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Wilson D, Hyde E, Wilson D, Claridge S, Leong K, Salciccioli J, Conroy R, Ganesha Babu G, Scott P, Manupati S, Lazdam M, Leventogiannis G, Barr C, Morgan J, Plank G, Rinaldi C, Niederer S, Zeljko H, Leventopoulos G, Ahmed N, Thomas G, Duncan E, Rodderick P, Morgan J, Chen Z, Jackson T, Behar J, Ali M, Bostock J, Lumley M, Williams R, Assress K, De Silva K, Gill J, Perera D, Rinaldi C, Ng F, Kanapeckaite L, Hu M, Roney C, Lim P, Harding S, Peters N, Varnava A, Kanagaratnam P, Marshall D, Sykes M, Lim P, Lee S, Rotheram N, Macedo A, Cobb V, Providencia R, Srinivasan N, Ahsan S, Chow A, Murgatroyd F, Silberbauer J, Hooper J, Zaman M, Yao Z, Zaidi A, Ahmed F, Virdee M, Heck P, Agarwal S, Lee J, Grace A, Begley D, Fynn S. Posters 2. Europace 2015; 17:v22-v25. [PMCID: PMC4892099 DOI: 10.1093/europace/euv330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
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Carey A, McCarthy H, Gill J, Thompson A, McNulty H. Novel segmental proxy measures for estimating weight and height in healthy school children aged 11–18 years. Clin Nutr ESPEN 2015; 10:e211. [DOI: 10.1016/j.clnesp.2015.03.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gill J, Chick J, Black H, Rees C, O'May F, Rush R, McPake BA. Alcohol purchasing by ill heavy drinkers; cheap alcohol is no single commodity. Public Health 2015; 129:1571-8. [PMID: 26411488 PMCID: PMC4684143 DOI: 10.1016/j.puhe.2015.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 07/14/2015] [Accepted: 08/20/2015] [Indexed: 12/02/2022]
Abstract
Objectives Potential strategies to address alcohol misuse remain contentious. We aim to characterise the drink purchases of one population group: heavy drinkers in contact with Scottish health services. We contrast our findings with national sales data and explore the impact of socio-economic status on purchasing behaviour. Study design Cross-sectional study comparing alcohol purchasing and consumption by heavy drinkers in Edinburgh and Glasgow during 2012. Methods 639 patients with serious health problems linked to alcohol (recruited within NHS hospital clinics (in- and out-patient settings) 345 in Glasgow, 294 in Edinburgh) responded to a questionnaire documenting demographic data and last week's or a ‘typical’ weekly consumption (type, brand, volume, price, place of purchase). Scottish Index of Multiple Deprivation quintile was derived as proxy of sociodemographic status. Results Median consumption was 184.8 (IQR = 162.2) UK units/week paying a mean of 39.7 pence per alcohol unit (£0.397). Off-sales accounted for 95% of purchases with 85% of those <50 pence (£0.5 UK) per alcohol unit. Corresponding figures for the Scottish population are 69% and 60%. The most popular low-priced drinks were white cider, beer and vodka with the most common off-sales outlet being the corner shop, despite supermarkets offering cheaper options. Consumption levels of the cheapest drink (white cider) were similar across all quintiles apart from the least deprived. Conclusions Heavy drinkers from all quintiles purchase the majority of their drinks from off-sale settings seeking the cheapest drinks, often favouring local suppliers. While beer was popular, recent legislation impacting on the sale of multibuys may prevent the heaviest drinkers benefiting from the lower beer prices available in supermarkets. Non-etheless, drinkers were able to offset higher unit prices with cheaper drink types and maintain high levels of consumption. Whilst price is key, heavy drinkers are influenced by other factors and adapt their purchasing as necessary. We surveyed drinking behaviour in 639 patients with alcohol-related harm. Consumption was predominantly from off-sale settings (median = 184.8 UK units/week). Popular drinks were cheap varieties of white cider and vodka. Price and location of point of sale were key drivers of consumption. 85% of units cost less that the proposed minimum unit price for alcohol.
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Gill J, Chick J, Lachenmeier DW, Rush R, O'May F, Black H. FOC6-8WHITE CIDER; A PRICE WORTH PAYING? Alcohol Alcohol 2015. [DOI: 10.1093/alcalc/agv079.27] [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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Brunet L, Moodie EEM, Cox J, Gill J, Cooper C, Walmsley S, Rachlis A, Hull M, Klein MB. Opioid use and risk of liver fibrosis in HIV/hepatitis C virus-coinfected patients in Canada. HIV Med 2015; 17:36-45. [PMID: 26140381 DOI: 10.1111/hiv.12279] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Opioid use and opioid-related mortality have increased dramatically since the 1990s in North America. The effect of opioids on the liver is incompletely understood. Some studies have suggested that opioids cause liver damage and others have failed to show any harm. HIV/hepatitis C virus (HCV)-coinfected persons may be particularly vulnerable to factors increasing liver fibrosis. We aimed to describe opioid use in an HIV/HCV-coinfected population in Canada and to estimate the association between opioid use and liver fibrosis. METHODS We conducted a cross-sectional descriptive analysis of the Canadian Co-infection Cohort Study data to characterize opioid use. We then conducted a longitudinal analysis to assess the average change in aspartate aminotransferase-to-platelet ratio index (APRI) score associated with opioid use using a generalized estimating equation with linear regression. We assessed the progression to significant liver fibrosis (APRI ≥ 1.5) associated with opioid use with pooled logistic regression. RESULTS In the 6 months preceding cohort entry, 32% of the participants had received an opioid prescription, 28% had used opioids illicitly and 18% had both received a prescription and used opioids illicitly. Neither prescribed nor illicit opioid use was associated with a change in the median APRI score [exp(β) 0.99 (95% confidence interval (CI) 0.82, 1.12) and exp(β) 0.95 (95% CI 0.81, 1.10), respectively] or with faster progression to liver fibrosis [hazard odds ratio (HOR) 1.20 (95% CI 0.73, 1.67) and HOR 1.09 (95% CI 0.63, 1.55), respectively]. CONCLUSIONS Although opioids were commonly used both legally and illegally in our cohort, we were unable to demonstrate a negative impact on liver fibrosis progression.
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Walton TA, Nishtar S, Lumb PJ, Crook MA, Marber MS, Gill J, Wierzbicki AS. Pro-protein convertase subtilisin/kexin 9 concentrations correlate with coronary artery disease atheroma burden in a Pakistani cohort with chronic chest pain. Int J Clin Pract 2015; 69:738-42. [PMID: 25707773 DOI: 10.1111/ijcp.12615] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To determine the relationship between proprotein convertase subtilisin kexin 9 (PCSK9) levels and atheroma burden in Pakistanis presenting to an ambulatory centre with chest pain. METHODS A prospective matched case-control study of 400 patients selected for presence/absence of angiographic disease referred between 2001 and 2003. A comprehensive cardiovascular disease risk factor profile was assessed including demographics, environmental and biochemical risk factors including insulin resistance and PCSK-9 levels. Coronary atheroma burden was quantified by Gensini score. RESULTS In this population, PCSK-9 levels were weakly correlated (r = 0.23) with male gender (p = 0.06) and number of diabetes years (p = 0.09), and inversely with log10 of lipoprotein (a) concentration (p = 0.07) but not LDL-C. In multiple regression analysis, Gensini score was associated with age (p = 0.002), established angina (p = 0.001), duration of diabetes (p = 0.05), low HDL-C (p < 0.001), lipoprotein (a) (p = 0.01), creatinine (p < 0.001), C-Reactive Protein (p = 0.02) and PSCK-9 (p = 0.05) concentrations. PCSK9 added to the regression model. Neither total cholesterol nor LDL-C were significant risk factors in this study. CONCLUSIONS Proprotein convertase subtilisin kexin 9 concentrations are correlated with atheroma burden in Indian Asian populations from the sub-continent, not taking statin therapy, independent of LDL-C or other CVD risk factors.
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Gill J, Zhang X, Joseph P. Single velocity-component modeling of leading edge turbulence interaction noise. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 137:3209-3220. [PMID: 26093411 DOI: 10.1121/1.4921547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A computational aeroacoustics approach is used to predict leading edge turbulence interaction noise for real airfoils. One-component (transverse), two-component (transverse and streamwise), and three-component (transverse, streamwise, and spanwise) synthesized turbulence disturbances are modeled instead of harmonic transverse gusts, to which previous computational studies of leading edge noise have often been confined. The effects of the inclusion of streamwise and spanwise disturbances on the noise are assessed. It is shown that accurate noise predictions can be made by modeling only transverse disturbances which reduces the computational expense of simulations. The accuracy of using only transverse disturbances is assessed for symmetric and cambered airfoils, and also for airfoils at non-zero angle of attack.
