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Smet S, Tanderup K, Nout R, Jürgenliemk-Schulz I, Spampinato S, Chargari C, Lindegaard J, Mahantshetty U, Strudza A, Schmid M, Hoskin P, Segedin B, Bruheim K, Rai B, Huang F, Van Der Steen-Basanik E, Cooper R, Van Limbergen E, Sundset M, Pötter R, Kirchheiner K. OC-0317: Risk factors for persistent late fatigue after radiochemotherapy in cervical cancer (EMBRACE study). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00341-8] [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]
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Jensen N, Pötter R, Fokdal L, Chargari C, Lindegaard J, Schmid M, Sturdza A, Mahantshetty U, Jürgenliemk-Schulz I, Hoskin P, Segedin B, Rai B, Bruheim K, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters B, Nout R, Kirisits C, Kirchheiner K, Tanderup K. PH-0404: Risk factors for late diarrhoea after radio(chemo)therapy in cervical cancer: EMBRACE I results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00426-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Peters M, De Leeuw A, Pötter R, Nomden C, Tanderup K, Kirchheiner K, Schmid M, Fortin I, Haie-Meder C, Lindegaard J, Sturdza A, Mahantshetty U, Hoskin P, Segedin B, Bruheim K, Rai B, Huang F, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Nout R, Jürgenliemk-Schulz I. OC-0566: Risk factors for nodal failure in the EMBRACE study cohort. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00588-0] [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]
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Vittrup A, Kirchheiner K, Tanderup K, Jensen N, Spampinato S, Fokdal L, Kirisits C, Haie-Meder C, Lindegaard J, Schmid M, Sturdza A, Mahantshetty U, Jürgenliemk-Schulz I, Hoskin P, Segedin B, Bruheim K, Rai B, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters B, Nout R, Pötter R. OC-0569: Incidence of severe gastrointestinal and urinary fistulas, bleeding and strictures: EMBRACE results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bird D, Teo M, Casanova N, Cooper R, Gilbert A, Mccallum H, Sebag-Montefiore D, Henry A, Speight R, Al-Qaisieh B, Nix M. PH-0410: Multi-centre, deep learning, sCT generation for anorectal cancers with AI robustness assessment. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00432-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Knoth J, Pötter R, Jürgenliemk-Schulz IM, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Wiebe E, Rai B, Cooper R, van der Steen-Banasik E, van Limbergen E, Pieters BR, Sundset M, Tan LT, Nout RA, Tanderup K, Kirisits C, Nesvacil N, Lindegaard JC, Schmid MP. Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging - An analysis from the EMBRACE study. Gynecol Oncol 2020; 159:136-141. [PMID: 32798000 DOI: 10.1016/j.ygyno.2020.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/05/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate differences in local tumour staging between clinical examination and MRI and differences between FIGO 2009, FIGO 2018 and TNM in patients with primary cervical cancer undergoing definitive radio-chemotherapy. METHODS Patients from the prospective observational multi-centre study "EMBRACE" were considered for analysis. All patients had gynaecological examination and pelvic MRI before treatment. Nodal status was assessed by MRI, CT, PET-CT or lymphadenectomy. For this analysis, patients were restaged according to the FIGO 2009, FIGO 2018 and TNM staging system. The local tumour stage was evaluated for MRI and clinical examination separately. Descriptive statistics were used to compare local tumour stages and different staging systems. RESULTS Data was available from 1338 patients. For local tumour staging, differences between MRI and clinical examination were found in 364 patients (27.2%). Affected lymph nodes were detected in 52%. The two most frequent stages with FIGO 2009 are IIB (54%) and IIIB (16%), with FIGO 2018 IIIC1 (43%) and IIB (27%) and with TNM T2b N0 M0 (27%) and T2b N1 M0 (23%) in this cohort. CONCLUSIONS MRI and clinical examination resulted in a different local tumour staging in approximately one quarter of patients. Comprehensive knowledge of the differential value of clinical examination and MRI is necessary to define one final local stage, especially when a decision about treatment options is to be taken. The use of FIGO 2009, FIGO 2018 and TNM staging system leads to differences in stage distributions complicating comparability of treatment results. TNM provides the most differentiated stage allocation.
