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Stevens B, Verdian L, Tomlinson J, Zegenhagen S, Pezzullo L. PM021 The Economic Burden of Heart Diseases in Colombia. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.257] [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] Open
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Stevens B, Pezzullo L, Verdian L, Tomlinson J, Zegenhagen S. PS024 The Burden of Heart Diseases in Select Latin American Countries. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.067] [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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Stevens B, Pezzullo L, Verdian L, Tomlinson J, Zegenhagen S. PS023 The Economic Burden of Heart Diseases in Brazil. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.066] [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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Tomlinson J, Glenn ES, Paine DR, Sandage SJ. What is the “Relational” in Relational Spirituality? A Review of Definitions and Research Directions. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2016. [DOI: 10.1080/19349637.2015.1066736] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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White AD, Mushtaq F, Raw RK, Giles OT, Crook IC, Tomlinson J, Miskovic D, Lodge JPA, Wilkie RM, Mon-Williams M. Does monitor position influence visual-motor performance during minimally invasive surgery? ACTA ACUST UNITED AC 2016. [DOI: 10.1102/2051-7726.2016.0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Erblich T, Hill PD, Tomlinson J, Bain BJ. The complex morphology of acute kidney injury with microangiopathic hemolytic anemia and hyposplenism. Am J Hematol 2015; 90:674. [PMID: 25820529 DOI: 10.1002/ajh.24026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 11/12/2022]
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Yu L, Tomlinson J, Alexander S, Hensley K, Han CY, Dwyer D, Stolina M, Dean C, Goodman W, Richards W, Li X. FP403AMG 416, A PEPTIDE AGONIST OF THE CALCIUM-SENSING RECEPTOR, PREVENTED VASCULAR CALCIFICATION IN A RAT MODEL OF UREMIA INDUCED BY ADENINE DIET. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv177.02] [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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Lambden S, Kelly P, Ahmetaj-Shala B, Wang Z, Lee B, Nandi M, Torondel B, Delahaye M, Dowsett L, Piper S, Tomlinson J, Caplin B, Colman L, Boruc O, Slaviero A, Zhao L, Oliver E, Khadayate S, Singer M, Arrigoni F, Leiper J. Dimethylarginine dimethylaminohydrolase 2 regulates nitric oxide synthesis and hemodynamics and determines outcome in polymicrobial sepsis. Arterioscler Thromb Vasc Biol 2015; 35:1382-92. [PMID: 25857313 DOI: 10.1161/atvbaha.115.305278] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/24/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Nitric oxide is a key to numerous physiological and pathophysiological processes. Nitric oxide production is regulated endogenously by 2 methylarginines, asymmetric dimethylarginine (ADMA) and monomethyl-L-arginine. The enzyme that specifically metabolizes asymmetric dimethylarginine and monomethyl-L-arginine is dimethylarginine dimethylaminohydrolase (DDAH). The first isoform dimethylarginine dimethylaminohydrolase 1 has previously been shown to be an important regulator of methylarginines in both health and disease. This study explores for the first time the role of endogenous dimethylarginine dimethylaminohydrolase 2 in regulating cardiovascular physiology and also determines the functional impact of dimethylarginine dimethylaminohydrolase 2 deletion on outcome and immune function in sepsis. APPROACH AND RESULTS Mice, globally deficient in Ddah2, were compared with their wild-type littermates to determine the physiological role of Ddah2 using in vivo and ex vivo assessments of vascular function. We show that global knockout of Ddah2 results in elevated blood pressure during periods of activity (mean [SEM], 118.5 [1.3] versus 112.7 [1.1] mm Hg; P=0.025) and changes in vascular responsiveness mediated by changes in methylarginine concentration, mean myocardial tissue asymmetric dimethylarginine (SEM) was 0.89 (0.06) versus 0.67 (0.05) μmol/L (P=0.02) and systemic nitric oxide concentrations. In a model of severe polymicrobial sepsis, Ddah2 knockout affects outcome (120-hour survival was 12% in Ddah2 knockouts versus 53% in wild-type animals; P<0.001). Monocyte-specific deletion of Ddah2 results in a similar pattern of increased severity to that seen in globally deficient animals. CONCLUSIONS Ddah2 has a regulatory role both in normal physiology and in determining outcome of severe polymicrobial sepsis. Elucidation of this role identifies a mechanism for the observed relationship between Ddah2 polymorphisms, cardiovascular disease, and outcome in sepsis.