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Koethe JR, Jenkins CA, Lau B, Shepherd BE, Silverberg MJ, Brown TT, Blashill AJ, Anema A, Willig A, Stinnette S, Napravnik S, Gill J, Crane HM, Sterling TR. Body mass index and early CD4 T-cell recovery among adults initiating antiretroviral therapy in North America, 1998-2010. HIV Med 2015; 16:572-7. [PMID: 25960080 DOI: 10.1111/hiv.12259] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Adipose tissue affects several aspects of the cellular immune system, but prior epidemiological studies have differed on whether a higher body mass index (BMI) promotes CD4 T-cell recovery on antiretroviral therapy (ART). The objective of this analysis was to assess the relationship between BMI at ART initiation and early changes in CD4 T-cell count. METHODS We used the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) data set to analyse the relationship between pre-treatment BMI and 12-month CD4 T-cell recovery among adults who started ART between 1998 and 2010 and maintained HIV-1 RNA levels < 400 copies/mL for at least 6 months. Multivariable regression models were adjusted for age, race, sex, baseline CD4 count and HIV RNA level, year of ART initiation, ART regimen and clinical site. RESULTS A total of 8381 participants from 13 cohorts contributed data; 85% were male, 52% were nonwhite, 32% were overweight (BMI 25-29.9 kg/m(2) ) and 15% were obese (BMI > 30 kg/m(2) ). Pretreatment BMI was associated with 12-month CD4 T-cell change (P < 0.001), but the relationship was nonlinear (P < 0.001). Compared with a reference of 22 kg/m(2) , a BMI of 30 kg/m(2) was associated with a 36 cells/μL [95% confidence interval (CI) 14, 59 cells/μL] greater CD4 T-cell count recovery among women and a 19 cells/μL (95% CI 9, 30 cells/μL) greater recovery among men at 12 months. At a BMI > 30 kg/m(2) , the observed benefit was attenuated among men to a greater degree than among women, although this difference was not statistically significant. CONCLUSIONS A BMI of approximately 30 kg/m(2) at ART initiation was associated with greater CD4 T-cell recovery at 12 months compared with higher or lower BMI values, suggesting that body composition may affect peripheral CD4 T-cell recovery.
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Levin P, Wei W, Miao R, Ye F, Xie L, Baser O, Gill J. Therapeutically interchangeable? A study of real-world outcomes associated with switching basal insulin analogues among US patients with type 2 diabetes mellitus using electronic medical records data. Diabetes Obes Metab 2015; 17:245-53. [PMID: 25359227 PMCID: PMC4383352 DOI: 10.1111/dom.12407] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/03/2014] [Accepted: 10/20/2014] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate real-world clinical outcomes for switching basal insulin analogues [insulin glargine (GLA) and insulin detemir (DET)] among US patients with type 2 diabetes mellitus (T2DM). METHODS Using the GE Centricity Electronic Medical Records database, this retrospective study examined two cohorts: cohort 1, comprising patients previously on GLA and then either switching to DET (DET-S) or continuing with GLA (GLA-C); and cohort 2, comprising patients previously on DET and then either switching to GLA (GLA-S) or continuing with DET (DET-C). Within each cohort, treatment groups were propensity-score-matched on baseline characteristics. At 1-year follow-up, insulin treatment patterns, glycated haemoglobin (HbA1c) levels, hypoglycaemic events, weight and body mass index (BMI) were evaluated. RESULTS The analysis included 13 942 patients: cohort 1: n = 10 657 (DET-S, n = 1797 matched to GLA-C, n = 8860) and cohort 2: n = 3285 (GLA-S, n = 858 matched to DET-C, n = 2427). Baseline characteristics were similar between the treatment groups in each cohort. At 1-year follow-up, in cohort 1, patients in the DET-S subgroup were significantly less persistent with treatment, more likely to use a rapid-acting insulin analogue, had higher HbA1c values, lower HbA1c reductions and lower proportions of patients achieving HbA1c <7.0 or <8.0% compared with patients in the GLA-C subgroup, while hypoglycaemia rates and BMI/weight values and change from baseline were similar in the two subgroups. In cohort 2, overall, there were contrasting findings between patients in the GLA-S and those in the DET-C subgroup. CONCLUSIONS This study showed contrasting results when patients with T2DM switched between basal insulin analogues, although these preliminary results may be subject to limitations in the analysis. Nevertheless, this study calls into question the therapeutic interchangeability of GLA and DET, and this merits further investigation.
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Ng C, Ng S, Gill J. Measuring the Prevalence of Major Depressive Disorder Among Palliative Patients – Comparing Four Sets of Diagnostic Criteria. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30567-8] [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: 11/24/2022] Open
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Blossom DB, Alelis KA, Chang DC, Flores AH, Gill J, Beall D, Peterson AM, Jensen B, Noble-Wang J, Williams M, Yakrus MA, Arduino MJ, Srinivasan A. Pseudo-outbreak ofMycobacterium abscessusInfection Caused by Laboratory Contamination. Infect Control Hosp Epidemiol 2015; 29:57-62. [DOI: 10.1086/524328] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.To investigate the cause(s) of an increased incidence of clinical cultures growingMycobacterium abscessusat a hospital in Florida.Design.Outbreak investigation.Setting.University-affiliated, tertiary-care hospital.Methods.A site visit was done during the first week of September 2006. We reviewed the medical records of patients from whomM. abscessuswas recovered during the period from January 1, 2003, through June 30, 2006. We collected environmental samples from various sites and evaluated specimen processing procedures in the microbiology laboratory. Isolates ofM. abscessusrecovered from the environment and from 12 randomly selected patients who sought medical care in 2006 were compared by pulsed-field gel electrophoresis (PFGE). Follow-up case surveillance was continued through March 31, 2007.Results.Specimens from 143 patients obtained from various anatomical sites grewM. abscessuson culture in 2005-2006, compared with specimens from 21 patients in 2003-2004. The 12 isolates from patients that were selected for molecular typing had indistinguishable PFGE patterns. Observations revealed no major breaches in the processing of mycobacterial specimens in the laboratory. Isolates grew only after prolonged incubation (mean ± SD, 45 ± 15 days) in test tubes containing diagonally oriented Middlebrook and Cohn 7H10 agar or Lowenstein-Jensen medium. Environmental samples obtained from the inside of the specimen incubator grewM. abscessuson culture. A test tube containing diagonally oriented, uninoculated Middlebrook and Cohn 7H10 agar that was incubated in the same incubator as clinical specimens grewM. abscessuswith a PFGE pattern that matched the pattern of the patient isolates. Cases ofM. abscessusinfection decreased to baseline after the hospital changed suppliers of mycobacterial media and cleaned the incubator.Conclusions.Although the source was never confirmed, our investigation suggests that this was a pseudo-outbreak ofM. abscessusinfection that resulted from contamination of mycobacterial cultures during incubation. Our findings emphasize the need for guidance on the disinfection of specimen incubators.
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Kearney S, Sharathkumar A, Rodriguez V, Chitlur M, Valentino L, Boggio L, Gill J. Neonatal circumcision in severe haemophilia: a survey of paediatric haematologists at United States Hemophilia Treatment Centers. Haemophilia 2014; 21:52-7. [DOI: 10.1111/hae.12528] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2014] [Indexed: 01/20/2023]
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Walton TA, Nishtar S, Lumb PJ, Crook MA, Marber MS, Gill J, Wierzbicki AS. Angiographic coronary artery disease and high-sensitivity troponin-T in a native Pakistani cohort presenting with chronic chest pain. Int J Clin Pract 2014; 68:1473-7. [PMID: 25283732 DOI: 10.1111/ijcp.12520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine the relationship between troponin-T levels and atheroma burden in Pakistanis presenting to an ambulatory centre with chest pain. METHODS A prospective case-control study of 400 patients selected for presence/absence of angiographic disease referred between 2001 and 2003. A comprehensive cardiovascular disease (CVD) risk factor profile was assessed including demographics, environmental and biochemical risk factors including insulin resistance and troponin-T levels. Coronary atheroma burden was quantified by Gensini score. RESULTS Clinically significant elevated troponin-T levels (> 30 pmol/l) were found in 40 patients (10%) with equal numbers in groups selected with or without angiographic disease. Troponin-T elevation (> 13 pmol/l) was present in 59 vs. 47 patients (30% vs. 24%; p = 0.04). Troponin-T levels did not correlate with any measured demographical, environmental, drug therapy or biochemical risk factor. No difference was found in concentrations of lipids, apolipoproteins, insulin resistance, C-reactive protein or sialic acid in cohorts stratified by troponin-T concentrations. In univariate analysis comparing patients with high (> 30 pmol/l) and low troponin-T levels (< 13 pmol/l) higher plasma total protein (91 g/l vs. 85 g/l; p = 0.01), increased immunoglobulin levels (41 g/l vs. 36 g/l; p = 0.02) and prevalence of hyperparathyroidism (40% vs. 21%; p = 0.04) were associated with higher troponin-T concentrations. CONCLUSIONS This study shows that measurement of troponin-T is not an alternative to imaging in an Indian asian population, but that it does identify a separate potentially high-risk population that would not be identified by the use of imaging alone which is potentially at higher risk of CVD events.
