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Lai C, Lim K, Healy C, Theaker J, Al-Shamkhani A, Healy E. 461 CD8 + T cell dysfunction in cutaneous squamous cell carcinomas. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.483] [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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Cardoso RN, Healy C, Viles-Gonzalez J, Coffey JO. ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature. Indian Pacing Electrophysiol J 2016; 15:236-44. [PMID: 27134440 PMCID: PMC4834441 DOI: 10.1016/j.ipej.2016.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Inappropriate ICD shocks are associated with increased mortality. They also impair patients' quality of life, increase hospitalizations, and raise health-care costs. Nearly 80% of inappropriate ICD shocks are caused by supraventricular tachycardia. Here we report the case of a patient who received a single-lead dual-chamber sensing ICD for primary prevention of sudden cardiac death and experienced inappropriate ICD shocks. V-A time, electrogram morphology, and response to antitachycardia pacing suggested atrioventricular nodal reentry tachycardia, which was confirmed in an electrophysiology study. Inspired by this case, we performed a literature review to discuss mechanisms for discrimination of supraventricular tachycardia with 1:1 A:V relationship from ventricular tachycardia with 1:1 retrograde conduction.
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Mandelbrot DA, Alberú J, Barama A, Marder BA, Silva HT, Flechner SM, Flynn A, Healy C, Li H, Tortorici MA, Schulman SL. Effect of Ramipril on Urinary Protein Excretion in Maintenance Renal Transplant Patients Converted to Sirolimus. Am J Transplant 2015; 15:3174-84. [PMID: 26176342 DOI: 10.1111/ajt.13384] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 05/17/2015] [Accepted: 05/17/2015] [Indexed: 01/25/2023]
Abstract
This prospective, randomized, double-blind, placebo-controlled study evaluated the effects of ramipril on urinary protein excretion in renal transplant patients treated with sirolimus following conversion from a calcineurin inhibitor. Patients received ramipril or placebo for up to 6 weeks before conversion and 52 weeks thereafter. Doses were increased if patients developed proteinuria (urinary protein/creatinine ratio ≥0.5); losartan was given as rescue therapy for persistent proteinuria. The primary end point was time to losartan initiation. Of 295 patients randomized, 264 met the criteria for sirolimus conversion (ramipril, 138; placebo, 126). At 52 weeks, the cumulative rate of losartan initiation was significantly lower with ramipril (6.2%) versus placebo (23.2%) (p < 0.001). No significant differences were observed between ramipril and placebo for change in glomerular filtration rate from baseline (p = 0.148) or in the number of patients with biopsy-confirmed acute rejection (13 vs. 5, respectively; p = 0.073). One patient in the placebo group died due to cerebrovascular accident. Treatment-emergent adverse events were consistent with the known safety profile of sirolimus and were not potentiated by ramipril co-administration. Ramipril was effective in reducing the incidence of proteinuria for up to 1 year following conversion to sirolimus in maintenance renal transplant patients.
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Xavier GM, Patist AL, Healy C, Pagrut A, Carreno G, Sharpe PT, Martinez-Barbera JP, Thavaraj S, Cobourne MT, Andoniadou CL. Activated WNT signaling in postnatal SOX2-positive dental stem cells can drive odontoma formation. Sci Rep 2015; 5:14479. [PMID: 26411543 PMCID: PMC4585991 DOI: 10.1038/srep14479] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 09/01/2015] [Indexed: 01/27/2023] Open
Abstract
In common with most mammals, humans form only two dentitions during their lifetime. Occasionally, supernumerary teeth develop in addition to the normal complement. Odontoma represent a small group of malformations containing calcified dental tissues of both epithelial and mesenchymal origin, with varying levels of organization, including tooth-like structures. The specific cell type responsible for the induction of odontoma, which retains the capacity to re-initiate de novo tooth development in postnatal tissues, is not known. Here we demonstrate that aberrant activation of WNT signaling by expression of a non-degradable form of β-catenin specifically in SOX2-positive postnatal dental epithelial stem cells is sufficient to generate odontoma containing multiple tooth-like structures complete with all dental tissue layers. Genetic lineage-tracing confirms that odontoma form in a similar manner to normal teeth, derived from both the mutation-sustaining epithelial stem cells and adjacent mesenchymal tissues. Activation of the WNT pathway in embryonic SOX2-positive progenitors results in ectopic expression of secreted signals that promote odontogenesis throughout the oral cavity. Significantly, the inductive potential of epithelial dental stem cells is retained in postnatal tissues, and up-regulation of WNT signaling specifically in these cells is sufficient to promote generation and growth of ectopic malformations faithfully resembling human odontoma.
