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Smyk W, Weber SN, Hall R, Gruenhage F, Lammert F, Krawczyk M. Genetic variant c.711A>T in the hepatobiliary phospholipid transporter ABCB4 is associated with significant liver fibrosis. JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY : AN OFFICIAL JOURNAL OF THE POLISH PHYSIOLOGICAL SOCIETY 2020; 71. [PMID: 32991311 DOI: 10.26402/jpp.2020.3.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/30/2020] [Indexed: 11/03/2022]
Abstract
Liver fibrosis is the common consequence of chronic liver diseases (CLD). Recently liver stiffness measurements (LSM) ≥ 9.1 kPa, as determined by transient elastography (TE), were demonstrated to predict significant fibrosis (stages ≥ F2) in a population-based setting. The PNPLA3 (adiponutrin) p.I148M polymorphism enhances the risk of liver injury. The aim of our study was to investigate the association between the procholestatic ABCB4 polymorphism c.711A>T and LSM ≥ 9.1 kPa in humans as well as the interaction between ABCB4 and PNPLA3 in a mouse model of chronic cholestasis. Prospectively, we recruited 712 patients with CLD (278 women, age 50 ± 13 years) with available TE results; liver biopsy results were available in 165 individuals. The ABCB4 c.711 genotype was determined by PCR-based assays. PNPLA3 expression and liver injury were studied in Abcb4-/- mice and wild-type controls. Overall, median LSM in our cohort was 6.7 kPa, and 226 individuals had LSM ≥ 9.1 kPa. Carriers of the ABCB4 variant c.711A presented more frequently with LSM ≥ 9.1 kPa (OR = 1.33, P = 0.020) and FIB-4 score ≥ 2.67 (OR = 1.38, P = 0.040). The presence of the risk allele was associated (P = 0.002) with FIB-4. In a multivariate model, the ABCB4 variant (OR = 1.43, P = 0.047) as well as BMI (P = 0.043, OR = 1.04) and age (OR = 1.02, P < 0.010) were independent risk factors for fibrosis stage ≥ F2. Abcb4 deficiency in mice led to enhanced liver injury, coupled with a decrease (P = 0.020) of hepatic PNPLA3 expression. To conclude, the procholestatic variant ABCB4 c.711A>T might represent a new genetic risk factor for clinically significant liver fibrosis. Lower expression of PNPLA3 in fibrotic Abcb4-/- livers points to the interaction between phospholipid metabolism and PNPLA3 in progressive liver injury.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B/genetics
- ATP Binding Cassette Transporter, Subfamily B/metabolism
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Animals
- Case-Control Studies
- Female
- Genetic Association Studies
- Genetic Predisposition to Disease
- Humans
- Liver/metabolism
- Liver/pathology
- Liver Cirrhosis/diagnosis
- Liver Cirrhosis/genetics
- Liver Cirrhosis/metabolism
- Liver Cirrhosis, Experimental/genetics
- Liver Cirrhosis, Experimental/metabolism
- Liver Cirrhosis, Experimental/pathology
- Male
- Mice, Knockout
- Middle Aged
- Phenotype
- Phospholipases A2, Calcium-Independent/genetics
- Phospholipases A2, Calcium-Independent/metabolism
- Phospholipids/metabolism
- Polymorphism, Single Nucleotide
- Risk Assessment
- Risk Factors
- Young Adult
- ATP-Binding Cassette Sub-Family B Member 4
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Irvine K, Hall R, Taylor L. A profile of the Centre for Health Record Linkage. Int J Popul Data Sci 2019; 4:1142. [PMID: 37655068 PMCID: PMC8142947 DOI: 10.23889/ijpds.v4i2.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Context The Centre for Health Record Linkage (CHeReL) was established in 2006 as a dedicated health and human services data linkage facility for two Australian jurisdictions, New South Wales and the geographically-nested Australian Capital Territory. The two jurisdictions have their own Governments and separate Health and Human Service systems. Purpose and Operations The primary purpose of the CHeReL is to make linked administrative and routinely collected health data available to researchers and government within relevant regulatory and governance frameworks. The CHeReL's data governance and technical operations draw on international best practice and have been refined by learnings from other data linkage centres. Outcomes Over twelve years of operation, more than 2,320 unique investigators from 140 institutions have used the CHeReL, producing 615 publications in peer-reviewed literature. A robust pipeline of new development is expected to further amplify the use of linked data for cutting edge medical research and support a vision of data-informed policy and data-driven government services.