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Child N, Bostock J, Rinaldi CA, Blauth C, Gill J. 26Good medium term success of convergent hybrid AF ablation in persistent AF. Europace 2014. [DOI: 10.1093/europace/euu238.8] [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
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Chubb H, Linton N, Rhode K, Gill J, Cooklin M, Rinaldi C, Wright M, Rosenthal E, O'Neill M, Williams S. 40Dot mapping: a novel technique for dual electrophysiological dataset representation facilitates recognition of complex intra-atrial re-entrant tachycardia substrate in repaired adult congenital heart disease. Europace 2014. [DOI: 10.1093/europace/euu239.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chubb H, Williams SE, Karim R, Harrison J, Gill J, Rinaldi CA, Cooklin M, Wright M, Razavi R, O'Neill M. 28Does a greater contact force create more scar? A quantification of the relationship between late gadolinium enhancement on cardiac MR imaging and catheter contact on af ablation. Europace 2014. [DOI: 10.1093/europace/euu238.10] [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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Williams S, Linton N, Harrison J, Chubb H, Cooklin M, Rinaldi A, Gill J, Wright M, O'Neill M. 64 * Abnormal electrogram populations are revealed by atrial programmed stimulation in paroxysmal atrial fibrillation. Europace 2014. [DOI: 10.1093/europace/euu242.6] [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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Kumar RM, Aziz T, Jamshaid H, Gill J, Kapoor A. Metastatic renal cell carcinoma without evidence of a primary renal tumour. ACTA ACUST UNITED AC 2014; 21:e521-4. [PMID: 24940113 DOI: 10.3747/co.21.1914] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Although metastases are common in patients with renal cell carcinoma (rcc), it is extremely rare for patients to present with metastatic rcc (mrcc) without evidence of a primary mass in the kidney. Two cases of mrcc with no detectable primary renal mass are reported here. Both patients had bilateral native kidneys in situ and no significant prior urologic history. The first patient presented with a hip fracture and was found to have multiple radiologic bony and lung metastases. Biopsy of a mass involving the pubic bone demonstrated clear cell mrcc. Multiple scans by computed tomography (ct) and confirmatory imaging by magnetic resonance demonstrated no renal mass. This first patient had disease stabilization for 18 months on sunitinib and was still alive at last follow-up. The second patient was diagnosed with clear-cell mrcc after thickened synovium was discovered and biopsied during a knee arthroplasty. Multiple scans by ct in this second patient demonstrated no primary renal mass. Sunitinib and radiotherapy to the knee lesion were initiated, but unfortunately, the patient deteriorated clinically and passed away from disease progression shortly after diagnosis. Because of the rare nature of these cases, a standardized course of action has not yet been established. However, we hypothesize that it is reasonable to manage metastases in these patients by following established mrcc protocols.
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Cooper C, Rollet-Kurhajec KC, Young J, Vasquez C, Tyndall M, Gill J, Pick N, Walmsley S, Klein MB. HIV virological rebounds but not blips predict liver fibrosis progression in antiretroviral-treated HIV/hepatitis C virus-coinfected patients. HIV Med 2014; 16:24-31. [PMID: 24837567 PMCID: PMC4312483 DOI: 10.1111/hiv.12168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Antiretroviral interruption is associated with liver fibrosis progression in HIV/hepatitis C virus (HCV) coinfection. It is not known what level of HIV viraemia affects fibrosis progression. METHODS We evaluated 288 HIV/HCV-coinfected cohort participants with undetectable HIV RNA (<50 HIV-1 RNA copies/mL) on two consecutive visits while on combination antiretroviral therapy (cART) without fibrosis [aspartate aminotransferase to platelet ratio index (APRI) <1.5], end-stage liver disease or HCV therapy. An HIV blip was defined as a viral load of ≥ 50 and <1000 copies/mL, preceded and followed by undetectable values. HIV rebound was defined as: (i) HIV RNA ≥ 50 copies/mL on two consecutive visits, or (ii) a single HIV RNA measurement ≥ 1000 copies/mL. Multivariate discrete-time proportional hazards models were used to assess the effect of different viraemia levels on liver fibrosis progression (APRI ≥ 1.5). RESULTS The mean age of the patients was 45 years, 74% were male, 81% reported a history of injecting drug use, 51% currently used alcohol and the median baseline CD4 count was 440 [interquartile range (IQR) 298, 609] cells/μL. Fifty-seven (20%) participants [12.4/100 person-years (PY); 95% confidence interval (CI) 9.2-15.7/100 PY] progressed to an APRI ≥ 1.5 over a mean 1.1 (IQR 0.6, 2.0) years of follow-up time at risk. Virological rebound [hazard ratio (HR) 2.3; 95% CI 1.1, 4.7] but not blips (HR 0.5; 95% CI 0.2, 1.1) predicted progression to APRI ≥ 1.5. Each additional 1 log10 copies/mL HIV RNA exposure (cumulative) was associated with a 20% increase in the risk of fibrosis progression (HR 1.2; 95% CI 1.0-1.3). CONCLUSIONS Liver fibrosis progression was associated with HIV rebound, but not blips, and with increasing cumulative exposure to HIV RNA, highlighting the importance of achieving and maintaining HIV suppression in the setting of HIV/HCV coinfection.
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Wallace RM, Stanek D, Griese S, Krulak D, Vora NM, Pacha L, Kan V, Said M, Williams C, Burgess TH, Clausen SS, Austin C, Gabel J, Lehman M, Finelli LN, Selvaggi G, Joyce P, Gordin F, Benator D, Bettano A, Cersovsky S, Blackmore C, Jones SV, Buchanan BD, Fernandez AI, Dinelli D, Agnes K, Clark A, Gill J, Irmler M, Blythe D, Mitchell K, Whitman TJ, Zapor MJ, Zorich S, Witkop C, Jenkins P, Mora P, Droller D, Turner S, Dunn L, Williams P, Richards C, Ewing G, Chapman K, Corbitt C, Girimont T, Franka R, Recuenco S, Blanton JD, Feldman KA. A large-scale, rapid public health response to rabies in an organ recipient and the previously undiagnosed organ donor. Zoonoses Public Health 2014; 61:560-70. [PMID: 24673934 DOI: 10.1111/zph.12105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Indexed: 11/29/2022]
Abstract
This article describes and contrasts the public health response to two human rabies cases: one organ recipient diagnosed within days of symptom onset and the transplant donor who was diagnosed 18 months post-symptom onset. In response to an organ-transplant-related rabies case diagnosed in 2013, organ donor and recipient investigations were conducted by multiple public health agencies. Persons with potential exposure to infectious patient materials were assessed for rabies virus exposure. An exposure investigation was conducted to determine the source of the organ donor's infection. Over 100 persons from more than 20 agencies spent over 2700 h conducting contact investigations in healthcare, military and community settings. The 564 persons assessed include 417 healthcare workers [5.8% recommended for post-exposure prophylaxis (PEP)], 96 community contacts (15.6% recommended for PEP), 30 autopsy personnel (50% recommended for PEP), and 21 other persons (4.8% recommended for PEP). Donor contacts represented 188 assessed with 20.2% recommended for PEP, compared with 5.6% of 306 recipient contacts recommended for PEP. Human rabies cases result in substantial use of public health and medical resources, especially when diagnosis is delayed. Although rare, clinicians should consider rabies in cases of encephalitis of unexplained aetiology, particularly for cases that may result in organ donation.
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Phan TT, Khan S, Dewhurst M, Lee D, James S, de Belder M, Linker NJ, Thornley A, Turley AJ, Ahmed FZ, Arumugam P, Allen S, Daniels K, Clarke B, Mamas M, James J, Zaidi AM, Ullah W, Hunter R, Lovell M, Dhinoja M, Earley M, Sporton S, Schilling R, Raju H, Hedley P, Arno G, Ware J, Jeffery S, Cook S, Christiansen M, Behr ER, Sohal M, Chen Z, Sammut E, Jackson T, Child N, Wright M, O'Neill M, Cooklin M, Gill J, Carr-White G, Razavi R, Rinaldi CA, Nunn LM, Lopes L, Syrris P, Plagnol V, Firman E, Dalageorgou C, Domingo D, Zorio E, Murday V, Findlay I, Duncan A, Fynn S, White A, Goddard M, Carr-White G, Robert L, Bueser T, Langman C, Bundgaard H, Ferrero-Miliani L, Wheeldon N, O'Beirne A, Suvarna SK, Lowe MD, McKenna WJ, Elliott PM, Lambiase PD. YOUNG INVESTIGATORS COMPETITION, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nanjappa A, Gill J, Sadat U, Colah S, Abu-Omar Y, Nair S. The effect of retrograde autologous priming on intraoperative blood product transfusion in coronary artery bypass grafting. Perfusion 2013; 28:530-5. [DOI: 10.1177/0267659113491776] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Retrograde autologous priming (RAP) of the cardiopulmonary bypass (CPB) circuit could reduce the degree of haemodilution associated with priming with acellular solutions. However, there is no strong evidence to prove that the practice of RAP reduced intraoperative packed red cell (PRC) or blood product transfusion. Objective: To evaluate the effect of RAP on intraoperative PRC usage in coronary artery bypass grafting (CABG). Methods: This study is a prospective, observational study on patients who underwent first-time, isolated CABG using CPB between April 2012 and July 2012. Two groups of patients were identified: 1. Non-RAP group (n=128) and 2. RAP group (n=73). The primary outcome for the study was the amount of PRC and blood product usage between the induction of anaesthesia and the cessation of CPB. Results: Use of PRC and blood products in the operating room was comparable in both groups. Univariate logistic regression showed that RAP was not an independent predictor of PRC or blood product transfusion (p=0.43). Multivariate logistic regression showed that CPB time, preoperative haemoglobin (Hb) levels and creatinine clearance were independent predictors of blood product transfusion. Conclusion: Practising RAP with mean volumes of 300 ml does not necessarily reduce PRC and other blood product transfusion requirements during CABG. In our practice, RAP was performed, aiming at displacing CPB circuit prime volume with which the perfusionist felt comfortable and dictated by haemodynamic parameters prior to commencing CPB. We presume this is the case in many units around the world. This practice, in our opinion, is not enough to achieve the benefits of RAP, if any, in the form of a reduction of packed red cell transfusion requirements. The true advantages of RAP in cardiac surgery need to be studied in a prospective, randomized, controlled trial.
