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Dsilva AA, Basheer A, Thomas K. Snake envenomation: is the 20 min whole blood clotting test (WBCT20) the optimum test for management? QJM 2019; 112:575-579. [PMID: 30918965 DOI: 10.1093/qjmed/hcz077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/14/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The 20 min whole blood clotting test (WBCT20) is a simple bedside test recommended by World Health Organization (WHO) to assess hemotoxic envenomation and guide administration of polyvalent anti-snake venom (ASV). However, reliability and validity of this test has not been well documented in literature. METHODS Sixty consecutive patients with history of snake bite were prospectively evaluated at a teaching hospital in India over 2 years. Envenomation was established by clinical and laboratory criteria. WBCT20 was done at 0, 4 and 12 h using standardized protocol. Prothrombin time (PT) with international normalized ratio (INR) was estimated at similar intervals to detect venom-induced consumption coagulopathy. Sensitivity, specificity and likelihood ratios (LR) were determined for WBCT20 using envenomation criteria as gold standard. WBCT20 was compared with PT/INR at cutoff values of ≥1.4 and ≥1.2. Two observers performed test-retest correlation to determine inter-observer variability of WBCT20. RESULTS . UNLABELLED Seventeen of 60 patients had evidence of hemotoxic envenomation. Four patients had combined neurotoxicity and hemotoxicity. Sensitivity and specificity of WBCT20 were 94 and 76%; positive and negative LR were 3.9 and 0.08, respectively. No inter-observer variability was noted. CONCLUSIONS WBCT20 is a highly sensitive test with excellent reliability for detecting envenomation. However, the false positive rate in this study was 24%. Asymptomatic snake bite patients with a positive WBCT20 but no corresponding clinical signs of envenomation should be tested using PT/INR before receiving ASV to prevent unnecessary waste of anti-venom.
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Osuna J, Thomas K, Edmonds E, Bangen K, Weigand A, Wong C, Cooper S, Bondi M. Subtle Cognitive Decline predicts progression to Mild Cognitive Impairment Above and Beyond Alzheimer’s Disease Risk Factors. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Early identification of those at risk for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) is critical for early intervention. Recent work shows that subtle cognitive decline (SCD), operationally-defined using sensitive neuropsychological scores, predicts progression to MCI/AD and is associated with AD biomarkers. We aimed to determine whether SCD adds unique value in predicting progression to MCI/AD above and beyond other AD risk factors.
Method
547 cognitively unimpaired participants from the Alzheimer’s Disease Neuroimaging Initiative (359 without SCD; 188 with SCD) underwent neuropsychological testing and lumbar puncture. Participants were classified as SCD if they performed >1 SD below the demographically-adjusted mean on 1) two neuropsychological total scores in different cognitive domains, or 2) two memory test process scores (e.g., intrusion errors), or 3) one total score and one process score. Cox regressions examined whether SCD status predicted progression to MCI and AD within 5 years after adjusting for age, education, sex, MMSE, depressive symptoms, ischemia risk, apolipoprotein E genotype, and AD biomarker “positivity” based on the cerebrospinal fluid phosphorylated tau-to-β-amyloid ratio.
Results
SCD status predicted progression to MCI (HR = 2.74, 95% CI = 2.07-3.63, p < .001) and AD (HR = 2.20, 95% CI = 1.04-4.65, p = .04) within 5 years, even after including known AD risk factors in the model.
Conclusion
SCD conveys a 2-3 fold increased risk of progression to MCI/AD and is a unique predictor above and beyond risk factors that are commonly used in preclinical AD research. These findings support our novel SCD criteria as a cost-effective and non-invasive method for identifying those at risk for future cognitive decline.
