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PESCOR Steering Committee, Weekes A, Raper J, Lupez K, Cox C, Thomas A, Esener D, Boyd J, Nomura J, Davison J, Ockerse P, Leech S. 267 Development and Validation of a Prognostic Tool: Pulmonary Embolism Short-Term Clinical Outcomes Risk Estimation. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.280] [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]
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Kochhar P, Dwarkanath P, Ravikumar G, Thomas A, Crasta J, Thomas T, Kurpad AV, Mukhopadhyay A. Placental expression of RNU44, RNU48 and miR-16-5p: stability and relations with fetoplacental growth. Eur J Clin Nutr 2021; 76:722-729. [PMID: 34508256 DOI: 10.1038/s41430-021-01003-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 08/04/2021] [Accepted: 08/24/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES The current study aimed to identify suitable reference miRNA for placental miRNA expression analysis in a set of well-characterized and fetal-sex balanced small- (SGA) and appropriate- (AGA) for gestational age full-term singleton pregnancies. SUBJECTS/METHODS In this retrospective study, placental samples (n = 106) from 35 SGA (19 male and 16 female) and 71 AGA (30 male and 41 female) full-term singleton pregnancies were utilized. Placental transcript abundance of three widely used reference miRNAs [miR-16-5p and Small nucleolar RNAs (snoRNAs) RNU44 and RNU48] were assessed by real-time quantitative PCR. Raw cycle threshold (Ct) analysis and RefFinder tool analysis were conducted for evaluating stability of expression of these miRNAs. RESULTS Raw Ct values of miR-16-5p were similar between SGA and AGA births (P = 0.140) and between male and female births within SGA (P = 0.159) and AGA (P = 0.060) births while that of RNU44 and RNU48 were higher in SGA births (P = 0.008 and 0.006 respectively) and in male births within the SGA group (P = 0.005) for RNU44 and in female births within the AGA group (P = 0.048) for RNU48. Across all 106 samples tested using the RefFinder tool, miR-16-5p and RNU44 were equally stable reference miRNAs. CONCLUSION We recommend miR-16-5p and RNU44 as suitable reference miRNAs for placental samples from settings similar to our study.
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Magliocco G, Le Bloc'h F, Thomas A, Desmeules J, Daali Y. Simultaneous determination of melatonin and 6-hydroxymelatonin in human overnight urine by LC-MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1181:122938. [PMID: 34521018 DOI: 10.1016/j.jchromb.2021.122938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
For the quantification of the pineal hormone melatonin and its metabolite, 6-hydroxymelatonin, in human overnight urine, a single accurate method by liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been developed. Urine samples were deconjugated using β-glucuronidase/arylsulfatase from Helix pomatia before solid phase extraction (SPE) purification. Chromatographic separation was performed using a reverse phase C18 column with a 7-minute gradient elution. Water was used as matrix to prepare the calibration standards, and deuterated analogues of melatonin and 6-hydroxymelatonin were used as internal standards. This newly developed method was validated in terms of linearity, accuracy, repeatability, intermediate precision, recovery, matrix effect, and stability according to the guidelines of the European Medicines Agency. The method was successfully applied to the analysis of overnight urine samples from 12 healthy volunteers, showing significant correlations of urinary melatonin and 6-hydroxymelatonin excretion rates with age. The urinary 6-hydroxymelatonin to melatonin ratio was also established and will be assessed in further studies as a potential endogenous metric of CYP1A2 activity.