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Ang R, Birnbaumer L, Gourine AV, Tinker A, Hamilton RM, Strandberg L, Cui X, Rath A, Liu J, Sirigam V, Ackerley C, Jaeggi E, Backx P, Silverman ED, Debney MT, Ng FS, Lyon AR, Peters NS, Opel A, Nobles M, Tinker A, Winter J, Chin SH, Brack KE, Ng GA, Finlay MC, Xu L, Nobles M, Lane J, Lowe M, Ben-Simon R, Bhar-Amato J, Hussain Q, Sebastian S, Taggart P, Tinker A, Lambiase PD, Almeida TP, Salinet J, Chu GS, Schlindwein FS, Ng GA, Williams SE, Linton NWF, Harrison J, Wright M, Plank G, O'Neill MD, Niederer S, Raine DT, Langley P, Shepherd E, Lord S, Murray S, Bourke JP, Chen Z, Hanson B, Sohal M, Child N, Sammut E, Jackson T, Shetty A, Bostock J, Gill J, Carr-White G, Rinaldi CA, Taggart P, Williams SE, Linton NW, Harrison J, Wright M, Rhode K, O'Neill MD, Barrows S, Jones K, Porter N. POSTER SESSION 2, HRC 2013. Europace 2013. [DOI: 10.1093/europace/eut320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Panayiotou M, King AP, Ma Y, Housden RJ, Rinaldi CA, Gill J, Cooklin M, O’Neill M, Rhode KS. A statistical model of catheter motion from interventional x-ray images: application to image-based gating. Phys Med Biol 2013; 58:7543-62. [DOI: 10.1088/0031-9155/58/21/7543] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Probst V, Sacher F, Derval N, Gourraud JB, Mabo P, Medkour F, Marec HL, Gill J. Correlation of intracardiac electrogram with surface electrocardiogram in Brugada syndrome patients. Europace 2013; 16:908-13. [DOI: 10.1093/europace/eut294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gill JS, Lan J, Dong J, Rose C, Hendren E, Johnston O, Gill J. The survival benefit of kidney transplantation in obese patients. Am J Transplant 2013; 13:2083-90. [PMID: 23890325 DOI: 10.1111/ajt.12331] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 05/03/2013] [Accepted: 05/07/2013] [Indexed: 01/25/2023]
Abstract
Obese patients have a decreased risk of death on dialysis but an increased risk of death after transplantation, and may derive a lower survival benefit from transplantation. Using data from the United States between 1995 and 2007 and multivariate non-proportional hazards analyses we determined the relative risk of death in transplant recipients grouped by body mass index (BMI) compared to wait-listed candidates with the same BMI (n = 208 498). One year after transplantation the survival benefit of transplantation varied by BMI: Standard criteria donor transplantation was associated with a 48% reduction in the risk of death in patients with BMI ≥ 40 kg/m(2) but a ≥ 66% reduction in patients with BMI < 40 kg/m2. Living donor transplantation was associated with ≥ 66% reduction in the risk of death in all BMI groups. In sub-group analyses, transplantation from any donor source was associated with a survival benefit in obese patients ≥ 50 years, and diabetic patients, but a survival benefit was not demonstrated in Black patients with BMI ≥ 40 kg/m(2). Although most obese patients selected for transplantation derive a survival benefit, the benefit is lower when BMI is ≥ 40 kg/m(2), and uncertain in Black patients with BMI ≥ 40 kg/m(2).
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Karl DM, Gill J, Zhou R, Riddle MC. Clinical predictors of risk of hypoglycaemia during addition and titration of insulin glargine for type 2 diabetes mellitus. Diabetes Obes Metab 2013; 15:622-8. [PMID: 23350795 DOI: 10.1111/dom.12072] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 12/12/2022]
Abstract
AIM Addition and titration of basal insulin is usually effective in improving glycaemic control in type 2 diabetes, but fear of hypoglycaemia remains a barrier. Ability to predict which patients might be at greatest risk of hypoglycaemia might facilitate individualization of treatment and improve safety. The aim of this study was to obtain information about clinical characteristics which might predict risk of hypoglycaemia during initiation of basal insulin. METHODS Patient-level data from 2251 participants in 11 studies in which insulin glargine was started and titrated using similar treat-to-target methods was pooled and analysed with logistic regression models. RESULTS Participants had mean age 58 years, diabetes duration 8.9 years, body mass index 31.0 and baseline A1c 8.8%. They attained mean A1c 7.1% during 6 months of treatment with final mean glargine dosage 0.44 units/kg. Symptomatic hypoglycaemia occurred in 52%, glucose-confirmed hypoglycaemia (blood glucose <50 mg/dl) in 17%, repeated glucose-confirmed events in 7% and severe hypoglycaemia in 1.5%. Independent predictors of glucose-confirmed hypoglycaemia were younger age, lower body mass index, use of a sulphonylurea in addition to metformin, lower attained A1c and lower dosage of glargine. CONCLUSIONS These findings confirm low rates of clinically important hypoglycaemia using this method, and suggest that higher risk of hypoglycaemia may be suspected when patients needing insulin are younger, less obese and taking metformin and a sulphonylurea, and especially when A1c levels ≤7.0% are attained with glargine dosage ≤0.4 units/kg.
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Russ GR, Tedesco-Silva H, Kuypers DR, Cohney S, Langer RM, Witzke O, Eris J, Sommerer C, von Zur-Mühlen B, Woodle ES, Gill J, Ng J, Klupp J, Chodoff L, Budde K. Efficacy of sotrastaurin plus tacrolimus after de novo kidney transplantation: randomized, phase II trial results. Am J Transplant 2013; 13:1746-56. [PMID: 23668931 DOI: 10.1111/ajt.12251] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/11/2013] [Accepted: 03/14/2013] [Indexed: 01/25/2023]
Abstract
Sotrastaurin, a novel immunosuppressant, blocks early T cell activation through protein kinase C inhibition. Efficacy and safety of sotrastaurin with tacrolimus were assessed in a dose-ranging non-inferiority study in renal transplant recipients. A total of 298 patients were randomized 1:1:1:1 to receive sotrastaurin 100 (n = 77; discontinued in December 2011) or 200 mg (n = 73) b.i.d. plus standard tacrolimus (sTAC; 5-12 ng/mL), sotrastaurin 300 mg (n = 75) b.i.d. plus reduced tacrolimus (rTAC; 2-5 ng/mL) or enteric-coated mycophenolic acid (MPA) plus sTAC (n = 73); all patients received basiliximab and corticosteroids. Composite efficacy failure (treated biopsy-proven acute rejection ≥ grade IA, graft loss, death or loss to follow up) rates at Month 12 were 18.8%, 12.4%, 10.9% and 14.0% for the sotrastaurin 100, 200 and 300 mg, and MPA groups, respectively. The median estimated glomerular filtration rates were 55.7, 53.3, 64.9 and 59.2 mL/min, respectively. Mean heart rates were faster with higher sotrastaurin doses and discontinuations due to adverse events and gastrointestinal adverse events were more common. Fewer patients in the sotrastaurin groups experienced leukopenia than in the MPA group (1.3-5.5% vs. 16.5%). Sotrastaurin 200 and 300 mg had comparable efficacy to MPA in prevention of rejection with no significant difference in renal function between the groups.
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Dason S, Allard C, Sheridan-Jonah A, Gill J, Jamshaid H, Aziz T, Kajal B, Kapoor A. Management of renal collecting duct carcinoma: a systematic review and the McMaster experience. ACTA ACUST UNITED AC 2013; 20:e223-32. [PMID: 23737692 DOI: 10.3747/co.20.1230] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Collecting duct carcinoma (cdc) is a rare, aggressive form of renal carcinoma that presents at an advanced stage and has a poor prognosis. Little is known concerning the optimal management of cdc. We present the results of a systematic review addressing the management of cdc and the McMaster University cdc series. METHODS The medline, Cochrane Library, and embase databases and conference proceedings were searched to identify studies relating to the management of cdc. Included studies reported on a minimum of 10 subjects receiving a single intervention. Series in which an evaluation of therapeutic effectiveness was not possible were excluded. The McMaster University (Hamilton, Ontario) series of 6 cases of cdc were retrospectively reviewed. RESULTS We identified 3 studies relevant to the management of cdc that included a total of 72 patients. A gemcitabine-cisplatin or -carboplatin regimen resulted in a 26% objective response rate in 23 patients with metastatic cdc. Two additional studies indicated that 49 patients treated with immunotherapy achieved no response. In the McMaster series, cytoreductive nephrectomy was performed in 4 of 6 patients. In 2 patients, mvac therapy (methotrexate-vinblastine-doxorubicin-cisplatin) achieved no response. No significant therapeutic complications occurred, but survival was poor (median: 11 months; range: 10-33 months). CONCLUSIONS Our review and clinical experience suggest that the current standard of care for metastatic cdc is a gemcitabine-cisplatin regimen.