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Healy C, Viles-Gonzalez JF, Sáenz LC, Soto M, Ramírez JD, d'Avila A. Arrhythmias in chagasic cardiomyopathy. Card Electrophysiol Clin 2015; 7:251-268. [PMID: 26002390 DOI: 10.1016/j.ccep.2015.03.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Chagas disease, a chronic parasitosis caused by the protozoa Trypanosoma cruzi, is an increasing worldwide problem because of the number of cases in endemic areas and the migration of infected individuals to more developed regions. Chagas disease affects the heart through cardiac parasympathetic neuronal depopulation, immune-mediated myocardial injury, parasite persistence in cardiac tissue with secondary antigenic stimulation, and coronary microvascular abnormalities causing myocardial ischemia. A lack of knowledge exists for risk stratification, management, and prevention of ventricular arrhythmias in patients with chagasic cardiomyopathy. Catheter ablation can be effective for the management of recurrent ventricular tachycardia.
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Healy C, Tanawuttiwat T, Viles-Gonzalez JF. Putting a name on it: Ebstein's anomaly. Am J Med 2015; 128:367-8. [PMID: 25433298 DOI: 10.1016/j.amjmed.2014.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 11/20/2014] [Accepted: 11/20/2014] [Indexed: 11/15/2022]
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Basson S, Charlesworth P, Healy C, Phelps S, Cleeve S. Botulinum toxin use in paediatric colorectal surgery. Pediatr Surg Int 2014; 30:833-8. [PMID: 24997611 DOI: 10.1007/s00383-014-3536-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2014] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate outcomes of intrasphincteric botulinum toxin injection (ISBTI) in children with intractable constipation. METHODS Retrospective case-note review of patients ≤ 16 years of age undergoing ISBTI between January 2010 and February 2014. Data collected included patient demographics, diagnosis, complications, follow-up duration and functional outcomes. Successful outcome was defined as resolution/improvement in symptoms and failed when there was no change in symptoms. Statistical analyses were performed using PRISM (GraphPad, CA, USA). p values <0.05 were considered as significant. RESULTS 43 patients [male 29, median age 5 years 9 months (range 13 months-13 years 5 months)] underwent 86 ISBTIs. Underlying diagnoses were idiopathic constipation (67 %), Hirschsprung disease (26 %), anorectal malformation (5 %), gastrointestinal dysmotility (2 %). 72 % (31/43) reported improvement in symptoms after the first ISBTI. 39 % of patients had recurrence of symptoms at 12-month median follow-up. 10 patients non-responsive to ISBTI required an antegrade continence enema or stoma. There was no correlation between age (p = 0.3), gender (p = 0.7), diagnosis (p = 0.84), or number of ISBTIs (p = 0.17) with successful outcome. CONCLUSION Successful outcomes occurred in 72 % patients after the first ISBTI. 25 % required further surgical management of their symptoms. Further work is required to help predict which patients will benefit from ISBTI.
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Khonsari RH, Healy C, Ohazama A, Sharpe PT, Dutel H, Charles C, Viriot L, Tafforeau P. Submicron imaging of soft-tissues using low-dose phase-contrast x-ray synchrotron microtomography with an iodine contrast agent. Anat Rec (Hoboken) 2014; 297:1803-7. [PMID: 25044664 DOI: 10.1002/ar.22997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 05/31/2014] [Indexed: 11/10/2022]
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Liu K, Tabler JT, Szabo-Rogers HL, Mesbahi A, Healy C, Barrell W, Wlodarczyk B, Wallingford JB, Finnell R. Novel links between ciliopathies and FGF-related craniofacial syndromes. Cilia 2012. [PMCID: PMC3555746 DOI: 10.1186/2046-2530-1-s1-o25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sheikh HJ, Healy C, Ramakrishnan V. A DIEP perforator with a twist! J Plast Reconstr Aesthet Surg 2012; 65:e318-9. [PMID: 22627174 DOI: 10.1016/j.bjps.2012.04.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 04/26/2012] [Indexed: 11/29/2022]
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Dorairaj JJ, Healy C, McMenamin M, Eadie PA. The untold truth about "bath salt" highs: A case series demonstrating local tissue injury. J Plast Reconstr Aesthet Surg 2011; 65:e37-41. [PMID: 22079081 DOI: 10.1016/j.bjps.2011.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 10/03/2011] [Indexed: 11/19/2022]
Abstract
The epidemic of injecting cathinone derivatives, marketed as "bath salts", by intravenous drug users among inner city Dubliners led to an associated rise in soft tissue complications. The spectrum of the cases encountered, ranging from self-limiting cellulitis to extensive abscess formation, at a single institution is described.
