols in telephone counselling for smoking cessation. DESIGN The American Cancer Society enrolled 6322 clients in a randomised trial comparing three counselling formats of varying duration and frequency of contact, with or without booster sessions, and mailed self help booklets without telephone counselling. SETTING AND PARTICIPANTS Participants were drawn from callers to the American Cancer Society's National Cancer Information Center seeking assistance with smoking cessation who provided informed consent and were adult daily smokers, ready to make a quit attempt within two weeks, and from states not served by an evidence based proactive telephone counselling programme. OUTCOMES Six-month cessation rates (30-day point prevalence) were measured in telephone interviews. RESULTS There was a significant counselling effect. The overall cessation rates that were yielded by a brief protocol including booster sessions were equivalent to those obtained with the American Cancer Society's standard protocol with boosters. CONCLUSIONS Based on these findings, the abbreviated protocol with five sessions and two boosters is considered to be an option for improving cost efficiency in the delivery of this service.
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Abstract
This paper describes the AnnoCryst system-a tool that was designed to enable authenticated collaborators to share online discussions about 3D crystallographic structures through the asynchronous attachment, storage, and retrieval of annotations. Annotations are personal comments, interpretations, questions, assessments, or references that can be attached to files, data, digital objects, or Web pages. The AnnoCryst system enables annotations to be attached to 3D crystallographic models retrieved from either private local repositories (e.g., Fedora) or public online databases (e.g., Protein Data Bank or Inorganic Crystal Structure Database) via a Web browser. The system uses the Jmol plugin for viewing and manipulating the 3D crystal structures but extends Jmol by providing an additional interface through which annotations can be created, attached, stored, searched, browsed, and retrieved. The annotations are stored on a standardized Web annotation server (Annotea), which has been extended to support 3D macromolecular structures. Finally, the system is embedded within a security framework that is capable of authenticating users and restricting access only to trusted colleagues.
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Affiliation(s)
- J Hunter
- The University of Queensland, St. Lucia, Queensland, Australia 4072.
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Abstract
BACKGROUND AND OBJECTIVE Ventilator-associated pneumonia is a nosocomial infection that occurs in patients receiving mechanical ventilation for >48 h. Many aspects of its diagnosis, treatment and management are controversial. We used a postal questionnaire to survey current practice within the UK. METHODS Questionnaire study of 207 general intensive care units in the UK. RESULTS The response rate was 77.3%. Regarding diagnosis, 30% of units obtained specimens from the lungs invasively, while the remainder relied on tracheal aspirates. In only 28.2% of units using tracheal aspirates were results reported in a quantitative manner. A clinical suspicion of ventilator-associated pneumonia would lead to the administration of empirical antibiotic therapy in the majority of units (77.2%), opinion being almost equally divided on whether this should be mono (49.1%) or combination therapy (50.9%). Although most units received regular microbiology feedback (90.5%), the involvement of a microbiologist in the antibiotic decision-making process was variable. Antibiotics were continued for a median of 7 days (inter-quartile range 5-8.5, range 2-14 days). Compliance with the principal methods of ventilator-associated pneumonia prevention was good. CONCLUSION There is widespread variation in the methods used for the diagnosis of ventilator-associated pneumonia within the UK. The majority of units rely on non-quantitative analysis of tracheal aspirates. This technique has a high percentage of false-positives, and suggests widespread over utilization of antibiotics. However, most agree that antibiotics should be given empirically when there is a clinical suspicion of ventilator-associated pneumonia. The widespread introduction of 'ventilator bundles' appears to have ensured that most units actively take measures to prevent ventilator-associated pneumonia.
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Affiliation(s)
- J Hunter
- Macclesfield District General Hospital, Department of Anaesthetics and Intensive Care, Macclesfield, UK.
