26
|
McLean R, Samelson L, Lorbergs A, Anderson D, Hoffmann U, Fox C, Bouxsein M, Kiel D. GREATER PERI-AORTIC ADIPOSE TISSUE IS ASSOCIATED WITH INCREASED TRUNK MUSCLE FAT IN MEN AND WOMEN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Fox C, Penhale B, Cross J, Poland F, Smith T, Hammond S. CARING FOR PEOPLE WITH HIP FRACTURE AND COGNITIVE IMPAIRMENTS: FINDINGS FROM PERFECTED. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
28
|
Cross J, Poland F, Hammond S, Backhouse T, Varley A, Penhale B, Lambert N, Fox C. DISRUPTIONS, DISCONTINUITIES, AND DISPERSIONS: AN ETHNOGRAPHY OF DISJUNCTURES IN ORTHOPAEDIC WARDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Varley A, Penhale B, Backhouse T, Lambert N, Poland F, Cross J, Hammond S, Fox C. “WORK IS LIKE A CONVEYOR BELT”: FINDINGS FROM AN ETHNOGRAPHIC STUDY OF ACUTE TRAUMA WARDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
30
|
Fox C, Boustani M, Austrom M. INTERNATIONAL TRANSLATIONAL CARE RESEARCH. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
31
|
Smith TO, Cooper A, Peryer G, Griffiths R, Fox C, Cross J. Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis. Int J Geriatr Psychiatry 2017; 32:386-396. [PMID: 28093812 DOI: 10.1002/gps.4655] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/01/2016] [Accepted: 12/06/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery. Pooled odds ratio (OR) and mean difference of those who experienced delirium compared to those who did not were calculated for each variable. Evidence was assessed using the Downs and Black appraisal tool and interpreted using the GRADE approach. RESULTS A total of 6704 people (2090 people with post-operative delirium) from 32 studies were analysed. There was moderate evidence of nearly a two-times greater probability of post-operative delirium for those aged 80 years and over (OR: 1.77; 95% CI: 1.09, 2.87), whether patients lived in a care institution pre-admission (OR: 2.65; 95% CI: 1.79, 3.92), and a six-times greater probability of developing post-operative delirium with a pre-admission diagnosis of dementia (OR: 6.07, 95% CI: 4.84, 7.62). There was no association with intra-operative variables and probability of delirium. CONCLUSION Clinicians treating people with a hip fracture should be vigilant towards post-operative delirium if their patients are older, have pre-existing cognitive impairment and poorer overall general health. This is also the case for those who experience post-operative complications such as pneumonia or a urinary tract infection. Copyright © 2017 John Wiley & Sons, Ltd.
Collapse
|
32
|
Yarur AJ, Kanagala V, Stein DJ, Czul F, Quintero MA, Agrawal D, Patel A, Best K, Fox C, Idstein K, Abreu MT. Higher infliximab trough levels are associated with perianal fistula healing in patients with Crohn's disease. Aliment Pharmacol Ther 2017; 45:933-940. [PMID: 28211593 DOI: 10.1111/apt.13970] [Citation(s) in RCA: 206] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 12/22/2016] [Accepted: 01/14/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Infliximab has been found to be efficacious in the treatment of fistulas in the setting of Crohn's disease, even though some patients do not benefit from therapy. AIM To assess the correlation between perianal fistula healing and trough levels of infliximab. METHODS In this cross-sectional study, we identified patients with Crohn's disease who had perianal fistulas and were treated with infliximab for at least 24 weeks. We excluded patients who underwent a faecal diversion procedure or proctectomy. Predictive variables included demographics, disease phenotype, disease activity, infliximab levels, anti-infliximab antibodies. The primary outcome was fistula healing defined as the absence of drainage. The secondary outcome was complete fistula closure and mucosal healing. RESULTS 117 patients were included. Patients with fistula healing had significantly higher median serum infliximab levels when compared to those with active fistulas [15.8 vs. 4.4 μg/mL, respectively (P < 0.0001)]. There was an incremental gain in fistula healing with higher infliximab levels. The AUC for the association between fistula healing and infliximab levels was 0.82 (P < 0.0001), while the AUC for the association of infliximab levels and fistula closure was 0.69 (P = 0.014). Patients with anti-infliximab antibodies had a lower chance of achieving fistula healing (OR: 0.04 [95%CI: 0.005-0.3], P < 0.001). CONCLUSIONS There is a significant association between serum infliximab levels and rates of fistula healing. Achieving infliximab levels ≥10.1 mcg/mL in patients with Crohn's disease and perianal fistulas may improve outcomes as part of a treat-to-target strategy.