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Tomlinson J, Yiasemidou M. Teaching future surgeons: a step towards better training? CLINICAL TEACHER 2015; 12:143. [PMID: 25789908 DOI: 10.1111/tct.12338] [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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Cozzolino M, Tomlinson J, Walsh L, Bellasi A. Emerging drugs for secondary hyperparathyroidism. Expert Opin Emerg Drugs 2015; 20:197-208. [PMID: 25702624 DOI: 10.1517/14728214.2015.1018177] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Secondary hyperparathyroidism (SHPT), a common, serious, and progressive complication of chronic kidney disease (CKD), is characterized by elevated serum parathyroid hormone (PTH), parathyroid gland hyperplasia, and mineral metabolism abnormalities. These disturbances may result in CKD-mineral and bone disorder (CKD-MBD), which is associated with poor quality of life and short life expectancy. AREAS COVERED The goal of SHPT treatment is to maintain PTH, calcium, and phosphorus within accepted targeted ranges. This review highlights the pathogenesis of SHPT and current SHPT therapeutic approaches, including the use of low-phosphate diets, phosphate binders, 1,25-dihydroxyvitamin D3 (calcitriol) and its analogs, calcimimetics, and parathyroidectomy in addition to discussing emerging drugs in development for SHPT. EXPERT OPINION Numerous studies indicate that mineral abnormalities occur early in the course of CKD, are prevalent by the time patients enter dialysis, and foreshadow a risk of cardiovascular and all-cause mortality. Several newly developed compounds may potentially overcome the limitations of current SHPT therapies. If emerging therapies can reduce PTH, normalize mineral metabolism, promote treatment adherence, and reduce the risk of side effects, they may provide the requisite features for improving long-term outcomes in patients with SHPT receiving dialysis and reduce the risks of CKD-MBD.
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Wang Z, Lambden S, Nandi M, Tomlinson J, Dyson A, Taylor V, Sujkovic E, McDonald N, Caddick S, Singer M, Leiper J. A novel dimethylarginine dimethylaminohydrolase (DDAH-1) inhibitor improves survival, hemodynamics and organ function in rodent sepsis. Nitric Oxide 2014. [DOI: 10.1016/j.niox.2014.09.010] [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]
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62
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Tomlinson J, Caplin B, Boruc O, Cutillas P, Dorman D, Faull P, Khadayate S, Mas V, Wang Z, Norman J, Wheeler D, Leiper J. Reduced renal dimethylarginine dimethylaminohydrolase 1 (DDAH1) activity protects against progressive kidney fibrosis and eGFR decline. Nitric Oxide 2014. [DOI: 10.1016/j.niox.2014.09.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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63
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Tomlinson J, Khan A. Letter to the editor: Orthopaedic education in the United Kingdom. Clin Orthop Relat Res 2014; 472:3235-6. [PMID: 25080265 PMCID: PMC4160489 DOI: 10.1007/s11999-014-3830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 07/17/2014] [Indexed: 01/31/2023]
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Sacks GD, Dawes AJ, Russell MM, Lin AY, Maggard-Gibbons M, Winograd D, Chung HR, Tomlinson J, Tillou A, Shew SB, Hiyama DT, Cryer HG, Brunicardi FC, Hiatt JR, Ko C. Evaluation of Hospital Readmissions in Surgical Patients. JAMA Surg 2014; 149:759-64. [DOI: 10.1001/jamasurg.2014.18] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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65
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66
