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Betancur Escobar S, Bouguecha A, Almohallami A, Niemeier H, Nolte I, Lucas K, Stukenborg-Colsmann C, Lerch M, Behrens BA. Patient-Individual Hip Cups: Simulation-Based Design and Sheet Metal Forming Manufacturing. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-C/bmt-2013-4076/bmt-2013-4076.xml. [DOI: 10.1515/bmt-2013-4076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lucas K, Maes M. Molecular mechanisms underpinning laser printer and photocopier induced symptoms, including chronic fatigue syndrome and respiratory tract hyperresponsiveness: pharmacological treatment with cinnamon and hydrogen. NEURO ENDOCRINOLOGY LETTERS 2013; 34:723-737. [PMID: 24522022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 11/12/2013] [Indexed: 06/03/2023]
Abstract
Emissions of laser printers and photocopiers (LP&P) may be associated with health problems. The aim of this review is to describe the clinical picture that is triggered by exposure to LP&P and the molecular mechanisms underpinning the symptoms. Exposure to LP&P to vulnerable subjects may cause a symptom complex consisting of 1) irritation and hyperresponsiveness of the upper and lower respiratory tract; and 2) chronic fatigue (syndrome, CFS). Symptoms occur within hours after L&P exposure and may last for some days or become chronic with exacerbations following LP&P exposure. Substances that can be found in toners or are generated during the printing process are Silica nanoparticles, Titanium Dioxide nanoparticles, Carbon Black, metals, ozone, volatile organic compounds (VOC), etc. The latter may generate oxidative and nitrosative stress (O&NS), damage-associated molecular patterns molecules, pulmonary and systemic inflammation, and modulate Toll Like Receptor 4 (TRL4)‑related mechanisms. It is concluded that LP&P emissions may cause activation of the TLR4 Radical Cycle and thus be associated with the onset of chronic inflammatory and O&NS illnesses, such as CFS, in some vulnerable individuals. Cinnamon, an antagonist of the TLR4 complex, and Hydrogen, a potent antiinflammatory and oxygen radical scavenger, may have efficacy treating LP&P-induced illness.
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Pope J, Thorne C, Cividino A, Lucas K. Effect of rheumatologist education on systematic measurements and treatment decisions in rheumatoid arthritis: the metrix study. J Rheumatol 2012; 39:2247-52. [PMID: 23070990 DOI: 10.3899/jrheum.120597] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine whether an educational intervention could result in changes in physicians' practice behavior. METHODS Twenty rheumatologists performed a prospective chart audit of 50 consecutive patients with rheumatoid arthritis (RA) and again after 6 months. Ten were randomized to the educational intervention: monthly Web-based conferences on the value of systematic assessments in RA, recent evidence-based information, practice efficiency, and other topics; this group also read articles on targeting care in RA. The others were randomized to no intervention. RESULTS One thousand serial RA charts were audited at baseline and 1000 at 6 months, with no between-group differences in patient characteristics: mean disease duration of 10 years; 77% women; 74% rheumatoid factor- positive; mean Disease Activity Score (DAS) 3.7; and 68% taking methotrexate, 14% taking steroids, and 27% taking biologics. At 6 months the intervention group collected more global assessments (patient global 53% preintervention vs 66% postintervention, and MD global 51% vs 60%; p < 0.05) and Health Assessment Questionnaires (37% vs 42%; p > 0.05; p = nonsignificant), whereas controls had no change in outcomes collected. For the intervention group there was a 32% increase in calculable composite scores [such as DAS, Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index; p < 0.05] but no change in the controls. There was more targeting to a low disease state. For those with SDAI between 3.3 and 11, the percentage of patients receiving a change in therapy was 66% in the intervention group and 36% in controls (p < 0.05). When DAS was between 2.4 and 3.6, 57% of the intervention group and 38% of controls made changes to treatment (p < 0.05). CONCLUSION Small-group learning with feedback from practice audits is an inexpensive way to improve outcomes in RA.