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McGraw SA, Healy C, Mohamedali B, Shivaraju A, Shroff A. Abstract P182: Comparing Blood Pressure Control in Diabetic Versus Nondiabetic Veterans Following Percutaneous Coronary Intervention. Circ Cardiovasc Qual Outcomes 2011. [DOI: 10.1161/circoutcomes.4.suppl_2.ap182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Blood pressure control in patients with coronary artery disease (CAD) or diabetes is essential to decrease morbidity and mortality. The US Joint National Committee VII (JNC-7) recommends systolic blood pressure (SBP) <130 and diastolic blood pressure (DBP) <80. These values can be attained using beta-blockers, angiotensin antagonists, calcium channel blockers, diuretics and nitrates.
Methods:
We conducted a retrospective cohort study focusing on the attainment of the JNC-7 guidelines, comparing 331 diabetic to 524 non-diabetic patients who underwent percutaneous coronary intervention (PCI) between September 2004 and December 2009 at the Jesse Brown Veterans Hospital in Chicago, IL.
Results:
Among the diabetic population, the mean SBP decreased 135 to 131mmHg (p = 0.0014) and mean DBP decreased 72 to 70mmHg (p= 0.0014). In non-diabetics, the mean SBP decreased 133 to 128mmHg (p<0.0001) and mean DBP decreased 73 to 71mmHg (p<0.0007). The percent of diabetics at JNC-7 SBP goal increased from 41 to 50% (136 to 166 of 331) (p= 0.0041), however the percent change at DBP goal was not significant. In non-diabetics, percent at goal for SBP increased 45 to 57% (236 to 299 of 524) (p<0.0001) and for DBP increased 69 to 76% (362 to 398 of 524) (p=0.0075). At six months, among diabetics, the medication usage increased for beta-blockers, from 80 to 92% (265 to 305 of 331) (p<0.0001) and for nitrates from 32 to 37% (106 to 122 of 302) (p=0.0465). Among non-diabetics, use of beta-blockers increased from 68 to 87% (356 to 456 of 524) (p<0.0001) and nitrates from 20 to 25% (105 to 131 of 524) (p=0.0054). Use of angiotensin antagonists also increased from 52 to 71% (272 to 372 if 524) (p<0.0001) among non-diabetics.
Conclusions:
There were improvements in blood pressure among both populations at six months post-PCI. Both groups attained JNC-7 SBP goals; only non-diabetics achieved DBP goal. Medication use increased for both groups with beta-blockers and nitrates. Angiotensin antagonists only increased significantly among non-diabetics. This demonstrates that post-intervention, tighter control of blood pressure is attempted however levels are not yet optimal.
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McGraw SA, Healy C, Mohamedali B, Shivaraju A, Shroff A. Abstract P183: Lipid Control in Veterans Following Percutaneous Intervention. Circ Cardiovasc Qual Outcomes 2011. [DOI: 10.1161/circoutcomes.4.suppl_2.ap183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Management of lipids is vital in patients with underlying coronary artery disease (CAD). According to the American College of Cardiology (ACC) guidelines, all patients with CAD should have low density lipoproteins (LDL) goals to be less than 100 mg/dl with the therapeutic option of treatment to less than 70 mg/dl. This can be achieved using multiple lipid lowering agents, however statin use is encouraged in CAD patients due to its multiple beneficial effects.
Methods:
We conducted a retrospective cohort study focusing on lipid management and statin use in 857 veterans undergoing percutaneous coronary intervention (PCI) between September 2004 and December 2009 at the Jesse Brown Veterans Hospital in Chicago, IL. Values were collected both pre-intervention as well as at six month follow up.
