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Gilbert E, Wahlquist AH. Exercise Decreases Depressive Symptoms of Chronic Illness. J Natl Med Assoc 2012. [DOI: 10.1016/s0027-9684(15)30164-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gilbert E, Wahlquist AH. Home = Birth Center = OB Unit for Pregnant Women at Low Risk. J Natl Med Assoc 2012. [DOI: 10.1016/s0027-9684(15)30165-6] [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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Gilbert E, Wahlquist AH. Normal High-Sensitivity Troponin and PESI Score of 0 Means Great Prognosis for Pulmonary Embolism. J Natl Med Assoc 2012. [DOI: 10.1016/s0027-9684(15)30167-x] [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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Labedi M, Wever-Pinzon O, Qaqa F, Alharethi R, Selzman C, Grakos S, Gilbert E, Budge D, Saidi A, Ried B, Kfoury A, Stehlik J, Bader F. 535 Clinical Predictors and Risks Factors for Left Ventricular Assist Device Thrombosis in HeartMate II Supported Patients. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.547] [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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Marven M, Ussher J, Perz J, Gilbert E, Keir A. 355 Sexual Wellbeing and Breast Cancer in Australia: the Experiences of Women and Health Professionals. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70421-5] [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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Gilbert E, Adams A, Buckingham CD. Examining the relationship between risk assessment and risk management in mental health. J Psychiatr Ment Health Nurs 2011; 18:862-8. [PMID: 22070749 DOI: 10.1111/j.1365-2850.2011.01737.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Thorough risk assessment helps in developing risk management plans that minimize risks that can impede mental health patients' recovery. Department of Health policy states that risk assessments and risk management plans should be inextricably linked. This paper examines their content and linkage within one Trust. Four inpatient wards for working age adults (18-65 years) in a large mental health Trust in England were included in the study. Completed risk assessment forms, for all patients in each inpatient ward were examined (n= 43), followed by an examination of notes for the same patients. Semi-structured interviews took place with ward nurses (n= 17). Findings show much variability in the amount and detail of risk information collected by nurses, which may be distributed in several places. Gaps in the risk assessment and risk management process are evident, and a disassociation between risk information and risk management plans is often present. Risk information should have a single location so that it can be easily found and updated. Overall, a more integrated approach to risk assessment and management is required, to help patients receive timely and appropriate interventions that can reduce risks such as suicide or harm to others.
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Ning X, Lee S, Wang Z, Kim D, Stubblefield B, Gilbert E, Murthy N. Maltodextrin-based imaging probes detect bacteria in vivo with high sensitivity and specificity. NATURE MATERIALS 2011; 10:602-7. [PMID: 21765397 PMCID: PMC6443089 DOI: 10.1038/nmat3074] [Citation(s) in RCA: 176] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 06/16/2011] [Indexed: 05/08/2023]
Abstract
The diagnosis of bacterial infections remains a major challenge in medicine. Although numerous contrast agents have been developed to image bacteria, their clinical impact has been minimal because they are unable to detect small numbers of bacteria in vivo, and cannot distinguish infections from other pathologies such as cancer and inflammation. Here, we present a family of contrast agents, termed maltodextrin-based imaging probes (MDPs), which can detect bacteria in vivo with a sensitivity two orders of magnitude higher than previously reported, and can detect bacteria using a bacteria-specific mechanism that is independent of host response and secondary pathologies. MDPs are composed of a fluorescent dye conjugated to maltohexaose, and are rapidly internalized through the bacteria-specific maltodextrin transport pathway, endowing the MDPs with a unique combination of high sensitivity and specificity for bacteria. Here, we show that MDPs selectively accumulate within bacteria at millimolar concentrations, and are a thousand-fold more specific for bacteria than mammalian cells. Furthermore, we demonstrate that MDPs can image as few as 10(5) colony-forming units in vivo and can discriminate between active bacteria and inflammation induced by either lipopolysaccharides or metabolically inactive bacteria.