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Madden A, Naughton A, Flynn R, Thomas A. A video case series of migrated Hem-o-lok clip retrieval post robotic assisted laparoscopic prostatectomy and a review of the literature. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Thomas A, Cappuzzo F, Ying C, Yamamoto N, Chen Y, Cortot A, Berghmans T, Reguart Aransay N, Shibata Y, Jianying Z, Yoshida T, Moulin C, Sarholz B, Ferrer-Playan J, Kalapur A, Bolleddula J, Paz-Ares L. 1666TiP Phase II study of berzosertib (M6620) + topotecan in patients with relapsed platinum-resistant SCLC: DDRiver SCLC 250. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.250] [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] Open
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Ceron-Romero N, Taofeek N, Thomas A, Vroonland E, Sanmartin K, Verghese M, Heinen E, Vizcarra JA. Capromorelin, a ghrelin receptor agonist, increases feed intake and body weight gain in broiler chickens (Gallus gallus domesticus). Poult Sci 2021; 100:101204. [PMID: 34182219 PMCID: PMC8250453 DOI: 10.1016/j.psj.2021.101204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/24/2021] [Accepted: 04/05/2021] [Indexed: 11/27/2022] Open
Abstract
Ghrelin is a hormone that induces orexigenic effects in mammals. However, in avian species, there is scant and conflictive results on the effect of ghrelin on feed intake (FI). Therefore, we evaluated the effect of a ghrelin receptor agonist (capromorelin) on FI, ADG, water intake (WI), animal behavior and concentrations of ghrelin, glucose, growth hormone (GH) and insulin in broiler chickens. One-day-old male broilers were reared as recommended by the industry. At 4 wk of age (experimental day 0; D0), birds were blocked by weight and randomly assigned to 3 treatments in 2 identical trials. Control birds received a vehicle control solution containing 0 mg/kgBW/d of capromorelin. Birds in treatments 2 and 3 received capromorelin at target doses of 6 or 12 mg/kgBW/d of capromorelin (n = 27). FI and WI were measured 3 times a day at 0700 h (Period 1; P1), 1200 h (P2) and 1700 h (P3), while BW was recorded daily. Blood samples were collected on D-1 and D5. Bird behavior (pecking, sitting and standing) was evaluated for 9 h on D2. Data were analyzed using a randomized complete block design with repeated measures over time. Orthogonal polynomial contrasts were used to determine linear and quadratic effects of increasing levels of capromorelin. Polynomial contrasts showed that capromorelin doses linearly increased FI (P = 0.002) and ADG (P = 0.019). There were no treatment, day or treatment x d interactions on glucose, ghrelin and GH concentrations. However, there was a treatment x d interaction (P = 0.041) on insulin concentrations. Concentrations of insulin were higher on D5 for the 0 and 12 mg/kgBW/d treatments as compared with D-1. Polynomial contrasts showed that capromorelin doses linearly increased number of pecks/h (P = 0.018). Per hour FI and WI was higher during P1 (i.e., 0700-1200) as compared to P2 and P3 (P < 0.001). Our observations suggest that capromorelin linearly increases feed intake; thus, the same effect of that reported in mammalian species.
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Roberts G, Lloyd JJ, Kane JPM, Durcan R, Lawley S, Howe K, Petrides GS, O'Brien JT, Thomas AJ. Cardiac 123I-MIBG normal uptake values are population-specific: Results from a cohort of controls over 60 years of age. J Nucl Cardiol 2021; 28:1692-1701. [PMID: 31529384 DOI: 10.1007/s12350-019-01887-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/22/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Cardiac 123I-MIBG image interpretation is affected by population differences and technical factors. We recruited older adults without cognitive decline and compared their cardiac MIBG uptake with results from the literature. METHODS Phantom calibration confirmed that cardiac uptake results from Japan could be applied to our center. We recruited 31 controls, 17 individuals with dementia with Lewy bodies (DLB) and 15 with Alzheimer's disease (AD). Images were acquired 20 minutes and four hours after injection using Siemens cameras with medium-energy low-penetration (MELP) collimators. Local normal heart-to-mediastinum (HMR) ratios were compared to Japanese results. RESULTS Siemens gamma cameras with MELP collimators should give HMRs very close to the calibrated values used in Japan. However, our cut-offs with controls were lower at 2.07 for early and 1.86 for delayed images. Applying our lower cut-off to the dementia patients may increase the specificity of cardiac MIBG imaging for DLB diagnosis in a UK population without reducing sensitivity. CONCLUSIONS Our local HMR cut-off values are lower than in Japan, higher than in a large US study but similar to those found in another UK center. UK centers using other cameras and collimators may need to use different cut-offs to apply our results.
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Frias M, Berarpour N, Pagano S, Sidibé J, Kamau F, Lecour S, Strijdom H, Thomas A, Vuilleumier N. HIV-infected patients display increased proatherogenic anti-apolipoprotein A1 autoantibodies, inflammatory and metabolomic markers. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.229] [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: 11/26/2022]
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Thomas A, Griffiths M, Kalakoutas A, Yates M, Sanders J. Recovery from aortic valve surgery: the trajectory of muscle mass, strength, and quality, and health-related quality of life (HRQoL). Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.050] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Barts Charity
OnBehalf
Queen Mary University of London (QMUL) and Barts Health NHS Trust
Background/Introduction:
The impact of intensive care unit-acquired weakness (ICUAW) is considerable and is associated with reduced physical function and impaired health-related quality of life (HRQoL). Patients’ undergoing elective cardiac surgery are known to lose significant muscle mass and strength in the first seven days after surgery, but little is known beyond that time.