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Fung K, Biasiolli L, Aung N, Hann E, Paiva JM, Lukaschuk E, Sanghvi MM, Carapella V, Rayner JJ, Werys K, Thomas K, Moon NO, Neubauer S, Piechnik SK, Petersen SE. 282Reference values for aortic distensibility derived from UK Biobank cardiovascular magnetic resonance (CMR) imaging cohort. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Crowley JD, Thomas KA, Donahoe SL, Child G, Hickey MC, Mooney ET. Hypoventilation, cardiac dysrhythmia, and cardiac arrest following acute
Brunfelsia
species (Yesterday, today, tomorrow) intoxication in a dog. Aust Vet J 2019; 97:202-207. [DOI: 10.1111/avj.12815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/05/2019] [Accepted: 03/20/2019] [Indexed: 12/01/2022]
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Ganatra N, Ban L, Harman K, Thomas K. How often are bath emollients prescribed to children with atopic eczema in primary care in England? A cross‐sectional study. Br J Dermatol 2019; 180:1252-1253. [DOI: 10.1111/bjd.17514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Schmidt JW, Vikram A, Thomas K, Arthur TM, Weinroth M, Parker J, Hanes A, Geornaras I, Morley PS, Wheeler TL, Belk KE. Antimicrobial Resistance in Retail Ground Beef with and Without a “Raised Without Antibiotics” Claim. MEAT AND MUSCLE BIOLOGY 2019. [DOI: 10.22175/mmb2019.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Hyer K, Dosa D, Peterson L, June J, Jester D, Dobbs D, Thomas K. DILEMMAS FACING NURSING HOMES AND ASSISTED LIVING PROVIDERS DURING HURRICANES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Harris D, Thomas K, Jutkowitz E. DOES TECHNOLOGY USE PROTECT AGAINST COGNITIVE DECLINE? RESULTS FROM A RETROSPECTIVE COHORT STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mohamad O, Spangler A, Kim D, Thomas K, Albuquerque K, Wooldridge R, Rivers A, Leitch M, Rao R, Haley B, Ahn C, Rahimi A. Novel Hyaluronan Formulation for Preventing Acute Skin Reactions in Breast During Radiation Therapy: A Randomized Clinical Trial. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kler S, Ogarek J, Shan M, Gozalo P, Gutman R, Dosa D, Thomas K. IDENTIFYING MEALS ON WHEELS CLIENTS AT RISK OF HOSPITALIZATION: A STRATEGY FOR ALLOCATING EXTRA HEALTH SERVICES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Thomas K, Kang J, Fenton-Kerimian M, Formenti S. Prone Partial Breast Irradiation (PBI): Prospective Randomized Trial to Compare Five Versus Three Fractions. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.164] [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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June J, Peterson L, Dosa D, Thomas K, Li M, Sun X, Sakib N, Hyer K. IMPACT OF HURRICANE IRMA ON EVACUATION PREPAREDNESS AND RESPONSE OF FLORIDA ASSISTED LIVING COMMUNITIES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1981] [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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Ingram J, Thomas K, Burton T, Rodrigues J, Howes R, Hood K, Thomas-Jones E, Cannings-John R, Collier F, Tappenden P, Leighton P. #18 Treatment of Hidradenitis Suppurativa Evaluation Study (THESEUS) (poster presentation). Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.10.019] [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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Kler S, Samuel L, Thomas K. SRPP Section Student Poster Award Finalists. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1208] [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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Thomas K, Corneau E. CASH BENEFITS FOR VETERANS’ LONG-TERM CARE: IDENTIFYING FACTORS PREDICTIVE OF ENROLLMENT AND VARIABILITY IN ACCESS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Smith L, Carder P, Thomas K, Kaskie B, Taylor S, Harrel L. DEMENTIA-SPECIFIC STAFF TRAINING: VARIATION AND TRENDS IN U.S. ASSISTED LIVING STATE POLICIES. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3426] [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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Fashaw S, Chisholm L, Mor V, Thomas K, Liu A, Gammonley D. THE USE OF PHYSICAL AND CHEMICAL RESTRAINTS AMONG NURSING HOME RESIDENTS OVER TIME: AN ISSUE OF HEALTH EQUITY? Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1993] [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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Antonopoulos AS, Herdman L, Thomas S, Akoumianakis I, Kotanidis C, Thomas K, Oikonomou EK, Psarros K, Sayeed R, Antoniades C. 104Metabolically healthy obesity is associated with a distinct epicardial fat phenotype and low myocardial oxidative stress. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.104] [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: 11/14/2022] Open