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Bozhilova N, Cooper R, Kuntsi J, Asherson P, Michelini G. Electrophysiological correlates of spontaneous mind wandering in attention-deficit/hyperactivity disorder. Behav Brain Res 2020; 391:112632. [PMID: 32361038 PMCID: PMC7303944 DOI: 10.1016/j.bbr.2020.112632] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/16/2020] [Accepted: 03/28/2020] [Indexed: 11/18/2022]
Abstract
We recently hypothesised that increased spontaneous mind wandering (MW-S) reflects a core process underlying attention-deficit/hyperactivity disorder (ADHD). Previous studies show that individuals with ADHD and neurotypical individuals with increased MW-S display similar cognitive-performance and electrophysiological (EEG) impairments in attentional processes. However, the cognitive-EEG markers associated with increased MW-S in ADHD remain poorly understood. We therefore investigated such markers in a sample of 69 sex- and age-matched adults with ADHD and 29 controls during the Sustained Attention to Response Task. We compared task performance and EEG measures (P3, time-frequency brain-oscillations) of attentional processes between groups, and examined their association with a validated self-report questionnaire of MW-S. Finally, we tested the hypothesis that MW-S and ADHD diagnosis relate to the same cognitive-EEG impairments using a hierarchical regression model. Compared to controls, adults with ADHD showed attenuations in P3, event-related alpha and beta suppression during response inhibition (No-Go trials), and theta power activations during response execution (Go trials), as well as increased reaction time variability and more commission/omission errors. MW-S was also continuously associated with most cognitive-EEG measures related to ADHD. The hierarchical regressions on measures associated with both ADHD diagnosis and MW-S showed that MW-S did not explain additional variance in the cognitive-EEG markers (except for beta suppression) beyond ADHD diagnosis, and vice versa. These findings are consistent with our hypothesis that ADHD diagnosis and MW-S share common neural deficits, and that MW-S may reflect a core symptom of the disorder.
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Merritt K, Catalan A, Cowley S, Demjaha A, Taylor M, McGuire P, Cooper R, Morrison P. Glyceryl trinitrate in first-episode psychosis unmedicated with antipsychotics: A randomised controlled pilot study. J Psychopharmacol 2020; 34:839-847. [PMID: 32436761 PMCID: PMC7376621 DOI: 10.1177/0269881120922967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is a pressing need for new classes of treatment for psychosis. A key therapeutic target for novel compounds is the NMDA receptor, which may be modulated by nitric oxide donors such as sodium nitroprusside (SNP). Recent studies of SNP in patients with psychosis have mixed results, and the drug has to be administered intravenously. Glyceryl trinitrate (GTN) is a well-established cardiovascular medicine that is also a nitric oxide donor, and can be given orally. AIMS We explored the safety and potential effects of GTN in unmedicated patients with a first episode of psychosis. METHODS This was a single-centre, randomised, double-blind, placebo-controlled trial from December 2016 to April 2019 (ClinicalTrials.gov identifier: NCT02906553). Patients received 3 × sprays of GTN or placebo for three consecutive days, and were re-assessed on Days 1, 2, 3 and 7. The primary outcome was cognition (Jumping to Conclusions task), secondary outcomes were symptoms (Positive and Negative Syndrome Scale (PANSS)), verbal memory (Hopkins Verbal Learning task), and mood (Bond-Lader Visual Analogue Scales). RESULTS Nineteen patients were randomised, and 13 participants were included in the analyses. Compared with placebo, GTN was well tolerated, but was not associated with significant effects on cognition, symptoms, or mood. Bayesian statistics indicate that our results were 2× more likely under the null hypothesis than the alternative hypothesis, providing anecdotal evidence that GTN does not improve psychotic symptoms. CONCLUSIONS We found no indication of an effect of GTN on symptoms of psychosis or cognition.
