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Luc JGY, Jackson K, Weinkauf JG, Freed DH, Nagendran J. Feasibility of Lung Transplantation From Donation After Circulatory Death Donors Following Portable Ex Vivo Lung Perfusion: A Pilot Study. Transplant Proc 2018; 49:1885-1892. [PMID: 28923643 DOI: 10.1016/j.transproceed.2017.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 04/03/2017] [Accepted: 04/27/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Donation after circulatory death (DCD) has the potential to significantly alleviate the shortage of transplantable lungs. We report our initial experience with the use of portable ex vivo lung perfusion (EVLP) with the Organ Care System Lung device for evaluation of DCD lungs. METHODS We performed a retrospective review of the DCD lung transplantation (LTx) experience at a single institution through the use of a prospective database. RESULTS From 2011 to 2015, 208 LTx were performed at the University of Alberta, of which 11 were DCD LTx with 7 (64%) that underwent portable EVLP. DCD lungs preserved with portable EVLP had a significantly shorter cold ischemic time (161 ± 44 vs 234 ± 60 minutes, P = .045), lower grade of primary graft dysfunction at 72 hours after LTx (0.4 ± 0.5 vs 2.1 ± 0.7, P = .003), similar mechanical ventilation time (55 ± 44 vs 103 ± 97 hours, P = .281), and hospital length of stay (29 ± 11 vs 33 ± 10 days, P = .610). All patients were alive at 1-year follow-up after LTx with improved functional outcomes and acceptable quality of life compared with before LTx, although there were no intergroup differences. CONCLUSIONS In our pilot cohort, portable EVLP was a feasible modality to increase confidence in the use of DCD lungs with validated objective evidence of lung function during EVLP that translates to acceptable clinical outcomes and quality of life after LTx. Further studies are needed to validate these initial findings in a larger cohort.
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 4: Post Disease Complications, Charity Support and Future Perspectives: MeningoNI Forum. THE ULSTER MEDICAL JOURNAL 2018; 87:99-101. [PMID: 29867263 PMCID: PMC5974664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/30/2022]
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 3: Diagnosis and Management: MeningoNI Forum. THE ULSTER MEDICAL JOURNAL 2018; 87:94-98. [PMID: 29867262 PMCID: PMC5974663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 10/29/2022]
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease in Northern Ireland - Past, Present & Future: MeningoNI Forum. THE ULSTER MEDICAL JOURNAL 2018; 87:83. [PMID: 29867259 PMCID: PMC5974660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/23/2022]
Abstract
Meningococcal disease has had devastating consequences in Northern Ireland since its first description locally in 1859. The incidence of this disease has significantly declined in recent years, however it is important to understand reasons for this changing epidemiology and to acknowledge the diagnostic and clinical management developments that have been made locally. This review aims to examine the changing face of this disease in Northern Ireland over the years, with particular reference to local disease prevention, epidemiology, diagnosis, clinical treatment and management, post-disease sequelae and the role of meningitis charities locally, in terms of patient support and research.
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 1: Microbiology And Historical Perspective: MeningoNI Forum. THE ULSTER MEDICAL JOURNAL 2018; 87:84-87. [PMID: 29867260 PMCID: PMC5974661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 12/05/2022]
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Millar BC, Banks L, Bourke TW, Cunningham M, Dooley JSG, Elshibly S, Goldsmith CE, Fairley D, Jackson K, Lamont S, Jessop L, McCrudden E, McConnell D, McAuley K, McKenna JP, Moore PJA, Smithson R, Stirling J, Shields M, Moore JE. Meningococcal Disease Section 2: Epidemiology and Vaccination of Meningococcal Disease in Northern Ireland: MeningoNI Forum. THE ULSTER MEDICAL JOURNAL 2018; 87:88-93. [PMID: 29867261 PMCID: PMC5974662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/23/2022]
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Maughan NM, Eldib M, Faul D, Conti M, Elschot M, Knešaurek K, Leek F, Townsend D, DiFilippo FP, Jackson K, Nekolla SG, Lukas M, Tapner M, Parikh PJ, Laforest R. Multi institutional quantitative phantom study of yttrium-90 PET in PET/MRI: the MR-QUEST study. EJNMMI Phys 2018; 5:7. [PMID: 29616365 PMCID: PMC5882483 DOI: 10.1186/s40658-018-0206-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/16/2018] [Indexed: 12/22/2022] Open
Abstract
Background Yttrium-90 (90Y) radioembolization involves the intra-arterial delivery of radioactive microspheres to treat hepatic malignancies. Though this therapy involves careful pre-treatment planning and imaging, little is known about the precise location of the microspheres once they are administered. Recently, there has been growing interest post-radioembolization imaging using positron-emission tomography (PET) for quantitative dosimetry and identifying lesions that may benefit from additional salvage therapy. In this study, we aim to measure the inter-center variability of 90Y PET measurements as measured on PET/MRI in preparation for a multi-institutional prospective phase I/II clinical trial. Eight institutions participated in this study and followed a standardized phantom filling and imaging protocol. The NEMA NU2-2012 body phantom was filled with 3 GBq of 90Y chloride solution. The phantom was imaged for 30 min in listmode on a Siemens Biograph mMR non-TOF PET/MRI scanner at five time points across 10 days (0.3–3.0 GBq). Raw PET data were sent to a central site for image reconstruction and data analysis. Images were reconstructed with optimal parameters determined from a previous study. Volumes of interest (VOIs) matching the known sphere diameters were drawn on the vendor-provided attenuation map and propagated to the PET images. Recovery coefficients (RCs) and coefficient of variation of the RCs (COV) were calculated from these VOIs for each sphere size and activity level. Results Mean RCs ranged from 14.5 to 75.4%, with the lowest mean RC coming from the smallest sphere (10 mm) on the last day of imaging (0.16 MBq/ml) and the highest mean RC coming from the largest sphere (37 mm) on the first day of imaging (2.16 MBq/ml). The smaller spheres tended to exhibit higher COVs. In contrast, the larger spheres tended to exhibit lower COVs. COVs from the 37 mm sphere were < 25.3% in all scans. For scans with ≥ 0.60 MBq/ml, COVs were ≤ 25% in spheres ≥ 22 mm. However, for all other spheres sizes and activity levels, COVs were usually > 25%. Conclusions Post-radioembolization dosimetry of lesions or other VOIs ≥ 22 mm in diameter can be consistently obtained (< 25% variability) at a multi-institutional level using PET/MRI for any clinically significant activity for 90Y radioembolization.