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Gilbert E, Wahlquist AH. Upper-Body Weight Lifting Does Not Increase Women's Risk of Breast Cancer–Related Lymphedema. J Natl Med Assoc 2011. [DOI: 10.1016/s0027-9684(15)30346-1] [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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Gilbert E, Wahlquist AH. Varenicline Increases Smokeless Tobacco Cessation. J Natl Med Assoc 2011. [DOI: 10.1016/s0027-9684(15)30345-x] [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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Gilbert E, Wahlquist AH. Echinacea Is Ineffective for Reducing Cold Symptoms. J Natl Med Assoc 2011. [DOI: 10.1016/s0027-9684(15)30348-5] [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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Gilbert E, Wahlquist AH. Clinical Judgment More Accurate Than CHALICE in Kids With Head Injury. J Natl Med Assoc 2011. [DOI: 10.1016/s0027-9684(15)30349-7] [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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Gilbert E, Eghiayan A. Contribution a Letude Des Troubles De La Menopause RoentgEnienne:Comparaison Avec Les Troubles Des Menopauses Chirurgicales. Acta Radiol 2010. [DOI: 10.3109/00016922809139530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gilbert E, Adams A, Mehanna H, Harrison B, Hartshorne GM. Who should be offered sperm banking for fertility preservation? A survey of UK oncologists and haematologists. Ann Oncol 2010; 22:1209-1214. [PMID: 21030380 DOI: 10.1093/annonc/mdq579] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Fertility after cancer therapy is a significant quality-of-life concern for many patients, their partners and families. Authoritative guidance states that men whose fertility may be affected by impending therapies should be offered sperm banking. Yet some patients are not offered this opportunity and are thereby disadvantaged. We sought to understand oncologists' and haematologists' decision making concerning sperm-banking referrals. DESIGN We surveyed all oncologists and haematologists on the Royal College of Radiotherapists' Faculty of Oncology and British Society for Haematology circulation lists. RESULTS From 2357 across all specialties, 499 responses were received: 253 haematologists and 246 oncologists (21% response rate). Twenty-one percent of respondents were unaware of local policies on sperm banking and 42% considered that sperm banking should be offered to more patients. Respondents' decisions reveal either assumptions about patients' needs based on characteristics such as age, sexual orientation and severity of illness or the influence of their own moral conclusions upon their patients. The survey identified paucity of training for clinicians, information for patients and systematic recording of discussions about fertility. CONCLUSIONS A robust care infrastructure supporting male fertility storage is needed urgently to include targeted information for cancer clinicians and patients, identified individuals responsible for coordination and documentation of discussions with patients.
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Gilbert E, Wahlquist AH. B-Type Natriuretic Peptide Monitoring + Protocol Improves Heart Failure Outcomes. J Natl Med Assoc 2010. [DOI: 10.1016/s0027-9684(15)30629-5] [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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Gilbert E, Wahlquist AH. Urinary Problems After Hysterectomy. J Natl Med Assoc 2010. [DOI: 10.1016/s0027-9684(15)30624-6] [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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Gilbert E, Wahlquist AH. Ivermectin Safe and Effective for Treatment of Resistant Head Lice. J Natl Med Assoc 2010. [DOI: 10.1016/s0027-9684(15)30628-3] [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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Gilbert E, Wahlquist AH. Two Drugs More Effective to Induce Remission of MDD. J Natl Med Assoc 2010. [DOI: 10.1016/s0027-9684(15)30625-8] [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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Drakos S, Hammond E, Reid B, Stoker S, Revelo M, Rasmusson B, Selzman C, Alharethi R, McCormick A, Gilbert E. 244: Effect of Mechanical Unloading on Fibrosis and Hypertrophy during Cardiac Remodeling in Humans. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Vogelaers D, De Bels D, Forêt F, Cran S, Gilbert E, Schoonheydt K, Blot S. Patterns of antimicrobial therapy in severe nosocomial infections: empiric choices, proportion of appropriate therapy, and adaptation rates--a multicentre, observational survey in critically ill patients. Int J Antimicrob Agents 2010; 35:375-81. [PMID: 20122817 DOI: 10.1016/j.ijantimicag.2009.11.015] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 10/22/2009] [Accepted: 11/23/2009] [Indexed: 12/18/2022]
Abstract
This prospective, observational multicentre (n=24) study investigated relationships between antimicrobial choices and rates of empiric appropriate or adequate therapy, and subsequent adaptation of therapy in 171 ICU patients with severe nosocomial infections. Appropriate antibiotic therapy was defined as in vitro susceptibility of the causative pathogen and clinical response to the agent administered. In non-microbiologically documented infections, therapy was considered adequate in the case of favourable clinical response <5 days. Patients had pneumonia (n=127; 66 ventilator-associated), intra-abdominal infection (n=23), and bloodstream infection (n=21). Predominant pathogens were Pseudomonas aeruginosa (n=29) Escherichia coli (n=26), Staphylococcus aureus (n=22), and Enterobacter aerogenes (n=21). In 49.6% of infections multidrug-resistant (MDR) bacteria were involved, mostly extended-spectrum beta-lactamase (EBSL)-producing Enterobacteriaceae and MDR non-fermenting Gram-negative bacteria. Prior antibiotic exposure and hospitalisation in a general ward prior to ICU admission were risk factors for MDR. Empiric therapy was appropriate/adequate in 63.7% of cases. Empiric schemes were classified according to coverage of (i) ESBL-producing Enterobacteriaceae and non-fermenting Gram-negative bacteria ("meropenem-based"), (ii) non-fermenting Gram-negative bacteria (schemes with an antipseudomonal agent), and (iii) first-line agents not covering ESBL-Enterobacteriaceae nor non-fermenting Gram-negative bacteria. Meropenem-based schemes allowed for significantly higher rates of appropriate/adequate therapy (p<0.001). This benefit remained when only patients without risk factors for MDR were considered (p=0.021). In 106 patients (61%) empiric therapy was modified: in 60 cases following initial inappropriate/inadequate therapy, in 46 patients in order to refine empiric therapy. In this study reflecting real-life practice, first-line use of meropenem provided significantly higher rates of the appropriate/adequate therapy, irrespective of presence of risk factors for MDR.