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Curtis J, Koerbin P, Raftos P, Berriman D, Hunter J. AONS—An obsolescence detection and notification service for Web archives and digital repositories. NEW REV HYPERMEDIA M 2007. [DOI: 10.1080/13614560701423711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vergote I, Finkler N, del Campo J, Lohr A, Hunter J, Matei D, Spriggs D, Kavanagh J, Vermorken J, Brown GL, Kaye S. Single agent, canfosfamide (C, TLK286) vs pegylated liposomal doxorubicin (D) or topotecan (T) in 3rd-line treatment of platinum (P) refractory or resistant ovarian cancer (OC): Phase 3 study results. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba5528] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA5528 Background: Canfosfamide (C) is a novel glutathione analog prodrug activated by glutathione S-transferase P1–1. P resistant OC has a poor prognosis and non-P agents are used for palliation. C reported objective responses in multicenter Phase 2 OC trials. Methods: Pts with P resistant OC who progressed after D or T, measurable disease (RECIST), adequate liver/renal/bone marrow function were eligible. Randomization was stratified by prior D or T treatment, ECOG PS (0 or 1 vs 2) and presence or absence of bulky disease (= 5cm). Patients received C at 1000 mg/m2 IV q3wks, or to D at 50 mg/m2 IV q4wks or T at 1.5 mg/m2 IV daily × 5 q3wks until progression. The trial had a 90% power to detect a 29% reduction in the relative risk of death. Results: 461 pts (C=232 and D or T=229) received 1052 cycles [median 3; range (r) 1–33], 699 (median 4; r 1–32), and 469 (median 5; r 1–21) for C, D and T respectively. Most common Grade 3–4 AEs for C were: nausea (31.6%), vomiting (8.7%), fatigue (6.1%), and anemia (5.6%), for D/T were: nausea (55.3%), anemia (15.2%), fatigue (6.9%), neutropenia (23.5%), thrombocytopenia (12.4%), febrile neutropenia (6%), stomatitis (6%), and PPE syndrome (6%). ORR for C was 4.3% including a CR, vs 10.9% ORR for D/T. Median survival (MS) was 8.5 mos for C, 13.6 mos for D/T (p=0.0001). Median progression-free survival was 2.3 mos for C and 4.4 mos for D/T, (p=0.0001). D/T MS was 14.2/10.8 mos, respectively. Conclusions: Canfosfamide did not meet the primary endpoint. C demonstrated single agent activity in P refractory or resistant OC and was well tolerated. C in combination with standard agents in less heavily treated OC trials are in progress. No significant financial relationships to disclose.
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Affiliation(s)
- I. Vergote
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - N. Finkler
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. del Campo
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - A. Lohr
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. Hunter
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - D. Matei
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - D. Spriggs
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. Kavanagh
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. Vermorken
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - G. L. Brown
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - S. Kaye
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
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93
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Dong XW, Goregoaker S, Engler H, Zhou X, Mark L, Crona J, Terry R, Hunter J, Priestley T. Small interfering RNA-mediated selective knockdown of NaV1.8 tetrodotoxin-resistant sodium channel reverses mechanical allodynia in neuropathic rats. Neuroscience 2007; 146:812-21. [PMID: 17367951 DOI: 10.1016/j.neuroscience.2007.01.054] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 01/23/2007] [Accepted: 01/26/2007] [Indexed: 01/10/2023]
Abstract
The biophysical properties of a tetrodotoxin resistant (TTXr) sodium channel, Na(V)1.8, and its restricted expression to the peripheral sensory neurons suggest that blocking this channel might have therapeutic potential in various pain states and may offer improved tolerability compared with existing sodium channel blockers. However, the role of Na(V)1.8 in nociception cannot be tested using a traditional pharmacological approach with small molecules because currently available sodium channel blockers do not distinguish between sodium channel subtypes. We sought to determine whether small interfering RNAs (siRNAs) might be capable of achieving the desired selectivity. Using Northern blot analysis and membrane potential measurement, several siRNAs were identified that were capable of a highly-selective attenuation of Na(V)1.8 message as well as functional expression in clonal ND7/23 cells which were stably transfected with the rat Na(V)1.8 gene. Functional knockdown of the channel was confirmed using whole-cell voltage-clamp electrophysiology. One of the siRNA probes showing a robust knockdown of Na(V)1.8 current was evaluated for in vivo efficacy in reversing an established tactile allodynia in the rat chronic constriction nerve-injury (CCI) model. The siRNA, which was delivered to lumbar dorsal root ganglia (DRG) via an indwelling epidural cannula, caused a significant reduction of Na(V)1.8 mRNA expression in lumbar 4 and 5 (L4-L5) DRG neurons and consequently reversed mechanical allodynia in CCI rats. We conclude that silencing of Na(V)1.8 channel using a siRNA approach is capable of producing pain relief in the CCI model and further support a role for Na(V)1.8 in pathological sensory dysfunction.
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Affiliation(s)
- X-W Dong
- Department of Neurobiology, Schering-Plough Research Institute, K-15-2-2600, 2015 Galloping Hill Road, Kenilworth, NJ 07033, USA.