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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, Stanley K, Morrissey D, Parsons S, Kuttikat A, Shenker N, Garrood T, Medley S, Ferguson AM, Keeling D, Duffort P, Irving K, Goulston L, Culliford D, Coakley P, Taylor P, Hart D, Spector T, Hakim A, Arden N, Mian A, Garrood T, Magan T, Chaudhary M, Lazic S, Sofat N, Thomas MJ, Moore A, Roddy E, Peat G, Rees F, Lanyon P, Jordan N, Chaib A, Sangle S, Tungekar F, Sabharwal T, Abbs I, Khamashta M, D'Cruz D, Dzifa Dey I, Isenberg DA, Chin CW, Cheung C, Ng M, Gao F, Qiong Huang F, Thao Le T, Yong Fong K, San Tan R, Yin Wong T, Julian T, Parker B, Al-Husain A, Yvonne Alexander M, Bruce I, Jordan N, Abbs I, D'cruz D, McDonald G, Miguel L, Hall C, Isenberg DA, Magee A, Butters T, Jury E, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Lazarus MN, Isenberg DA, Ehrenstein M, Carter LM, Isenberg DA, Ehrenstein MR, Chanchlani N, Gayed M, Yee CS, Gordon C, Ball E, Rooney M, Bell A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Sutton EJ, Watson KD, Isenberg D, Rahman A, Gordon C, Yee CS, Lanyon P, Jayne D, Akil M, D'Cruz D, Khamashta M, Lutalo P, Erb N, Prabu A, Edwards CJ, Youssef H, McHugh N, Vital E, Amft N, Griffiths B, Teh LS, Zoma A, Bruce I, Durrani M, Jordan N, Sangle S, D'Cruz D, Pericleous C, Ruiz-Limon P, Romay-Penabad Z, Carrera-Marin A, Garza-Garcia A, Murfitt L, Driscoll PC, Giles IP, Ioannou Y, Rahman A, Pierangeli SS, Ripoll VM, Lambrianides A, Heywood WE, Ioannou J, Giles IP, Rahman A, Stevens C, Dures E, Morris M, Knowles S, Hewlett S, Marshall R, Reddy V, Croca S, Gerona D, De La Torre Ortega I, Isenberg DA, Leandro M, Cambridge G, Reddy V, Cambridge G, Isenberg DA, Glennie M, Cragg M, Leandro M, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Artim Esen B, Pericleous C, MacKie I, Ioannou Y, Rahman A, Isenberg DA, Giles I, Skeoch S, Haque S, Pemberton P, Bruce I. BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wallia S, Bhopal RS, Douglas A, Bhopal R, Sharma A, Hutchison A, Murray G, Gill J, Sattar N, Lawton J, Tuomilehto J, Mcknight J, Forbes J, Lean M, Sheikh A. Culturally adapting the prevention of diabetes and obesity in South Asians (PODOSA) trial. Health Promot Int 2013; 29:768-79. [PMID: 23574693 DOI: 10.1093/heapro/dat015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Type 2 diabetes is extremely common in South Asians, e.g. in men from Pakistani and Indian populations it is about three times as likely as in the general population in England, despite similarities in body mass index. Lifestyle interventions reduce the incidence of diabetes. Trials in Europe and North America have not, however, reported on the impact on South Asian populations separately or provided the details of their cross-cultural adaptation processes. Prevention of diabetes and obesity in South Asians (PODOSA) is a randomized, controlled trial in Scotland of an adapted, lifestyle intervention aimed at reducing weight and increasing physical activity to reduce type 2 diabetes in Indians and Pakistanis. The trial was adapted from the Finnish Diabetes Prevention Study. We describe, reflect on and discuss the following key issues: The core adaptations to the trial design, particularly the delivery of the intervention in homes by dietitians rather than in clinics. The use of both a multilingual panel and professional translators to help translate and/or develop materials. The processes and challenges of phonetic translation. How intervention resources were adapted, modified, newly developed and translated into Urdu and Gurmukhi (written Punjabi). The insights gained in PODOSA (including time pressures on investigators, imperfections in the adaptation process, the power of verbal rather than written information, the utilization of English and the mother-tongue languages simultaneously by participants and the costs) might help the research community, given the challenge of health promotion in multi-ethnic, urban societies.
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Clapp M, Witz C, Gill J, Haddad G, Griffith J, Skorupski J, Bello S, Wang WH, Williams D. The Comparison of Pregnancy Outcomes in Fresh and Frozen-Thawed Embryo Transfers in Gonadotropin-Releasing Hormone Agonist Triggered In Vitro Fertilization Cycles. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gill JS, Schaeffner E, Chadban S, Dong J, Rose C, Johnston O, Gill J. Quantification of the early risk of death in elderly kidney transplant recipients. Am J Transplant 2013; 13:427-32. [PMID: 23167257 DOI: 10.1111/j.1600-6143.2012.04323.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 09/04/2012] [Accepted: 09/26/2012] [Indexed: 01/25/2023]
Abstract
To inform decision making regarding transplantation in patients ≥ 65 years, we quantified the early posttransplant risk of death by determining the time to equal risk and equal survival between transplant recipients and wait-listed dialysis patients in the United States between 1995 and 2007 (total n = 25 468). Survival was determined using separate multivariate nonproportional hazards analyses in low-, intermediate- and high-risk cardiovascular risk patients. Compared to wait-listed patients with similar cardiovascular risk, standard criteria (SCD) and expanded criteria (ECD) recipients had a higher risk of death in the perioperative and early-posttransplant period. In contrast, low and intermediate risk living donor (LD) recipients had an immediate survival advantage compared to similar risk wait-listed patients. In all risk groups, transplantation was associated with a long-term survival advantage compared to dialysis, but there were marked differences in time to equal risk of death, and time to equal survival by donor type. For example, survival in high-risk recipients of an LD, SCD and ECD transplant became equal to that in similar risk wait-listed patients 130, 368 and 521 days after transplantation. Early posttransplant mortality risk is eliminated in low- and intermediate-risk patients, and markedly reduced in high-risk patients with LD transplantation.
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Gill JS, Gill J, Barnieh L, Dong J, Rose C, Johnston O, Tonelli M, Klarenbach S. Income of living kidney donors and the income difference between living kidney donors and their recipients in the United States. Am J Transplant 2012; 12:3111-8. [PMID: 22882723 DOI: 10.1111/j.1600-6143.2012.04211.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Disincentives for living kidney donation are common but are poorly understood. We studied 54 483 living donor kidney transplants in the United States between 2000 and 2009, limiting to those with valid zip code data to allow determination of median household income by linkage to the 2000 U.S. Census. We then determined the income and income difference of donors and recipients. The median household income in donors and recipients was $46 334 ±$17 350 and $46 439 ±$17 743, respectively. Donation-related expenses consume ≥ 1 month's income in 76% of donors. The mean ± standard deviation income difference between recipients and donors in transplants involving a wealthier recipient was $22 760 ± 14 792 and in 90% of transplants the difference was <$40 000 dollars. The findings suggest that the capacity for donors to absorb the financial consequences of donation, or of recipients to reimburse allowable expenses, is limited. There were few transplants with a large difference in recipient and donor income, suggesting that the scope and value of any payment between donors and recipients is likely to be small. We conclude that most donors and recipients have similar modest incomes, suggesting that the costs of donation are a significant burden in the majority of living donor transplants.
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Abecassis M, Bridges N, Clancy C, Dew M, Eldadah B, Englesbe M, Flessner M, Frank J, Friedewald J, Gill J, Gries C, Halter J, Hartmann E, Hazzard W, Horne F, Hosenpud J, Jacobson P, Kasiske B, Lake J, Loomba R, Malani P, Moore T, Murray A, Nguyen MH, Powe N, Reese P, Reynolds H, Samaniego M, Schmader K, Segev D, Shah A, Singer L, Sosa J, Stewart Z, Tan J, Williams W, Zaas D, High K. Solid-organ transplantation in older adults: current status and future research. Am J Transplant 2012; 12:2608-22. [PMID: 22958872 PMCID: PMC3459231 DOI: 10.1111/j.1600-6143.2012.04245.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
An increasing number of patients older than 65 years are referred for and have access to organ transplantation, and an increasing number of older adults are donating organs. Although short-term outcomes are similar in older versus younger transplant recipients, older donor or recipient age is associated with inferior long-term outcomes. However, age is often a proxy for other factors that might predict poor outcomes more strongly and better identify patients at risk for adverse events. Approaches to transplantation in older adults vary across programs, but despite recent gains in access and the increased use of marginal organs, older patients remain less likely than other groups to receive a transplant, and those who do are highly selected. Moreover, few studies have addressed geriatric issues in transplant patient selection or management, or the implications on health span and disability when patients age to late life with a transplanted organ. This paper summarizes a recent trans-disciplinary workshop held by ASP, in collaboration with NHLBI, NIA, NIAID, NIDDK and AGS, to address issues related to kidney, liver, lung, or heart transplantation in older adults and to propose a research agenda in these areas.