Purpose
We sought to investigate the effect of cardiac surgery on ICUAW (including muscle mass, strength, muscle quality) and HRQoL (including anxiety and depression and reintegration into society) until out-patient follow-up.
Methods
Eligible patients included adults undergoing a surgical elective aortic valve replacement without any pre-existing causes of severe muscle weakness or wasting. Muscle mass was measured using ultrasound of the rectus femoris cross-sectional area (RFcsa). Muscle quality was calculated using histogram analysis, specifically pixel intensity (PI), whereby a lower value is indicative of healthier muscle tissue. Muscle strength was measured using hand-held dynamometry specifically grip strength. HRQoL (EQ5D), anxiety and depression (hospital anxiety and depression scale (HADS)) and reintegration to normal living (RNLI index) were also collected. Measurements were assessed preoperatively, at day 7 and at out-patient follow-up.
Results
Thirty-one patients were recruited, with 22 (70.9%) patients attending follow-up. Patients lost 6.5% RFcsa (p= <0.0001) in the first seven days post-surgery and 10.1% (p = 0.0014) between preoperative assessment and follow-up. Hand-held grip strength decreased significantly (10.6%, p= <0.0001) in the first seven days post-surgery, however, differing to RFcsa, recovered considerably between day 7 and follow-up (7.7%, p = 0.018). Decreased muscle quality was observed solely in the first seven days after surgery (8.3%, p = 0.0094). The EQ5D visual analogue scale and crosswalk index increased significantly from preoperative assessment to follow-up (10%, p = 0.0250; 17.6%, p = 0.022 respectively) and day 7 to follow-up (11.7%, p = 0.0311; 27.9%, p = 0.011 respectively). While depression scores significantly decreased between the same time points as the EQ5D, changes in anxiety and RNLI scores, were non-significant.
Conclusion
Patients undergoing surgical aortic valve replacements lose considerable muscle mass in hospital, failing to recover even at out-patient follow-up. Furthermore, muscle quality decreases in the first seven days after surgery in line with the acute muscle loss. However, the impact on strength is less extensive as patients appear to recover the loss by follow-up. Patients’ health scores, function index and depression scores also improve, suggesting that muscle mass is the only outcome to not recover at follow-up. Therefore, patients appear to recover well from AVR surgery even surpassing some of their preoperative results, with the exception of the RFcsa.
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Mueller F, Losacco GL, Nicoli R, Guillarme D, Thomas A, Grata E. Enantiomeric methadone quantitation on real post-mortem dried matrix spots samples: Comparison of liquid chromatography and supercritical fluid chromatography coupled to mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1177:122755. [PMID: 34107411 DOI: 10.1016/j.jchromb.2021.122755] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/12/2021] [Accepted: 04/30/2021] [Indexed: 11/18/2022]
Abstract
This study describes two bioanalytical methods for the quantitation of the two methadone enantiomers in dried matrix spots using high performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS) and high performance supercritical chromatography tandem mass spectrometry (HPSFC-MS/MS). Dried matrix spots were obtained by spotting 10 µL of each sample fluid on a Whatman paper. Methadone and its main metabolite, EDDP, were extracted with 100 µL methanol and subsequently injected into the LC-MS/MS and SFC-MS/MS systems. Enantiomeric separation was achieved with AGP-column for the LC conditions and with Chiralpak IH-3 in SFC. The two methods were fully validated and 93 post-mortem samples were analysed with both analytical methods. Results from validation parameters and results obtained for all post-mortem samples were compared with a significant spearman correlation of rs = 0.9978 for R-methadone and rs = 0.9981 for S-methadone. The LC method provided better results in terms of uncertainty, retention factor and resolution, whereas SFC provides better sensitivity, with lower LOD. Median R-/S-methadone ratio in peripheral blood was found equal to 1.60 (N = 32), varying from 0.79 to 4.23. The reported values were in good agreement with previously published results. Based on the results obtained here, SFC-MS/MS can be considered a reliable alternative to the widely used LC-MS/MS for the quantitation of methadone enantiomers in bioanalysis and should be evaluated for other bioanalytical methods. Both methods can be easily and quickly used in toxicological routine analysis for the methadone quantitation in human fluids matrices, even if considering that the polysaccharide coated column IH-3 used in SFC does not allow the enantiomeric EDDP separation.
