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Stek AM, Best BM, Luo W, Capparelli E, Burchett S, Hu C, Li H, Read JS, Jennings A, Barr E, Smith E, Rossi SS, Mirochnick M. Effect of pregnancy on emtricitabine pharmacokinetics. HIV Med 2012; 13:226-35. [PMID: 22129166 PMCID: PMC3342997 DOI: 10.1111/j.1468-1293.2011.00965.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the study was to describe emtricitabine pharmacokinetics during pregnancy and postpartum. METHODS The International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT), formerly Pediatric AIDS Clinical Trials Group (PACTG), study P1026s is a prospective pharmacokinetic study of HIV-infected pregnant women taking antiretrovirals for clinical indications, including a cohort taking emtricitabine 200 mg once daily. Intensive steady-state 24-hour emtricitabine pharmacokinetic profiles were performed during the third trimester and 6-12 weeks postpartum, and on maternal and umbilical cord blood samples collected at delivery. Emtricitabine was measured by liquid chromatography-mass spectrometry with a quantification limit of 0.0118 mg/L. The target emtricitabine area under the concentration versus time curve, from time 0 to 24 hours post dose (AUC(0-24) ), was ≥7 mg h/L (≤30% reduction from the typical AUC of 10 mg h/L in nonpregnant historical controls). Third-trimester and postpartum pharmacokinetics were compared within subjects. RESULTS Twenty-six women had pharmacokinetics assessed during the third trimester (median 35 weeks of gestation) and 22 postpartum (median 8 weeks postpartum). Mean [90% confidence interval (CI)] emtricitabine pharmacokinetic parameters during the third trimester vs. postpartum were, respectively: AUC: 8.0 (7.1-8.9) vs. 9.7 (8.6-10.9) mg h/L (P = 0.072); apparent clearance (CL/F): 25.0 (22.6-28.3) vs. 20.6 (18.4-23.2) L/h (P = 0.025); 24 hour post dose concentration (C(24) ): 0.058 (0.037-0.063) vs. 0.085 (0.070-0.010) mg/L (P = 0.006). The mean cord:maternal ratio was 1.2 (90% CI 1.0-1.5). The viral load was <400 HIV-1 RNA copies/mL in 24 of 26 women in the third trimester, in 24 of 26 at delivery, and in 15 of 19 postpartum. Within-subject comparisons demonstrated significantly higher CL/F and significantly lower C(24) during pregnancy; however, the C(24) was well above the inhibitory concentration 50%, or drug concentration that suppresses viral replication by half (IC(50) ) in all subjects. CONCLUSIONS While we found higher emtricitabine CL/F and lower C(24) and AUC during pregnancy compared with postpartum, these changes were not sufficiently large to warrant dose adjustment during pregnancy. Umbilical cord blood concentrations were similar to maternal concentrations.
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Abstract
BACKGROUND Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices. METHODS A telephone questionnaire completed by pre-school managers (n=54) examined pre-school dietary practices, food provision and the association between these and pre-school size, nutritional training attendance, possession of the Food and Nutrition Guidelines for Pre-school Services and having a healthy eating policy. Nutritional training needs were also investigated. RESULTS Twenty-five pre-schools provided all food for attending children; parents were sole providers in six. Thirty-four pre-schools had a written healthy eating policy. Attendance at nutritional training was reported by 40. Possession of the Guidelines (n=40) did not consistently result in their use. Poor parental and staff involvement in policy and menu development was cited. Although the delayed introduction of iron-containing foods and a feeding beaker in infants was clearly evident, inappropriate beverages and snacks were served to children aged 1-5 years in 43 and 37 pre-schools, respectively. Training priorities cited by managers included parental education and the provision of information regarding menu planning and healthy food choices. CONCLUSIONS Nutritional training should advocate whole staff familiarity with and use of current guidelines, in addition to encouraging nutritional policy development and enforcement. Parental education is warranted. Dietary education should focus specifically on appropriate weaning practices, healthy beverage and snack provision and menu planning.