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Abstract
CONTEXT The Centre for Health Record Linkage (CHeReL) was established in 2006 as a dedicated health and human services data linkage facility for two Australian jurisdictions, New South Wales and the geographically-nested Australian Capital Territory. The two jurisdictions have their own Governments and separate Health and Human Service systems. PURPOSE AND OPERATIONS The primary purpose of the CHeReL is to make linked administrative and routinely collected health data available to researchers and government within relevant regulatory and governance frameworks. The CHeReL's data governance and technical operations draw on international best practice and have been refined by learnings from other data linkage centres. OUTCOMES Over twelve years of operation, more than 2,320 unique investigators from 140 institutions have used the CHeReL, producing 615 publications in peer-reviewed literature. A robust pipeline of new development is expected to further amplify the use of linked data for cutting edge medical research and support a vision of data-informed policy and data-driven government services.
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Gentzler R, Mohindra N, Jalal S, Reckamp K, Hall R, Hanna N, Chae Y, Villaflor V, Koczywas M, Helenowski I, Rademaker A, Patel J. P1.01-67 Ph I/II Carboplatin, Nab-Paclitaxel and Pembrolizumab for Advanced NSCLC (HCRN LUN13-175): Outcomes by Nab-Paclitaxel Dose. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mcloughlin E, Hanson L, Moore M, Horton B, Gentzler R, Hall R. P2.01-52 Clinical Characteristics and Outcomes in NSCLC Patients Associated with Very High PD-L1 Expression. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kazakov A, Hall R, Weber SN, Trouvain A, Lammert F, Maack C, Boehm M, Laufs U, Werner C. P4997Raf kinase inhibitor protein of the bone marrow contributes to cardiac fibrogenesis in pressure-overloaded myocardium. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Raf Kinase Inhibitor Protein (RKIP) regulates myocardial remodeling under conditions of enhanced myocardial oxidative stress in pressure-overloaded left ventricle (LV) modulating myocardial production of reactive oxygen species (ROS). A second mode of action may be the mobilization of circulating fibroblasts (fibrocytes) from the bone-marrow (BM). However the underlying mechanisms are incompletely understood.
Methods and results
To further characterize the role of RKIP in BM cells for myocardial remodeling 10-week-old wild-type (WT) C57BL/6N mice were subjected to transplantation of bone marrow (BMT) from 10-week-old C57BL/6-RKIP-deficient (RKIP−/−) N or WT C57BL/6N mice expressing green fluorescent protein (GFP)+ ubiquitously. 28 days later, transverse aortic constriction (TAC, 360 μm) or SHAM-operation was performed. 5 weeks post TAC, LV systolic pressure (LVSP) and heart weight to tibia length ratio were significantly increased in both types of BMT, compared with corresponding SHAM. Increased afterload elicited myocardial fibrosis as assessed by picrosirius red staining (WT/WT SHAM 15±2.5%, WT/WT TAC 21.3±1.4%, p<0.05; RKIP−/−/WT SHAM 17±2%, RKIP−/−/WT TAC 18±3%, p=ns) and significantly increased the number of LV fibroblasts per mm2 estimated by immunostaining for intracellular fibronectin, which were further reduced by transplantation of RKIP−/−N BM (WT/WT SHAM 5499±313, WT/WT TAC 7493±741 per mm2, p<0.05; RKIP−/−/WT SHAM 5737±259, RKIP−/−/WT TAC 5282±551, per mm2, p=ns). Moreover, transplantation of RKIP−/−N BM significantly diminished the number of circulating BM-derived GFP+ fibroblasts in the peripheral blood and LV myocardium during pressure overload (WT/WT SHAM 961±129, WT/WT TAC 2326±273 per mm2, p<0.05; RKIP−/−/WT SHAM 1041±209, RKIP−/−/WT TAC 1518±107, per mm2, p=ns). The myocardial redox status was assessed by the co-immunostaining for ROS production marker 8-hydroxyguanosin (8-dOHG), cardiomyocyte marker α-sarcomeric actin and fibroblast marker intracellular fibronectin. Pressure overload during 5 weeks significantly increased the percentages of 8-dOHG+cardiomyocytes (WT/WT SHAM 34±9%, WT/WT TAC 63±6%, p<0.05; RKIP−/−/WT SHAM 29±6%, RKIP−/−/WT TAC 31±8%, p=ns) and 8-dOHG+fibroblasts (WT/WT SHAM 57±6%, WT/WT TAC 73±4%, p<0.05; RKIP−/−/WT SHAM 58±2%, RKIP−/−/WT TAC 58±7%, p=ns) in mice transplanted with WT BM but not with RKIP−/−N BM.