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AbdelRazek M, Khalaf M, Shah R, Jackson K, Desai M, Sundaram V, Kothary N. Abstract No. 509 Same-day discharge after chemoembolization: a predictive model to assist physicians in minimizing overnight admissions. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Franceschi AM, Abballe V, Raad RA, Nelson A, Jackson K, Babb J, Vahle T, Fenchel M, Zhan Y, Valadez GH, Shepherd TM, Friedman KP. Visual detection of regional brain hypometabolism in cognitively impaired patients is independent of positron emission tomography-magnetic resonance attenuation correction method. World J Nucl Med 2018; 17:188-194. [PMID: 30034284 PMCID: PMC6034547 DOI: 10.4103/wjnm.wjnm_61_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Fluorodeoxyglucose (FDG) positron emission tomography-magnetic resonance (PET/MR) is useful for the evaluation of cognitively-impaired patients. This study aims to assess two different attenuation correction (AC) methods (Dixon-MR and atlas-based) versus index-standard computed tomography (CT) AC for the visual interpretation of regional hypometabolism in patients with cognitive impairment. Two board-certified nuclear medicine physicians blindly scored brain region FDG hypometabolism as normal versus hypometabolic using two-dimensional (2D) and 3D FDG PET/MR images generated by MIM software. Regions were quantitatively assessed as normal versus mildly, moderately, or severely hypometabolic. Hypometabolism scores obtained using the different methods of AC were compared, and interreader, as well as intra-reader agreement, was assessed. Regional hypometabolism versus normal metabolism was correctly classified in 16 patients on atlas-based and Dixon-based AC map PET reconstructions (vs. CT reference AC) for 94% (90%–96% confidence interval [CI]) and 93% (89%–96% CI) of scored regions, respectively. The averaged sensitivity/specificity for detection of any regional hypometabolism was 95%/94% (P = 0.669) and 90%/91% (P = 0.937) for atlas-based and Dixon-based AC maps. Interreader agreement for detection of regional hypometabolism was high, with similar outcome assessments when using atlas- and Dixon-corrected PET data in 93% (Κ =0.82) and 93% (Κ =0.84) of regions, respectively. Intrareader agreement for detection of regional hypometabolism was high, with concordant outcome assessments when using atlas- and Dixon-corrected data in 93%/92% (Κ =0.79) and 92/93% (Κ =0.78). Despite the quantitative advantages of atlas-based AC in brain PET/MR, routine clinical Dixon AC yields comparable visual ratings of regional hypometabolism in the evaluation of cognitively impaired patients undergoing brain PET/MR and is similar in performance to CT-based AC. Therefore, Dixon AC is acceptable for the routine clinical evaluation of dementia syndromes.
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Wong D, Littlejohn M, Yuen L, Jackson K, Mason H, Bayliss J, Rosenberg G, Gaggar A, Kitrinos K, Subramanian M, Marcellin P, Buti M, Janssen HLA, Gane E, Locarnini S, Thompson A, Revill PA. HBeAg levels at week 24 predict response to 8 years of tenofovir in HBeAg-positive chronic hepatitis B patients. Aliment Pharmacol Ther 2018; 47:114-122. [PMID: 29023803 DOI: 10.1111/apt.14362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 09/09/2017] [Accepted: 09/14/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hepatitis B e antigen (HBeAg) seroconversion is a treatment endpoint for HBeAg-positive CHB, and a necessary precursor to HBsAg loss. Biomarkers that predict serological outcomes would be useful. AIM To evaluate the utility of measuring HBeAg levels for predicting HBeAg seroconversion and HBsAg loss under long-term tenofovir (TDF) therapy. METHODS A total of 266 patients were enrolled into a phase III study of TDF vs adefovir (ADV) for 48 weeks in HBeAg-positive patients, followed by open-label TDF up to 384 weeks. Serum HBeAg levels were measured for subjects with samples available at both baseline and week 24 of treatment (n = 200). Analysis compared subjects who achieved HBeAg seroconversion by week 384 vs no HBeAg seroconversion. RESULTS HBeAg seroconversion rate was 52% by week 384. Time to HBeAg seroconversion was 80 weeks (IQR: 36-162). HBeAg decline at week 24 was associated with HBeAg seroconversion (1.63 vs 0.90 log10 PEIU/mL, P = .002). The optimal threshold for identifying HBeAg seroconversion was HBeAg decline ≥2.2 log10 PEIU/mL at week 24, with HBeAg seroconversion achieved by 76% of patients, compared to 44% if HBeAg decline <2.2 log10 (P < .0001). HBeAg decline ≥2.2 log10 PEIU/mL at week 24 was associated with HBsAg loss in genotype A or D patients (38% vs 15%, P = .03). Precore/basal core promotor variants were associated with lower baseline HBeAg levels, but not HBeAg seroconversion. CONCLUSION Decline in HBeAg levels by week 24 was associated with HBeAg seroconversion and HBsAg loss in HBeAg-positive chronic hepatitis B patients treated with long-term TDF.
