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Artz JH, White SN, Zadvornyy OA, Fugate CJ, Hicks D, Gauss GH, Posewitz MC, Boyd ES, Peters JW. Biochemical and Structural Properties of a Thermostable Mercuric Ion Reductase from Metallosphaera sedula. Front Bioeng Biotechnol 2015. [PMID: 26217660 PMCID: PMC4500099 DOI: 10.3389/fbioe.2015.00097] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Mercuric ion reductase (MerA), a mercury detoxification enzyme, has been tuned by evolution to have high specificity for mercuric ions (Hg2+) and to catalyze their reduction to a more volatile, less toxic elemental form. Here, we present a biochemical and structural characterization of MerA from the thermophilic crenarchaeon Metallosphaera sedula. MerA from M. sedula is a thermostable enzyme, and remains active after extended incubation at 97°C. At 37°C, the NADPH oxidation-linked Hg2+ reduction specific activity was found to be 1.9 μmol/min⋅mg, increasing to 3.1 μmol/min⋅mg at 70°C. M. sedula MerA crystals were obtained and the structure was solved to 1.6 Å, representing the first solved crystal structure of a thermophilic MerA. Comparison of both the crystal structure and amino acid sequence of MerA from M. sedula to mesophillic counterparts provides new insights into the structural determinants that underpin the thermal stability of the enzyme.
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Lopez Pineiro C, Hicks D. Reception of Spanish sociology by domestic and foreign audiences differs and has consequences for evaluation. RESEARCH EVALUATION 2014. [DOI: 10.1093/reseval/rvu030] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ahsan S, Leung JY, Hicks D. TACKLING KNIFE CRIME–A JOINT VENTURE BETWEEN ED AND POLICE IN REDBRIDGE TO IDENTIFY PATTERNS OF ATTENDANCE OF DOMESTIC VIOLENCE VICTIMS. Arch Emerg Med 2013. [DOI: 10.1136/emermed-2013-203113.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sarkozy A, Hicks D, Hudson J, Laval S, Barresi R, Guglieri M, Harris E, Straub V, Bushby K, Lochmuller H. P.5.9 Clinical and molecular analysis of a large cohort of patients with anoctaminopathy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.461] [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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Hicks D, Farsani GT, Laval S, Collins J, Martoni E, Shah A, Zou Y, Koch M, Bonnemann C, Lochmuller H, Bushby K, Roberts M, Straub V. O.1 Collagen XII as a new disease gene for Bethlem-like myopathy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.379] [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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Torabi Farsani G, Hicks D, laval S, Salih M, Seidhamed M, Cossins J, Beeson D, Straub V, Lochmüller H, Bushby K. P.1.6 Investigating collagen VI biosynthesis and assembly in the context of ALG2 impairment in Ullrich/CMS-like family. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ma T, Patel PK, Izumi N, Springer PT, Key MH, Atherton LJ, Benedetti LR, Bradley DK, Callahan DA, Celliers PM, Cerjan CJ, Clark DS, Dewald EL, Dixit SN, Döppner T, Edgell DH, Epstein R, Glenn S, Grim G, Haan SW, Hammel BA, Hicks D, Hsing WW, Jones OS, Khan SF, Kilkenny JD, Kline JL, Kyrala GA, Landen OL, Le Pape S, MacGowan BJ, Mackinnon AJ, MacPhee AG, Meezan NB, Moody JD, Pak A, Parham T, Park HS, Ralph JE, Regan SP, Remington BA, Robey HF, Ross JS, Spears BK, Smalyuk V, Suter LJ, Tommasini R, Town RP, Weber SV, Lindl JD, Edwards MJ, Glenzer SH, Moses EI. Onset of hydrodynamic mix in high-velocity, highly compressed inertial confinement fusion implosions. PHYSICAL REVIEW LETTERS 2013; 111:085004. [PMID: 24010449 DOI: 10.1103/physrevlett.111.085004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Indexed: 06/02/2023]
Abstract
Deuterium-tritium inertial confinement fusion implosion experiments on the National Ignition Facility have demonstrated yields ranging from 0.8 to 7×10(14), and record fuel areal densities of 0.7 to 1.3 g/cm2. These implosions use hohlraums irradiated with shaped laser pulses of 1.5-1.9 MJ energy. The laser peak power and duration at peak power were varied, as were the capsule ablator dopant concentrations and shell thicknesses. We quantify the level of hydrodynamic instability mix of the ablator into the hot spot from the measured elevated absolute x-ray emission of the hot spot. We observe that DT neutron yield and ion temperature decrease abruptly as the hot spot mix mass increases above several hundred ng. The comparison with radiation-hydrodynamic modeling indicates that low mode asymmetries and increased ablator surface perturbations may be responsible for the current performance.