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Wilson JD, Eardley W, Odak S, Jennings A. To what degree is digital imaging reliable? Validation of femoral neck shaft angle measurement in the era of picture archiving and communication systems. Br J Radiol 2011; 84:375-9. [PMID: 21159801 PMCID: PMC3473462 DOI: 10.1259/bjr/29690721] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2009] [Revised: 03/15/2010] [Accepted: 03/25/2010] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study investigates the reliability of femoral neck shaft angle (NSA) measurements made with the software and images available in routine clinical practice. METHODS Using the Centricity Enterprise™ (GE Healthcare Pty Ltd Piscataway, NJ) picture archiving and communication system (PACS), the NSA of the proximal femur was measured from anteroposterior radiographs of adult hips. 3 independent observers, using a standardised technique, performed a total of 120 measurements. RESULTS The Pearson's correlation coefficient for the intraobserver agreement was 0.98 (p<0.01) and for interobserver measurements 0.86 (p<0.01). Bland-Altman plots revealed the limits of intraobserver agreement to be ±2.5°, but interobserver limits of agreement to be ±6°. The intraclass correlation coefficient (ICC) was also calculated. The interobserver ICC was 0.62 (0.42-0.78, 95% confidence interval (CI); p<0.001). The intraobserver ICC was 0.98 (0.95-0.99, 95% CI; p<0.001). CONCLUSION PACS software has many advantages, but when using systems that can display angle measurements to one-tenth of a degree caution must be exercised to ensure that reliability of these measurements is not overestimated. We found that in the context of measuring the NSA of the proximal femur the reliability of the measurement, even under the best conditions, is only ±6° for different observers.
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Schneider SM, Gardner AF, Weiss LD, Wood JP, Ybarra M, Beck DM, Stauffer AR, Wilkerson D, Brabson T, Jennings A, Mitchell M, McGrath RB, Christopher TA, King B, Muelleman RL, Wagner MJ, Char DM, McGee DL, Pilgrim RL, Moskovitz JB, Zinkel AR, Byers M, Briggs WT, Hobgood CD, Kupas DF, Kruger J, Stratford CJ, Jouriles N. The future of emergency medicine. Acad Emerg Med 2010; 17:998-1003. [PMID: 20836784 DOI: 10.1111/j.1553-2712.2010.00854.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Schneider SM, Gardner AF, Weiss LD, Wood JP, Ybarra M, Beck DM, Stauffer AR, Wilkerson D, Brabson T, Jennings A, Mitchell M, McGrath RB, Christopher TA, King B, Muelleman RL, Wagner MJ, Char DM, McGee DL, Pilgrim RL, Moskovitz JB, Zinkel AR, Byers M, Briggs WT, Hobgood CD, Kupas DF, Kruger J, Stratford CJ, Jouriles N. The Future of Emergency Medicine. Ann Emerg Med 2010; 56:178-83. [DOI: 10.1016/j.annemergmed.2010.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 04/14/2010] [Accepted: 03/30/2010] [Indexed: 11/28/2022]
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Schneider SM, Gardner AF, Weiss LD, Wood JP, Ybarra M, Beck DM, Stauffer AR, Wilkerson D, Brabson T, Jennings A, Mitchell M, McGrath RB, Christopher TA, King B, Muelleman RL, Wagner MJ, Char DM, McGee DL, Pilgrim RL, Moskovitz JB, Zinkel AR, Byers M, Briggs WT, Hobgood CD, Kupas DF, Kruger J, Stratford CJ, Jouriles N. The Future of Emergency Medicine. J Emerg Nurs 2010; 36:330-5. [DOI: 10.1016/j.jen.2010.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jennings A, Davies GJ, Costarelli V, Dettmar PW. Bowel habit, diet and body weight in preadolescent children. J Hum Nutr Diet 2010; 23:511-9. [PMID: 20163508 DOI: 10.1111/j.1365-277x.2009.01039.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The possible influence of diet and body weight on bowel habit in children is unknown. The present study aimed to investigate the inter-relationships between bowel function, excess body weight and dietary intake in a group of preadolescent children. METHODS Eighty-four preadolescent children aged 7-10 years were recruited [mean (SD) age 9.7 (1.0) years]. All children completed a bowel habit diary, examining specific parameters of bowel function and a weighed food inventory concurrently for seven consecutive days. Height and weight measurements were also taken. Children were grouped according to whether they met dietary recommendations and by overweight status; differences in bowel function between the groups were then analysed. RESULTS Children who exceeded reference values for fat were more likely to report an incidence of straining to start (P = 0.005) and pain during defaecation (P = 0.021). Subjects who met protein recommendations were less likely to report incomplete evacuation (P = 0.000) and those who met zinc recommendations were less likely to report pain during defaecation (P = 0.044). Excess body weight (according to International Obesity Task Force cut-offs) was also associated with poor bowel habit, with overweight and obese children reporting lower defaecation frequency and a higher incidence of straining and feelings of incomplete evacuation, although these findings were not statistically significant. Defaecation frequency in healthy children was 1.4 defaecations per day compared to 1.2 defaecations for overweight and obese children. CONCLUSION A poor diet that fails to meet dietary recommendations as well as being overweight and obese appears to be associated with increased defaecation problems in preadolescent children.
