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Begbie F, Walker G, Kubba H, Sabharwal A. Acute colonic pseudo-obstruction in a child taking trihexyphenidyl for drooling: Prescribers beware. Int J Pediatr Otorhinolaryngol 2015; 79:932-934. [PMID: 25912627 DOI: 10.1016/j.ijporl.2015.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/25/2015] [Accepted: 03/28/2015] [Indexed: 11/17/2022]
Abstract
Colonic pseudo-obstruction (Ogilvie's Syndrome) in children is relatively uncommon. We report an unusual case of colonic pseudo-obstruction in an 8-year-old child with cerebral palsy and long-term hypomotility issues being treated for drooling with the anticholinergic medication trihexyphenidyl. He presented as an emergency with severe abdominal distension, abdominal tenderness and vomiting. An emergency laparotomy revealed colonic dilatation and a defunctioning ileostomy was created. To our knowledge, this is the first case reporting colonic pseudo-obstruction as a possible complication of treatment with trihexyphenidyl. We suggest prescribers should exercise caution when prescribing trihexyphenidyl in patients with long-term intestinal hypomotility issues.
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Zurkiya O, Ganguli S, Irani Z, Liu R, Oliveira G, Walker G, Wicky S, Salazar G. Incidence of May-Thurner syndrome (MTS) in patients under evaluation of lower extremity venous reflux: implications for treatment. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.375] [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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Perez R, Estape R, Lambrou N, Walker G, Torres E, Lacayo M, Parris D, Gallas M. The Relationship of Fibroid Weight to Operative Outcomes of Robot-Assisted Laparoscopic Myomectomy in a Predominantly Hispanic Population. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.257] [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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D'Souza P, Walker G. Spotlight on chronic lymphocytic leukemia: a Pharma Matters report. DRUGS OF TODAY (BARCELONA, SPAIN : 1998) 2014; 50:485-501. [PMID: 25101331 DOI: 10.1358/dot.2014.50.7.2178279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
A paradigm shift in the treatment of chronic lymphocytic leukemia (CLL) has taken place over the past decade, as therapies have progressed from providing palliative relief to inducing complete remission, eradicating minimal disease and improving survival. The development of Rituxan® (rituximab) and its use in immunochemotherapy regimens has transformed the treatment of CLL and is the current gold standard in physically fit individuals aged < 65 years. Despite this therapeutic development, Rituxan-based immunochemotherapy is limited in the two CLL groups that form the majority of CLL cases-the elderly and patients with comorbidities and high risk factors. Moreover, within 2 years of first- and second-line therapy, around 25% and 50% of patients relapse, respectively, and patients who experience remission for several years exhibit poor responses to subsequent therapies. Therefore, there still remains a significant unmet need in CLL. The rapid development of small-molecule agents targeting the B-cell receptor signaling pathway has been stimulated both by the association of this pathway with the initiation and progression of CLL as well as the high response rates and durable remissions reported in early-stage trials. Imbruvica (ibrutinib), an oral first-in-class Bruton's tyrosine kinase inhibitor, recently entered the market following accelerated approval in the relapsed/refractory setting, but long-term survival data are currently immature. New therapies face several significant challenges: to provide even greater response rates, particularly in the elderly and in patients with comorbidities and high risk factors, and to overcome resistance to current treatments. Currently, the only curative treatment for CLL, allogeneic hematopoietic stem cell transplantation, is not an option for the majority of CLL patients. The ultimate question is whether small-molecule therapeutics can achieve a cure for CLL. It is hoped that developments in identifying the cytogenetic and molecular changes associated with the prognosis and pathogenesis of CLL will enable the rapid development of next-generation targeted therapies.