Results:
Both pre and post PCI, focus was maintained on the total cholesterol as well as the LDL levels. The mean total cholesterol prior to intervention was 166mg/dl and decreased to150mg/dl at six month follow up. The LDL mean pre-PCI was 98mg/dl and at six months the mean LDL decreased to 86mg/dl. With regards to ACC guidelines, the percent at goal for LDL less than 100mg/dl increased from 59% pre-PCI to 74% post-PCI Furthermore, treatment to less than 70mg/dl increased from 22 to 32% at six months. Lastly, the use of statins increased from 72 to 89%.
Conclusions:
There were in improvements in both total cholesterol and LDL values at six months post-PCI. There were also improvements in the percentage of patients who met the ACC recommended goal of LDL cholesterol less than 100mg/dl and the suggested goal of 70mg/dl. At six months, there was also an increase in usage of statin therapy.
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Healy C, McGraw SA, Mohamedali B, Shivaraju A, Scholfield M, Shroff A. Abstract P166: Blood Pressure Control Following Percutaneous Coronary Intervention at a VA Hospital. Circ Cardiovasc Qual Outcomes 2011. [DOI: 10.1161/circoutcomes.4.suppl_2.ap166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Blood pressure (BP) control in patients with coronary artery disease (CAD) decreases morbidity and mortality. The US Joint National Committee VII (JNC-7) recommends patients with underlying CAD have a goal systolic blood pressure (SBP) < 130 and a diastolic blood pressure (DBP) < 80. These goals can be achieved by using multiple classes of drugs, including beta-blockers (BB), angiotensin antagonists (ACE-I/ARB), calcium channel blockers (CCB), diuretics, and nitrates.
Methods:
We conducted a retrospective cohort study focusing on the attainment of JNC-7 recommended BP goals in a diverse population of 857 veterans undergoing Percutaneous Coronary Intervention (PCI) between September 2004 and December 2009 at the Jesse Brown Veterans Hospital in Chicago, IL. Data was collected comparing both BP measurements and anti-hypertensive regimens pre and post PCI.
Results:
In the 857 patients studied, the mean SBP decreased from 134 mm Hg to 129 mm Hg (p<0.0001), and the mean DBP decreased from 73 mm Hg to 71 mm Hg (p<0.0001). In regards to the JNC-7 guidelines, the percent of patients who achieved SBP goals increased from 44% to 54% (377 to 463 of 857) (p<0.0001), and the percent of patients who achieved DBP goals increased from 71% to 78% (608 to 668 of 857) (p<0.0001). There was a change in the use of each drug class; the use of ACE-I/ARB increased from 72% to 89% (617 to 763 out of 857) (p<0.0001), the use of BB increased from 63% to 76% (540 to 651 out of 857) (p<0.0001), the use of diuretics increased from 41% to 43% (351 to 369 out of 857) (p=0.2997), and the use nitrates increased from 24% to 29% (206 to 249 out of 857) (p=0.0007). The use of CCB, however, decreased from 34% to 30% (291 to 257 out of 857) (p=0.0121).
Conclusions:
There was improvement in both mean BP and percentage of patients achieving JNC-7 recommended goals for SBP & DBP at six months post PCI, though overall percentages still remain suboptimal. Additionally, medication use improved in most drug classes, with the exception of calcium channel blockers. In particular, both beta-blocker and angiotensin antagonist use increased significantly.
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Healy C, McGraw SA, Mohamedali B, Shivaraju A, Scholfield M, Shroff A. Abstract P253: Lipid Control in Minority and Nonminority Veterans Following Percutaneous Intervention. Circ Cardiovasc Qual Outcomes 2011. [DOI: 10.1161/circoutcomes.4.suppl_2.ap253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Control of lipids is vital in patients with Coronary Artery Disease (CAD). According to the American College of Cardiology (ACC) guidelines, all patients with CAD should have low density lipoprotein (LDL) goals of less than 100 mg/dl. It is unclear whether race plays a role in lipid control.
Methods:
We conducted a retrospective cohort study focusing on lipid management and statin use in 857 veterans, 41% minority (M) & 59% non-minority (NM), undergoing percutaneous coronary intervention (PCI) between September 2004 and December 2009 at the Jesse Brown Veterans Hospital in Chicago, IL. Values were collected both pre-intervention and at six month follow up.