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Thangaratinam S, Rogozińska E, Jolly K, Glinkowski S, Duda W, Borowiack E, Roseboom T, Tomlinson J, Walczak J, Kunz R, Mol BW, Coomarasamy A, Khan KS. Interventions to reduce or prevent obesity in pregnant women: a systematic review. Health Technol Assess 2012; 16:iii-iv, 1-191. [PMID: 22814301 DOI: 10.3310/hta16310] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Around 50% of women of childbearing age are either overweight [body mass index (BMI) 25-29.9 kg/m(2)] or obese (BMI ≥ 30 kg/m(2)). The antenatal period provides an opportunity to manage weight in pregnancy. This has the potential to reduce maternal and fetal complications associated with excess weight gain and obesity. OBJECTIVES To evaluate the effectiveness of dietary and lifestyle interventions in reducing or preventing obesity in pregnancy and to assess the beneficial and adverse effects of the interventions on obstetric, fetal and neonatal outcomes. DATA SOURCES Major electronic databases including MEDLINE, EMBASE, BIOSIS and Science Citation Index were searched (1950 until March 2011) to identify relevant citations. Language restrictions were not applied. REVIEW METHODS Systematic reviews of the effectiveness and harm of the interventions were carried out using a methodology in line with current recommendations. Studies that evaluated any dietary, physical activity or mixed approach intervention with the potential to influence weight change in pregnancy were included. The quality of the studies was assessed using accepted contemporary standards. Results were summarised as pooled relative risks (RRs) with 95% confidence intervals (CIs) for dichotomous data. Continuous data were summarised as mean difference (MD) with standard deviation. The quality of the overall evidence synthesised for each outcome was summarised using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology and reported graphically as a two-dimensional chart. RESULTS A total of 88 studies (40 randomised and 48 non-randomised and observational studies, involving 182,139 women) evaluated the effect of weight management interventions in pregnancy on maternal and fetal outcomes. Twenty-six studies involving 468,858 women reported the adverse effect of the interventions. Meta-analysis of 30 RCTs (4503 women) showed a reduction in weight gain in the intervention group of 0.97 kg compared with the control group (95% CI -1.60 kg to -0.34 kg; p = 0.003). Weight management interventions overall in pregnancy resulted in a significant reduction in the incidence of pre-eclampsia (RR 0.74, 95% CI 0.59 to 0.92; p = 0.008) and shoulder dystocia (RR 0.39, 95% CI 0.22 to 0.70; p = 0.02). Dietary interventions in pregnancy resulted in a significant decrease in the risk of pre-eclampsia (RR 0.67, 95% CI 0.53 to 0.85; p = 0.0009), gestational hypertension (RR 0.30, 95% CI 0.10 to 0.88; p = 0.03) and preterm birth (RR 0.68, 95% CI 0.48 to 0.96; p = 0.03) and showed a trend in reducing the incidence of gestational diabetes (RR 0.52, 95% CI 0.27 to 1.03). There were no differences in the incidence of small-for-gestational-age infants between the groups (RR 0.99, 95% CI 0.76 to 1.29). There were no significant maternal or fetal adverse effects observed for the interventions in the included trials. The overall strength of evidence for weight gain in pregnancy and birthweight was moderate for all interventions considered together. There was high-quality evidence for small-for-gestational-age infants as an outcome. The quality of evidence for all interventions on pregnancy outcomes was very low to moderate. The quality of evidence for all adverse outcomes was very low. LIMITATIONS The included studies varied in the reporting of population, intensity, type and frequency of intervention and patient complience, limiting the interpretation of the findings. There was significant heterogeneity for the beneficial effect of diet on gestational weight gain. CONCLUSIONS Interventions in pregnancy to manage weight result in a significant reduction in weight gain in pregnancy (evidence quality was moderate). Dietary interventions are the most effective type of intervention in pregnancy in reducing gestational weight gain and the risks of pre-eclampsia, gestational hypertension and shoulder dystocia. There is no evidence of harm as a result of the dietary and physical activity-based interventions in pregnancy. Individual patient data meta-analysis is needed to provide robust evidence on the differential effect of intervention in various groups based on BMI, age, parity, socioeconomic status and medical conditions in pregnancy.