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Anand V, Ong T, Bicker A, Walker G, Logan P, Sahota O. P247: PHYsical activity Study of older people In hospital: a Cross-sectional analysis using AcceLerometers (PHYSICAL). Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70419-x] [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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Kiani R, Tyrer F, Jesu A, Bhaumik S, Gangavati S, Walker G, Kazmi S, Barrett M. Mortality from sudden unexpected death in epilepsy (SUDEP) in a cohort of adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:508-520. [PMID: 23647577 DOI: 10.1111/jir.12047] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/02/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND People with intellectual disability (ID) and epilepsy are more likely to die prematurely than the general population. A significant number of deaths in people with epilepsy may be potentially preventable through better seizure control, regular monitoring and raising awareness among patients and carers. The aim of this project was to study mortality from sudden unexpected death in epilepsy (SUDEP) in adults with ID. METHODS All adults (≥20 years old) living in Leicester city, Leicestershire and Rutland, UK, with ID between 1993 and 2010 were identified using the Leicestershire Intellectual Disability Register database. People with and without ID who died during the same period were identified using death certificate data from the Office for National Statistics (ONS). Deaths from probable and definite SUDEP were identified. Additional information on adults with ID who had died from probable or definite SUDEP was obtained from case notes and post-mortem reports, where available. Cases of probable and definite SUDEP in adults with ID were compared with the general population using standardised mortality ratios (SMRs). RESULTS A total of 898 adults with ID had died over the 18-year study period. Of these, 244 deaths (27%) occurred in people with ID who had a diagnosis of epilepsy. Twenty-six people with ID died from probable or definite SUDEP, which was the second most common cause of death among adults with ID and epilepsy. All-cause specific SMRs were 2.2 [95% confidence interval (CI): 2.0-2.4] and 2.8 (95% CI: 2.5-3.1) for men and women with ID respectively. SMRs were 3.2 (95% CI: 2.7-3.8) and 5.6 (95% CI: 4.6-6.7) for men and women with epilepsy and ID respectively. During the same study period, 83 adults without ID had died of probable or definite SUDEP. The SMRs for SUDEP in patients with ID were 37.6 for men (95% CI: 21.9-60.2) and 52.0 for women (95% CI: 23.8-98.8). We found that in the majority of ID cases there was little detailed documentation on the circumstances surrounding deaths, no communication with patients/carers about risk of SUDEP and an absence of post-mortem reports or carers' referral for bereavement counselling. CONCLUSION The authors believe that a comprehensive risk management under a multiagency/multidisciplinary framework should be undertaken for all adults with ID and epilepsy in day-to-day clinical practice to reduce mortality in people with ID.
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Sanhueza JM, Heuer C, Jackson R, Hughes P, Anderson P, Kelly K, Walker G. Pregnancy rates of beef cattle are not affected by Campylobacter fetus subsp. venerealis real-time PCR-positive breeding sires in New Zealand. N Z Vet J 2014; 62:237-43. [PMID: 24580097 DOI: 10.1080/00480169.2014.898202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS Campylobacter fetus subspecies venerealis (C. fetus venerealis) is the causal agent of bovine genital campylobacteriosis, a venereal disease that is asymptomatic in bulls but responsible for reproductive wastage in female cattle. In New Zealand, a commercial real-time PCR assay was introduced in 2007 to identify the DNA of this pathogen in preputial scrapings; however, concerns were raised about the specificity of the test following anecdotal reports of a high number of test-positive bulls with no apparent relationship to reproductive performance. The objective of this study, therefore, was to examine the association between real-time PCR assay results from beef breeding bulls and pregnancy rates in beef herds using these bulls. METHODS Veterinarians from four veterinary practices selected beef cattle herds with relatively high and low pregnancy rates between December 2008 and February 2009. Preputial scrapings were collected from bulls used for mating in those herds. Samples were tested using the real-time PCR assay under consideration. Bivariable and multivariable analyses were used to assess the relationship between pregnancy rates in each mob (15-month-old heifers, 27-month-old heifers and mixed-age cows) and the percentage of real-time PCR-positive bulls in each mob. RESULTS Sixty-four (28.8%) of 222 bulls tested positive, 130 (58.6%) tested negative, and 28 (12.6%) returned an inconclusive result to the real-time PCR assay. The percentage of bulls testing real-time PCR-positive in these mobs was not associated with pregnancy rates (p=0.757) after controlling for mob, average body condition score of cows, cow to bull ratio, length of the mating period, and farm. CONCLUSION Real-time PCR assay results were not associated with pregnancy rates, suggesting that the specificity of the real-time PCR assay was too low to be used to reliably detect C. fetus venerealis. This study adds to a growing body of evidence indicating that C. fetus venerealis strains are either absent from, or present at clinically insignificant levels of endemicity among, beef breeding herds in New Zealand. CLINICAL SIGNIFICANCE The real-time PCR assay that was assessed in this study should not be used for the detection of C. fetus venerealis in bulls or for investigations of low conception rates in cattle in New Zealand. During the course of this survey, sequencing analysis of an apparent C. fetus venerealis isolate from the intestines of a Friesian bull turned out to be Campylobacter hyointestinalis. As a consequence, this real-time PCR assay for C. fetus venerealis is no longer being offered by diagnostic laboratories in New Zealand.