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Wang J, Hicks D. Detecting structural change in university research systems: A case study of British research policy. RESEARCH EVALUATION 2013. [DOI: 10.1093/reseval/rvt016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Anderson C, Hicks D, Scarborough H, Vanderlinden L, Tabakoff B, Behbakht K, Spillman M. Neuropathic pain inhibitor Kindolor augments efficacy of gemcitabine and paclitaxel in ovarian cancer cell lines, allowing reduced chemotherapy concentration. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Robey H, Celliers P, Kline J, Mackinnon A, Boehly T, Landen O, Eggert J, Hicks D, Pape SL, Farley D, Bowers M, Krauter K, Munro D, Jones O, Milovich J, Clark D, Spears B, Town RJ, Haan SW, Dixit S, Schneider M, Dewald E, Widmann K, Moody J, Döppner T, Radousky H, Nikroo A, Kroll J, Hamza A, Horner J, Bhandarkar S, Dzenitis E, Alger E, Giraldez E, Castro C, Moreno K, Haynam C, LaFortune K, Widmayer C, Shaw M, Jancaitis K, Parham T, Holunga D, Walters C, Haid B, Malsbury T, Trummer D, Coffee K, Burr B, Berzins L, Choate C, Brereton S, Azevedo S, Chandrasekaran H, Glenzer S, Caggiano J, Knauer J, Frenje J, Casey D, Johnson MG, Séguin FH, Young B, Edwards M, Wonterghem BV, Kilkenny J, MacGowan B, Atherton L, Lindl J, Meyerhofer D, Moses E. Shock timing on the National Ignition Facility: The first precision tuning series. EPJ WEB OF CONFERENCES 2013. [DOI: 10.1051/epjconf/20135902005] [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
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Weber S, Callahan D, Cerjan C, Edwards M, Haan S, Hicks D, Jones O, Kyrala G, Meezan N, Olson R, Robey H, Spears B, Springer P, Town R. NIF capsule performance modeling. EPJ WEB OF CONFERENCES 2013. [DOI: 10.1051/epjconf/20135902011] [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
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Neelov IM, Janaszewska A, Klajnert B, Bryszewska M, Makova NZ, Hicks D, Pearson HA, Vlasov GP, Ilyash MY, Vasilev DS, Dubrovskaya NM, Tumanova NL, Zhuravin IA, Turner AJ, Nalivaeva NN. Molecular properties of lysine dendrimers and their interactions with Aβ-peptides and neuronal cells. Curr Med Chem 2013; 20:134-143. [PMID: 23033946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 06/06/2012] [Accepted: 09/27/2012] [Indexed: 06/01/2023]
Abstract
Prevention of amyloidosis by chemical compounds is a potential therapeutic strategy in Alzheimer's, prion and other neurodegenerative diseases. Regularly branched dendrimers and less regular hyperbranched polymers have been suggested as promising inhibitors of amyloid aggregation. As demonstrated in our previous studies, some widely used dendrimers (PAMAM, PPI) could not only inhibit amyloid aggregation in solution but also dissolve mature fibrils. In this study we have performed computer simulation of polylysine dendrimers of 3rd and 5th generations (D3 and D5) and analysed the effect of these dendrimers and some hyperbranched polymers on a lysine base (HpbK) on aggregation of amyloid peptide in solution. The effects of dendrimers on cell viability and their protective action against Aβ-induced cytotoxicity and alteration of K+channels was also analysed using human neuroblastoma SH-SY5Y cells. In addition, using fluorescence microscopy, we analysed uptake of FITC-conjugated D3 by SH-SY5Y cells and its distribution in the brain after intraventricular injections to rats. Our results demonstrated that dendrimers D3 and D5 inhibited amyloid aggregation in solution while HpbK enhanced amyloid aggregation. Cell viability and patch-clamp studies have shown that D3 can protect cells against Aβ-induced cytotoxicity and K+channel modulation. In contrast, HpbK had no protective effect against Aβ. Fluorescence microscopy studies demonstrated that FITC-D3 accumulates in the vacuolar compartments of the cells and can be detected in various brain structures and populations of cells after injections to the brain. As such, polylysine dendrimers D3 and D5 can be proposed as compounds for developing antiamyloidogenic drugs.