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Minar P, Jackson K, Tsai YT, Sucharew H, Rosen MJ, Denson LA. Validation of Neutrophil CD64 Blood Biomarkers to Detect Mucosal Inflammation in Pediatric Crohn's Disease. Inflamm Bowel Dis 2017; 24:198-208. [PMID: 29272485 PMCID: PMC5831176 DOI: 10.1093/ibd/izx022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND In a pilot study, neutrophil CD64 surface expression was significantly elevated in newly diagnosed, pediatric-onset Crohn's disease. We aimed to test the CD64 biomarkers (neutrophil CD64 surface expression and soluble CD64) as determinates for mucosal inflammation in a larger pediatric Crohn's cohort with the hypotheses that the CD64 biomarkers would reliably detect intestinal inflammation and correlate with endoscopic severity scores. METHODS We enrolled patients referred for colonoscopy for either suspected inflammatory bowel disease or with established Crohn's. Neutrophil CD64 index was determined by flow cytometry using a commercial kit (Leuko64, Trillium) and soluble CD64 by ELISA (LifeSpan). RESULTS A total of 209 patients (72 controls, 76 new inflammatory bowel disease patients, and 61 established Crohn's) were enrolled. Both neutrophil CD64 index and soluble CD64 were significantly elevated in new Crohn's compared with controls. The area under the curve (AUC) for neutrophil CD64 index ≥1 was 0.85 (95% confidence interval, 0.77-0.92), 75% sensitive and 89% specific for new Crohn's. Comparatively, soluble CD64 ≥39 ng/mL was 92% sensitive and 85% specific (AUC, 0.93) for new Crohn's. Neutrophil CD64 index, soluble CD64, and fecal calprotectin discriminated endoscopic inactive from moderate and severe activity while soluble CD64 differentiated endoscopic mild from moderate and severe activity. Neutrophil CD64 index (r = 0.46, P < 0.001) and fecal calprotectin (r = 0.55, P < 0.001) correlated well with the Simple Endoscopic Score-Crohn's disease. Spearman correlation between the CD64 index and calprotectin was 0.39 (P < 0.001). CONCLUSIONS In a large Crohn's disease cohort, we found that neutrophil CD64 index and soluble CD64 were significantly elevated during active gastrointestinal inflammation.
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Nguyen HT, Minar P, Jackson K, Fulkerson PC. Vaccinations in immunosuppressive-dependent pediatric inflammatory bowel disease. World J Gastroenterol 2017; 23:7644-7652. [PMID: 29204064 PMCID: PMC5698257 DOI: 10.3748/wjg.v23.i42.7644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/14/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the vaccination rates in pediatric immunosuppression-dependent inflammatory bowel disease (IBD) and review the safety and efficacy of vaccinations in this population.
METHODS The electronic medical records from October 2009 to December 2015 of patients diagnosed with IBD at 10 years of age or younger and prescribed anti-tumor necrosis factor alpha (anti-TNF-α) therapy were reviewed for clinical history, medication history, vaccination history, and hepatitis B and varicella titers. Literature discussing vaccination response in IBD patients were identified through search of the MEDLINE database and reviewed using the key words “inflammatory bowel disease”, “immunization”, “vaccination”, “pneumococcal”, “varicella”, and “hepatitis B”. Non-human and non-English language studies were excluded. Search results were reviewed by authors to select articles that addressed safety and efficacy of immunizations in inflammatory bowel disease.
RESULTS A total of 51 patients diagnosed with IBD prior to the age of 10 and receiving anti-TNF-α therapy were identified. Thirty-three percent of patients (17/51) had incomplete or no documentation of vaccinations. Sixteen case reports, cohort studies, cross-sectional studies, and randomized trials were determined through review of the literature to describe the safety and efficacy of hepatitis B, pneumococcal, and varicella immunizations in adult and pediatric patients with IBD. These studies showed that patients safely tolerated the vaccines without significant adverse effects. Importantly, IBD patients receiving immunosuppressive medications, particularly anti-TNF-α treatment, have decreased vaccine response compared to controls. However, the majority of patients are still able to achieve protective levels of specific antibodies.
CONCLUSION Immunizations have been shown to be well-tolerated and protective immunity can be achieved in patients with IBD requiring immunosuppressive therapy.
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Gomez E, Bishop J, Jackson K, Muram T, Phillips D, Wilhelm S. 434 Treatment with ixekizumab does not interfere with the efficacy of tetanus and pneumococcal vaccines in healthy subjects. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jackson K, Kelty E, Tennant M. Equine peripheral dental caries: An epidemiological survey assessing prevalence and possible risk factors in Western Australian horses. Equine Vet J 2017; 50:79-84. [DOI: 10.1111/evj.12718] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 07/09/2017] [Indexed: 01/16/2023]
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Hubert G, Tam Chung T, Prosser C, Lien D, Weinkauf J, Brown N, Goodvin M, Jackson K, Tabak J, Salgado J, Alzaben A, Mager D. Micronutrient Monitoring and Bone Health in Adults with Cystic Fibrosis Undergoing Lung Transplant. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Gates LS, Leyland KM, Sheard S, Jackson K, Kelly P, Callahan LF, Pate R, Roos EM, Ainsworth B, Cooper C, Foster C, Newton JL, Batt ME, Arden NK. Physical activity and osteoarthritis: a consensus study to harmonise self-reporting methods of physical activity across international cohorts. Rheumatol Int 2017; 37:469-478. [PMID: 28238075 PMCID: PMC5357277 DOI: 10.1007/s00296-017-3672-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/02/2017] [Indexed: 01/03/2023]
Abstract
Physical activity (PA) is increasingly recognised as an important factor within studies of osteoarthritis (OA). However, subjective methods used to assess PA are highly variable and have not been developed for use within studies of OA, which creates difficulties when comparing and interpreting PA data in OA research. The aim of this study was, therefore, to gain expert agreement on the appropriate methods to harmonise PA data among existing population cohorts to enable the investigation of the association of PA and OA. The definition of PA in an OA context and methods of harmonization were established via an international expert consensus meeting and modified Delphi exercise using a geographically diverse committee selected on the basis of individual expertise in physical activity, exercise medicine, and OA. Agreement was met for all aims of study: (1) The use of Metabolic Equivalent of Task (MET) minutes per week (MET-min/week) as a method for harmonising PA variables among cohorts; (2) The determination of methods for treating missing components of MET-min/week calculation; a value will be produced from comparable activities within a representative cohort; (3) Exclusion of the domain of occupation from total MET-min/week; (4) The need for a specific measure of joint loading of an activity in addition to intensity and time, in studies of diseases, such as OA. This study has developed a systematic method to classify and harmonise PA in existing OA cohorts. It also provides minimum requirements for future studies intending to include subjective PA measures.