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Abbi KKS, Zhu J, Ehmann WC, Epner E, Carraher M, Mierski J, Talamo G, Lucas K, Rybka W, Claxton D. G-CSF mobilized vs conventional donor lymphocytes for therapy of relapse or incomplete engraftment after allogeneic hematopoietic transplantation. Bone Marrow Transplant 2012; 48:357-62. [DOI: 10.1038/bmt.2012.144] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Otter SJ, Lucas K, Springett K, Moore A, Davies K, Young A, Walker-Bone K. Identifying patient-reported outcomes in rheumatoid arthritis: the impact of foot symptoms on self-perceived quality of life. Musculoskeletal Care 2012; 10:65-75. [PMID: 22337478 DOI: 10.1002/msc.1001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The importance of patient-reported outcome measures in healthcare is increasingly recognized but these need to be patient generated. Given that foot symptoms are very common in rheumatoid arthritis (RA), we chose a patient-centred model with which to investigate the patients' perspective on how their foot symptoms affected them as individuals and impacted on their self-perceived quality of life, rather than using the traditional approaches of clinical examination (e.g. prevalence of deformities) or radiological assessments. METHODS A 33-item self-administered postal questionnaire was sent to all people with RA attending outpatient clinics in three hospitals over the course of one month (n=390). The questionnaire used both quantitative and qualitative approaches to enquire about the nature and extent of foot complaints and how respondents believed this affected their quality of life. RESULTS In total, 190 usable replies were received (49%). Nearly all respondents (n=177; 93.2%) reported that their quality of life was adversely affected by their foot complaint(s), with over half describing their quality of life as being badly or very badly affected. When asked to rate how severely foot complaints affected their quality of life using a 10 cm visual analogue scale, the mean score was 5.36 (range 0-10 ± SD 3), indicating that foot complaints have a moderate-to-severe effect on quality of life. Those aspects of daily living most significantly affected were: the ability to walk and the ability to wear a variety of shoes. CONCLUSION This study demonstrated that people with RA focus on different aspects of the impact of their disease to doctors. Rather than foot deformity or ulceration, disease activity score or health assessment questionnaire score, patients were easily able to pinpoint the key negativities of living with RA in their feet and indicated choice of footwear and ability to walk as crucial. This study and similar ones are key to identifying appropriate patient-reported outcome measures.
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McInnes A, Jeffcoate W, Vileikyte L, Game F, Lucas K, Higson N, Stuart L, Church A, Scanlan J, Anders J. Foot care education in patients with diabetes at low risk of complications: a consensus statement. Diabet Med 2011; 28:162-7. [PMID: 21219423 PMCID: PMC3040291 DOI: 10.1111/j.1464-5491.2010.03206.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To define and agree a practical educational framework for delivery by all healthcare professionals managing patients with diabetes, particularly those at low risk of developing foot complications. METHODS A consensus meeting of a multidisciplinary expert panel. Prior to the meeting, relevant clinical papers were disseminated to the panel for review. The consensus was largely based upon the experts' clinical experience and judgement. RESULTS Four main health behaviours were identified for those at low risk of developing foot complications, namely: control of blood glucose levels; attendance at annual foot screening examination; reporting of any changes in foot health immediately; and the engagement in a simple daily foot care routine. CONCLUSION There is currently little evidence-based literature to support specific foot care practices. Patients with diabetes at low risk of developing complications should be encouraged to undertake a basic foot care regimen to reduce their likelihood of developing complications.
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Marotta P, Lucas K. Management of hepatitis B: a longitudinal national survey - impact of the Canadian Hepatitis B Consensus Guidelines. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2010; 24:537-42. [PMID: 21152457 PMCID: PMC2948762 DOI: 10.1155/2010/931326] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Accepted: 02/08/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Canadian Association for the Study of the Liver, and The Association of Medical Microbiology and Infectious Diseases Canada, jointly developed the Canadian Chronic Hepatitis B (HBV) Consensus Guidelines to assist practitioners involved in the management of this complex disease. These guidelines were published in The Canadian Journal of Gastroenterology in June 2007 and distributed to all Canadian gastroenterologists and hepatologists. OBJECTIVE To assess the degree to which Canadian specialist physicians were able to incorporate the recommendations from the Canadian HBV Consensus Guidelines into their daily practice. METHODS A 30 min telephone survey probing the management strategies of 80 key HBV specialists was completed on three occasions, eight months apart, to longitudinally assess the impact of the Canadian HBV Consensus Guidelines on the management of HBV. The questionnaire detailed HBV practice patterns, the impact of the Canadian HBV Consensus Guidelines on clinical practice and HBV management. RESULTS The majority of specialists incorporated many of the published recommendations outlined in the Canadian HBV Consensus Guidelines into their daily practice for patients with HBV. However, because public drug coverage is a major hurdle in the management of HBV, patients are provided markedly different HBV treatments depending on whether they have public or private drug insurance coverage. CONCLUSIONS The management of HBV is growing in complexity and continues to evolve rapidly. The Canadian HBV Consensus Guidelines have served as a valuable tool for many physicians in the management of HBV. However, effective treatment algorithms continue to be rendered irrelevant by restrictive drug coverage issues. Coverage for effective therapies and, therefore, management of HBV, differs widely across Canada depending on therapy reimbursement criteria rather than patient characteristics.