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Fairhead T, Hendren E, Tinckam K, Rose C, Sherlock CH, Shi L, Crowcroft NS, Gubbay JB, Landsberg D, Knoll G, Gill J, Kumar D. Poor seroprotection but allosensitization after adjuvanted pandemic influenza H1N1 vaccine in kidney transplant recipients. Transpl Infect Dis 2012; 14:575-83. [PMID: 22999005 DOI: 10.1111/tid.12006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 04/20/2012] [Accepted: 07/04/2012] [Indexed: 01/05/2023]
Abstract
BACKGROUND Seasonal and pandemic influenza virus infections in renal transplant patients are associated with poor outcomes. During the pandemic of 2009-2010, the AS03-adjuvanted monovalent H1N1 influenza vaccine was recommended for transplant recipients, although its immunogenicity in this population was unknown. We sought to determine the safety and immunogenicity of an adjuvant-containing vaccine against pandemic influenza A H1N1 2009 (pH1N1) administered to kidney transplant recipients. METHODS We prospectively enrolled 124 adult kidney transplant recipients in the fall of 2009 at two transplant centers. Cohort 1 (n = 42) was assessed before and after pH1N1 immunization, while Cohort 2 (n = 82) was only assessed post immunization. Humoral response was measured by the hemagglutination inhibition assay. Vaccine safety was assessed by adverse event reporting, graft function, and human leukocyte antigen (HLA) alloantibody measurements. RESULTS Cohort 1 had a low rate of baseline seroprotection to pH1N1 (7%) and a low rate of seroprotection after immunization (31%). No patient <6 months post transplant (n = 5) achieved seroprotection. Seroprotection rate was greater in patients receiving double as compared with triple immunosuppression (80% vs. 24%, P = 0.01). In Cohort 2, post-immunization seroprotection was 35%. In both cohorts, no confirmed cases of pH1N1 infection occurred. No difference was seen in estimated glomerular filtration rate before (54.3 mL/min/1.73 m(2) ) and after (53.8 mL/min/1.73 m(2) ) immunization, and no acute rejections had occurred after immunization at last follow-up. In Cohort 1, 11.9% of patients developed new anti-HLA antibodies. CONCLUSION An adjuvant-containing vaccine to pH1N1 provided poor seroprotection in renal transplant recipients. Receiving triple immunosuppression was associated with a poor seroresponse. Vaccination appeared safe, but some patients developed new anti-HLA antibodies post vaccination. Alternative strategies to improve vaccine responses are necessary.
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Ayeroff E, Gill J, Alvarez G. Estimating the quantity and quality of working memory representations with continuous report versus change detection. J Vis 2012. [DOI: 10.1167/12.9.345] [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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Kirubakaran S, Zuberi Z, Gill J. Acute myocardial infarction due to a coronary embolus during left atrial ablation for persistent atrial fibrillation. Europace 2012; 15:211. [PMID: 22778231 DOI: 10.1093/europace/eus194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Shamji M, Moon ES, Glennie R, Soroceanu A, Lin C, Bailey C, Simmonds A, Fehlings M, Dodwell E, Dold A, El-Hawary R, Hashem M, Dold A, Dold A, Jones S, Bailey C, Karadimas S, Whitehurst D, Norton J, Norton J, Manson N, Kesani A, Bednar D, Lundine K, Hartig D, Fichadi A, Fehlings M, Kim S, Harris S, Lin C, Gill J, Abraham E, Shamji M, Choi S, Goldstein C, Wang Z, McCabe M, Noonan V, Nadeau M, Ferrara S, Kelly A, Melnyk A, Arora D, Quateen A, Dea N, Ranganathan A, Zhang Y, Casha S, Rajamanickam K, Santos A, Santos A, Wilson J, Wilson J, Street J, Wilson J, Lewis R, Noonan V, Street J, El-Hawary R, Egge N, Lin C, Schouten R, Lin C, Kim A, Kwon B, Huang E, Hwang P, Allen K, Jing L, Mata B, Gabr M, Richardson W, Setton L, Karadimas S, Fehlings M, Fleming J, Bailey C, Gurr K, Bailey S, Siddiqi F, Lawendy A, Sanders D, Staudt M, Canacari E, Brown E, Robinson A, McGuire K, Chrysostoum C, Rampersaud YR, Dvorak M, Thomas K, Boyd M, Gurr K, Bailey S, Nadeau M, Fisher C, Batke J, Street J, Boyd M, Dvorak M, Fisher C, Kwon B, Paquette S, Vaccaro A, Chapman J, Arnold P, Shaffrey C, Kopjar B, Snyder B, Wright J, Lewis S, Zeller R, El-Hawary R, Moroz P, Bacon S, Jarzem P, Hedden D, Howard J, Sturm P, Cahill P, Samdani A, Vitale M, Gabos P, Bodin N, d’Amato C, Harris C, Smith J, Parent E, Hill D, Hedden D, Moreau M, Mahood J, Lewis S, Bodrogi A, Abbas H, Goldstein S, Bronstein Y, Bacon S, Chua S, Magana S, Van Houwelingen A, Halpern E, Jhaveri S, Lewis S, Lim A, Leelapattana P, Fleming J, Siddiqqi F, Bailey S, Gurr K, Moon ES, Satkunendrarajah K, Fehlings M, Noonan V, Dvorak M, Bryan S, Aronyk K, Fox R, Nataraj A, Pugh J, Elliott R, McKeon M, Abraham E, Fleming J, Gurr K, Bailey S, Siddiqi F, Bailey C, Davis G, Rogers M, Staples M, Quan G, Batke J, Boyd M, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Shamji M, Hurlbert R, Jacobs W, Duplessis S, Casha S, Jha N, Hewson S, Massicotte E, Kopjar B, Mortaz S, Coyte P, Rampersaud Y, Rampersaud Y, Goldstein S, Andrew B, Modi H, Magana S, Lewis S, Roffey D, Miles I, Wai E, Manson N, Eastwood D, Elliot R, McKeon M, Bains I, Yong E, Sutherland G, Hurlbert R, Rampersaud Y, Chan V, Persaud O, Koshkin A, Brull R, Hassan N, Petis S, Kowalczuk M, Petrisor B, Drew B, Bhandari M, DiPaola C, Boyd M, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, McLachlin S, Bailey S, Gurr K, Bailey C, Dunning C, Fehlings M, Vaccaro A, Wing P, Itshayek E, Biering-Sorensen F, Dvorak M, McLachlin S, Bailey S, Gurr K, Dunning C, Bailey C, Bradi A, Pokrupa R, Batke J, Boyd M, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Kelly A, Wen T, Kingwell S, Chak J, Singh V, Cripton P, Fisher C, Dvorak M, Oxland T, Wali Z, Yen D, Alfllouse A, Alzahrani A, Jiang H, Mahood J, Kortbeek F, Fox R, Nataraj A, Street J, Boyd M, Paquette S, Kwon B, Batke J, Dvorak M, Fisher C, Reddy R, Rampersaud R, Hurlbert J, Yong W, Casha S, Zygun D, McGowan D, Bains I, Yong V, Hurlbert R, Mendis B, Chakraborty S, Nguyen T, Tsai E, Chen A, Atkins D, Noonan V, Drew B, Tsui D, Townson A, Dvorak M, Chen A, Atkins D, Noonan V, Drew B, Dvorak M, Craven C, Ford M, Ahn H, Drew B, Fehlings M, Kiss A, Vaccaro A, Harrop J, Grossman R, Frankowski R, Guest J, Dvorak M, Aarabi B, Fehlings M, Noonan V, Cheung A, Sun B, Dvorak M, Vaccaro A, Harrop J, Massicotte E, Dvorak M, Fisher C, Rampersaud R, Lewis S, Fehlings M, Marais L, Noonan V, Queyranne M, Fehlings M, Dvorak M, Atkins D, Hurlbert R, Fox R, Fourney D, Johnson M, Fehlings M, Ahn H, Ford M, Yee A, Finkelstein J, Tsai E, Bailey C, Drew B, Paquet J, Parent S, Christie S, Dvorak M, Noonan V, Cheung A, Sun B, Dvorak M, Sturm P, Cahill P, Samdani A, Vitale M, Gabos P, Bodin N, d’Amato C, Harris C, Smith J, Lange J, DiPaola C, Lapinsky A, Connolly P, Eck J, Rabin D, Zeller R, Lewis S, Lee R, Boyd M, Dvorak M, Fisher C, Kwon B, Paquette S, DiPaola C, Street J, Bodrogi A, Goldstein S, Sofia M, Lewis S, Shin J, Tung K, Ahn H, Lee R, Batke J, Ghag R, Noonan V, Dvorak M, Goyal T, Littlewood J, Bains I, Cho R, Thomas K, Swamy G. Canadian Spine Society abstracts1.1.01 Supraspinal modulation of gait abnormalities associated with noncompressive radiculopathy may be mediated by altered neurotransmitter sensitivity1.1.02 Neuroprotective effects of the sodium-glutamate blocker riluzole in the setting of experimental chronic spondylotic myelopathy1.1.03 The effect of timing to decompression in cauda equina syndrome using a rat model1.2.04 Intraoperative waste in spine surgery: incidence, cost and effectiveness of an educational program1.2.05 Looking beyond the clinical box: the health services impact of surgical adverse events1.2.06 Brace versus no brace for the treatment of thoracolumbar burst fractures without neurologic injury: a multicentre prospective randomized controlled trial1.2.07 Adverse event rates in surgically treated spine injuries without neurologic deficit1.2.08 Functional and quality of life outcomes in geriatric patients with type II odontoid fracture: 1-year results from the AOSpine North America Multi-Center Prospective GOF Study1.3.09 National US practices in pediatric spinal fusion: in-hospital complications, length of stay, mortality, costs and BMP utilization1.3.10 Current trends in the surgical treatment of adolescent idiopathic scoliosis in Canada1.3.11 Sagittal spinopelvic parameters help predict the risk of proximal junctional kyphosis for children treated with posterior distraction-based implants1.4.12 