Collapse
|
33
|
Kron T, Ungureanu E, Antony R, Hardcastle N, Clements N, Ukath J, Fox C, Lonski P, Wanigaratne D, Haworth A. Patient specific quality control for Stereotactic Ablative Body Radiotherapy (SABR): it takes more than one phantom. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/777/1/012017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
34
|
Carnini C, Miglietta D, Puviani V, Calderazzo MA, Finch H, Fox C, Fitzgerald M, Patacchini R, Civelli M, Villetti G. CHI25243, a novel potent inhaled inhibitor of neutrophil elastase for the treatment of bronchiectasis and other chronic inflammatory lung disease. Pneumologie 2016. [DOI: 10.1055/s-0036-1592255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
35
|
Savulich G, Piercy T, Brühl AB, Fox C, Suckling J, Rowe JB, O'Brien JT, Sahakian BJ. Focusing the Neuroscience and Societal Implications of Cognitive Enhancers. Clin Pharmacol Ther 2016; 101:170-172. [PMID: 27557349 DOI: 10.1002/cpt.457] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/19/2016] [Accepted: 08/14/2016] [Indexed: 11/11/2022]
Abstract
Cognitive enhancement can benefit the individual and society, but also has associated risks and ethical concerns. Cognitive-enhancing drugs are used in the treatment of neuropsychiatric disorders. Nonpharmacological strategies are also emerging, which have the potential to improve motivational deficits associated with neuropsychiatric symptoms and should be prioritized for development. The increasing lifestyle use of "smart" and other drugs indicates the desire for healthy people to improve themselves. Safety and ethical implications are discussed.
Collapse
|
36
|
Sacks Z, Cortas C, Felker-Kantor E, Fox C, Guiney O, Hudspeth J, Nadas M, Trinh E, Morse M. The Marshall Wolf Haiti Medical Education Fellowship: An innovative
faculty development opportunity. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
37
|
Brooker C, Gojkovic D, Sirdifield C, Fox C. Lord Bradley's review of people with mental health or learning disabilities in the criminal justice system in England: All not equal in the eyes of the law? Int J Prison Health 2016; 5:171-5. [PMID: 25757423 DOI: 10.1080/17449200903115847] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
38
|
Kelly AS, Fox CK, Rudser KD, Gross AC, Ryder JR. Pediatric obesity pharmacotherapy: current state of the field, review of the literature and clinical trial considerations. Int J Obes (Lond) 2016; 40:1043-50. [PMID: 27113643 DOI: 10.1038/ijo.2016.69] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 03/22/2016] [Accepted: 04/04/2016] [Indexed: 12/13/2022]
Abstract
Despite the increasing number of medications recently approved to treat obesity among adults, few agents have been formally evaluated in children or adolescents for this indication. Moreover, there is a paucity of guidance in the literature addressing best practices with regard to pediatric obesity pharmacotherapy clinical trial design, and only general recommendations have been offered by regulatory agencies on this topic. The purposes of this article are to (1) offer a background of the current state of the field of pediatric obesity medicine, (2) provide a brief review of the literature summarizing pediatric obesity pharmacotherapy clinical trials, and (3) highlight and discuss some of the unique aspects that should be considered when designing and conducting high-quality clinical trials evaluating the safety and efficacy of obesity medications in children and adolescents. Suggestions are offered in the areas of target population and eligibility criteria, clinical trial end-point selection, trial duration, implementation of lifestyle modification therapy and recruitment and retention of participants. Efforts should be made to design and conduct trials appropriately to ensure that high-quality evidence is generated on the safety and efficacy of various medications used to treat pediatric obesity.