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Grosse K, Schütze A, Ettrich U, Brannasch K, Scharnagel R, Gossrau G, Lucas K, Kaiser U, Sabatowski R. 995 ONE YEAR CATAMNESIS AFTER MULTIMODAL TREATMENT OF PATIENTS SUFFERING FROM CHRONIC BACK PAIN. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60998-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zamani J, Vogel S, Moore A, Lucas K. Exploring the use of exercise therapy in UK osteopathic practice. INT J OSTEOPATH MED 2008. [DOI: 10.1016/j.ijosm.2008.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wasserman JL, Lucas K, Lee SH, Ashton A, Crowl CT, Marković N. Fabrication of one-dimensional programmable-height nanostructures via dynamic stencil deposition. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2008; 79:073909. [PMID: 18681718 DOI: 10.1063/1.2960573] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Dynamic stencil deposition (DSD) techniques offer a variety of fabrication advantages not possible with traditional lithographic processing, such as the ability to directly deposit nanostructures with programmable-height profiles. However, DSD systems have not enjoyed widespread usage due to their complexity. We demonstrate a simple, low-profile, portable, one-dimensional nanotranslation system that facilitates access to nanoscale DSD abilities. Furthermore we show a variety of fabricated programmable-height nanostructures, including parallel arrays of such structures, and suggest other applications that exploit the unique capabilities of DSD fabrication methods.
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Lucas K, Cowan M, Horn B, Dunham K, Bao L. 272: Cytomegalovirus (CMV) Specific Cytotoxic T Lymphocytes from a CMV Sero-Negative Donor for Persistent CMV Infection Post-Transplant. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lopatinskaya L, Zwemmer J, Uitdehaag B, Lucas K, Polman C, Nagelkerken L. Mediators of apoptosis Fas and FasL predict disability progression in multiple sclerosis over a period of 10 years. Mult Scler 2007; 12:704-9. [PMID: 17262997 DOI: 10.1177/1352458506070826] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
TNF-alpha, IL-12p35, IL-12p40, IL-4, IL-10, TGF-beta1, CCR3, CXCR3, CCR5, Fas and FasL mRNA levels in PBMC of 25 multiple sclerosis (MS) patients were quantified at baseline by real-time PCR according to a post-hoc study design. The baseline values of the different markers were analysed with respect to their correlation with the increase in disability over a period of 10 years. High levels of Fas mRNA were associated with a favourable disease course in relapsing-remitting (RR) MS (R2 = 0.74, P = 0.0001, n = 13), as measured by the Expanded Disability Status Scale (EDSS); high levels of FasL mRNA were associated with relatively mild disease progression (R2 = 0.86, P = 0.0001, n =12) in secondary progressive (SP) MS. These findings suggest that Fas-mediated apoptosis plays a major role in the mechanism underlying long-term disease progression in MS.:
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Lucas K. On the rate of variation of the exciting current as a factor in electric excitation. J Physiol 2007; 36:253-74. [PMID: 16992906 PMCID: PMC1533589 DOI: 10.1113/jphysiol.1907.sp001231] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Lucas K. An analysis of changes and differences in the excitatory process of nerves and muscles based on the physical theory of excitation. J Physiol 2007; 40:225-49. [PMID: 16993005 PMCID: PMC1533744 DOI: 10.1113/jphysiol.1910.sp001367] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Lucas K. The analysis of complex excitable tissues by their response to electric currents of short duration. J Physiol 2007; 35:310-31. [PMID: 16992859 PMCID: PMC1465826 DOI: 10.1113/jphysiol.1907.sp001195] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Lucas K. On the transference of the propagated disturbance from nerve to muscle with special reference to the apparent inhibition described by Wedensky. J Physiol 2007; 43:46-90. [PMID: 16993084 PMCID: PMC1512754 DOI: 10.1113/jphysiol.1911.sp001459] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Lucas K. On a mechanical method of correcting photographic records obtained from the capillary electrometer. J Physiol 2007; 44:225-42. [PMID: 16993124 PMCID: PMC1512819 DOI: 10.1113/jphysiol.1912.sp001513] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Lucas K. On summation of propagated disturbances in the claw of astacus, and on the double neuro-muscular system of the adductor. J Physiol 2007; 51:1-35. [PMID: 16993373 PMCID: PMC1402684 DOI: 10.1113/jphysiol.1917.sp001781] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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