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94
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Abstract
BACKGROUND Family-centred care (FCC) is a widely used model in paediatrics, and is felt instinctively to be the best way to provide care to children in hospital. However, its effectiveness has not been measured. OBJECTIVES The primary objective of this review was to assess the effects of family-centred models of care for hospitalised children when compared to standard or professionally-centred models of care, on child, family and health service outcomes. SEARCH STRATEGY We searched: MEDLINE (1966 to February 2004); the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, Issue 2, 2004); CINAHL (1982 to February 2004); PsycINFO (1972 to February 2004); ERIC (1982 to February 2004); Sociological Abstracts (1963 to February 2004); Social Work Abstracts (1977 to February 2004); and AMI (Australasian Medical Index) (1966 to February 2004). SELECTION CRITERIA We searched for randomised controlled trials (RCTs) or quasi-randomised controlled trials including cluster randomised trials and controlled clinical trials (CCTs), and controlled before and after studies (CBAs), in which family-centred care models are compared with professionally-centred models of care for hospitalised children (aged up to 12 years). Studies also had to meet criteria for family-centredness and methodological quality. In order to assess studies for the degree of family-centredness, this review utilised a modified rating scale based on a validated instrument. DATA COLLECTION AND ANALYSIS Two review authors undertook the searches, and three authors independently assessed trial quality and extracted data. We contacted study authors for additional information. MAIN RESULTS No studies met inclusion criteria, and hence no analysis could be undertaken. Five studies came close to inclusion. Three of these studies were excluded primarily because of inadequate or unclear blinding of outcome assessment, while for one study the age group was outside the parameters of this review. One study met most criteria, but the children were aged up to 18 years. We contacted the study authors who kindly provided a subset analysis, but on further examination the study also proved to have inadequate blinding procedures and so was not included. It was not possible to undertake any subset analysis of populations. Of the other studies identified through the search, 13 met some of the inclusion criteria but were reports of qualitative research and are reviewed elsewhere. AUTHORS' CONCLUSIONS This review has highlighted the dearth of high quality quantitative research about family-centred care. A much more stringent examination of the use of family-centred care as a model for care delivery to children and families in health services is needed.
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Affiliation(s)
- L Shields
- University of Hull, Faculty of Health and Social Care, Cottingham Rd, Hull, UK, HU6 7RX.
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95
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Abstract
OBJECTIVE To study the influence of non-standard controls on return to driving after disability, including prevalence of accidents/retraining difficulties. DESIGN Postal questionnaires sent within two years of assessment to 972 disabled drivers seen over a three-year period. SETTING Scottish Driving Assessment Service. SUBJECTS All patients considered capable of driving after assessment during the study period. RESULTS Five hundred and eighty-nine people (61 %) replied who were representative of the total population (mean age 55 years, range 19-87); 73% were male and 70% were disabled for up to two years. Overall 79% respondents had returned to driving (highest reported success with standard manual car (86%) and lowest using left foot to accelerate and brake (66%) (chi2 = 16.6, P = 0.005)). A significantly higher proportion of the 30 patients (6.5%) admitting to accidents and 25 (5.4%) to problems with retraining were using non-standard driving techniques, especially the use of hand controls. CONCLUSION Disabled drivers returning to drive using non-familiar controls had lower success and a higher proportion of accidents and/or problems with retraining than people using conventional controls. If confirmed in larger studies this may have implications for policy-makers as well as specialist practitioners.
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Affiliation(s)
- R S Prasad
- Scottish Driving Assessment Service, Rehabilitation Medicine Directorate, Astley Ainslie Hospital, Grange Loan, Edinburgh, UK.
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96
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Morton JM, Galanko JA, Soper NJ, Low DE, Hunter J, Traverso LW. NIS vs SAGES: a comparison of national and voluntary databases. Surg Endosc 2006; 20:1124-8. [PMID: 16703443 DOI: 10.1007/s00464-004-8829-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2004] [Accepted: 08/25/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND Surgical outcomes are increasingly examined in an effort to improve quality and reduce medical error. The Nationwide Inpatient Sample (NIS) is a retrospective, claims-derived and population-based database and the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) Outcomes Project is a prospective, voluntary and specialty surgeon database. We hypothesized that these two sources of outcome data would differ in regard to a single, commonly performed procedure. METHODS Both the NIS, a national sample of all nonfederal hospital discharges, and the gastroesophageal reflux disease log of the SAGES Outcomes Project were queried for all fundoplications performed between 1999 and 2001 using either ICD-9 procedure code 44.66 or CPT codes 43280 or 43324. Patients with an emergency admission, age <17 years, and/or diagnoses for either esophageal cancer or achalasia were excluded. Both demographic and outcome variables were compared by either t-test or chi-square analysis, with a p value of <0.05 as significant. RESULTS Both data sets were comparable for age and gender; however, the SAGES group had a higher rate of teaching hospital affiliation (71 vs 48%, p < 0.001). SAGES fundoplications had a consistently higher rate of comorbidities, including Barrett's esophagus (2.3 vs 1.1%, p = 0.005). The NIS fundoplications had a clear trend toward more associated procedures, including cholecystectomy (7.2 vs 2%, p < 0.001). Complication rates for the NIS data set were higher, including pulmonary complications (1.7 vs 0.5%, p = 0.03). No statistically significant differences existed between the two data sets for either length of stay or mortality. CONCLUSIONS The two databases indicate that fundoplication is an operation with low morbidity and mortality. The SAGES Outcomes Project demonstrated that participating surgeons had a higher affiliation with teaching hospitals, higher reporting of comorbidity, and lower associated procedures than the NIS. Despite having more comorbidity and technical difficulty, patients from the SAGES Outcomes Project had equivalent or lower complication rates.