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Lamb RC, Matcham F, Turner MA, Rayner L, Simpson A, Hotopf M, Barker JNWN, Jackson K, Smith CH. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting. Br J Dermatol 2016; 176:1028-1034. [PMID: 27363600 DOI: 10.1111/bjd.14833] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND National Institute for Health and Care Excellence guidance recommends assessment of psychological and social well-being in people with psoriasis. OBJECTIVES To screen systematically for depression and anxiety in patients with psoriasis in routine clinical practice and to identify at-risk groups for psychiatric morbidity. METHODS Consecutive patients attending a single, tertiary centre over a 10-month period were invited to complete the Patient Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Dermatology Life Quality Index (DLQI) as part of IMPARTS: Integrating Mental and Physical Healthcare: Research, Training and Services. Information on demographics, treatment and clinical disease severity was collated from electronic patient records. Regression models were used to identify at-risk groups for psychiatric morbidity. RESULTS Of 607 patients included (56·2% on biologics), 9·9% (95% confidence interval 7·5-12·3%) screened positive for major depressive disorder (MDD) and 13·1% (79/604) (95% confidence interval 10·4-15·8%) for generalized anxiety disorder (GAD; GAD-7 score > 9). Suicidal ideation was reported in 35% of those with MDD; DLQI was < 10 in 38·3% and 45·6% cases of MDD and GAD, respectively. After adjusting for covariates, the risk of MDD or GAD was significantly higher in women and those with severe clinical disease, psoriatic arthritis and previous depression/anxiety. The risk of GAD was significantly increased with Asian ethnicity and use of topical treatments only. CONCLUSIONS Systematic screening for anxiety and depression identifies clinically important levels of depression and anxiety that may be missed using DLQI data alone. Women and those with severe disease, psoriatic arthritis and/or a prior history of psychiatric morbidity may be at particular risk.
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Ostenson J, Pujara AC, Mikheev A, Moy L, Kim SG, Melsaether AN, Jhaveri K, Adams S, Faul D, Glielmi C, Geppert C, Feiweier T, Jackson K, Cho GY, Boada FE, Sigmund EE. Voxelwise analysis of simultaneously acquired and spatially correlated 18 F-fluorodeoxyglucose (FDG)-PET and intravoxel incoherent motion metrics in breast cancer. Magn Reson Med 2016; 78:1147-1156. [PMID: 27779790 DOI: 10.1002/mrm.26505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE Diffusion-weighted imaging (DWI) and 18 F-fluorodeoxyglucose-positron emission tomography (18 F-FDG-PET) independently correlate with malignancy in breast cancer, but the relationship between their structural and metabolic metrics is not completely understood. This study spatially correlates diffusion, perfusion, and glucose avidity in breast cancer with simultaneous PET/MR imaging and compares correlations with clinical prognostics. METHODS In this Health Insurance Portability and Accountability Act-compliant prospective study, with written informed consent and approval of the institutional review board and using simultaneously acquired FDG-PET and DWI, tissue diffusion (Dt ), and perfusion fraction (fp ) from intravoxel incoherent motion (IVIM) analysis were registered to FDG-PET within 14 locally advanced breast cancers. Lesions were analyzed using 2D histograms and correlation coefficients between Dt , fp , and standardized uptake value (SUV). Correlations were compared with prognostics from biopsy, metastatic burden from whole-body PET, and treatment history. RESULTS SUV||Dt correlation coefficient significantly distinguished treated (0.11 ± 0.24) from nontreated (-0.33 ± 0.26) patients (P = 0.005). SUV||fp correlations were on average negative for the whole cohort (-0.17 ± 0.13). CONCLUSION Simultaneously acquired and registered FDG-PET/DWI allowed quantifiable descriptions of breast cancer microenvironments that may provide a framework for monitoring and predicting response to treatment. Magn Reson Med 78:1147-1156, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Cox JO, DeCarmen TS, Ouyang Y, Strachan B, Sloane H, Connon C, Gibson K, Jackson K, Landers JP, Cruz TD. A novel, integrated forensic microdevice on a rotation-driven platform: Buccal swab to STR product in less than 2 h. Electrophoresis 2016; 37:3046-3058. [PMID: 27620618 DOI: 10.1002/elps.201600307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/25/2016] [Accepted: 09/01/2016] [Indexed: 11/08/2022]
Abstract
This work describes the development of a novel microdevice for forensic DNA processing of reference swabs. This microdevice incorporates an enzyme-based assay for DNA preparation, which allows for faster processing times and reduced sample handling. Infrared-mediated PCR (IR-PCR) is used for STR amplification using a custom reaction mixture, allowing for amplification of STR loci in 45 min while circumventing the limitations of traditional block thermocyclers. Uniquely positioned valves coupled with a simple rotational platform are used to exert fluidic control, eliminating the need for bulky external equipment. All microdevices were fabricated using laser ablation and thermal bonding of PMMA layers. Using this microdevice, the enzyme-mediated DNA liberation module produced DNA yields similar to or higher than those produced using the traditional (tube-based) protocol. Initial microdevice IR-PCR experiments to test the amplification module and reaction (using Phusion Flash/SpeedSTAR) generated near-full profiles that suffered from interlocus peak imbalance and poor adenylation (significant -A). However, subsequent attempts using KAPA 2G and Pfu Ultra polymerases generated full STR profiles with improved interlocus balance and the expected adenylated product. A fully integrated run designed to test microfluidic control successfully generated CE-ready STR amplicons in less than 2 h (<1 h of hands-on time). Using this approach, high-quality STR profiles were developed that were consistent with those produced using conventional DNA purification and STR amplification methods. This method is a smaller, more elegant solution than current microdevice methods and offers a cheaper, hands-free, closed-system alternative to traditional forensic methods.