Correlations between changes in surface topography and changes in radiograph measurements from before to 6 months after surgery in adolescents with idiopathic scoliosis1.4.13 High upper instrumented vertebra (UIV) sagittal angle is associated with UIV fracture in adult deformity corrections1.4.14 Correction of adult idiopathic scoliosis using intraoperative skeletal traction1.5.01 Cauda equina: using management protocols to reduce delays in diagnosis1.5.02 Predicting the need for tracheostomy in patients with acute traumatic spinal cord injury1.5.03 A novel animal model of cervical spondylotic myelopathy: an opportunity to identify new therapeutic targets1.5.04 A review of preference-based measures of health-related quality of life in spinal cord injury research1.5.05 Predicting postoperative neuropathic pain following surgery involving nerve root manipulation based on intraoperative electromyographic activity1.5.06 Detecting positional injuries in prone spinal surgery1.5.07 Percutaneous thoracolumbar stabilization for trauma: surgical morbidity, clinical outcomes and revision surgery1.5.08 Systemic inflammatory response syndrome in spinal cord injury patients: Does its presence at admission affect patient outcomes?2.1.15 One hundred years of spine surgery — a review of the evolution of our craft and practice in the spine surgical century [presentation]2.1.16 Prevalence of preoperative MRI findings of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion2.1.17 Adverse event rates of surgically treated cervical spondylopathic myelopathy2.1.18 Morphometricand dynamic changes in the cervical spine following anterior cervical discectomy and fusion and cervical disc arthroplasty2.1.19 Is surgery for cervical spondylotic myelopathy cost-effective? A cost–utility analysis based on data from the AO Spine North American Prospective Multicentre CSM Study2.2.20 Cost–utility of lumbar decompression with or without fusion for patients with symptomatic degenerative lumbar spondylolisthesis (DLS)2.2.21 Minimally invasive surgery lumbar fusion for low-grade isthmic and degenerative spondylolisthesis: 2- to 5-year follow-up2.2.22 Results and complications of posterior-only reduction and fusion for high-grade spondylolisthesis2.3.23 Fusion versus no fusion in patients with central lumbar spinal stenosis and foraminal stenosis undergoing decompression surgery: comparison of outcomes at baseline and follow-up2.3.24 Two-year results of interspinous spacers (DIAM) as an alternative to arthrodesis for lumbar degenerative disorders2.3.25 Treatment of herniated lumbar disc by sequestrectomy or conventional discectomy2.4.26 No sustained benefit of continuous epidural analgesia for minimally invasive lumbar fusion: a randomized double-blinded placebo controlled study2.4.27 Evidence and current practice in the radiologic assessment of lumbar spine fusion2.4.28 Wiltse versus midline approach for decompression and fusion of the lumbar spine2.5.09 The effect of soft tissue restraints following type II odontoid fractures in the elderly — a biomechanical study2.5.10 Development of an international spinal cord injury (SCI) spinal column injury basic data set2.5.11 Evaluation of instrumentation techniques for a unilateral facet perch and fracture using a validated soft tissue injury model2.5.12 Decreasing neurologic consequences in patients with spinal infection: the testing of a novel diagnostic guideline2.5.13 Prospective analysis of adverse events in surgical treatment of degenerative spondylolisthesis2.5.14 Load transfer characteristics between posterior fusion devices and the lumbar spine under anterior shear loading: an in vitro investigation2.5.15 Preoperative predictive clinical and radiographic factors influencing functional outcome after lumbar discectomy2.5.16 A Thoracolumbar Injury Classification and Severity Score (TLICS) of 4: What should we really do?3.1.29 Adverse events in emergent oncologic spine surgery: a prospective analysis3.1.30 En-bloc resection of primary spinal and paraspinal tumours with critical vascular involvement3.1.31 The treatment impact of minocycline on quantitative MRI in acute spinal cord injury3.1.32 Benefit of minocycline in spinal cord injury — results of a double-blind randomized placebo-controlled study3.2.33 Improvement of magnetic resonance imaging correlation with unilateral motor or sensory deficits using diffusion tensor imaging3.2.34 Comparing care delivery for acute traumatic spinal cord injury in 2 Canadian centres: How do the processes of care differ?3.2.35 Improving access to early surgery: a comparison of 2 centres3.3.36 The effects of early surgical decompression on motor recovery after traumatic spinal cord injury: results of a Canadian multicentre study3.3.37 A clinical prediction model for long-term functional outcome after traumatic spinal cord injury based on acute clinical and imaging factors3.3.38 Effect of motor score on adverse events and quality of life in patients with traumatic spinal cord injury3.4.39 The impact of facet dislocation on neurologic recovery after cervical spinal cord injury: an analysis of data on 325 patients from the Surgical Trial in Acute Spinal Cord Injury Study (STASCIS)3.4.40 Toward a more precise understanding of the epidemiology of traumatic spinal cord injury in Canada3.4.41 Access to care (ACT) for traumatic SCI: a survey of acute Canadian spine centres3.4.42 Use of the Spine Adverse Events Severity (SAVES) instrument for traumatic spinal cord injury3.5.17 Does the type of distraction-based growing system for early onset scoliosis affect postoperative sagittal alignment?3.5.18 Comparison of radiation exposure during thoracolumbar fusion using fluoroscopic guidance versus anatomic placement of pedicle screws3.5.19 Skeletal traction for intraoperative reduction in adolescent idiopathic scoliosis3.5.20 Utility of intraoperative cone-beam computed tomography (O-ARM) and stereotactic navigation in acute spinal trauma surgery3.5.21 Use of a central compression rod to reduce thoracic level spinal osteotomies3.5.22 ICD-10 coding accuracy for spinal cord injured patients3.5.23 Feasibility of patient recruitment in acute SCI trials3.5.24 Treatment of adult degenerative scoliosis with DLIF approaches. Can J Surg 2012. [DOI: 10.1503/cjs.012212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Klein MB, Rollet KC, Saeed S, Cox J, Potter M, Cohen J, Conway B, Cooper C, Côté P, Gill J, Haase D, Haider S, Hull M, Moodie E, Montaner J, Pick N, Rachlis A, Rouleau D, Sandre R, Tyndall M, Walmsley S. HIV and hepatitis C virus coinfection in Canada: challenges and opportunities for reducing preventable morbidity and mortality. HIV Med 2012; 14:10-20. [PMID: 22639840 DOI: 10.1111/j.1468-1293.2012.01028.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2012] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Hepatitis C virus (HCV) has emerged as an important health problem in the era of effective HIV treatment. However, very few data exist on the health status and disease burden of HIV/HCV-coinfected Canadians. METHODS HIV/HCV-coinfected patients were enrolled prospectively in a multicentre cohort from 16 centres across Canada between 2003 and 2010 and followed every 6 months. We determined rates of a first liver fibrosis or endstage liver disease (ESLD) event and all-cause mortality since cohort enrolment and calculated standardized mortality ratios compared with the general Canadian population. RESULTS A total of 955 participants were enrolled in the study and followed for a median of 1.4 (interquartile range 0.5-2.3) years. Most were male (73%) with a median age of 44.5 years; 13% self-identified as aboriginal. There were high levels of current injecting drug and alcohol use and poverty. Observed event rates [per 100 person-years; 95% confidence interval (CI)] were: significant fibrosis (10.21; 8.49, 12.19), ESLD (3.16; 2.32, 4.20) and death (3.72; 2.86, 4.77). The overall standardized mortality ratio was 17.08 (95% CI 12.83, 21.34); 12.80 (95% CI 9.10, 16.50) for male patients and 28.74 (95% CI 14.66, 42.83) for female patients. The primary causes of death were ESLD (29%) and overdose (24%). CONCLUSIONS We observed excessive morbidity and mortality in this HIV/HCV-coinfected population in care. Over 50% of observed deaths may have been preventable. Interventions aimed at improving social circumstances, reducing harm from drug and alcohol use and increasing the delivery of HCV treatment in particular will be necessary to reduce adverse health outcomes among HIV/HCV-coinfected persons.