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Rogers S, Tomlinson J, Blissett J. Infant feeding, cortisol metabolism and weight gain in the first six months of life. Appetite 2012. [DOI: 10.1016/j.appet.2012.05.098] [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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Caplin B, Wang Z, Slaviero A, Tomlinson J, Dowsett L, Delahaye M, Salama A, Wheeler DC, Leiper J. Alanine-glyoxylate aminotransferase-2 metabolizes endogenous methylarginines, regulates NO, and controls blood pressure. Arterioscler Thromb Vasc Biol 2012; 32:2892-900. [PMID: 23023372 DOI: 10.1161/atvbaha.112.254078] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Asymmetric dimethylarginine is an endogenous inhibitor of NO synthesis that may mediate cardiovascular disease. Alanine-glyoxylate aminotransferase-2 (AGXT2) has been proposed to degrade asymmetric dimethylarginine. We investigated the significance of AGXT2 in methylarginine metabolism in vivo and examined the effect of this enzyme on blood pressure. METHODS AND RESULTS In isolated mouse kidney mitochondria, we show asymmetric dimethylarginine deamination under physiological conditions. We demonstrate increased asymmetric dimethylarginine, reduced NO, and hypertension in an AGXT2 knockout mouse. We provide evidence for a role of AGXT2 in methylarginine metabolism in humans by demonstrating an inverse relationship between renal (allograft) gene expression and circulating substrate levels and an association between expression and urinary concentrations of the product. Finally, we examined data from a meta-analysis of blood pressure genome-wide association studies. No genome-wide significance was observed, but taking a hypothesis-driven approach, there was a suggestive association between the T allele at rs37369 (which causes a valine-isoleucine substitution and altered levels of AGXT2 substrate) and a modest increase in diastolic blood pressure (P=0.0052). CONCLUSIONS Although the effect of variation at rs37369 needs further study, these findings suggest that AGXT2 is an important regulator of methylarginines and represents a novel mechanism through which the kidney regulates blood pressure.
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Bell T, Nie J, Tomlinson J, Leiper J, Wilcox CS, Welch WJ. Abstract 223: Genetic Deletion or Pharmacological Blockade of Ddah-1 Impairs Reabsorption of Fluid From the Rat Renal Proximal Tubule Perfused in vivo. Hypertension 2012. [DOI: 10.1161/hyp.60.suppl_1.a223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nitric oxide (NO) stimulates proximal tubule (PT) Na
+
and fluid reabsorption. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS) but its effects on tubular function are unknown. ADMA is metabolized by dimethylarginine dimethylaminohydrolase (DDAH) whose type 1 isoform is predominant in the PT. SNIPs of DDAH-1 predicted the rate of decline of renal function in patients with chronic kidney disease (CKD). Therefore, we tested the hypothesis that DDAH-1 metabolizes ADMA in the proximal tubule and thereby enhances PT fluid reabsorption (J
v
). J
v
was measured in anesthetized rats by direct in vivo microperfusion and recollection of artificial tubular fluid (ATF) in S2 segments of the PT isolated between oil blocks. Addition of a selective inhibitor of DDAH-1, L-257 (10
-4
M) to ATF did not effect J
v
when compared to addition of vehicle (3.40.6 vs 3.10.3 nl/min/mm). However, L-257 administered as a bolus intravenous injection (60mg/kg) 2hrs before microperfusion of the PT with L-257 significantly reduced J
v
to 1.80.2 nl/min/mm, (P<0.05) and significantly enhanced urine flow rate (2.1±0.3 vs 9.0±1.8 μl/min; P<0.05). Microperfusion of ADMA (10
-4
M) or L-NAME (10
-4
M) into the PT both reduced J
v
significantly to 2.00.2 and 1.80.2 nl/min/mm, respectively (P<0.05). Rats pretreated with a rapid intravenous injection of siRNA targeted to DDAH-1 that reduced its renal mRNA expression significantly also had reduced J
v
(3.1±0.2 vs 2.2±6.2 nl/min/mm; P<0.05) and had a further reduction in J
v
with 10
-4
M ADMA added to ATF to 1.4±0.1 nl/min/mm; (P<0.005). In conclusion, PT fluid reabsorption is regulated by ADMA and its tubular metabolism by DDAH-1. The two hour delay in the effects of a bolus injection of L-257 to diminish J
v
indicated the time required after inhibition of DDAH-1 for accumulation of sufficient tubular ADMA to impair PT reabsorption. Thus, L-257 is a novel regulator of PT function and is a proximal tubule diuretic. SNIPs that alter DDAH-1 in the PT may change renal function and contribute to CKD progression.