Collapse
|
39
|
Sakel M, Boukouvalas A, Buono R, Moten M, Mirza F, Chan WY, Maidment I, Cross J, Smith TO, Myint PK, Fox C. Does anticholinergics drug burden relate to global neuro-disability outcome measures and length of hospital stay? Brain Inj 2015; 29:1426-30. [PMID: 26287759 DOI: 10.3109/02699052.2015.1060358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury. RESEARCH DESIGN A retrospective case note review assessed total rehabilitation unit admission. METHODS AND PROCEDURES Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a UK university hospital. Data analysed included: Northwick Park Dependency Score (NPDS), Rehabilitation complexity Scale (RCS), Functional Independence Measure and Functional Assessment Measure FIM-FAM (UK version 2.2), LOS and ACB. Outcome was different in RCS, NPDS and FIM-FAM between admission and discharge. MAIN OUTCOMES AND RESULTS A positive change was reported in ACB results in a positive change in NPDS, with no significant effect on FIM-FAM, either Motor or Cognitive, or on the RCS. Change in ACB correlated to the length of hospital stay (regression correlation = -6.64; SE = 3.89). There was a significant harmful impact of increase in ACB score during hospital stay, from low to high ACB on NPDS (OR = 9.65; 95% CI = 1.36-68.64) and FIM-FAM Total scores (OR = 0.03; 95% CI = 0.002-0.35). CONCLUSIONS There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort.
Collapse
|
40
|
Fox C, Gladstone D. MO-F-CAMPUS-T-05: SQL Database Queries to Determine Treatment Planning Resource Usage. Med Phys 2015. [DOI: 10.1118/1.4925446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
41
|
Graham P, Browne L, Capp A, Delaney G, Fox C, Millar E, Nasser E, Papadatos G. Predictors of responses and sexual function for women in the St George breast boost randomized trial (StGBBT). Breast 2015. [DOI: 10.1016/j.breast.2015.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
42
|
Wilson CL, Jurk D, Fullard N, Banks P, Page A, Luli S, Elsharkawy AM, Gieling RG, Chakraborty JB, Fox C, Richardson C, Callaghan K, Blair GE, Fox N, Lagnado A, Passos JF, Moore AJ, Smith GR, Tiniakos DG, Mann J, Oakley F, Mann DA. NFκB1 is a suppressor of neutrophil-driven hepatocellular carcinoma. Nat Commun 2015; 6:6818. [PMID: 25879839 PMCID: PMC4410629 DOI: 10.1038/ncomms7818] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/02/2015] [Indexed: 02/07/2023] Open
Abstract
Hepatocellular carcinoma (HCC) develops on the background of chronic hepatitis.
Leukocytes found within the HCC microenvironment are implicated as regulators of
tumour growth. We show that diethylnitrosamine (DEN)-induced murine HCC is
attenuated by antibody-mediated depletion of hepatic neutrophils, the latter
stimulating hepatocellular ROS and telomere DNA damage. We additionally report a
previously unappreciated tumour suppressor function for hepatocellular nfkb1
operating via p50:p50 dimers and the co-repressor HDAC1. These anti-inflammatory
proteins combine to transcriptionally repress hepatic expression of a S100A8/9,
CXCL1 and CXCL2 neutrophil chemokine network. Loss of nfkb1 promotes
ageing-associated chronic liver disease (CLD), characterized by steatosis,
neutrophillia, fibrosis, hepatocyte telomere damage and HCC.
