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Li C, Patel K, Allen P, TU Z, Kilkenny J, Wallace C, Nadig S, Tomlinson S, Atkinson C. A Novel Injury Site-Targeted Complement Inhibitor Which Protects against Lung Transplant Ischemia Reperfusion Injury. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Tu Z, Allen P, Wallace C, Li C, Kilkenny J, Patel K, Nadig S, Atkinson C. Endothelial Stabilization Reduces the Effects of Brain Death Induced Acute Lung Injury Post-Transplant. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Tran D, Tu Z, Atkinson C, Nadig S. Modulating Mitochondrial Fusion/Fission Induces Immunoprotective Effects in Models of Cardiac Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.168] [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
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Zamora C, Hung SC, Tomingas C, Atkinson C, Castillo M. Engorgement of Deep Medullary Veins in Neurosarcoidosis: A Common-Yet-Underrecognized Cerebrovascular Finding on SWI. AJNR Am J Neuroradiol 2018; 39:2045-2050. [PMID: 30237298 DOI: 10.3174/ajnr.a5783] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/18/2018] [Indexed: 12/25/2022]
Abstract
We describe the prevalence and potential significance of deep medullary vein engorgement on SWI in patients with neurosarcoidosis, a finding that has not been described previously. Engorgement was evaluated for possible associations with meningeal or perivascular disease, intracranial hemorrhage, and venous thrombosis, as well as with modified Rankin Scale scores at the time of MR imaging and at follow-up. Deep medullary vein engorgement was seen in 7 of 21 patients and was more common in men. Patients with venous engorgement had a significantly increased incidence of microhemorrhages, perivascular disease, and hydrocephalus. There was no association with the degree of leptomeningeal disease, venous dural sinus thrombosis, or modified Rankin Scale scores. In conclusion, deep medullary vein engorgement was common in our patients with neurosarcoidosis. Although its pathophysiology remains uncertain, it could be related to venous or perivenous abnormalities and may represent a useful secondary finding of cerebrovascular disease.
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Atkinson C, Howes N, Thomas S, Lewis S. Immunonutrition for patients undergoing surgery for head and neck cancer – a systematic review and meta-analysis. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Patel K, Cheng Q, Allen D, Aliweah A, Knochelmann H, Paulos C, Goddard M, Nadig S, Atkinson C. Recipient Emphysema Differentially Affects Immunologic Responses During Acute Lung Allograft Rejection in a Pre-Clinical Model. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Atkinson C, Yuen J, Poder J, Hau E, Chin Y. P2.14-010 The Time-Weighted Mid-Ventilation Technique: Reducing Planning Target Volumes For Patients Undergoing Lung Stereotactic Body Radiotherapy. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1382] [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]
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Atkinson C, Short V, Ness A, Lewis S, Longman R, Thomas S, Leary S, Hollingworth W, Penfold C. MON-LB339: Predictors of Early Post-Operative Feeding: An Observational Study in a Colorectal Surgery Population. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)31087-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cheng Q, Patel K, Zhu P, Rucker L, Allen P, Vasu C, Nadig S, Atkinson C. Donor Organ Pretreatment with a Gap and Tight Junction Stabilizing Peptide Prevents IRI in a Mouse Lung Transplant Model. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.170] [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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Patel K, Cheng Q, Finnegan R, Ballish Z, Rucker L, Nadig S, Atkinson C. Augmentation of UW Solution with a Gap and Tight Junction Stabilizing Peptide, αCT1, Ameliorates Ischemia Reperfusion Injury, Facilitates Prolonged Graft Storage, and Protects Against the Development of Allograft Vasculopathy. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1074] [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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Tran D, Dong C, Alawieh A, Beeson G, Atkinson C, Nadig S. Static Cold Storage Induces Metabolic Alterations and Autophagy in Models of Cardiac Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1062] [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] Open
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Atkinson C, Penfold C, Longman R, Thomas S, Hollingworth W, Leary S, Lewis S, Ness A. MON-LB280: An Exploratory subgroup Analysis from a Randomised Controlled Trial (RCT) of Chewing Gum after Colorectal Surgery. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Luck SE, Emery VC, Atkinson C, Sharland M, Griffiths PD. Compartmentalized dynamics of cytomegalovirus replication in treated congenital infection. J Clin Virol 2016; 82:152-158. [PMID: 27500364 DOI: 10.1016/j.jcv.2016.07.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) is the most prevalent congenital infection in developed countries. A significant number of infected infants develop long-term neurodevelopmental and hearing impairment irrespective of whether disease is detectable at birth. Studies of viral load and replication dynamics have informed the treatment of CMV in adult populations but no similar data exist in neonates. OBJECTIVES To study CMV virus kinetics in different body fluids of babies treated for congenital infection. STUDY DESIGN CMV virus load was sequentially analyzed in blood, urine and saliva in 17 babies treated for symptomatic congenital CMV infection. RESULTS Virus was detectable in the urine and saliva of all babies at baseline but in only 15/17 in blood. At the end of 6 weeks of antiviral treatment CMV remained detectable in 9/14 blood samples, 9/12 urine samples and 4/7 salivary swabs. Median half-life (T1/2) of virus decline in blood was 2.4 days (IQR 1.9-3.3) and basic reproductive number (Ro) was 2.3. Although T1/2 values were similar in urine and saliva to those observed in blood, virus dynamics differed both during and after treatment. CONCLUSIONS T1/2 and Ro in blood in this group of neonates were similar to values derived from studies of immunocompromised adults. The persistent viremia observed in treated neonates cannot therefore be adequately explained by the virus dynamics early in treatment. The different dynamics exhibited in blood and urine suggests that studying changes in distinct body compartments may assist in further understanding long-term manifestations of disease.