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Edwards K, Jones N, Newton J, Foster C, Judge A, Jackson K, Arden NK, Pinedo-Villanueva R. THE COST EFFECTIVENESS OF EXERCISE-BASED CARDIAC REHABILITATION: A SYSTEMATIC REVIEW. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096900.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Callis Duffin K, Bagel J, Bukhalo M, Mercado Clement IJ, Choi SL, Zhao F, Gill A, Pangallo B, Shuler C, Mallbris L, Jackson K. Phase 3, open-label, randomized study of the pharmacokinetics, efficacy and safety of ixekizumab following subcutaneous administration using a prefilled syringe or an autoinjector in patients with moderate-to-severe plaque psoriasis (UNCOVER-A). J Eur Acad Dermatol Venereol 2016; 31:107-113. [PMID: 27500949 PMCID: PMC5215575 DOI: 10.1111/jdv.13768] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/21/2016] [Indexed: 12/31/2022]
Abstract
Background The efficacy of ixekizumab, an anti‐interleukin‐17A (anti‐IL‐17A) monoclonal IgG4 antibody, was demonstrated in moderate‐to‐severe psoriasis patients when administered via prefilled syringe (PFS). Objective To evaluate the effect of two drug delivery devices on the pharmacokinetics (PK) of ixekizumab as well as efficacy and safety with both devices. Methods In the first 12 weeks of an open‐label, phase 3 study, moderate‐to‐severe psoriasis patients were randomized to ixekizumab delivery via PFS or autoinjector device. Randomization was stratified by weight (<80 kg, 80–100 kg, >100 kg), injection assistance (yes/no) and injection site (arm, thigh or abdomen). Following a 160‐mg initial dose at week 0, patients received subcutaneous 80‐mg ixekizumab as a single injection every 2 weeks for 12 weeks. Blood samples were collected following the initial 160‐mg dose on days 2, 4, 7, 10 and 14 for PK analysis. Primary PK parameters were maximum concentration (Cmax) and area under the curve (AUC0‐tlast) where tlast is the time of last sample (14 days ± 24 h). Efficacy was assessed by percent improvement on the Psoriasis Area and Severity Index (PASI) at week 12. Adverse event reporting, vital signs and clinical laboratory data were used to evaluate safety. Results Of 204 randomized patients, 192 were included in the PK analysis (PFS: 94; autoinjector: 98). The PFS and autoinjector showed similar geometric mean Cmax (90% CI) [15.0 μg/mL (13.9–16.1) vs. 14.8 μg/mL (13.8–15.9)] and geometric mean AUC0‐tlast (90% CI) [157 μg × day/mL (147–168) vs. 154 μg × day/mL (144–165)]. When comparing Cmax and AUC0‐tlast of the autoinjector to PFS, the geometric LS mean ratios were 0.97. At week 12, mean percent PASI improvement (via modified baseline observation carried forward) was similar with the PFS (89.3%) and autoinjector (86.9%). Both devices had safety results that were consistent with the known safety profile of ixekizumab. Conclusion The PK, efficacy and safety of ixekizumab administered subcutaneously by PFS and autoinjector were similar. Clinicaltrials.gov number: NCT01777191 https://clinicaltrials.gov/ct2/show/NCT01777191
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Jackson K, Frame J, Oates J, Wilson S. An effective view. Health Informatics J 2016. [DOI: 10.1177/146045829900500205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Victoria Infirmary National Health Service (NHS) Trust, Glasgow, UK has recently completed the pilot phase of implementing an internal Intranet system. The project was initially funded by the NHS Management Executive with the purpose of establishing an internal web to provide non-patient specific clinical and non-clinical information throughout the Trust. The pilot phase has been a great success, with the Intranet content currently consisting of departmental information, protocols, clinical guidelines and notices of meetings. The Intranet is now beginning to take on the function of a hospital handbook.
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Ghoneum M, Jackson K, Salem F, Gill G. Murine Inter-Sex Difference in Methylcholanthrene Induced Tumor and its Correlation with NK Activity. Int J Immunopathol Pharmacol 2016. [DOI: 10.1177/039463209100400102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Susceptibility to 3-methylcholanthrene (MC) induced tumor development between adult male and female C3H mice at 3–4 mo. old was examined. Animals that were injected (s.c.) with a tumorigenic dose (150 μg/mouse) of MC demonstrated a significant difference in the latent period of tumor development between both sexes. Female mice were more responsive and developed tumors at 3 wks after treatment, whereas, male mice were less responsive as indicated by the longer latent period (10 wks). In order to correlate these data with activity of natural killer (NK) cells, splenic NK activity was measured by 4 hr 51Cr-release assay. The results showed male mice having higher activity: 27 lytic units (LU) in comparison to female ones (3 LU). This was attributed to a decrease in the lytic effect of female NK cells (11%) compared to male mice (20%), since the binding capacity of effector cells to their targets was similar in both sexes (15%), as indicated by single cell assay. The possible role of an immunosuppressive factor (IF) in the sera of female mice was investigated. NK cells from young females demonstrated 33% suppression in activity post culture with sera from 3–4 mo. old female mice. In conclusion, this study demonstrates a sex-linked tumor development by MC treatment, and correlates this phenomenon with differences of NK activity between young male and female mice as well as in the age-dependent decline of reactivity. A possible immunosuppressive mechanism may be operative in explaining as to why MC is more effective in tumorigenesis in female mice as opposed to males.