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Zurkiya O, Ganguli S, Irani Z, Liu R, Oklu R, Oliveira G, Salazar G, Wicky S, Zhao T, King D, Velmahos G, Yeh D, Walker G. Provocative mesenteric angiography for gastrointestinal hemorrhage. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Prabhakar, Alkasab T, Harvey H, Ganguli S, Salazar G, Walker G, Kalva S, Liu R, Irani Z, Wicky S, Oliveira G, Oklu R. Grapevine: a novel PACS-integrated group peer-review system to improve quality and standardization in vascular and interventional radiology. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Walker G, Panades M, Sreenivasan T, Sundar S. Radical Radiotherapy is Effective in Patients with Ultra-high Presenting PSA. Clin Oncol (R Coll Radiol) 2013. [DOI: 10.1016/j.clon.2012.12.023] [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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Butros S, Oklu R, Walker G, Kalva S, Salazar G, Wicky S, Ganguli S. Translumbar ports: feasibility and efficacy of direct translumbar inferior vena cava approach for long-term central venous access. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kalva S, Elmi A, Somarouthu B, Karaosmanoglu A, Liu R, Ganguli S, Oklu R, Walker G, Salazar G, Wicky S. Angiographic intervention in patients with gastrointestinal bleeding. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.393] [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] Open
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Kim L, Walker G, Oliveira G. Magnetic resonance (MR) evaluation of dilated pelvic veins: what the vascular and interventional radiologist needs to know. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.409] [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] Open
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Politi R, Kawai T, Wu S, Wicky S, Walker G. Review of the HeRO (hemodialysis reliable outflow) device: a novel approach for hemodialysis. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.296] [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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Meehan T, Stecker M, Kalva S, Oklu R, Walker G, Ganguli S. Efficacy of transcatheter arterial embolization for acute hemorrhage originating from gastric adenocarcinoma. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Abstract
This report discusses a case of spontaneous pneumomediastinum in a 25-year-old medical student. The patient presented with chest pain and a tonal change in voice. Symptoms occurred after an episode of stretching and were exacerbated by coughing. There was no history of underlying respiratory disease and he was a non-smoker. Management was conservative. At the four-week follow-up appointment, bronchoscopy and computed tomography of the thorax demonstrated complete resolution. Spontaneous pneumomediastinum is uncommon, with rhinolalia being a rare presenting feature. It should be considered as a differential diagnosis in patients with chest pain associated with a change in voice. A detailed history may reveal preceding activities associated with raised intrathoracic pressure.
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Breakey RWF, Walker G, Oldfield W. Spontaneous pneumomediastinum presenting as rhinolalia and chest pain. Ann R Coll Surg Engl 2012; 94:e243-5. [PMID: 23131214 PMCID: PMC3954305 DOI: 10.1308/003588412x13373405387339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This report discusses a case of spontaneous pneumomediastinum in a 25-year-old medical student. The patient presented with chest pain and a tonal change in voice. Symptoms occurred after an episode of stretching and were exacerbated by coughing. There was no history of underlying respiratory disease and he was a non-smoker. Management was conservative. At the four-week follow-up appointment, bronchoscopy and computed tomography of the thorax demonstrated complete resolution. Spontaneous pneumomediastinum is uncommon, with rhinolalia being a rare presenting feature. It should be considered as a differential diagnosis in patients with chest pain associated with a change in voice. A detailed history may reveal preceding activities associated with raised intrathoracic pressure.
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Mahmoud O, Wolfson A, Dean E, Cohen D, Walker G, Pitcher J, Conway S, Benedetto P, Fernandez G, Temple H. A 10-year Single Institutional Experience Using Adjuvant External Beam Radiation Therapy for Extremity Soft-tissue Sarcomas. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.2299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Huang K, Walker G, Stoyanova R, Sandler K, Horwitz E, Buyyounouski M, Pollack A. Primary Prostate Radiation Therapy: Where Are We Failing? Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.471] [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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Stoyanova R, Walker G, Sandler K, Khor L, Horwitz E, Buyyounouski M, Pollack A. Determinants of Prostate Biopsy Positivity 2 Years After Radiation Therapy for Men With Prostate Cancer Treated on a Randomized Trial. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nogueira R, Jovin T, Smith W, Rymer M, Liebeskind D, Budzik R, Devlin T, Walker G, Lutsep H. P-006 Angiographic and clinical outcomes after endovascular therapy for acute ischemic stroke due to vertebrobasilar occlusions: pooled analysis of the Merci Registry, MERCI, and multi MERCI trials. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455b.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Liebeskind D, Jansen O, Walker G, Macho J, Killer M, Wahlgren N. P-025 TREVO measures of successful revascularization: defining optimal endpoints for acute stroke in the stentriever era. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455b.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Walker G, Arnold AS, Franke-Arnold S. Trans-spectral orbital angular momentum transfer via four-wave mixing in Rb vapor. PHYSICAL REVIEW LETTERS 2012; 108:243601. [PMID: 23004270 DOI: 10.1103/physrevlett.108.243601] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Indexed: 06/01/2023]
Abstract
We report the transfer of phase structure and, in particular, of orbital angular momentum from near-infrared pump light to blue light generated in a four-wave-mixing process in 85Rb vapor. The intensity and phase profile of the two pump lasers at 780 and 776 nm, shaped by a spatial light modulator, influences the phase and intensity profile of light at 420 nm, which is generated in a subsequent coherent cascade. In particular, we observe that the phase profile associated with orbital angular momentum is transferred entirely from the pump light to the blue. Pumping with more complicated light profiles results in the excitation of spatial modes in the blue that depend strongly on phase matching, thus demonstrating the parametric nature of the mode transfer. These results have implications on the inscription and storage of phase information in atomic gases.
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