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Delahunt B, Egevad L, Srigley JR, Steigler A, Murray JD, Atkinson C, Matthews J, Duchesne G, Spry NA, Christie D, Joseph D, Attia J, Denham JW. Validation of International Society of Urological Pathology (ISUP) grading for prostatic adenocarcinoma in thin core biopsies using TROG 03.04 'RADAR' trial clinical data. Pathology 2016; 47:520-5. [PMID: 26325671 DOI: 10.1097/pat.0000000000000318] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In 2014 a consensus conference convened by the International Society of Urological Pathology (ISUP) adopted amendments to the criteria for Gleason grading and scoring (GS) for prostatic adenocarcinoma. The meeting defined a modified grading system based on 5 grading categories (grade 1, GS 3+3; grade 2, GS 3+4; grade 3, GS 4+3; grade 4, GS 8; grade 5, GS 9-10). In this study we have evaluated the prognostic significance of ISUP grading in 496 patients enrolled in the TROG 03.04 RADAR Trial. There were 19 grade 1, 118 grade 2, 193 grade 3, 88 grade 4 and 79 grade 5 tumours in the series, with follow-up for a minimum of 6.5 years. On follow-up 76 patients experienced distant progression of disease, 171 prostate specific antigen (PSA) progression and 39 prostate cancer deaths. In contrast to the 2005 modified Gleason system (MGS), the hazards of the distant and PSA progression endpoints, relative to grade 2, were significantly greater for grades 3, 4 and 5 of the 2014 ISUP grading scheme. Comparison of predictive ability utilising Harrell's concordance index, showed 2014 ISUP grading to significantly out-perform 2005 MGS grading for each of the three clinical endpoints.
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Atkinson C, Thompson ME. Analysis of two parallel queues by common exit service and infinite queue size. ADV APPL PROBAB 2016. [DOI: 10.2307/1426472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A system of two parallel queues is considered, where each customer must leave after service through a common gate G. It is assumed that service times at the two stations I and II are independent and identically distributed, and that exit service takes a fixed length of time. A I-customer may be served at station I only if the previous I-customer has completed exit service. Integral equations are formulated from which the distribution of the total service time may be obtained when the two queue sizes are infinite. These equations are solved for exponential and generalized erlangian service times. Extensions to the case of k parallel queues and to the case of Poisson arrivals and finite queue sizes are discussed briefly.
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Atkinson C, Penfold CM, Ness AR, Longman RJ, Thomas SJ, Hollingworth W, Kandiyali R, Leary SD, Lewis SJ. Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection. Br J Surg 2016; 103:962-70. [PMID: 27146793 PMCID: PMC5084762 DOI: 10.1002/bjs.10194] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 03/08/2016] [Accepted: 03/10/2016] [Indexed: 12/20/2022]
Abstract
Background Chewing gum may stimulate gastrointestinal motility, with beneficial effects on postoperative ileus suggested in small studies. The primary aim of this trial was to determine whether chewing gum reduces length of hospital stay (LOS) after colorectal resection. Secondary aims included examining bowel habit symptoms, complications and healthcare costs. Methods This clinical trial allocated patients randomly to standard postoperative care with or without chewing gum (sugar‐free gum for at least 10 min, four times per day on days 1–5) in five UK hospitals. The primary outcome was LOS. Cox regression was used to calculate hazard ratios for LOS. Results Data from 402 of 412 patients, of whom 199 (49·5 per cent) were allocated to chewing gum, were available for analysis. Some 40 per cent of patients in both groups had laparoscopic surgery, and all study sites used enhanced recovery programmes. Median (i.q.r.) LOS was 7 (5–11) days in both groups (P = 0·962); the hazard ratio for use of gum was 0·94 (95 per cent c.i. 0·77 to 1·15; P = 0·557). Participants allocated to gum had worse quality of life, measured using the EuroQoL 5D‐3L, than controls at 6 and 12 weeks after operation (but not on day 4). They also had more complications graded III or above according to the Dindo–Demartines–Clavien classification (16 versus 6 in the group that received standard care) and deaths (11 versus 0), but none was classed as related to gum. No other differences were observed. Conclusion Chewing gum did not alter the return of bowel function or LOS after colorectal resection. Registration number: ISRCTN55784442 (http://www.controlled-trials.com). No advantage observed
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Mullan S, Szmaragd C, Cooper MD, Wrathall JHM, Jamieson J, Bond A, Atkinson C, Main DCJ. Animal welfare initiatives improve feather cover of cage-free laying hens in the UK. Anim Welf 2016. [DOI: 10.7120/09627286.25.2.243] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Finnegan R, Zhu P, Stephenson S, Nadig S, Atkinson C. Cold Storage Stabilization of Gap Junctions Reduces Post Transplant Ischemia Reperfusion Injury. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Short V, Atkinson C, Ness AR, Thomas S, Burden S, Sutton E. Patient experiences of perioperative nutrition within an Enhanced Recovery After Surgery programme for colorectal surgery: a qualitative study. Colorectal Dis 2016; 18:O74-80. [PMID: 26682875 PMCID: PMC4755035 DOI: 10.1111/codi.13245] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/26/2015] [Indexed: 02/08/2023]