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Liu J, Jackson K, Weinkauf J, Kapasi A, Hirji A, Laing B, Mullen J, Freed D, Nagendran J, Meyer S, Lien D, Halloran K. Baseline Lung Allograft Dysfunction Negatively Impacts Survival Following Lung Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Jackson K, Bartlett R, Friedman K, Shepherd T, Koesters T, Teruel J, Fenchel M, Hermosillova-Valadez G, Faul D, Boada F. Quantitative impact of Dixon μmap variability in dual-time-point brain PET/MR. EJNMMI Phys 2015; 2:A74. [PMID: 26956335 PMCID: PMC4798694 DOI: 10.1186/2197-7364-2-s1-a74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ersser S, Farasat H, Jackson K, Gardiner E, Sheppard Z, Cowdell F. Parental self-efficacy and the management of childhood atopic eczema: development and testing of a new clinical outcome measure. Br J Dermatol 2015; 173:1479-85. [DOI: 10.1111/bjd.14175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 11/27/2022]
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Nestory M, Casadei Gardini A, Bravaccini S, Serra P, Jackson K, Akwilina P, Austin S, Frassineti G, Amadori D. Exploratory study of histopathological characteristics of Hepatocellular carcinoma (HCC) in African (Tanzania) and Caucasian (Italian) population. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.46] [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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Hanson JD, Pourier S, Jackson K, Jensen J. The Oglala Sioux Tribe CHOICES Program: Preventing Alcohol-Exposed Pregnancies with American Indian Women. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.044] [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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Galavis P, Friedman K, Chandarana H, Jackson K. TU-AB-BRA-06: Texture Feature Reproducibility Between PET/CT and PET/MR Imaging Modalities. Med Phys 2015. [DOI: 10.1118/1.4925511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Weinkauf J, Miciak G, Kapasi A, Jackson K, Halloran K, Lien D. A Retrospective Analysis of the Safety and Efficacy of a 6-Week Pulmonary Rehabilitation Program in Patients With Severe Pulmonary Arterial Hypertension. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Schrott L, Jackson K, Yi P, Dietz F, Johnson G, Basting T, Purdum G, Tyler T, Rios J, Castor T, Alexander J. Acute Oral Bryostatin-1 Administration Improves Learning Deficits in the APP/PS1 Transgenic Mouse Model of Alzheimer’s Disease. Curr Alzheimer Res 2015; 12:22-31. [DOI: 10.2174/1567205012666141218141904] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 11/17/2014] [Accepted: 11/30/2014] [Indexed: 11/22/2022]
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Laratta C, Lien D, Puttagunta L, Jackson K, Mullen J, Kapasi A, Weinkauf J. A Case Report of Living-donor Lobar Lung Transplantation for Scleroderma-associated Usual Interstitial Pneumonia: Eight Years and Counting. Transplant Proc 2015; 47:190-3. [DOI: 10.1016/j.transproceed.2014.10.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 10/29/2014] [Indexed: 10/24/2022]
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Boxer O, Jackson K, Kohlman S. B-31 * Problem Solving Weaknesses in Children with Nonverbal Learning Differences. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.119] [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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Fidalgo P, Ahmed M, Meyer SR, Lien D, Weinkauf J, Cardoso FS, Jackson K, Bagshaw SM. Incidence and outcomes of acute kidney injury following orthotopic lung transplantation: a population-based cohort study. Nephrol Dial Transplant 2014; 29:1702-9. [DOI: 10.1093/ndt/gfu226] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Ersser SJ, Farasat H, Jackson K, Dennis H, Sheppard ZA, More A. A service evaluation of the Eczema Education Programme: an analysis of child, parent and service impact outcomes. Br J Dermatol 2014; 169:629-36. [PMID: 23646904 DOI: 10.1111/bjd.12414] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The systematic support of parents of children with eczema is essential in effective disease management. The few existing support models have a limited evidence base. This paper reports the outcome-orientated service evaluation of an original, extensive, social learning-theory based, nurse-led Eczema Education Programme (EEP). OBJECTIVES To evaluate the EEP using specified child and parental outcomes and service impact data. METHODS From a sample of 257 parent-child dyads attending the EEP, a pretest-post-test design evaluated its child impact using health-related quality of life measures (Infants' Dermatitis Quality of Life index, which includes a small dermatitis severity element, and Children's Dermatology Life Quality Index), severity measures (Patient Orientated Eczema Measure), a new parental measure (Parental Self-Efficacy in Eczema Care Index) and service impact data based on general practitioner (GP) attendance patterns pre- and postintervention. RESULTS Statistically significant impacts were observed on infant quality of life (P < 0·001), child quality of life (P = 0·027), disease severity (P < 0·001) and parental self-efficacy (P < 0·001). Improvements in child quality of life, parental efficacy and service impact were also evident from qualitative data. The cumulative total of all GP visits for selected participants post-EEP reduced by 62%. CONCLUSIONS The EEP appears to be an effective model of delivering structured education to parents of children with eczema, and one generalizable to other multiethnic metropolitan populations. As a noncontrolled study, this rigorous service evaluation highlights the model's significance and the case for an evaluative multicentre randomized controlled trial of this educational intervention to inform a nurse-led programme of care.
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Nguyen V, Tan PK, Greenup AJ, Glass A, Davison S, Samarasinghe D, Holdaway S, Strasser SI, Chatterjee U, Jackson K, Locarnini SA, Levy MT. Anti-viral therapy for prevention of perinatal HBV transmission: extending therapy beyond birth does not protect against post-partum flare. Aliment Pharmacol Ther 2014; 39:1225-34. [PMID: 24666381 DOI: 10.1111/apt.12726] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 01/03/2014] [Accepted: 03/04/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Antepartum anti-viral therapy (AVT) is often administered to prevent perinatal transmission of hepatitis B virus (HBV) infection. Little is known about the effect of AVT on post-partum flare rates and severity. AIM To examine whether extending AVT beyond birth influences the post-partum course. METHODS One hundred and one pregnancies in 91 women with HBV DNA levels ≥log 7 IU/mL were included. AVT (initially lamivudine, later tenofovir disoproxil fumarate) was commenced from 32 weeks gestation and stopped soon after birth and at 12 weeks post-partum. Outcomes according to post-partum treatment duration were examined: Group 1 = AVT ≤4 weeks (n = 44), Group 2 = AVT >4 weeks (n = 43), Group 3 = no AVT (n = 14). RESULTS The majority of women were HBeAg+ (97%), median age 29 years, baseline HBV DNA log 8.0 IU/mL and follow-up 48 weeks post-partum. Post-partum treatment duration was 2 weeks for Group 1 and 12 weeks for Group 2, P < 0.01. Flare rates were not significantly different: Group 1 = 22/44 (50%), Group 2 = 17/43 (40%) and Group 3 = 4/14 (29%), P = 0.32. Onset of flare was similar at 8/10/9 weeks post-partum for Groups 1/2/3 respectively, P = 0.34. The majority of flares spontaneously resolved. HBeAg seroconversion (n = 1/5/1 in Groups 1/2/3, P = 0.27) was not associated with treatment duration or the occurrence of a post-partum flare. CONCLUSIONS Post-partum flares are common and usually arise early after delivery. They are often mild in severity and most spontaneously resolve. Extending anti-viral therapy does not protect against post-partum flares or affect HBeAg seroconversion rates.