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Mullen C, Gardner S, Glazier DI, Kay SJD, Livingston K, Strakovsky II, Workman RL, Abt S, Achenbach P, Afzal F, Ahmed Z, Akondi CS, Annand JRM, Bashkanov M, Beck R, Biroth M, Borisov NS, Braghieri A, Briscoe WJ, Cividini F, Collicott C, Costanza S, Denig A, Dieterle M, Downie EJ, Drexler P, Fegan S, Ferretti-Bondy MI, Ghosal D, Gorodnov I, Gradl W, Günther M, Gurevic G, Heijkenskjöld L, Hornidge D, Huber GM, Jermann N, Kaeser A, Korolija M, Kashevarov VL, Krusche B, Kulikov VV, Lazarev A, Lutterer S, MacGregor IJD, Manley DM, Martel PP, Martemianov MA, Meier C, Miskimen R, Mocanu M, Mornacchi E, Neganov A, Oberle M, Ostrick M, Otte P, Paudyal D, Pedroni P, Powell A, Prakhov SN, Reicherz G, Ron G, Rostomyan T, Sfienti C, Sokhoyan V, Spieker K, Steffen O, Strub T, Supek I, Thiel A, Thiel M, Thomas A, Unverzagt M, Usov YA, Wagner S, Walford NK, Watts DP, Werthmüller D, Wettig J, Witthauer L, Wolfes M, Zachariou N. Single π 0 production off neutrons bound in deuteron with linearly polarized photons. THE EUROPEAN PHYSICAL JOURNAL. A, HADRONS AND NUCLEI 2021; 57:205. [PMID: 34720708 PMCID: PMC8550430 DOI: 10.1140/epja/s10050-021-00521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/10/2021] [Indexed: 06/13/2023]
Abstract
The quasifree γ → d → π 0 n ( p ) photon beam asymmetry, Σ , has been measured at photon energies, E γ , from 390 to 610 MeV, corresponding to center of mass energy from 1.271 to 1.424 GeV, for the first time. The data were collected in the A2 hall of the MAMI electron beam facility with the Crystal Ball and TAPS calorimeters covering pion center-of-mass angles from 49 ∘ to 148 ∘ . In this kinematic region, polarization observables are sensitive to contributions from the Δ ( 1232 ) and N(1440) resonances. The extracted values of Σ have been compared to predictions based on partial-wave analyses (PWAs) of the existing pion photoproduction database. Our comparison includes the SAID, MAID and Bonn-Gatchina analyses; while a revised SAID fit, including the new Σ measurements, has also been performed. In addition, isospin symmetry is examined as a way to predict π 0 n photoproduction observables, based on fits to published data in the channels π 0 p , π + n and π - p .
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Thomas A, Vakhrusheva O, Michaelis M, Cinatl J, Rothweiler F, Albersen M, Haferkamp A, Juengel E, Tsaur I. Patterns and mechanisms of resistance to cisplatin and osimertinib in penile squamous cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01056-3] [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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Thomas A, Stenzel P, Tagscherer K, Roth W, Schindeldecker M, Albersen M, Vakhrusheva O, Haferkamp A, Juengel E, Tsaur I. Elements of Wnt/β-catenin signaling pathway as prognostic biomarkers and therapeutic targets in penile squamous cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01055-1] [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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Collins P, O'Connell C, Omer SA, Inder MS, Madden A, Smyth L, Casey R, Manecksha R, Thomas A, Browne R, O'Neill A, Tierney S, Flynn R. 401 Three Birds with One Stone: Ureteric Calculus Precipitates Diagnosis and Resection of Three Primary Neoplasms. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A 67 year-old female presented to our centre with a 2 day history of right flank pain, clinically suggestive of ureteric colic. Computed tomography (CT) confirmed a 6mm right ureteric calculus. However, CT also revealed a large 13cm ipsilateral renal mass, concerning for renal cell carcinoma (RCC). At ureteroscopy for management of the obstructing calculus, a small papillary lesion was noted in the bladder, and excised. Histology confirmed pTa low-grade transitional cell carcinoma.