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Jennings A, Norman A, Whitelock D, Haynes S, James G. Elective peri-operative intra-aortic balloon counterpulsation during maxillofacial free flap reconstructive surgery in a patient with severe cardiomyopathy. Anaesthesia 2010; 65:204-6. [DOI: 10.1111/j.1365-2044.2009.06182.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bobrow BJ, Demaerschalk BM, Wood JP, Villarin A, Clark L, Jennings A. Views of emergency physicians on thrombolysis for acute ischemic stroke. J Brain Dis 2009; 1:29-37. [PMID: 23818807 PMCID: PMC3676339 DOI: 10.4137/jcnsd.s2231] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The 3-hour window for treating stroke with intravenous tissue plasminogen activator (t-PA) requires well-organized, integrated efforts by emergency physicians and stroke neurologists. OBJECTIVE To evaluate attitudes and knowledge of emergency physicians about intravenous t-PA for acute ischemic stroke, particularly in primary stroke centers (PSCs) with stroke neurology teams. METHODS A 15-question pilot Internet survey administered by the Arizona College of Emergency Physicians. RESULTS Between March and August 2005, 100 emergency physicians responded: 71 in Arizona and 29 in Missouri. Forty-eight percent practiced at PSCs; 48% thought t-PA was effective, 20% did not, and 32% were uncertain. PSC or non-PSC location of practice did not influence endorsement (odds ratio, 0.96; 95% confidence interval, 0.27-1.64). Of those opposing t-PA, 87% cited risk of hemorrhage. CONCLUSIONS Most emergency physicians did not endorse t-PA. Improved collaboration between emergency physicians and stroke neurologists is needed.
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Jennings A, Duggan E, Graif Y, Perry I, Hourihane J. Hymenoptera Sting Allergy in Irish School Children. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pierce E, Hildebrandt G, Askew D, Eid S, Jennings A, Cooke K. Differential Mechanisms for CD4+ and CD8+ Mediated Inflammation in the Development of Experimental Idiopathic Pneumonia Syndrome. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bailey J, Jennings A, Parapia L. Change of pathology request forms can reduce unwanted requests and tests. J Clin Pathol 2005; 58:853-5. [PMID: 16049288 PMCID: PMC1770878 DOI: 10.1136/jcp.2004.023101] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Developments in clinical and laboratory medical practice have resulted in a large increase in laboratory workload, with considerable financial implications. It has been shown that the design of laboratory request cards can influence patterns of test ordering and possibly reduce inappropriate requests. AIMS/METHODS To redesign pathology request cards with a view to reducing inappropriate test requesting. RESULTS A redesign of the request cards used by general practitioners in the Bradford area led to a significant reduction in the ordering of specific investigations. CONCLUSIONS The redesigning of pathology request cards can have a beneficial effect on test requesting.
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Jennings A, Tennant M. Discovery Strategies in a BioPharmaceutical Startup: Maximising your Chances of Success Using Computational Filters. Curr Pharm Des 2005; 11:335-44. [PMID: 15723629 DOI: 10.2174/1381612053382151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Small research-based pharmaceutical start-ups often lack the budget and do not have the infrastructure available to apply all possible techniques for compound selection. This review details our use of a range of techniques such as high-throughput docking and similarity searching to maximize the success rate when attempting to identify pharmaceutically relevant ligands in a resource-constrained environment.
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Galanis G, Jennings A, Beckett P. Runway width effects in the visual approach to landing. THE INTERNATIONAL JOURNAL OF AVIATION PSYCHOLOGY 2002; 11:281-301. [PMID: 11858256 DOI: 10.1207/s15327108ijap1103_03] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The effect of changes in runway width on the perception of glide-slope has been the subject of extensive investigations. Despite considerable research, an explanation of this effect has been elusive. A mathematical model for glide-slope perception was published recently based on the premise that a desirable goal of perception is to form a perception with minimal uncertainty. One of the qualitative predictions of that model was that changes in the aspect ratio of the runway would affect the perceived glide-slope. In this article, the predictions of the model are quantified and are shown to be in close agreement with experimental results in the literature.
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Bromidge SM, Griffith K, Heightman TD, Jennings A, King FD, Moss SF, Newman H, Riley G, Routledge C, Serafinowska HT, Thomas DR. Novel (4-piperazin-1-ylquinolin-6-yl) arylsulfonamides with high affinity and selectivity for the 5-HT(6) receptor. Bioorg Med Chem Lett 2001; 11:2843-6. [PMID: 11597412 DOI: 10.1016/s0960-894x(01)00558-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The discovery of (4-piperazin-1-ylquinolin-6-yl) arylsulfonamides and their binding affinities for a selection of 5-HT and dopamine subreceptors is described. Many compounds show high affinity (pK(i)>8) for the 5-HT(6) receptor and >100-fold selectivity against a range of other receptors. Structure-activity relationships of these compounds are discussed.