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Lien D, Weinkauf J, Kapasi A, Helmersen D, Thakrar M, Fenton M, Wong J, Lazarescu A, Jackson K. Esophogeal Motility and Impedence pH in Patients Listed for Lung Transplantation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.764] [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] Open
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Littlejohn M, Davies J, Yuen L, Edwards R, Sozzi T, Jackson K, Cowie B, Tong S, Davis J, Locarnini S. Molecular virology of hepatitis B virus, sub-genotype C4 in northern Australian Indigenous populations. J Med Virol 2014; 86:695-706. [PMID: 24497078 DOI: 10.1002/jmv.23888] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2013] [Indexed: 12/18/2022]
Abstract
Indigenous Australians experience a significant health burden from chronic hepatitis B infection; however, the strain of hepatitis B virus (HBV) found among Indigenous Australians has not been well characterized. Blood samples were collected from 65 Indigenous Australians with chronic HBV infection from across the Top End of Australia's Northern Territory. Phylogenetic analysis of HBV from these samples revealed that 100% of the isolates were genotype C, sub-genotype C4, expressing the serotype ayw3. This strain is a divergent group within the HBV/C genotype, and has only been described in Indigenous Australians. Evidence of recombination was suggested by discordant phylogenetic clustering of the C4 sequences when comparing the full genome to the surface region and confirmed by recombination analysis which showed the surface gene region to be most closely related to genotype J, while the remaining regions of the genome were most similar to genotype C sequences. Mutational analysis revealed the presence of multiple mutations that have been linked with more rapid liver disease progression and an increased risk of hepatocellular carcinoma. These mutations were detected in the majority of sequences examined. Variants associated with vaccine failure were detected as the predominant viral quasi-species in 3/35 samples. In summary, the HBV C4 variant found in this population has a high potential to cause advanced liver disease and to escape vaccination programs. Further in vitro functional and natural history studies are warranted in order to determine the clinical and public health consequences of infection with the HBV C4 variant in these communities.
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Fidalgo P, Ahmed M, Meyer SR, Lien D, Weinkauf J, Cardoso FS, Jackson K, Bagshaw SM. Incidence and outcomes of acute kidney injury following orthotopic lung transplant: a population-based cohort study. Crit Care 2014. [PMCID: PMC4069507 DOI: 10.1186/cc13577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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90
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Correia C, Jackson K, Véran JP, Andersen D, Lardière O, Bradley C. Static and predictive tomographic reconstruction for wide-field multi-object adaptive optics systems. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2014; 31:101-113. [PMID: 24561945 DOI: 10.1364/josaa.31.000101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Multi-object adaptive optics (MOAO) systems are still in their infancy: their complex optical designs for tomographic, wide-field wavefront sensing, coupled with open-loop (OL) correction, make their calibration a challenge. The correction of a discrete number of specific directions in the field allows for streamlined application of a general class of spatio-angular algorithms, initially proposed in Whiteley et al. [J. Opt. Soc. Am. A15, 2097 (1998)], which is compatible with partial on-line calibration. The recent Learn & Apply algorithm from Vidal et al. [J. Opt. Soc. Am. A27, A253 (2010)] can then be reinterpreted in a broader framework of tomographic algorithms and is shown to be a special case that exploits the particulars of OL and aperture-plane phase conjugation. An extension to embed a temporal prediction step to tackle sky-coverage limitations is discussed. The trade-off between lengthening the camera integration period, therefore increasing system lag error, and the resulting improvement in SNR can be shifted to higher guide-star magnitudes by introducing temporal prediction. The derivation of the optimal predictor and a comparison to suboptimal autoregressive models is provided using temporal structure functions. It is shown using end-to-end simulations of Raven, the MOAO science, and technology demonstrator for the 8 m Subaru telescope that prediction allows by itself the use of 1-magnitude-fainter guide stars.
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Pariser G, Hager K, Gillette P, Golemboski K, Jackson K. Active Steps for Diabetes. DIABETES EDUCATOR 2013; 40:60-7. [DOI: 10.1177/0145721713514281] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this study was to examine the effects of Active Steps for Diabetes (ASD), a self-management education (DSME) program for aging adults with diabetes and frailty, on blood glucose control (A1C) and level of frailty of participants. Methods Fifty females (62.2 ± 10.1 years old) with type 2 diabetes and frailty completed the program; 16 used a walking aid. Outcome measures included A1C and the modified Physical Performance Test (mPPT). Repeated measures analysis of variance was used to compare outcomes before and after the program and between participants who did and did not use a walking aid. Results ASD was effective in reducing A1C and frailty in participants who did and did not use a walking aid. The reduction in A1C was similar for the 2 groups. The reduction in frailty was greater for the group that used a walking aid. Conclusion Physical activity, a keystone for blood glucose control, is difficult for older adults who are frail. ASD provides a model for DSME that may reduce frailty of participants and increase their capacity for physical activity.
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El Masri K, Jackson K, Borasino S, Law M, Askenazi D, Alten J. Successful continuous renal replacement therapy using two single-lumen catheters in neonates and infants with cardiac disease. Pediatr Nephrol 2013; 28:2383-7. [PMID: 23996479 DOI: 10.1007/s00467-013-2578-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/11/2013] [Accepted: 07/12/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acute kidney injury (AKI) frequently occurs in neonates and infants after cardiopulmonary bypass (CPB) and may require renal replacement therapy (RRT). Peritoneal dialysis (PD) is the RRT modality of choice in neonates with AKI after CPB, but continuous renal replacement therapy (CRRT) may be necessary if PD is ineffective or contraindicated. Vascular access is challenging in this population, in part, due to small central vein size that may preclude placement. The risk of malfunction or morbidity associated with standard dialysis catheters may be excessive in neonates with congenital heart disease. We describe a unique approach to vascular access for CRRT in six small patients with AKI. CASE-DIAGNOSIS/TREATMENT This is a retrospective review of six patients with fluid overload and AKI that received CRRT because PD was contraindicated. In all cases, CRRT was performed via two hemostasis valve sheaths placed into separate veins for dialysis access and return. The low-resistance sheaths provided excellent blood flow with normalization of metabolic derangements and significant fluid removal (median negative 167 ml/kg at 72 h). Mean circuit life before the first change was 55.2 ± 30.4 h. CONCLUSIONS The use of two small single-lumen catheters in separate veins enables consistent and effective hemodiafiltration in neonates and infants with challenging vascular access.