Following discussion at the Urology multidisciplinary tumour board, MRI venogram (MRV) was recommended to delineate the extension of tumour into the renal vein, and to characterise a pelvic mass seen on original CT. MRV showed enhancing material extending into the IVC, consistent with tumour thrombus. However, it also identified a concerning 6cm solid ovarian mass.
The patient proceeded to open right radical nephrectomy and IVC thrombectomy, hysterectomy, bilateral salpingo-oopherectomy, and omental biopsy, with combined input from Urological, Gynaecological and Vascular surgical teams. Post-operative course was uneventful. Histology showed an 11cm pT3a G2 clear cell RCC, and 7.5cm ovarian fibroma, both fully excised. This case demonstrated the serendipity of a simple ureteric calculus precipitating a cascade of investigations, that ultimately led to complete resection of three primary neoplasms.
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Belaidi E, Moulin S, Thomas A, Bultot L, Dontaine J, Pépin J, Arnaud C, Guigas B, Bertrand L. Metformin improves infarct size in mice exposed to chronic intermittent hypoxia, a major feature of obstructive sleep apnea. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2021.04.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hastings RK, Openshaw MR, Vazquez M, Moreno-Cardenas AB, Fernandez-Garcia D, Martinson L, Kulbicki K, Primrose L, Guttery DS, Page K, Toghill B, Richards C, Thomas A, Tabernero J, Coombes RC, Ahmed S, Toledo RA, Shaw JA. Longitudinal whole-exome sequencing of cell-free DNA for tracking the co-evolutionary tumor and immune evasion dynamics: longitudinal data from a single patient. Ann Oncol 2021; 32:681-684. [PMID: 33609721 DOI: 10.1016/j.annonc.2021.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 11/30/2022] Open
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Shivde R, Jaishankar D, Thomas A, Le Poole I. 549 Design and in vitro efficacy of TRP-1 CAR T cells to target melanoma. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mayrovitz HN, Lorenzo-Valido C, Pieper E, Thomas A. FOREARM AND BICEPS CIRCUMFERENTIAL VARIATIONS IN SKIN TISSUE DIELECTRIC CONSTANT AND FIRMNESS. Lymphology 2021. [DOI: 10.2458/lymph.4672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Tissue dielectric constant (TDC) and skin firmness assessed via indentation force (FORCE) help quantify lymphedema and track changes. We sought to determine potential differences in these parameters dependent on arm circumferential locations. Thus, TDC and FORCE were measured in 40 healthy women at medial, anterior and lateral locations on forearm and biceps. In five other women with unilateral lymphedema (68.6±7.6 years), TDC was measured at corresponding circumferential forearm positions. Measurements were done in triplicate using compact noninvasive devices. Results for healthy women (23.8±2.7 years) showed forearm medial TDC values (26.7±2.2) were less than anterior (28.0±2.4) or lateral (28.0±2.5) positions (p<0.001). Lymphedema patients had elevated values but similar medial-anterior-lateral patterns (33.7±8.0, 39.8±10.2 and 42.9±10.0). Biceps medial TDC values (24.1±2.2) were also less than either anterior (27.0±2.1) or lateral (28.2±3.3). Contrastingly, medial FORCE values at forearm and biceps were less than at anterior and lateral locations (p<0.001) and increased in the order of medial-anterior-lateral on forearm (p<0.001). The present findings provide reference values for both TDC and FORCE of commonly measured arm sites with specificity as to circumferential variations. This observed variation indicates the need for care in locating measurement positions for tracking patients with lymphedema.