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Cooper R, Wilkie G, Samuel K, McMillan L, Vickers M, Turner M, Campbell J, Fraser A. Therapeutic EBV-specific T cell cytotoxicity against allogeneic LCLs in vitro directly correlates to intracellular IFNγ/TNFα expression in response to EBV peptide stimulation. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fairfax B, Taylor C, Watson R, Nassiri I, Fang H, Mahe E, Cooper R, Danielli S, Woodcock V, Traill Z, Knight J, Payne M, Middleton M. Early peripheral T-cell responses predict oncological outcome to checkpoint immune blockade in metastatic melanoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.020] [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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Peeters G, Cooper R, Tooth L, van Schoor NM, Kenny RA. A comprehensive assessment of risk factors for falls in middle-aged adults: co-ordinated analyses of cohort studies in four countries. Osteoporos Int 2019; 30:2099-2117. [PMID: 31201482 DOI: 10.1007/s00198-019-05034-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/27/2019] [Indexed: 01/19/2023]
Abstract
UNLABELLED We identified demographic, health and lifestyle factors associated with falls in adults aged 50-64 years from Australia, The Netherlands, Great Britain and Ireland. Nearly all factors were associated with falls, but there were differences between countries and between men and women. Existing falls prevention programs may also benefit middle-aged adults. INTRODUCTION Between ages 40-44 and 60-64 years, the annual prevalence of falls triples suggesting that middle age may be a critical life stage for preventive interventions. We aimed to identify demographic, health and lifestyle factors associated with falls in adults aged 50-64 years. METHODS Harmonised data were used from four population-based cohort studies based in Australia (Australian Longitudinal Study on Women's Health, n = 10,641, 51-58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4663, 40-64 years in 2010), the Netherlands (Longitudinal Ageing Study Amsterdam, n = 862, 55-64 years in 2012-13) and Great Britain (MRC National Survey of Health and Development, n = 2987, 53 years in 1999). Cross-sectional and prospective associations of 42 potential risk factors with self-reported falls in the past year were examined separately by cohort and gender using logistic regression. In the absence of differences between cohorts, estimates were pooled using meta-analysis. RESULTS In cross-sectional models, nearly all risk factors were associated with fall risk in at least one cohort. Poor mobility (pooled OR = 1.71, CI = 1.34-2.07) and urinary incontinence (OR range = 1.53-2.09) were consistently associated with falls in all cohorts. Findings from prospective models were consistent. Statistically significant interactions with cohort and sex were found for some of the risk factors. CONCLUSION Risk factors known to be associated with falls in older adults were also associated with falls in middle age. Compared with findings from previous studies of older adults, there is a suggestion that specific risk factors, for example musculoskeletal conditions, may be more important in middle age. These findings suggest that available preventive interventions for falls in older adults may also benefit middle-aged adults, but tailoring by age, sex and country is required.
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Munjal I, Ng C, Imtiaz Z, Cooper R, Cope L. Adequacy of trauma c-spine X-rays: a case for ;straight to CT?’. Clin Radiol 2019. [DOI: 10.1016/j.crad.2019.09.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vusirikala A, Ben-Shlomo Y, Kuh D, Stafford M, Cooper R, Morgan GS. Mid-life social participation and physical performance at age 60-64: evidence from the 1946 British Birth Cohort Study. Eur J Public Health 2019; 29:986-992. [PMID: 30726911 DOI: 10.1093/eurpub/ckz005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous studies linking social activity and disability have been limited by focussing on self-reported physical performance in older adults (>65). We examined whether social participation in mid-life is associated with objective and subjective measures of physical performance in older age. METHODS Participants of the Medical Research Council National Survey of Health and Development reported their involvement in social activities at ages 43 and 60-64 years; frequency of such involvement was classified into thirds. Physical performance was measured at age 60-64 using: grip strength; standing balance; chair rises; timed get-up-and-go; self-reported physical function from the Short Form-36. Multivariable regression was used to examine longitudinal associations between social participation and each physical performance measure. We also investigated whether change in social participation between 43 and 60-64 was associated with each outcome. RESULTS In fully adjusted models, higher frequency of social participation at 43 was associated with faster chair rise (1.42 repetitions/min, 95% CI 0.45-2.39) and timed get-up-and-go speed (2.47 cm/s, 95% CI 0.27-4.67) and lower likelihood of self-report limitations (OR of low physical function 0.67, 95% CI 0.50-0.91) at 60-64 compared with low frequency. Better performance in objectively measured outcomes was observed only if higher social participation persisted over time whereas lower odds of self-reported limitations were found in all groups when compared to those with persistently low participation (ORs 0.43-0.56, all P≤0.02). CONCLUSION Our findings suggest that associations between higher levels of social participation in mid-life and better physical performance exist only if this social participation persists through to older age.