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Jackson K, Ruppert K, Shapiro R. Post-transplant lymphoproliferative disorder after pancreas transplantation: a United Network for Organ Sharing database analysis. Clin Transplant 2013; 27:888-94. [DOI: 10.1111/ctr.12252] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2013] [Indexed: 11/29/2022]
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Norton JL, Jackson K, Chen JW, Boston R, Nolen-Walston RD. Effect of clenbuterol on tracheal mucociliary transport in horses undergoing simulated long-distance transportation. J Vet Intern Med 2013; 27:1523-7. [PMID: 24033504 DOI: 10.1111/jvim.12166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 05/08/2013] [Accepted: 07/17/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Pneumonia is observed in horses after long-distance transportation in association with confinement of head position leading to reduction in tracheal mucociliary clearance rate (TMCR). HYPOTHESIS/OBJECTIVES Clenbuterol, a beta-2 agonist shown to increase TMCR in the horse, will ameliorate the effects of a fixed elevated head position on large airway contamination and inflammation in a model of long-distance transportation model. ANIMALS Six adult horses. METHODS A cross-over designed prospective study. Horses were maintained with a fixed elevated head position for 48 hours to simulate long-distance transport, and treated with clenbuterol (0.8 μg/kg PO q12h) or a placebo starting 12 hours before simulated transportation. TMCR was measured using a charcoal clearance technique. Data were collected at baseline and 48 hours, and included TMCR, tracheal wash cytology and quantitative culture, rectal temperature, CBC, fibrinogen, and serum TNFα, IL-10, and IL-2 levels. There was a 18-21 day washout between study arms, and data were analyzed using regression analysis and Wilcoxon rank-sum tests. RESULTS Tracheal mucociliary clearance rate was significantly decreased after transportation in both treatment (P = .002) and placebo (P = .03) groups. There was a significant effect of treatment on TMCR, with the treatment group showing half the reduction in TMCR compared with the placebo group (P = .002). Other significant differences between before- and after-transportation samples occurred for serum fibrinogen, peripheral eosinophil count, quantitative culture, tracheal bacteria, and degenerate neutrophils, though no treatment effect was found. CONCLUSIONS AND CLINICAL IMPORTANCE Treatment with clenbuterol modestly attenuates the deleterious effects of this long-distance transportation model on tracheal mucociliary clearance.
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Jackson K, Ersser SJ, Dennis H, Farasat H, More A. The Eczema Education Programme: intervention development and model feasibility. J Eur Acad Dermatol Venereol 2013; 28:949-56. [PMID: 23909847 DOI: 10.1111/jdv.12221] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/22/2013] [Accepted: 06/21/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The systematic support of parents of children with eczema is essential to their effective management; however, we have few models of support. This study examines the rationale, evidence base and development of a large-scale, structured, theory-based, nurse-led intervention, the 'Eczema Education Programme' (EEP), for parents of children with eczema. OBJECTIVES To outline development of the EEP, model of delivery, determine its feasibility and evaluate this based on service access and parental satisfaction data. METHODS Parent-child dyads meeting EEP referral criteria were recruited and demographic information recorded. A questionnaire survey of parental satisfaction was conducted 4 weeks post EEP; parental focus groups at 6 weeks provided comparative qualitative data. Descriptive statistics were derived from the questionnaire data using Predictive Analytics Software (PASW); content analysis was applied to focus group data. RESULTS A total of 356 parents attended the EEP during the evaluation period. Service access was achieved for those in a challenging population. Both survey data (n = 146 parents, 57%) and focus group data (n = 21) revealed a significant level of parental satisfaction with the programme. CONCLUSIONS It was feasible to provide the EEP as an adjunct to normal clinical care on a large scale, achieving a high level of patient/parent satisfaction and access within an urban area of multiple deprivation and high mobility. The intervention is transferable and the results are generalizable to other ethnically diverse child eczema populations within metropolitan areas in Britain. A multicentre RCT is required to test the effectiveness of this intervention on a larger scale.
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Jackson K, Mollee P, Morris K, Kennedy G. Addition of etoposide to standard acute myeloid leukaemia induction chemotherapy does not improve survival. Intern Med J 2013; 43:953-4. [DOI: 10.1111/imj.12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 05/06/2013] [Indexed: 11/30/2022]
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May C, O'Rourke K, Jackson K, Francis L, Kennedy GA. Purpura fulminans in a patient with paroxysmal nocturnal haemoglobinuria. Intern Med J 2013; 43:102. [PMID: 23324094 DOI: 10.1111/imj.12030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 10/16/2012] [Indexed: 11/28/2022]
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Zhou Y, Friedman K, Shepherd T, Ding Y, Chandarana H, Glielmi C, Geppert C, Faul D, Jackson K, Perry N, De Leon M, Boada F. O1–10–02: Quantitative mMR (PET/MRI) for Alzheimer's disease detection. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.04.105] [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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99
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Jackson K, McAnaney C, Teuteberg J, Dew M, Bhama J, Bermudez C, Ramani R, McNamara D, Kormos R. Impact of Early Adverse Events (AE’s) on Later Mortality in Patients Supported by Continuous-Flow Ventricular Assist Devices (CF-VAD). J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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100
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Jackson K, Mooney C, Walker J. Optimising the mix and match of needs and available resources for patients dying in hospital. Intern Med J 2013; 43:349-50. [DOI: 10.1111/imj.12079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 12/11/2012] [Indexed: 11/26/2022]
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