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JOHNY J, Roy S, John E, Yusuf S, David V, T Valson A, Thomas A, J Eapen J, Varughese S, Alexander S. POS-150 CLINICAL AND HISTOPATHOLOGICAL PROFILE AND OUTCOME OF PATIENTS WITH BIOPSY PROVEN PGNMID (PROLIFERATIVE GLOMERULONEPHRITIS WITH MONOCLONAL IMMUNOGLOBULIN DEPOSITS). Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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ALAM R, Sundar Raj S, Lalwani M, Joseph Eapen J, Thomas A, Elias John E, Yusuf S, Vc A, Alexander S, George David V, Varughese S, T.Valson A. POS-687 DONOR CYSTATIN C eGFR> 100 ml/min/1.73m2 IS AN INDEPENDENT PREDICTOR OF GRAFT SURVIVAL IN INDIAN KIDNEY TRANSPLANT RECIPIENTS. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.719] [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] Open
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Lee RJ, Wysocki O, Bhogal T, Shotton R, Tivey A, Angelakas A, Aung T, Banfill K, Baxter M, Boyce H, Brearton G, Copson E, Dickens E, Eastlake L, Gomes F, Hague C, Harrison M, Horsley L, Huddar P, Hudson Z, Khan S, Khan UT, Maynard A, McKenzie H, Palmer D, Robinson T, Rowe M, Thomas A, Tweedy J, Sheehan R, Stockdale A, Weaver J, Williams S, Wilson C, Zhou C, Dive C, Cooksley T, Palmieri C, Freitas A, Armstrong AC. Erratum to 'Longitudinal characterisation of haematological and biochemical parameters in cancer patients prior to and during COVID-19 reveals features associated with outcome': [ESMO Open Volume 6, Issue 1, February 2021, 100005]. ESMO Open 2021; 6:100056. [PMID: 33545518 PMCID: PMC7842131 DOI: 10.1016/j.esmoop.2021.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Thomas A, Watts P. Vertical Tropia Following Horizontal Transposition Surgery. Br Ir Orthopt J 2021; 17:51-55. [PMID: 34278218 PMCID: PMC8269773 DOI: 10.22599/bioj.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/11/2021] [Indexed: 11/30/2022] Open
Abstract
Aim The aim of this study was to determine the prevalence of vertical tropia following horizontal transposition of both vertical rectus muscles (HToVR) in patients with Duane syndrome or sixth nerve palsy. Methods This retrospective study included patients with Duane syndrome or sixth nerve palsy who had undergone HToVR muscles. Data collected included: age, gender, diagnosis, laterality, pre-operative angle of deviation, type of surgery and post-operative angle of deviation at one week, three months and six months. Information on the use of botulinum toxin (BT) ipsilateral medial rectus (MR), additional surgery was performed, and the presence of preoperative and postoperative binocular function and any vertical deviation was collected. Results There were 11 patients, eight patients with a diagnosis of Duane syndrome and three patients with a diagnosis of sixth nerve palsy. The mean age of the patients was 13 ± 14.79 years (range 5-55 years), four were female. The prevalence of post-operative vertical tropia was 54%. The mean vertical deviation for distance, was 7.6^ ± 2.94 (SD) (range 3^-9^). Stereoacuity was present preoperatively in 5 patients and 8 postoperatively. No patient developed diplopia or received further surgery for the vertical tropia. Of the six patients who had intraoperative BT at the time of the HToVR, four developed a vertical deviation. Conclusion The prevalence of vertical deviation following HToVR muscles was 54% in our series. None of the patients with an induced postoperative vertical deviation reported diplopia or required further surgery for it.
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Takahashi N, Tlemsani C, Pongor L, Rajapakse V, Tyagi M, Wen X, Fasaye G, Schmidt K, Kim C, Rajan A, Swift S, Sciuto L, Vilimas R, Webb S, Nichols S, Figg W, Pommier Y, Calzone K, Steinberg S, Wei J, Guha U, Turner C, Khan J, Thomas A. OA11.05 Whole Exome Sequencing Reveals the Potential Role of Hereditary Predisposition in Small Cell Lung Cancer, a Tobacco-Related Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Surendranathan A, Kane J, Bentley A, Barker S, McNally R, Bamford C, Taylor JP, Thomas A, McKeith I, Burn D, O'Brien JT. Introduction of an assessment toolkit associated with increased rate of DLB diagnosis. ALZHEIMERS RESEARCH & THERAPY 2021; 13:50. [PMID: 33608039 PMCID: PMC7896389 DOI: 10.1186/s13195-021-00786-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/03/2021] [Indexed: 11/25/2022]
Abstract
Background Dementia with Lewy bodies (DLB) and dementia in Parkinson’s disease (PDD) are recognised to be under-recognised in clinical practice in the UK, with only one third to a half of expected cases diagnosed. We aimed to assess whether clinical diagnostic rates could be increased by the introduction of a structured assessment toolkit for clinicians. Methods We established baseline diagnostic rates for DLB and PDD in four memory clinics and three movement disorder/Parkinson’s disease (PD) clinics in two separate geographical regions in the UK. An assessment toolkit specifically developed to assist with the recognition and diagnosis of DLB and PDD was then introduced to the same clinical teams and diagnostic rates for DLB and PDD were reassessed. For assessing DLB diagnosis, a total of 3820 case notes were reviewed before the introduction of the toolkit, and 2061 case notes reviewed after its introduction. For PDD diagnosis, a total of 1797 case notes were reviewed before the introduction of the toolkit and 3405 case notes after it. Mean values and proportions were analysed using Student’s t test for independent samples and χ2 test, respectively. Results DLB was diagnosed in 4.6% of dementia cases prior to the introduction of the toolkit, and 6.2% of dementia cases afterwards, an absolute rise of 1.6%, equal to a 35% increase in the number of DLB cases diagnosed when using the toolkit (χ2 = 4.2, P = 0.041). The number of PD patients diagnosed with PDD was not found overall to be significantly different when using the toolkit: 9.6% of PD cases before and 8.2% of cases after its introduction (χ2 = 1.8, P = 0.18), though the ages of PD patients assessed after the toolkit’s introduction were lower (73.9 years vs 80.0 years, t = 19.2, p < 0.001). Conclusion Introduction of the assessment toolkit was associated with a significant increase in the rate of DLB diagnosis, suggesting that a structured means of assessing symptoms and clinical features associated with DLB can assist clinicians in recognising cases. The assessment toolkit did not alter the overall rate of PDD diagnosis, suggesting that alternate means may be required to improve the rate of diagnosis of dementia in Parkinson’s disease.