Nfkb1S340A/S340Amice carrying a mutation
designed to selectively disrupt p50:p50:HDAC1 complexes are more susceptible to HCC;
by contrast, mice lacking S100A9 express reduced neutrophil chemokines and are
protected from HCC. Inhibiting neutrophil accumulation in CLD or targeting their
tumour-promoting activities may offer therapeutic opportunities in HCC. The role of neutrophils in cancer development is not widely
appreciated. Here, the authors show that NF-κB-deficient hepatocytes
overproduce chemokines, leading to hepatocellular carcinoma due to excessive neutrophil
recruitment, and that neutrophil depletion prevents liver cancer in these
mice.
Collapse
|
43
|
Fox C, Edwards MH, Dennison EM, Cooper C. Personal and Societal Burden of Osteoporotic Fractures. Clin Rev Bone Miner Metab 2015. [DOI: 10.1007/s12018-015-9181-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
44
|
McCoy M, Fox C, Sattler A, Curry C, Finnegan A, Morse M, Sacks Z, Wallace J, Westerhaus M. Integrating social medicine into international curricula: A case study
across Uganda and Haiti. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
45
|
Slattery D, Fox C, Richard J. 80 The Danger of Creating an Oxygen-Enriched Environment in the Back of an Ambulance: The Risk of Various Oxygen-Delivery Devices. Ann Emerg Med 2014. [DOI: 10.1016/j.annemergmed.2014.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
46
|
Jary HR, Kachidiku J, Banda H, Kapanga M, Doyle JV, Banda E, Fox C, Gordon SB, Mortimer K. Feasibility of conducting a randomised controlled trial of a cookstove intervention in rural Malawi. Int J Tuberc Lung Dis 2014; 18:240-7. [PMID: 24429320 PMCID: PMC4436815 DOI: 10.5588/ijtld.13.0485] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND: Exposure to household air pollution (HAP) causes 4 million deaths annually, and strategies to reduce HAP exposure are urgently required. OBJECTIVE: To evaluate the acceptability and feasibility of conducting a trial of a cookstove intervention in rural Malawi. DESIGN: Non-smoking women were randomised to continuing to use an open fire (control) or to using a wood-burning clay cookstove (intervention). Symptom burden, oxygen saturation and exhaled carbon monoxide (eCO) were assessed at baseline and 7-day follow-up. A subset of women underwent HAP exposure monitoring. Of 51 women recruited, 50 (98%) completed the main study. The methodology was acceptable to participants. Headache, back pain and cough were the most commonly reported symptoms at baseline and follow-up. Median eCO was within normal limits, but with a difference of 0.5 parts per million (ppm) in median change of eCO from baseline to follow-up seen between the two groups (P ∙ 0.035). The peak ambient CO concentration detected was 150 ppm. This study suggests that a large cookstove intervention trial in Malawi would be feasible with careful community sensitisation. Monitoring exposure to HAP is challenging, and further studies evaluating potential biomarkers of exposure, including eCO, should be undertaken.
Collapse
|
47
|
Fox C, Kay EJ, Anderson R. Involving dental practitioners in setting the dental research agenda. Br Dent J 2014; 217:307-10. [DOI: 10.1038/sj.bdj.2014.807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/09/2022]
|
48
|
Fox C, Kay EJ, Anderson R. Evidence-based dentistry – overcoming the challenges for the UK's dental practitioners. Br Dent J 2014; 217:191-4. [DOI: 10.1038/sj.bdj.2014.703] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/09/2022]
|
49
|
Chung H, Emms G, Fox C. Vibration Reduction in Lightweight Floor/Ceiling Systems with a Sand-Sawdust Damping Layer. ACTA ACUST UNITED AC 2014. [DOI: 10.3813/aaa.918742] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
50
|
Glaser A, Zhang R, Andreozzi J, Davis S, Fox C, Gladstone D, Pogue B. TH-C-17A-03: Dynamic Visualization and Dosimetry of IMRT and VMAT Treatment Plans by Video-Rate Imaging of Cherenkov Radiation in Pure Water. Med Phys 2014. [DOI: 10.1118/1.4889614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|