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Eblimit A, Agrawal SA, Thomas K, Anastassov IA, Abulikemu T, Moayedi Y, Mardon G, Chen R. Corrigendum to "Conditional loss of Spata7 in photoreceptors causes progressive retinal degeneration in mice" [Exp. Eye Res. 166 (2018) 120-130]. Exp Eye Res 2018; 171:119. [PMID: 29579643 DOI: 10.1016/j.exer.2018.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Libertini M, Mitra I, van der Graaf WTA, Miah AB, Judson I, Jones RL, Thomas K, Moskovic E, Szucs Z, Benson C, Messiou C. Aggressive fibromatosis response to tamoxifen: lack of correlation between MRI and symptomatic response. Clin Sarcoma Res 2018; 8:13. [PMID: 29785261 PMCID: PMC5950191 DOI: 10.1186/s13569-018-0100-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 04/04/2018] [Indexed: 01/22/2023] Open
Abstract
Background One of the commonly used systemic agents for the treatment of aggressive fibromatosis is the anti-oestrogen drug tamoxifen. However, data on efficacy and optimum methods of response assessment are limited, consisting mainly of small case series and reports. Methods A retrospective database was used to identify consecutive patients diagnosed with aggressive fibromatosis (AF) and treated with tamoxifen plus/minus non-steroidal anti-inflammatory drugs at our tertiary referral centre between 2007 and 2014. MRI and symptom changes were recorded. Results Thirty-two patients (13 male 19 female, median age 41 years) were included. Median duration of treatment with tamoxifen was 316 days. Of 9 patients with progressive disease by RECIST 1.1 (28%): 4 patients experienced worsening symptoms; 3 patients had improved symptoms and 2 had no change in symptoms. Of 22 patients with stable disease (69%): 11 had no change in symptoms; 6 had improved symptoms and 5 patients had worsening symptoms. One patient achieved a partial response with improved symptoms. Conclusions No relationship was identified between symptomatic benefit and response by RECIST 1.1 on MRI. Prospective studies in AF should incorporate endpoints focusing on patient symptoms.
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Sibbald C, Park C, Leonardi-Bee J, Ratib S, Thomas K, Langan S. 276 Systematic review of autoimmune comorbidities in vitiligo. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.282] [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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Shelley C, Gore M, Tan S, Thomas K, Eeles R. Cervical Spine Fractures in Patients Undergoing Palliative Radiotherapy to the Cervical Spine: Implications for Practice. Clin Oncol (R Coll Radiol) 2018; 30:458. [PMID: 29653748 DOI: 10.1016/j.clon.2018.02.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 02/28/2018] [Indexed: 10/17/2022]
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Popat H, Thomas K, Farnell DJJ. Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners. Br Dent J 2018; 221:21-4. [PMID: 27388086 DOI: 10.1038/sj.bdj.2016.495] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/09/2022]
Abstract
Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations.
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Yan C, Kumar S, Thomas K, See P, Farrer I, Ritchie D, Griffiths J, Jones G, Pepper M. Engineering the spin polarization of one-dimensional electrons. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2018; 30:08LT01. [PMID: 29334361 DOI: 10.1088/1361-648x/aaa7ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present results of magneto-focusing on the controlled monitoring of spin polarization within a one-dimensional (1D) channel, and its subsequent effect on modulating the spin-orbit interaction (SOI) in a 2D GaAs electron gas. We demonstrate that electrons within a 1D channel can be partially spin polarized as the effective length of the 1D channel is varied in agreement with the theoretical prediction. Such polarized 1D electrons when injected into a 2D region result in a split in the odd-focusing peaks, whereas the even peaks remain unaffected (single peak). On the other hand, the unpolarized electrons do not affect the focusing spectrum and the odd and even peaks remain as single peaks, respectively. The split in odd-focusing peaks is evidence of direct measurement of spin polarization within a 1D channel, where each sub-peak represents the population of a particular spin state. Confirmation of the spin splitting is determined by a selective modulation of the focusing peaks due to the Zeeman energy in the presence of an in-plane magnetic field. We suggest that the SOI in the 2D regime is enhanced by a stream of polarized 1D electrons. The spatial control of spin states of injected 1D electrons and the possibility of tuning the SOI may open up a new regime of spin-engineering with application in future quantum information schemes.
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Baeten S, Bouckaert A, Thomas K, Loumaye E. The Prognosis of In Vitro Fertilization (IVF) : a Regression Approach. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1635531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryLogistic regression can be used to investigate prognostic factors in the treatment of infertility by in vitro fertilization (IVF). It was observed that the probability of success is not constant over repeated attempts, but decreases according to a selection process. Another prognostic factor, the number of cells of the largest embryo, was also observed.
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