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Lee RJ, Wysocki O, Bhogal T, Shotton R, Tivey A, Angelakas A, Aung T, Banfill K, Baxter M, Boyce H, Brearton G, Copson E, Dickens E, Eastlake L, Gomes F, Hague C, Harrison M, Horsley L, Huddar P, Hudson Z, Khan S, Khan UT, Maynard A, McKenzie H, Palmer D, Robinson T, Rowe M, Thomas A, Tweedy J, Sheehan R, Stockdale A, Weaver J, Williams S, Wilson C, Zhou C, Dive C, Cooksley T, Palmieri C, Freitas A, Armstrong AC. Longitudinal characterisation of haematological and biochemical parameters in cancer patients prior to and during COVID-19 reveals features associated with outcome. ESMO Open 2021; 6:100005. [PMID: 33399072 PMCID: PMC7808077 DOI: 10.1016/j.esmoop.2020.100005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/16/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cancer patients are at increased risk of death from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cancer and its treatment affect many haematological and biochemical parameters, therefore we analysed these prior to and during coronavirus disease 2019 (COVID-19) and correlated them with outcome. PATIENTS AND METHODS Consecutive patients with cancer testing positive for SARS-CoV-2 in centres throughout the United Kingdom were identified and entered into a database following local governance approval. Clinical and longitudinal laboratory data were extracted from patient records. Data were analysed using Mann-Whitney U test, Fisher's exact test, Wilcoxon signed rank test, logistic regression, or linear regression for outcomes. Hierarchical clustering of heatmaps was performed using Ward's method. RESULTS In total, 302 patients were included in three cohorts: Manchester (n = 67), Liverpool (n = 62), and UK (n = 173). In the entire cohort (N = 302), median age was 69 (range 19-93 years), including 163 males and 139 females; of these, 216 were diagnosed with a solid tumour and 86 with a haematological cancer. Preinfection lymphopaenia, neutropaenia and lactate dehydrogenase (LDH) were not associated with oxygen requirement (O2) or death. Lymphocyte count (P < 0.001), platelet count (P = 0.03), LDH (P < 0.0001) and albumin (P < 0.0001) significantly changed from preinfection to during infection. High rather than low neutrophils at day 0 (P = 0.007), higher maximal neutrophils during COVID-19 (P = 0.026) and higher neutrophil-to-lymphocyte ratio (NLR; P = 0.01) were associated with death. In multivariable analysis, age (P = 0.002), haematological cancer (P = 0.034), C-reactive protein (P = 0.004), NLR (P = 0.036) and albumin (P = 0.02) at day 0 were significant predictors of death. In the Manchester/Liverpool cohort 30 patients have restarted therapy following COVID-19, with no additional complications requiring readmission. CONCLUSION Preinfection biochemical/haematological parameters were not associated with worse outcome in cancer patients. Restarting treatment following COVID-19 was not associated with additional complications. Neutropaenia due to cancer/treatment is not associated with COVID-19 mortality. Cancer therapy, particularly in patients with solid tumours, need not be delayed or omitted due to concerns that treatment itself increases COVID-19 severity.
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