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Neelov I, Janaszewska A, Klajnert B, Bryszewska M, Makova N, Hicks D, Pearson H, Vlasov G, Ilyash M, Vasilev D, Dubrovskaya N, Tumanova N, Zhuravin I, Turner A, Nalivaeva N. Molecular Properties of Lysine Dendrimers and their Interactions with Aβ-Peptides and Neuronal Cells. Curr Med Chem 2012. [DOI: 10.2174/0929867311302010013] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rinderknecht HG, Johnson MG, Zylstra AB, Sinenian N, Rosenberg MJ, Frenje JA, Waugh CJ, Li CK, Sèguin FH, Petrasso RD, Rygg JR, Kimbrough JR, MacPhee A, Collins GW, Hicks D, Mackinnon A, Bell P, Bionta R, Clancy T, Zacharias R, Döppner T, Park HS, LePape S, Landen O, Meezan N, Moses EI, Glebov VU, Stoeckl C, Sangster TC, Olson R, Kline J, Kilkenny J. A novel particle time of flight diagnostic for measurements of shock- and compression-bang times in D3He and DT implosions at the NIF. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2012; 83:10D902. [PMID: 23126906 DOI: 10.1063/1.4731000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The particle-time-of-flight (pTOF) diagnostic, fielded alongside a wedge range-filter (WRF) proton spectrometer, will provide an absolute timing for the shock-burn weighted ρR measurements that will validate the modeling of implosion dynamics at the National Ignition Facility (NIF). In the first phase of the project, pTOF has recorded accurate bang times in cryogenic DT, DT exploding pusher, and D(3)He implosions using DD or DT neutrons with an accuracy better than ±70 ps. In the second phase of the project, a deflecting magnet will be incorporated into the pTOF design for simultaneous measurements of shock- and compression-bang times in D(3)He-filled surrogate implosions using D(3)He protons and DD-neutrons, respectively.
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Aranday-Cortes E, Bull NC, Villarreal-Ramos B, Gough J, Hicks D, Ortiz-Peláez Á, Vordermeier HM, Salguero FJ. Upregulation of IL-17A, CXCL9 and CXCL10 in Early-Stage Granulomas Induced byMycobacterium bovisin Cattle. Transbound Emerg Dis 2012; 60:525-37. [DOI: 10.1111/j.1865-1682.2012.01370.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Indexed: 12/21/2022]
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Robey HF, Celliers PM, Kline JL, Mackinnon AJ, Boehly TR, Landen OL, Eggert JH, Hicks D, Le Pape S, Farley DR, Bowers MW, Krauter KG, Munro DH, Jones OS, Milovich JL, Clark D, Spears BK, Town RPJ, Haan SW, Dixit S, Schneider MB, Dewald EL, Widmann K, Moody JD, Döppner TD, Radousky HB, Nikroo A, Kroll JJ, Hamza AV, Horner JB, Bhandarkar SD, Dzenitis E, Alger E, Giraldez E, Castro C, Moreno K, Haynam C, LaFortune KN, Widmayer C, Shaw M, Jancaitis K, Parham T, Holunga DM, Walters CF, Haid B, Malsbury T, Trummer D, Coffee KR, Burr B, Berzins LV, Choate C, Brereton SJ, Azevedo S, Chandrasekaran H, Glenzer S, Caggiano JA, Knauer JP, Frenje JA, Casey DT, Johnson MG, Séguin FH, Young BK, Edwards MJ, Van Wonterghem BM, Kilkenny J, MacGowan BJ, Atherton J, Lindl JD, Meyerhofer DD, Moses E. Precision shock tuning on the national ignition facility. PHYSICAL REVIEW LETTERS 2012; 108:215004. [PMID: 23003273 DOI: 10.1103/physrevlett.108.215004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Indexed: 06/01/2023]
Abstract
Ignition implosions on the National Ignition Facility [J. D. Lindl et al., Phys. Plasmas 11, 339 (2004)] are underway with the goal of compressing deuterium-tritium fuel to a sufficiently high areal density (ρR) to sustain a self-propagating burn wave required for fusion power gain greater than unity. These implosions are driven with a very carefully tailored sequence of four shock waves that must be timed to very high precision to keep the fuel entropy and adiabat low and ρR high. The first series of precision tuning experiments on the National Ignition Facility, which use optical diagnostics to directly measure the strength and timing of all four