Abstract
AIM Nutrition is an important element of the Enhanced Recovery After Surgery (ERAS) programme. Patients have previously indicated that nutrition is a key component of ERAS that requires improvement. Our aim was to explore the perioperative nutrition experiences of colorectal surgical patients to identify barriers and facilitators to the integration of nutrition within ERAS. METHOD Sixteen individuals undergoing colorectal surgery participated in a semi-structured interview between postoperative day three and hospital discharge. The topic guide was developed iteratively throughout the study; topics included preoperative counselling, carbohydrate loading, fasting and postoperative nutrition. A constant comparison technique was employed during coding, and an inductive thematic analysis was used. Validity was ensured by double coding a sample of transcripts. RESULTS Findings are presented in the context of the following clinical themes: preoperative information, preoperative fasting, carbohydrate loading and nutritional drinks, postoperative diet and discharge. Individuals received too much general information which was repetitive, contradictory and not disease specific; this formed a key barrier affecting nutrition. Other barriers were negative experiences of nutritional drinks, stoma management, nausea and vomiting, and challenges from the hospital environment. Facilitators included interactions with staff, food accessibility and choice, and motivation for discharge. CONCLUSION The key barrier to adherence of perioperative nutrition protocols was poor provision of information. Targeted information regarding postoperative diet, stoma management and coping with nausea and vomiting would be beneficial for colorectal surgical patients. Easily accessible food provided by ward staff was considered a facilitator.
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Vyas K, Atkinson C, Clark D, Irish D. Comparison of five commercially available immunochromatographic tests for the detection of norovirus in faecal specimens. J Hosp Infect 2015; 91:176-8. [DOI: 10.1016/j.jhin.2015.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 06/27/2015] [Indexed: 01/13/2023]
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Skolimowska K, Ramsay I, Atkinson C, Krichevskaya S, Nebbia G, Haque T. Chromosomal integration of HHV-6 – A diagnostic quandary. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.093] [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]
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Aldridge RW, Mattes FM, Rolando N, Rolles K, Smith C, Shirling G, Atkinson C, Burroughs AK, Milne RSB, Emery VC, Griffiths PD. Effects of donor/recipient human leukocyte antigen mismatch on human cytomegalovirus replication following liver transplantation. Transpl Infect Dis 2015; 17:25-32. [PMID: 25572799 PMCID: PMC4345424 DOI: 10.1111/tid.12325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/16/2014] [Accepted: 09/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Natural immunity against cytomegalovirus (CMV) can control virus replication after solid organ transplantation; however, it is not known which components of the adaptive immune system mediate this protection. We investigated whether this protection requires human leukocyte antigen (HLA) matching between donor and recipient by exploiting the fact that, unlike transplantation of other solid organs, liver transplantation does not require HLA matching, but some donor and recipient pairs may nevertheless be matched by chance. METHODS To further investigate this immune control, we determined whether chance HLA matching between donor (D) and recipient (R) in liver transplants affected a range of viral replication parameters. RESULTS In total, 274 liver transplant recipients were stratified according to matches at the HLA A, HLA B, and HLA DR loci. The incidence of CMV viremia, kinetics of replication, and peak viral load were similar between the HLA matched and mismatched patients in the D+/R+ and D-/R+ transplant groups. D+/R- transplants with 1 or 2 mismatches at the HLA DR locus had a higher incidence of CMV viremia >3000 genomes/mL blood compared to patients matched at this locus (78% vs. 17%; P = 0.01). Evidence was seen that matching at the HLA A locus had a small effect on peak viral loads in D+/R- patients, with median peak loads of 3540 and 14,706 genomes/mL in the 0 and combined (1 and 2) mismatch groups, respectively (P = 0.03). CONCLUSION Overall, our data indicate that, in the setting of liver transplantation, prevention of CMV infection and control of CMV replication by adaptive immunity is minimally influenced by HLA matching of the donor and recipient. Our data raise questions about immune control of CMV in the liver and also about the cells in which the virus is amplified to give rise to CMV viremia.
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Atkinson C, Penfold C, Ness A, Longman R, Thomas S, Hollingworth W, Leary S, Lewis S. LB024-MON: A Randomised Trial of Chewing Gum to Reduce Post-Operative Ileus. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Main D, Mullan S, Atkinson C, Cooper M, Wrathall J, Blokhuis H. Best practice framework for animal welfare certification schemes. Trends Food Sci Technol 2014. [DOI: 10.1016/j.tifs.2014.03.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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