Conclusions
In pressure-overload induced enhanced myocardial ROS production, deficiency of RKIP-expression in the bone marrow abrogates left ventricular fibrosis by reduction of myocardial ROS production and mobilization of BM-derived fibroblasts. These findings suggest that the function of RKIP in the bone marrow may be important for maladaptive myocardial remodelling.
Acknowledgement/Funding
Deutsche Forschungsgemeinschaft: KA4024/3-1, SFB TRR219; Saarland University HOMFOR, Dr. Marija Orlovich foundation, Corona foundation s199/10060/2014
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Wrigley P, Wood P, Stewart P, Hall R, Robertson D. Module layout optimization using a genetic algorithm in light water modular nuclear reactor power plants. NUCLEAR ENGINEERING AND DESIGN 2019. [DOI: 10.1016/j.nucengdes.2018.10.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hall R, Rutledge J, Hall K, Colon-Emeric C. RACIAL DIFFERENCES IN RESILIENCE AMONG OLDER DIALYSIS PATIENTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2242] [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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Gralla R, Hollen P, Hall R, Gentzler R, Cheng H, Halmos B, Crawford J, Cerise J, Lesser M. P2.01-39 Can Benefit or Futility in Treating Advanced Nsclc Be Determined Early Using the LCSS 3-Item Global Index (3-IGI) PRO? J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baris L, Hall R, Roos-Hesselink JW. P1239Pregnancy outcomes in women with tetralogy of fallot: data from the european society of cardiology (esc) registry on pregnancy and cardiac disease (ROAPC). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1239] [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: 11/14/2022] Open
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Lay CR, Mills D, Belova A, Sarofim MC, Kinney PL, Vaidyanathan A, Jones R, Hall R, Saha S. Emergency Department Visits and Ambient Temperature: Evaluating the Connection and Projecting Future Outcomes. GEOHEALTH 2018; 2:182-194. [PMID: 32159014 PMCID: PMC7007124 DOI: 10.1002/2018gh000129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/01/2018] [Accepted: 05/24/2018] [Indexed: 05/20/2023]
Abstract
The U.S. Global Climate Change Research Program has identified climate change as a growing public health threat. We investigated the potential effects of changes in ambient daily maximum temperature on hyperthermia and cardiovascular emergency department (ED) visits using records for patients age 64 and younger from a private insurance database for the May-September period for 2005-2012. We found a strong positive relationship between daily maximum temperatures and ED visits for hyperthermia but not for cardiovascular conditions. Using the fitted relationship from 136 metropolitan areas, we calculated the number and rate of hyperthermia ED visits for climates representative of year 1995 (baseline period), as well as years 2050 and 2090 (future periods), for two climate change scenarios based on outcomes from five global climate models. Without considering potential adaptation or population growth and movement, we calculate that climate change alone will result in an additional 21,000-28,000 hyperthermia ED visits for May to September, with associated treatment costs between $6 million and $52 million (2015 U.S. dollars) by 2050; this increases to approximately 28,000-65,000 additional hyperthermia ED visits with treatment costs between $9 million and $118 million (2015 U.S. dollars) by 2090. The range in projected additional hyperthermia visits reflects the difference between alternative climate scenarios, and the additional range in valuation reflects different assumptions about per-case valuation.