shocks inside a hohlraum-driven, cryogenic liquid-deuterium-filled capsule interior have now been performed. The results of these experiments are presented demonstrating a significant decrease in adiabat over previously untuned implosions. The impact of the improved shock timing is confirmed in related deuterium-tritium layered capsule implosions, which show the highest fuel compression (ρR~1.0 g/cm(2)) measured to date, exceeding the previous record [V. Goncharov et al., Phys. Rev. Lett. 104, 165001 (2010)] by more than a factor of 3. The experiments also clearly reveal an issue with the 4th shock velocity, which is observed to be 20% slower than predictions from numerical simulation.
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Anderson C, Bemis L, Medlin E, Manning N, Dye W, Hicks D, Spillman M. Differential estrogen regulation of ovarian cancer MicroRNAs integrates BRCA1 and progesterone receptor pathways. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.314] [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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Panicker J, Lochmuller H, Bushby K, Straub V, Hicks D, Sarkozy A, Ray P. 165 Novel ANO5 gene mutations, c.989dupT and c.2018A→G causing Limb Girdle Muscular dystrophy 2L. Journal of Neurology, Neurosurgery and Psychiatry 2012. [DOI: 10.1136/jnnp-2011-301993.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hicks D, Martoni E, Straub V, Lochmüller H, Laval S, Bushby K. P79 Identification of novel variants in patients with non-collagen VI Bethlem myopathy by the emerging technology of exomic sequencing. Neuromuscul Disord 2012. [DOI: 10.1016/s0960-8966(12)70087-1] [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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Johnson N, Brookes S, Healy D, Spencer Y, Hicks D, Nunez A, Wells G, Fooks A. Pathology Associated with a Human Case of Rabies in the United Kingdom Caused by European Bat Lyssavirus Type-2. Intervirology 2012; 55:391-4. [DOI: 10.1159/000333019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/21/2011] [Indexed: 12/25/2022] Open
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Dabbs DJ, Hicks D, Tubbs R, Bhargava R, Brufsky A. P4-09-22: Multicenter Quality Assurance Profile Review of Lobular Breast Carcinomas Versus the 21 Gene Recurrence Score: Assessment of Clinical Relevance. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-09-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
The oncotype dx (ODX) 21 gene recurrence score (RS), was intended to predict the 10 year risk of breast cancer recurrence for estrogen receptor positive, lymph node negative disease (NEJM 2004;351:2817–26). The proportions of patients that were reported as low, intermediate and high risk were 51%/22%, 27%. This population of patients was dominated by ductal carcinomas (DCA), with a paucity of classical lobular carcinomas (CLCA), which are ER-rich and low grade histology. To date, there is dearth of data regarding the relationship of the RS and CLCA, and the clinical relevance regarding the ODX RS in CLCA has not been studied.
Methods
As part of quality assurance review at three institutions, the ODX RS for all CLCA were reviewed in order to determine the perceived clinical relevance of the ODX RS compared to the proportions of RS reported (NEJM 2004;351:2817–26).
Results
A total of 219 cases of ODX were performed on CLCA. The low/intermediate/high risk profile was 58%/40%/2%.
Conclusions (1) The risk profile of ODX for CLCA is very different from the original DCA dominant population previously reported. (2) If the goal of ODX is to identify candidates for chemotherapy, then a high RS is a rare event for CLCA, and as such, the judgment to administer chemotherapy to an individual patient would most likely depend upon factors other than the ODX, because 98 percent of patients are combined low/intermediate risk RS.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-22.