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Barth JH, Balen AH, Jennings A. Appropriate design of biochemistry request cards can promote the use of protocols and reduce unnecessary investigations. Ann Clin Biochem 2001; 38:714-6. [PMID: 11732657 DOI: 10.1258/0004563011900957] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Attempts to control laboratory workload in the past always proved to be short-lived. We designed a request card based on clinical conditions for a gynaecology out-patient clinic to help clinical staff to adhere to agreed investigation protocols. Each request card had a tick-box associated with a clinical condition. The tests performed for each condition were advertised on a poster in the clinic. The workload was assessed for a 2-year period before and after the introduction of these cards. The numbers of all endocrine tests, except progesterone and sex hormone binding globulin, fell by 19% (P<0.0001) whereas the clinical cases seen remained steady at 227 per month. This report demonstrates that agreed protocols can be implemented but that a persistent aide-mémoire is necessary.
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Jennings A. Evaluation of substernal goiters using computed tomography and MR imaging. Endocrinol Metab Clin North Am 2001; 30:401-14, ix. [PMID: 11444168 DOI: 10.1016/s0889-8529(05)70192-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Computed tomography and MR imaging are valuable techniques for determining the presence and extent of substernal goiters, their impingement on adjacent structures in the neck and chest, and whether mediastinal masses are thyroidal in origin. This article discusses the advantages and disadvantages of each technique and the radiologic characteristics of substernal goiters. Radiographic examples of both techniques are included to illustrate common clinical settings. Finally, suggestions for choosing which patients will benefit from scanning and which technique will safely provide the maximum information in various clinical settings are discussed.
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Wakefield D, Jennings A, McCluskey PJ. Intravenous pulse methylprednisolone in the treatment of uveitis associated with multiple sclerosis. Clin Exp Ophthalmol 2000; 28:103-6. [PMID: 10933772 DOI: 10.1046/j.1442-9071.2000.00282.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To demonstrate the safety and effectiveness of intravenous methylprednisolone (IVMP) in the treatment of uveitis in association with multiple sclerosis (MS). METHODS Uveitis is an unusual manifestation of MS that may be severe, chronic and require systemic immunosuppression therapy. High-dose IVMP has previously been shown to be effective in the treatment of inflammatory eye disease and MS. Eight episodes of uveitis in five patients with MS were treated over a 10-year period in an open, uncontrolled trial. Two patients had chronic anterior uveitis, one patient had bilateral panuveitis and two patients had intermediate uveitis. RESULTS All patients responded to IVMP with evidence of a decrease in intraocular inflammatory activity and improved visual acuity (VA) within 2 weeks of commencing treatment. There were no severe ocular or systemic steroid side effects. CONCLUSIONS Intravenous methylprednisolone is an effective, well-tolerated form of therapy for uveitis in patients with MS.
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Jennings A. The use of available social support networks by older blacks. JOURNAL OF NATIONAL BLACK NURSES' ASSOCIATION : JNBNA 2000; 10:4-13. [PMID: 10732592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Research has indicated that strong social networks positively influence the health of older Black adults. However, scales used in studies to measure social support do not reveal whether these networks are actually activated. The purpose of this descriptive study was to describe the reasons older Blacks with chronic illnesses did not utilize available support networks in their health care management. Following a community-based survey of 383 older Blacks, where each participant had a social support score completed from the Lubben Social Network Scale, a smaller group of 116 Blacks was selected to participate in a qualitative interview. It was found that 59 out of the 116 older Blacks had high social support scores on the Lubben Scale, but only 40 of these individuals reported the use of support networks for the maintenance of their health regimen. These findings illustrated that some older Blacks with strong support networks chose to function independently of their social support networks in the maintenance of their health.
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Giles LJ, Jennings A, Ng B, Creed G, Gallard L, Pierre D, Beale R, McLuckie A. Treatment of hypophosphataemia in critically ill patients with a two day dosing regimen. Crit Care 2000. [PMCID: PMC3333095 DOI: 10.1186/cc891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Jennings A. Who supports elderly African Americans in adhering to their healthcare regimen? HOME HEALTHCARE NURSE 1999; 17:519-25. [PMID: 10745776 DOI: 10.1097/00004045-199908000-00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Knowing who supports elderly African Americans in adhering to their healthcare regimen is vital information. This study found that the majority of elderly individuals discussed their chronic illnesses and problems related to managing their illnesses with family members rather than with formal providers. Additionally, family members were also significant in coordinating transportation; assisting with managing medications, diet, and exercise regimens; and monitoring symptoms of chronic illnesses. These findings provide direction on how to develop effective care plans and affect positive outcomes for elderly African American clients.
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Jennings A. Detecting viruses in sera: methods used and their merits. DEVELOPMENTS IN BIOLOGICAL STANDARDIZATION 1999; 99:51-9. [PMID: 10404876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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