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Berrington de Gonzalez A, Curtis RE, Gilbert E, Berg CD, Smith SA, Stovall M, Ron E. Second solid cancers after radiotherapy for breast cancer in SEER cancer registries. Br J Cancer 2009; 102:220-6. [PMID: 19935795 PMCID: PMC2813734 DOI: 10.1038/sj.bjc.6605435] [Citation(s) in RCA: 172] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Radiotherapy for breast cancer reduces disease recurrence and breast cancer mortality. However, it has also been associated with increased second cancer risks in exposed sites. Methods: We evaluated long-term second cancer risks among 182 057 5-year survivors of locoregional invasive breast cancer diagnosed between 1973 and 2000 and reported to US NCI-SEER Program cancer registries. Multivariate Poisson regression was used to estimate the relative risk (RR) and excess cases of second cancer in women who had surgery and radiotherapy, compared with those who had surgery alone. Second cancer sites were grouped according to doses received from typical tangential breast fields. Results: By the end of 2005 (median follow-up=13.0 years), 15 498 second solid cancers had occurred, including 6491 contralateral breast cancers. The RRs for radiotherapy were 1.45 (95% confidence interval (CI)=1.33–1.58) for high-dose second cancer sites (1+ Gy: lung, oesophagus, pleura, bone and soft tissue) and 1.09 (1.04–1.15) for contralateral breast cancer (≈1 Gy). These risks decreased with increasing age and year of treatment. There was no evidence of elevated risks for sites receiving medium (0.5–0.99 Gy, RR=0.89 (0.74–1.06)) or low doses (<0.5 Gy, RR=1.01 (0.95–1.07)). The estimated excess cases of cancer in women treated with radiotherapy were as follows: 176 (95% CI=69–284) contralateral breast cancers or 5% (2–8%) of the total in all 1+year survivors, and 292 (222–362) other solid cancers or 6% (4–7%) of the total. Conclusions: Most second solid cancers in breast cancer survivors are not related to radiotherapy.
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Wiedrich T, Keller D, Arya S, Gilbert E, Trigg M. Adverse Histopathologic Effects of Chemotherapeutic Agents in Childhood Leukemia and Lymphoma. ACTA ACUST UNITED AC 2009; 2:267-83. [PMID: 6542655 DOI: 10.3109/15513818409022260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pathologic material from 84 children with leukemia or lymphoma who died and were autopsied at the University of Wisconsin Hospital between 1967 and 1980 was reviewed to assess the adverse tissue changes due to the chemotherapy administered. In each case the histopathologic findings were correlated with the chemotherapy given. Individual drug dosage is administered (per m2) correlated with the adverse tissue findings at autopsy. Data presented suggest that the drug dose administered should be correlated not only with tumor response but also with tissue effects (some of which produce no noticeable, immediate, clinically apparent changes) to decrease the likelihood of producing irreversible tissue changes.
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Gilbert E, Wahlquist AH. Early Treatment for PTSD. J Natl Med Assoc 2009. [DOI: 10.1016/s0027-9684(15)30992-5] [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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73
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Gilbert E, Wahlquist AH. All Diets Work Equally Poorly. J Natl Med Assoc 2009. [DOI: 10.1016/s0027-9684(15)30994-9] [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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Gilbert E, Wahlquist AH. Vitamin D, at High Doses, Prevents Fractures. J Natl Med Assoc 2009. [DOI: 10.1016/s0027-9684(15)30989-5] [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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75
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Gilbert E, Wahlquist AH. Not Much Seems to Prevent Renal Disease in Children with Henoch-Schönlein Purpura. J Natl Med Assoc 2009. [DOI: 10.1016/s0027-9684(15)30922-6] [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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