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Parvaiz M, Gill J, Barratt J, Allan A, Isgar B. 577 Role of Intra-operative Specimen Imaging and Systematic Cavity Shaves in Reducing Re-excision Rate for Breast-conserving Cancer Surgery. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70642-1] [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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Arujuna A, Williams S, Whittaker J, Shetty A, Roy D, Bostock J, Kirubakaran S, O'Neill M, Gill J, Cooklin M, Patel N, Blauth C, Bucknall C, Hamid S, Rinaldi CA. Trends, indications and outcomes of cardiac implantable device system extraction: a single UK centre experience over the last decade. Int J Clin Pract 2012; 66:218-25. [PMID: 22257047 DOI: 10.1111/j.1742-1241.2011.02863.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The rising number of device implantation has seen a parallel in the rising numbers of lead extraction. Herein we have analysed our experience in cardiac device and lead extraction in a single tertiary centre over the last decade. METHOD Retrospective analysis of all consecutive patients undergoing lead extractions performed between 2001 and 2010. Procedural success and complications as defined by the Heart Rhythm Society policy. RESULTS A total of 745 leads were extracted with a procedural success of 98.9% [382 cases; partial success in 6.9% (26) cases] and failure in 1.1% (4). Major complication rate was 1% (four cases) and minor complication rate was 3.6%. By both univariate and multivariate analysis only duration of lead implantation was an indicator for success (p < 0.0001). The mean implantation time for failed lead extraction was 203 ± 64 months compared with 71.8 ± 16.5 months in the successful cohort (p < 0.0001). Laser-assisted extraction was required in 176 cases. With regard to extraction indication, lead malfunction/recall showed a significant increase during the study period (p = 0.03). On time trend analysis the rise in coronary sinus (CS) lead extraction over time was significant. (p = 0.02) Despite a trend for increased laser use over time this did not achieve statistical significance, p = 0.06. CONCLUSIONS A decade's experience of percutaneous lead extraction suggests that a high procedural success rate with a low complication rate is achieved in a high-volume centre. During this time, an increase in both defibrillator and CS lead explantation and a rising trend in laser assistance with almost 50% of cases needing laser usage were observed.
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Panayiotou M, King AP, Ma Y, Rinaldi CA, Gill J, Cooklin M, O'Neil M, Rhode KS. Automatic image-based retrospective gating of interventional cardiac X-ray images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2012:4970-4973. [PMID: 23367043 DOI: 10.1109/embc.2012.6347108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gating of X-ray fluoroscopy images is required for catheter reconstruction for registration of pre-procedural images with fluoroscopy for guidance and biophysical modelling. We propose a novel and clinically useful retrospective method for automatic image-based cardiac and respiratory motion gating. The technique is based on tracking and statistical analysis of the shape of the coronary sinus catheter. We applied our method on five mono-plane imaging sequences comprising a total of 322 frames from five different patients undergoing radiofrequency ablation for the treatment of atrial fibrillation. We established systole, end-inspiration and end-expiration gating with success rates of 100%, 89.47% and 81.25% respectively.
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Carter J, Price R, Gill J, Hunt R, Thorne A, El-Abbar M. NICE Breast Reconstruction guidelines. Are we good enough? Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, Klarenbach S, Gill J. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant 2011; 11:2093-109. [PMID: 21883901 DOI: 10.1111/j.1600-6143.2011.03686.x] [Citation(s) in RCA: 864] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Individual studies indicate that kidney transplantation is associated with lower mortality and improved quality of life compared with chronic dialysis treatment. We did a systematic review to summarize the benefits of transplantation, aiming to identify characteristics associated with especially large or small relative benefit. Results were not pooled because of expected diversity inherent to observational studies. Risk of bias was assessed using the Downs and Black checklist and items related to time-to-event analysis techniques. MEDLINE and EMBASE were searched up to February 2010. Cohort studies comparing adult chronic dialysis patients with kidney transplantation recipients for clinical outcomes were selected. We identified 110 eligible studies with a total of 1 922 300 participants. Most studies found significantly lower mortality associated with transplantation, and the relative magnitude of the benefit seemed to increase over time (p < 0.001). Most studies also found that the risk of cardiovascular events was significantly reduced among transplant recipients. Quality of life was significantly and substantially better among transplant recipients. Despite increases in the age and comorbidity of contemporary transplant recipients, the relative benefits of transplantation seem to be increasing over time. These findings validate current attempts to increase the number of people worldwide that benefit from kidney transplantation.
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Gill J, Alvarez G. The bias towards a contralateral representation in parietal activity is increased during full-field attentional tracking. J Vis 2011. [DOI: 10.1167/11.11.178] [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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Fonseca V, Gill J, Zhou R, Leahy J. An analysis of early insulin glargine added to metformin with or without sulfonylurea: impact on glycaemic control and hypoglycaemia. Diabetes Obes Metab 2011; 13:814-22. [PMID: 21481127 PMCID: PMC3170705 DOI: 10.1111/j.1463-1326.2011.01412.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the benefits of initiating insulin at an earlier versus later treatment stage, and regimens with/without sulfonylurea (SU). METHODS Pooled analysis of 11 prospective randomized clinical trials, including 2171 adults with uncontrolled type 2 diabetes initiating insulin glargine following a specific titration algorithm. Clinical outcomes were glycated haemoglobin A1c (HbA1c) reduction, per cent achieving HbA1c ≤ 7.0%, weight gain and hypoglycaemic events. Statistical analysis compared outcomes 24 weeks after basal insulin initiation in patients previously uncontrolled on 0/1 oral antidiabetic drug (OAD) versus 2 OADs, and in patients taking metformin (MET) or SU alone or in combination at baseline. A meta-analysis was also conducted. RESULTS For the pooled analysis, patients on 0/1 OAD and those on MET monotherapy at baseline had the largest 24-week reductions in HbA1c following the addition of insulin glargine (∼0.44 U/kg). Of patients failing MET/SU monotherapy and MET + SU in combination, 68.1, 50.4 and 56.4% achieved HbA1c ≤ 7.0%, respectively (p = 0.0006). Weight gain was lowest when basal insulin was added to MET. Patients on 0/1 OAD at baseline had significantly less symptomatic hypoglycaemia when basal insulin was added than those on 2 OADs (p = 0.0007). Despite higher insulin doses, those taking MET alone had less hypoglycaemia than those taking SU or MET + SU. Results were confirmed in the meta-analysis. CONCLUSION Adding insulin glargine to MET monotherapy early in treatment may provide efficacy/safety benefits over regimens including SU. This may reflect treatment earlier in the disease and supports the inclusion of insulin as a second step in the American Diabetes Association/European Association for the Study of Diabetes treatment algorithm.
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Browne S, Gill J, Dong J, Rose C, Johnston O, Zhang P, Landsberg D, Gill JS. The impact of pancreas transplantation on kidney allograft survival. Am J Transplant 2011; 11:1951-8. [PMID: 21749643 DOI: 10.1111/j.1600-6143.2011.03627.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Whether pancreas after kidney transplantation (PAK) compromises kidney allograft survival, and what pre-PAK glomerular filtration rate (GFR) should be used to select patients for PAK is unclear. We analyzed all (n = 2776) PAK recipients in the United States between 1989 and 2007 and compared their risk of kidney failure to a comparator group of n = 13 635 young adult diabetic kidney only transplant recipients during the same time after accounting for selection bias by the use of a propensity score for PAK in a multivariate time to event analysis. In a secondary analysis, we determined the association of pre-PAK GFR with subsequent kidney allograft survival. Despite an increased risk of death early after pancreas transplantation, PAK recipients had a decreased long-term risk of kidney allograft failure compared to diabetic kidney only transplant recipients HR = 0.89; 95% CI: [0.78-1.00]; p = 0.05. An association of pre-PAK GFR with kidney survival was not evident until 3 years after pancreas transplantation, and patients with a pre-PAK GFR of 30-39 mL/min still attained 10-year post-PAK kidney survival of 69%. We conclude that PAK is associated with improved kidney allograft survival, and pre-PAK GFR 30-39 mL/min should not preclude PAK. Expanded use of PAK is warranted.
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Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, Klarenbach S, Gill J. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant 2011. [PMID: 21883901 DOI: 10.1111/j.1600-6143.2011.03686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Individual studies indicate that kidney transplantation is associated with lower mortality and improved quality of life compared with chronic dialysis treatment. We did a systematic review to summarize the benefits of transplantation, aiming to identify characteristics associated with especially large or small relative benefit. Results were not pooled because of expected diversity inherent to observational studies. Risk of bias was assessed using the Downs and Black checklist and items related to time-to-event analysis techniques. MEDLINE and EMBASE were searched up to February 2010. Cohort studies comparing adult chronic dialysis patients with kidney transplantation recipients for clinical outcomes were selected. We identified 110 eligible studies with a total of 1 922 300 participants. Most studies found significantly lower mortality associated with transplantation, and the relative magnitude of the benefit seemed to increase over time (p < 0.001). Most studies also found that the risk of cardiovascular events was significantly reduced among transplant recipients. Quality of life was significantly and substantially better among transplant recipients. Despite increases in the age and comorbidity of contemporary transplant recipients, the relative benefits of transplantation seem to be increasing over time. These findings validate current attempts to increase the number of people worldwide that benefit from kidney transplantation.
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