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Peppone L, Rickles A, Huston A, Sprod L, Hicks D, Mustian K, Skinner K. The Association between Prognostic Demographic and Tumor Characteristics of Breast Carcinomas with Serum 25-OH Vitamin D Levels. Cancer Epidemiol Biomarkers Prev 2011. [DOI: 10.1158/1055-9965.epi-11-0089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sparrow JR, Hicks D, Hamel CP. The retinal pigment epithelium in health and disease. Curr Mol Med 2011; 10:802-23. [PMID: 21091424 DOI: 10.2174/156652410793937813] [Citation(s) in RCA: 397] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 09/13/2010] [Indexed: 12/15/2022]
Abstract
Retinal pigment epithelial cells (RPE) constitute a simple layer of cuboidal cells that are strategically situated behind the photoreceptor (PR) cells. The inconspicuousness of this monolayer contrasts sharply with its importance [1]. The relationship between the RPE and PR cells is crucial to sight; this is evident from basic and clinical studies demonstrating that primary dysfunctioning of the RPE can result in visual cell death and blindness. RPE cells carry out many functions including the conversion and storage of retinoid, the phagocytosis of shed PR outer segment membrane, the absorption of scattered light, ion and fluid transport and RPE-PR apposition. The magnitude of the demands imposed on this single layer of cells in order to execute these tasks, will become apparent to the reader of this review as will the number of clinical disorders that take origin from these cells.
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Frid A, Hirsch L, Gaspar R, Hicks D, Kreugel G, Liersch J, Letondeur C, Sauvanet JP, Tubiana-Rufi N, Strauss K. The Third Injection Technique Workshop in Athens (TITAN). DIABETES & METABOLISM 2010; 36 Suppl 2:S19-29. [PMID: 20933206 DOI: 10.1016/s1262-3636(10)70003-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The first Injection Technique workshop brought together endocrinologists and injection experts from around the world in Strasbourg in 1997. From its work came groundbreaking recommendations which advanced best practices in areas such as the use of a skin fold when injecting. The second Injection Technique workshop, with an expanded format including nurses and diabetes educators, took place in Barcelona in 2000. The initial stimulus to use shorter injecting needles can be said to date from this meeting. The third Injection Technique workshop was held in Athens in September 2009 and involved 127 experts from across the globe. After a comprehensive review of all publications since 2000 as well as several unpublished studies, the attendees divided into smaller groups to debate and draft new injecting recommendations based on the new data and their collective experience. This paper summarizes all the formal presentations given at this practical consensus workshop.
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Frid A, Hirsch L, Gaspar R, Hicks D, Kreugel G, Liersch J, Letondeur C, Sauvanet JP, Tubiana-Rufi N, Strauss K. New injection recommendations for patients with diabetes. DIABETES & METABOLISM 2010; 36 Suppl 2:S3-18. [PMID: 20933208 DOI: 10.1016/s1262-3636(10)70002-1] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM Injections administered by patients are one of the mainstays of diabetes management. Proper injection technique is vital to avoiding intramuscular injections, ensuring appropriate delivery to the subcutaneous tissues and avoiding common complications such as lipohypertrophy. Yet few formal guidelines have been published summarizing all that is known about best practice. We propose new injection guidelines which are thoroughly evidence-based, written and vetted by a large group of international injection experts. METHODS A systematic literature study was conducted for all peer-reviewed studies and publications which bear on injections in diabetes. An international group of experts met regularly over a two-year period to review this literature and draft the recommendations. These were then presented for review and revision to 127 experts from 27 countries at the TITAN workshop in September, 2009. RESULTS Of 292 articles reviewed, 157 were found to meet the criteria of relevance to the recommendations. Each recommendation was graded by the weight it should have in daily practice and by its degree of support in the medical literature. The topics covered include The Role of the Professional, Psychological Challenges, Education, Site Care, Storage, Suspension and Priming, Injecting Process, Proper Use of Pens and Syringes, Insulin analogues, Human and Pre-mixed Insulins, GLP-1 analogs, Needle Length, Skin Folds, Lipohypertrophy, Rotation, Bleeding and Bruising, Pregnancy, Safety and Disposal. CONCLUSION These injecting recommendations provide practical guidance and fill an important gap in diabetes management. If followed, they should help ensure comfortable, effective and largely complication-free injections.
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