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Shakir R, Adams R, Cooper R, Downing A, Geh I, Gilbert D, Jacobs C, Jones C, Lorimer C, Namelo W, Sebag-Montefiore D, Shaw P, Muirhead R. Patterns and predictors of relapse following radical chemoradiotherapy delivered using intensity-modulated radiotherapy with a simultaneous integrated boost in anal squamous cell carcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.158] [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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Hayes A, Burgoyne P, Cooper R, Pingen M, Graham G, Campbell J. Using chemokine sorting to imrpove NK cell function in an anti-tumour model. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.341] [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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Burgoyne P, Hayes A, Cooper R, Fraser A, Graham G, Campbell J. GMP-compliant sorting of dendritic cells for CCR7 expression improves therapeutic efficacy in cancer by enhancing lymph node migration and antigen-specific T cell activation. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fraser A, Cooper R, Barnett M, McGowan N, Campbell J. Development and implementation of a therapeutic GMP-compliant allogeneic peptide EBV-specific T cell bank using optimized culture and analysis processes. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.344] [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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Mowlem FD, Skirrow C, Reid P, Maltezos S, Nijjar SK, Merwood A, Barker E, Cooper R, Kuntsi J, Asherson P. Validation of the Mind Excessively Wandering Scale and the Relationship of Mind Wandering to Impairment in Adult ADHD. J Atten Disord 2019; 23:624-634. [PMID: 27255536 PMCID: PMC6429624 DOI: 10.1177/1087054716651927] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigates excessive mind wandering (MW) in adult ADHD using a new scale: the Mind Excessively Wandering Scale (MEWS). METHOD Data from two studies of adult ADHD was used in assessing the psychometric properties of the MEWS. Case-control differences in MW, the association with ADHD symptoms, and the contribution to functional impairment were investigated. RESULTS The MEWS functioned well as a brief measure of excessive MW in adult ADHD, showing good internal consistency (α > .9), and high sensitivity (.9) and specificity (.9) for the ADHD diagnosis, comparable with that of existing ADHD symptom rating scales. Elevated levels of MW were found in adults with ADHD, which contributed to impairment independently of core ADHD symptom dimensions. CONCLUSION Findings suggest excessive MW is a common co-occurring feature of adult ADHD that has specific implications for the functional impairments experienced. The MEWS has potential utility as a screening tool in clinical practice to assist diagnostic assessment.
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Knoth J, Pötter R, Jürgenliemk-Schulz I, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Wiebe E, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Sundset M, Tan L, Nout R, Tanderup K, Kirisits C, Nesvacil N, Lindegaard J, Schmid M. PO-0827 Comparison of clinical examination and MRI for local cervical cancer staging (FIGO and T(NM)). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31247-2] [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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Ajayi SO, Adeoye AM, Raji YR, Tayo B, Salako BL, Ogunniyi A, Ojo A, Cooper R. Self-reported Sleep Disorder and Ambulatory Blood Pressure Phenotypes in Patients with or without Chronic Kidney Disease: Findings from Ibadan CRECKID Study. West Afr J Med 2019; 36:61-68. [PMID: 30924118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sleep disordered breathing has been closely linked to pathogenesis, poor control of hypertension, and progression of chronic kidney disease (CKD). Though hypertension and CKD are highly prevalent in Nigeria, the effects of sleep disorders on CKD and hypertension phenotypes have not been widely studied. This study investigated the relationship between self-reported sleep disorders, and ambulatory blood pressure phenotypes in patients with hypertension and those with or without CKD. METHODS Participants aged 18 years and above who consented were recruited into the study. Anthropometric measurements including height, weight, and waist and hip circumferences were obtained, Office/clinic hypertension was defined as SBP =140mmHg and/or DBP =90mmHg or being on pharmacological treatment for hypertension. 24-hour ambulatory blood pressure monitoring were done. Obstructive sleep apnea was assessed using Stop Bang questionnaire. Estimated GFR was calculated using CKD-EPI Creatinine 2Equation and CKD was defined as eGFR<60ml/min/1.73m . RESULTS A total of three hundred and forty-nine (349) patients were enrolled for the study: 175 males and 174 females. Moderate to severe risk for obstructive sleep apnea (OSA) was observed in 51.4% of patients with CKD, 58.5% of hypertensive and 17.3% of apparently healthy participants. Male participants were more likely than female patients to have moderate and high OSA risk (41.7% vs 32.8%) and (10.3% vs 4.6%) respectively. Compared with other groups, CKD patients had the highest office and ambulatory blood pressure parameters; p<0.0001. CONCLUSION This study has demonstrated that obstructive sleep apnoea is prevalent among patients with chronic kidney disease and hypertension. Furthermore, the phenotypes of hypertension are accentuated in CKD and therefore, OSA may well be an important risk factor for CKD.