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Affiliation(s)
- J M Morton
- Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, H3680, Stanford, CA 94305-5655, USA.
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97
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Hunter J, Singh S, Morgan M. Objective monitoring of adherence with home exercise training during pulmonary rehabilitation for chronic obstructive pulmonary disease. Physiotherapy 2006. [DOI: 10.1016/j.physio.2005.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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98
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Schwab AP, Hickey J, Hunter J, Banks MK. Characteristics of blast furnace slag leachate produced under reduced and oxidized conditions. J Environ Sci Health A Tox Hazard Subst Environ Eng 2006; 41:381-95. [PMID: 16484071 DOI: 10.1080/10934520500423527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A laboratory study was conducted to determine the environmental conditions necessary to reproduce leachates observed emerging from blast furnace slag acting as the foundation of highways in northwest Indiana. The leachates in the field are often highly alkaline with a pungent sulfur odor, a distinct green or milky-white in color, and sulfate concentrations exceeding 2,000 mg/L. Slag was equilibrated in the laboratory under both oxidized and anoxic environments and at various slag:water ratios. Constant anoxic conditions were required to produce to green colors in the slag, but high sulfate concentrations were observed only when the suspensions were fully oxidized. Leachate from the study site appears to form as a result of a series of complex chemical reactions including fluctuating oxidized and reduced conditions.
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Affiliation(s)
- A P Schwab
- Department of Agronomy, Purdue University, West Lafayette, Indiana, USA
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99
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Bates R, Hunter J, Meredith M, Nichols MH, King WD, Monroe KW. 282 HELMET USE DOCUMENTATION PRE- AND POSTINJURY DOCUMENTATION SHEET. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0008.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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100
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Dietrich CS, Modesitt SC, DePriest PD, Ueland FR, Wilder J, Reedy MB, Pavlik EJ, Kryscio R, Cibull M, Giesler J, Manahan K, Huh W, Cohn D, Powell M, Slomovitz B, Higgins RV, Merritt W, Hunter J, Puls L, Gehrig P, van Nagell JR. The efficacy of adjuvant platinum-based chemotherapy in Stage I uterine papillary serous carcinoma (UPSC). Gynecol Oncol 2005; 99:557-63. [PMID: 16154185 DOI: 10.1016/j.ygyno.2005.07.104] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Revised: 06/30/2005] [Accepted: 07/19/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the efficacy of adjuvant platinum-based chemotherapy in Stage I uterine papillary serous carcinoma (UPSC). METHODS A retrospective multi-institutional investigation was performed to identify surgically staged patients with Stage I UPSC who were (1) treated after surgery with 3-6 courses of platinum-based chemotherapy without radiation from 1990-2003, and (2) followed for a minimum of 12 months, or until recurrence. RESULTS Six patients (IA-2, IB-3, IC-1) were treated with carboplatin (AUC 6) or cisplatin (50 mg/m2) alone. One patient recurred to the vagina, was treated with chemo-radiation, and is alive and well at 122 months. One patient recurred to the lung, liver, and brain, and died of disease at 24 months. The remaining 4 patients are alive with no evidence of disease 15-124 months (mean 62 months) after treatment. Two patients (IB-1, IC-1) were treated with cisplatin (50 mg/m2) and cyclophosphamide (1000 mg/m2), and both are alive and well with no evidence of disease 75 and 168 months after treatment. Twenty-one patients (IA-5, IB-13, IC-3) were treated with a combination of carboplatin (AUC 6) and paclitaxel (135 mg/m2-175 mg/m2). One patient recurred to the vagina after 3 cycles of carboplatin/paclitaxel, and was treated with chemo-radiation. She is now without evidence of disease 10 months after treatment. At present, all 21 patients with Stage I UPSC treated following surgical staging with carboplatin/paclitaxel chemotherapy are alive and well with no evidence of disease 10-138 months (mean 41 months) after treatment. CONCLUSION Combination carboplatin/paclitaxel chemotherapy following surgery is effective in the treatment of Stage I UPSC.
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Affiliation(s)
- C S Dietrich
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536, USA
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