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Prost-Squarcioni C, Caux F, Schmidt E, Jonkman MF, Vassileva S, Kim SC, Iranzo P, Daneshpazhooh M, Terra J, Bauer J, Fairley J, Hall R, Hertl M, Lehman JS, Marinovic B, Patsatsi A, Zillikens D, Werth V, Woodley DT, Murrell DF. International Bullous Diseases Group: consensus on diagnostic criteria for epidermolysis bullosa acquisita. Br J Dermatol 2018; 179:30-41. [PMID: 29165796 DOI: 10.1111/bjd.16138] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Epidermolysis bullosa acquisita (EBA) is a complex autoimmune bullous disease disease with variable clinical presentations and multiple possible diagnostic tests, making an international consensus on the diagnosis of EBA essential. OBJECTIVES To obtain an international consensus on the clinical and diagnostic criteria for EBA. METHODS The International Bullous Diseases Group (IBDG) met three times to discuss the clinical and diagnostic criteria for EBA. For the final voting exercise, 22 experts from 14 different countries voted on 50 different items. When > 30% disagreed with a proposal, a discussion was held and re-voting carried out. RESULTS In total, 48 of 50 proposals achieved consensus after discussion. This included nine diagnostic criteria, which are summarized in a flow chart. The IBDG was unable to determine one procedure that would be applicable worldwide. A limitation of the study is that differential diagnosis of bullous systemic lupus erythematosus has not been addressed. CONCLUSIONS This first international consensus conference established generally agreed-upon clinical and laboratory criteria defining the clinical classification of and diagnostic testing for EBA. Holding these voting exercises in person with the possibility of discussion prior to voting has advantages in reaching consensus over Delphi exercises with remote voting.
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Bhatia S, Streilein R, Hall R. 079 Correlation of IgG autoantibodies against acetylcholine receptors and desmogleins in patients with pemphigus vulgaris treated with steroid sparing agents or rituximab. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cardones A, Lee S, Hooten J, Hall R, Sullivan K, Palmeri M. 611 A novel method of objectively quantifying cutaneous sclerosis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Werth V, Culton D, Blumberg L, Humphries J, Blumberg R, Hall R. 538 FcRn blockade with SYNT001 for the treatment of pemphigus. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.546] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lo S, Phillips DI, Peters JR, Hall M, Hall R. Papilloedema and Cranial Nerve Palsies Complicating Apparent Benign Aseptic Meningitis. J R Soc Med 2018; 84:201-2. [PMID: 2027143 PMCID: PMC1293181 DOI: 10.1177/014107689108400406] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Three patients who presented with apparently uncomplicated aseptic meningitis subsequently developed papilloedema and sixth cranial nerve palsies between 11 and 16 days after the onset of the illness. All three patients recovered completely without treatment. Raised intracranial pressure is a poorly recognized complication of aseptic meningitis that may represent a post-infective or 'allergic' response to an enteroviral infection. While clinicians should be aware of this possible complication of aseptic meningitis, differentiation from tuberculous meningitis may be difficult necessitating empirical treatment with anti-TB drugs.
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Shone GR, Richards SH, Hourihan MD, Hall R, Thomas JP, Scanlon MF. Non-Secretory Adenomas of the Pituitary Treated by Trans-Ethmoidal Sellotomy. J R Soc Med 2018; 84:140-3. [PMID: 2013893 PMCID: PMC1293132 DOI: 10.1177/014107689108400308] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A consecutive series of 35 clinically non-secretory pituitary adenomas treated surgically by the trans-ethmoidal approach is presented. Mean age at presentation was 60 years, with a male-to-female ratio of 2:1. These tumours present later than hormone secreting tumours: 90% were over 2 cm in diameter at operation. Seventy-one per cent of patients had impaired vision and 89% had hypopituitarism. Surgical treatment relieved or significantly improved visual fields in 79% of patients with impaired vision. Ninety-one per cent required permanent hormone replacement. Mean follow-up was for 4.4 years. Five tumours recurred, causing recurrent visual symptoms. No tumours recurred in those patients treated with postoperative radiotherapy, but follow-up in this group was only for a mean of 2.7 years.