Results:
The mean total cholesterol and LDL decreased from prior to intervention to six month follow up in both groups. The mean total cholesterol pre-PCI and at six month follow up was 166 mg/dl & 150 mg/dl, respectively, in the minority group and 165 mg/dl & 150 mg/dl, respectively, in the non-minority group. The mean LDL pre-PCI and at six month follow up was 100 mg/dl & 88 mg/dl, respectively, in the minority group and 94 mg/dl & 82 mg/dl, respectively in the non-minority group. The percent of patients at LDL goals of 100 mg/dl pre-PCI and at six month follow up were 55% and 73% in the minority group and 64% and 77% in the non-minority group. The percent of patients on a statin pre-PCI and at six month follow up were 70% and 91% in the minority group and 75% and 88% in the non-minority group.
Conclusions:
There were improvements in both total cholesterol and LDL values at six months post-PCI in both the minority and non-minority groups. There were also improvements in the percentage of patients who met the ACC recommended goal of LDL cholesterol less than 100 mg/dl at six months in both groups. At six months, there was also an increase in usage of statin therapy in both groups. Race did not appear to play a significant role in lipid management.
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Webber NK, Healy C, Calonje E, Dadzie OE, Powell AM. Images in paediatrics. Childhood melanoma. Arch Dis Child 2010; 95:821. [PMID: 20810401 DOI: 10.1136/adc.2010.193375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Clover AJP, Fitzpatrick E, Healy C. Analysis of methods of providing anonymity in facial photographs; a randomised controlled study. IRISH MEDICAL JOURNAL 2010; 103:243-245. [PMID: 21046866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Clinical images are invaluable in medical teaching and research publications. In the past efforts to conceal patient identity, if any, were limited to a black bar concealing the eyes. However, there is no consensus on this among major journals and publishing houses. This research analyses the effectiveness of blacking out the eyes in facial photographs and evaluates alternative techniques. 126 questionnaires were completed. The average numbers of correct responses out of 30 was 24.64 (82.13%) in the control group, 20.59 (68.63%) in the eyes, 20.42 (68.07%) in the eyes and nose group, and 17.53 (58.43%) in the T-shaped group (eyes, nose and mouth). The traditional method of covering the eyes does significantly decrease recognition, however it is only as effective as covering the nose and mouth. The more of the face that is covered the less likely it is that the person is recognised. However, there are people who remain identifiable no matter how much of the face is covered. This work highlights the importance of obtaining consent prior to publication as well as attempting to hide identity.
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Foraita R, Behrens T, Holcátová I, Conway D, Metspalu A, Znaor A, Lagiou P, Healy C, Simonato L, Talamini R, Merletti F, Hashibe M, Brennan P, Ahrens W. Gene-nutrition interactions that modify the risk of upper aero-digestive tract cancer. Screening results of a European multi-center case-control study. DAS GESUNDHEITSWESEN 2010. [DOI: 10.1055/s-0030-1266734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rogers S, Rahman N, Ryan D, Flint S, Healy C, Stassen LFA. Guidelines for treating patients taking bisphosphonates prior to dental extractions. JOURNAL OF THE IRISH DENTAL ASSOCIATION 2010; 56:40. [PMID: 20337145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Gandhi C, Healy C, Wanderer AA, Hoffman HM. Familial atypical cold urticaria: description of a new hereditary disease. J Allergy Clin Immunol 2010; 124:1245-50. [PMID: 19910034 DOI: 10.1016/j.jaci.2009.09.035] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Revised: 09/10/2009] [Accepted: 09/18/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Acquired cold urticaria (ACU) is usually a self-limited, sporadic, cutaneous disease diagnosed based on history and a positive cold stimulation time test (CSTT) result. We describe 3 unrelated families (A, B, and C) with lifelong atypical cold urticaria distinguished from ACU and familial cold autoinflammatory syndrome. OBJECTIVE We sought to describe a new hereditary disease of cold urticaria and study its pathogenesis. METHODS Questionnaires, interviews, physical examinations, skin testing, and biopsies were performed. Absolute values, means, and prevalence percentages of data are reported. RESULTS Thirty-five subjects are described with familial atypical cold urticaria (FACU; family A, 17; family B, 8; and family C, 10) displaying an autosomal dominant pattern of inheritance. All tested subjects had negative CSTT results. Completed questionnaires from affected and unaffected members of families A and B (n = 35) revealed that all affected subjects had lifelong symptoms that began in early childhood with pruritus, erythema, and urticaria after cold exposure. Angioedema (family A, 23%; family B, 42%) and syncope, near syncope, or both (family A, 46%; family B, 86%) were also present. Triggers included cold atmosphere (100%), aquatic activities (family A, 92%; family B, 100%), handling cold objects (family A, 54%; family B, 71%), and ingestion of cold foods or beverages (family A, 69%; family B, 100%). Skin biopsy specimens demonstrated a mast cell infiltrate with the appearance of degranulation after cold challenge. CONCLUSIONS FACU is a new cold-induced inherited disease that is different than ACU in its natural history, atmospheric cold elicitation, severity of systemic reactions, and CSTT results. FACU differs from familial cold autoinflammatory syndrome in symptom timing and the absence of fever, chills, and joint pain. The cause is suspected to be mast cell related. Treatment of reactions is similar to that for ACU. Further evaluation of pathogenesis and genetics is warranted.