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Walter* S, Dong J, Alexander S, Hunter T, Yin K, Maclean D, Tomlinson J, Karim F, Johnson R, Stevens K, Patel R, Clancy M, Graham D, Delles C, Jardine A, Behets G, Viaene L, Meijers B, D'haese P, Evenepoel P, Seiler S, Herath E, Flugge F, Weihrauch A, Fliser D, Heine GH, Brandenburg V, Kruger T, Wagstaff R, Floege J, Specht P, Ketteler M, Angelini ML, Angelini ML, Cianciolo G, La Manna G, Cappuccilli ML, Della Bella E, Rum I, Conte D, Cuna V, Dormi A, Todeschini P, Donati G, Costa R, Bagnara GP, Stefoni S. Bone and mineral diseases - 1. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs193] [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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Reynolds R, Vita P, Tomlinson J, Munro A, Raffaele C, Schutz H, Hony J, Colagiuri S, Shaw T, Buchanan J, Milat A, Rissel C, Bauman A, Gill T, Caterson I. The healthy workers portal: An online repository of workplace health information. Obes Res Clin Pract 2011. [DOI: 10.1016/j.orcp.2011.08.014] [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: 11/30/2022]
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Lowthian JA, Curtis AJ, Comitti BL, Cameron PA, Keogh MJ, Johnson WR, Tomlinson J, Stripp AM. Streamlining elective surgery care in a public hospital: the Alfred experience. Med J Aust 2011; 194:448-51. [DOI: 10.5694/j.1326-5377.2011.tb03057.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 03/14/2011] [Indexed: 11/17/2022]
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Tomlinson J. TH-SAM-201B-02: Stereotactic Breast Biopsy Equipment Surveys. Med Phys 2010. [DOI: 10.1118/1.3469460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tomlinson J, Millward A, Stenhouse E, Pinkney J. Type 2 diabetes and cardiovascular disease in polycystic ovary syndrome: what are the risks and can they be reduced? Diabet Med 2010; 27:498-515. [PMID: 20536945 DOI: 10.1111/j.1464-5491.2010.02994.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a risk factor for Type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), but these risks are poorly defined. This study aimed to evaluate the evidence for these risks and whether screening and risk reduction are feasible. Medline reviews and data quality analysis were used using standard tools. Results showed that (i) polycystic ovary syndrome is a risk factor forT2DM but the magnitude of risk is uncertain, (ii) fasting plasma glucose is an inadequate screening test forT2DM in this population and the oral glucose tolerance test is superior, (iii) the identification of women with PCOS for diabetes screening is constrained by current diagnostic criteria for PCOS; however, women with oligomenorrhoea and those with diagnosed PCOS and obesity or a family history of T2DM are at highest risk, (iv) risk factors for T2DM are improved by weight loss interventions and by metformin. However, no studies have determined whether T2DM incidence is reduced, (v) polycystic ovary syndrome is associated with cardiovascular disease (CVD) risk factors but data on CVD incidence are weak, (vi) risk factors for CVD are improved by the same interventions and statins and (vi) no studies have evaluated whether CVD incidence is reduced. While PCOS has important metabolic associations, and short-term interventions reduce risk factors for T2DM and CVD, data on prevalence and incidence of T2DM and particularly CVD are poor. There is a need for a clear definition of PCOS, for diabetes screening protocols and for long-term studies to determine whether risks can be reduced.
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Tomlinson J, Cunningham J. SOFT BONES AND HARD ARTERIES-CAN WE REVERSE THE TREND IN CKD? J Ren Care 2009; 35 Suppl 1:28-33. [DOI: 10.1111/j.1755-6686.2009.00060.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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