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Kok A, Stafford M, Cosco TD, Huisman M, Deeg DJH, Kuh D, Cooper R. FACTORS ASSOCIATED WITH REMAINING FREE FROM FUNCTIONAL LIMITATIONS DESPITE SOCIOECONOMIC ADVERSITY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.094] [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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Sherlaw W, Fernandez A, McColl K, Cooper R. Learning from transnational differences in how risk of harm is viewed in human research ethics. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.747] [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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Denham N, Pearman CM, Ding WY, Waktare J, Gupta D, Snowdon R, Hall M, Cooper R, Modi S, Todd D, Mahida S. 4287Systematic re-evaluation of ion channel mutations associated with Brugada syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4287] [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: 11/12/2022] Open
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Partridge DG, Winnard C, Townsend R, Cooper R, Stockley I. Joint aspiration, including culture of reaspirated saline after a 'dry tap', is sensitive and specific for the diagnosis of hip and knee prosthetic joint infection. Bone Joint J 2018; 100-B:749-754. [PMID: 29855250 DOI: 10.1302/0301-620x.100b6.bjj-2017-0970.r2] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Aims The aim of this study was to establish the diagnostic accuracy of culture of joint aspirate with and without saline injection-reaspiration. Patients and Methods This is a retrospective analysis of 580 hip and knee aspirations in patients who were deemed to have a moderate to high risk of infection, and who subsequently proceeded to revision arthroplasty over a period of 12 years. It was carried out at a large quaternary referral centre where preoperative aspiration is routine. Results Fluid was aspirated primarily in 313 (54%) cases and after saline injection-reaspiration of a 'dry tap' in 267 (46%) cases. Overall sensitivity and specificity of the diagnostic aspirate were 84% (78% to 89%) and 85% (81% to 88%), respectively. Sensitivity and specificity of saline injection-reaspiration after 'dry tap' were 87% (79% to 92%) and 79% (72% to 84%) compared with 81% (71% to 88%) and 90% (85% to 93%) for direct aspiration. Conclusion Preoperative joint aspiration and culture is a sensitive and specific test for the confirmation of diagnosis in patients at a moderate to high risk of prosthetic joint infection. Culture of saline injection-reaspiration also provides accurate diagnostic information in the event of a 'dry tap'. Both methods allow susceptibility testing of relevant organisms and are therefore able to guide perioperative antibiotic therapy. Cite this article: Bone Joint J 2018;100-B:749-54.
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Dodds RM, Kuh D, Sayer AA, Cooper R. Can measures of physical performance in mid-life improve the clinical prediction of disability in early old age? Findings from a British birth cohort study. Exp Gerontol 2018; 110:118-124. [PMID: 29885357 DOI: 10.1016/j.exger.2018.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 05/14/2018] [Accepted: 06/01/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Poor performance in physical tests such as grip strength and walking speed is a risk factor for disability in old age, although whether such measures improve the discrimination of clinical prediction models when traditional clinical risk factors are already known is not clear. The prevalence of disability in mid-life is relatively low and hence screening in this age group may present an opportunity for early identification of those at increased future risk who may benefit most from preventative interventions. METHODS Data were drawn from two waves of the Medical Research Council National Survey of Health and Development. We examined whether several chronic conditions, poor health behaviours and lower scores on three measures of physical performance (grip strength, chair rise speed and standing balance time) at age 53 were associated with self-reported mobility and/or personal care disability at age 69. We used the area under the curve statistic (AUC) to assess model discrimination. RESULTS At age 69, 44% (826/1855) of participants reported mobility and/or personal care disability. Our final clinical prediction model included sex, knee osteoarthritis, taking 2+ medications, smoking, increased BMI and poor performance in all three physical tests, with an AUC of 0.740 compared with 0.708 for a model which did not include the performance measures. CONCLUSION Measures of physical performance in midlife improve discrimination in clinical prediction models for disability over 16 years. Importantly, these and similar measures are also potential targets of future diet, exercise and pharmacological intervention in mid-life.
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