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Constantinidou A, Afuwape SA, Linsell L, Hung T, Acland K, Healy C, Ramirez AJ, Harries M. Informational needs of patients with melanoma and their views on the utility of investigative tests. Int J Clin Pract 2009; 63:1595-600. [PMID: 19832815 DOI: 10.1111/j.1742-1241.2009.02096.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The aim of the study was to identify the informational needs of patients with melanoma on disease status and prognosis, and to ascertain their views on the utility of positron emission tomography (PET) and sentinel node biopsy (SNB). PATIENTS AND METHODS Patients attending the weekly melanoma outpatient clinic at St Thomas' Hospital London UK between February and August 2007 participated in this cross-sectional survey. Views of 106 melanoma patients were elicited using a face-to face semi-structured questionnaire. RESULTS The majority of participants wanted to know everything about their disease (88%). Prognostic information (> 85%) and information on palliative care input (97%) were highly valued. More than 50% expected the doctor to impart this information without negotiation. Nearly 70% of the responders who had previously had a PET scan felt they should decide if and when the scans should be performed. Fifty three percentage had undergone the SNB because the doctor had suggested it. CONCLUSIONS Patients with melanoma want detailed and prompt information about their disease including prognosis. Regular PET scans provide reassurance. The role of SNB is not clear to all patients.
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Sheth N, Sarker SJ, Harries M, Healy C, Russell-Jones R, Acland K. Predictors of patient satisfaction with initial diagnosis and management of malignant melanoma. Clin Exp Dermatol 2009; 35:599-602. [DOI: 10.1111/j.1365-2230.2009.03639.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Twigg SRF, Healy C, Babbs C, Sharpe JA, Wood WG, Sharpe PT, Morriss-Kay GM, Wilkie AOM. Skeletal analysis of the Fgfr3(P244R) mouse, a genetic model for the Muenke craniosynostosis syndrome. Dev Dyn 2009; 238:331-42. [PMID: 19086028 DOI: 10.1002/dvdy.21790] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Muenke syndrome, defined by heterozygosity for a Pro250Arg substitution in fibroblast growth factor receptor 3 (FGFR3), is the most common genetic cause of craniosynostosis in humans. We have used gene targeting to introduce the Muenke syndrome mutation (equivalent to P244R) into the murine Fgfr3 gene. A rounded skull and shortened snout (often skewed) with dental malocclusion was observed in a minority of heterozygotes and many homozygotes. Development of this incompletely penetrant skull phenotype was dependent on genetic background and sex, with males more often affected. However, these cranial abnormalities were rarely attributable to craniosynostosis, which was only present in 2/364 mutants; more commonly, we found fusion of the premaxillary and/or zygomatic sutures. We also found decreased cortical thickness and bone mineral densities in long bones. We conclude that although both cranial and long bone development is variably affected by the murine Fgfr3(P244R) mutation, coronal craniosynostosis is not reliably reproduced.
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Marron M, Boffetta P, Ahrens W, Pohlabeln H, Benhamou S, Bouchardy C, Lagiou P, Georgila C, Bencko V, Holcátová I, Merletti F, Richiardi L, Kjaerheim K, Agudo A, Castellsague X, Macfarlane T, Macfarlane G, Talamini R, Barzan L, Canova C, Simonato L, Lowry R, Conway D, McKinney P, Znaor A, Healy C, McCartan B, Møller H, Brennan P, Hashibe M. Alcohol drinking and the risk of upper aero digestive tract cancer: European multicenter case-control study ARCAGE. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71862-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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