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Brunton PA, Loch C, Waddell JN, Bodansky HJ, Hall R, Gray A. Estimation of jaw-opening forces in adults. Orthod Craniofac Res 2017; 21:57-62. [DOI: 10.1111/ocr.12215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2017] [Indexed: 11/29/2022]
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Hall R. An evaluation of the enteral feeding protocol for adult mechanically ventilated patients commencing early enteral tube feeding. Clin Nutr ESPEN 2017. [DOI: 10.1016/j.clnesp.2017.07.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Baris L, Shotan A, Van Hagen I, Johnson M, Hall R, Roos-Hesselink J. P6048Pregnancy in women with ventricular dysfunction: data from the European Society of Cardiology Registry of Pregnancy and Cardiac Disease (ROPAC). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6048] [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: 11/14/2022] Open
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Kazakov A, Trouvain A, Hall R, Werner C, Rodionycheva S, Lammert F, Maack C, Lorenz K, Boehm M, Laufs U. P1585Fibrotic myocardial remodeling is regulated by rkip and nrf2 depending on redox status. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1585] [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: 11/13/2022] Open
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Van Hagen I, Baart S, Fong Soe Khioe R, Sliwa K, Taha N, Lelonek M, Tavazzi L, Maggioni A, Johnson M, Maniadakis N, Fordham R, Hall R, Roos-Hesselink J. P1625Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease: data from ROPAC, an ESC registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1625] [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: 11/13/2022] Open
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Tyrer P, Tarabi SA, Bassett P, Liedtka N, Hall R, Nagar J, Imrie A, Tyrer H. Nidotherapy compared with enhanced care programme approach training for adults with aggressive challenging behaviour and intellectual disability (NIDABID): cluster-randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:521-531. [PMID: 28124397 DOI: 10.1111/jir.12360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 12/11/2016] [Accepted: 12/15/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Aggressive challenging behaviour is very common in care homes for people with intellectual disability, and better psychological treatments are needed. Nidotherapy aims to change the environment of people with mental illness and is an appropriate treatment for this group of disorders. METHOD The design was a cluster randomised trial of 20 care homes in which the staff either received training in nidotherapy or the enhanced care programme approach (ECPA), with equivalent duration of treatment in each arm. Cluster randomisation of care homes was carried out at the beginning of the study by an independent statistician. Primary and secondary outcomes were not specified exactly in view of absence of previous study data, but changes over time in scores on two scales, the Modified Overt Aggression Scale and the Problem Behaviour Check List were the main outcome measures. Serious violent incidents were recorded using the Quantification of Violence Scale. All these measures were recorded monthly by research assistants who were carefully kept blind to the allocation of treatment. RESULTS A total of 200 residents entered the trial, 115 allocated to the ECPA arm and 85 to the nidotherapy one. Seven residents left the care homes in the course of the study, and six were replaced; these were included 79 in the analysis as the trial was a pragmatic one. There were no material reductions in challenging behaviour in the first 8 months of the trial in either group, but in the last 7 months, those allocated to nidotherapy had a 33% reduction in Modified Overt Aggression Scale (MOAS) scores and a 43% reduction in Problem Behaviour Check List scores compared with 5% and 13%, respectively, for the ECPA group, differences which for the MOAS were close to statistical significance. DISCUSSION Nidotherapy shows promise in the management of aggressive challenging behaviour in care homes, but a delay in its benefit might be expected if given to staff only. The treatment is worthy of further evaluation and development.
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Goland S, van Hagen I, Elbaz-Greener G, Elkayam U, Shotan A, Merz W, Enar S, Gaisin I, Pieper P, Johnson M, Hall R, Blatt A, Roos-Hesselink J. Pregnancy in women with hypertrophic cardiomyopathy: data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC). Eur Heart J 2017; 38:2683-2690. [DOI: 10.1093/eurheartj/ehx189] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 04/27/2017] [Indexed: 11/14/2022] Open
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Muelenaer P, Hall R, Kelly P, Kochersberger K, Muelenaer A, Powell J, Talbot P, Taylor A. TEAM Malawi (Technology-Education-Advocacy-Medicine Malawi): A
Multidisciplinary Global Health Experience. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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