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Behar RZ, Bahl V, Wang Y, Lin S, Xu N, Davis B, Talbot P. A method for rapid dose-response screening of environmental chemicals using human embryonic stem cells. J Pharmacol Toxicol Methods 2012; 66:238-45. [PMID: 22820057 DOI: 10.1016/j.vascn.2012.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 06/05/2012] [Accepted: 07/05/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Human embryonic stem cells (hESC) provide an invaluable model for assessing the effects of environmental chemicals and drugs on human prenatal development. However, hESC are difficult to adapt to 96-well plate screening assays, because they survive best when plated as colonies, which are difficult to count and plate accurately. The purpose of this study is to present an experimental method and analysis procedure to accomplish reliable screening of toxicants using hESC. METHODS We present a method developed to rapidly and easily determine the number of cells in small colonies of hESC spectrophotometerically and then accurately dispense equivalent numbers of cells in 96-well plates. The MTT assay was used to evaluate plating accuracy, and the method was tested using known toxicants. RESULTS The quality of the plate set-up and analysis procedure was evaluated with NIH plate validation and assessment software. All statistical parameters measured by the software were acceptable, and no drift or edge effects were observed. The 96-well plate MTT assay with hESC was tested by performing a dose-response screen of commercial products, which contain a variety of chemicals. The screen was done using single wells/dose, and the reliability of this method was demonstrated in a subsequent screen of the same products repeated three times. The single and triple screens were in good agreement, and NOAELs and IC(50)s could be determined from the single screen. The effects of vapor from volatile chemicals were studied, and methods to monitor and avoid vapor effects were incorporated into the assay. DISCUSSION Our method overcomes the difficulty of using hESC for reliable quantitative 96-well plate assays. It enables rapid dose-response screening using equipment that is commonly available in laboratories that culture hESC. This method could have a broad application in studies of environmental chemicals and drugs using hESC as models of prenatal development.
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Engedal K, Davis B, Richarz U, Han J, Schäuble B, Andreasen N. Two galantamine titration regimens in patients switched from donepezil. Acta Neurol Scand 2012; 126:37-44. [PMID: 21992111 DOI: 10.1111/j.1600-0404.2011.01594.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In addition to inhibiting acetylcholinesterase, galantamine has allosteric-modulating activity at nicotinic receptors. This may make galantamine an attractive option for patients starting treatment for Alzheimer's disease (AD), but also for those who have not benefited from their current therapy. This study explored outcomes in subjects with AD transitioning from donepezil because of insufficient tolerability or efficacy. MATERIALS AND METHODS Subjects previously receiving donepezil for mild-to-moderate AD were enrolled in a 12-week randomized, open-label study. After screening and a 7-day washout, subjects were randomly allocated to galantamine fast (8 mg/week increments) or slow (8 mg/4 week) titration to 16-24 mg. Efficacy outcomes included the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog/11), Mini-Mental State Examination (MMSE), Clinician's Interview-Based Impression of Change - Plus Caregiver's Input (CIBIC-plus) and Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL). RESULTS Eighty-six of 89 patients (fast titration, n = 44; slow titration, n = 45) completed the study. At week 12, ADAS-cog/11 score improved from screening by 2.6 and 0.6 in the fast- and slow-titration arms, respectively (overall, -1.6; P = 0.002). MMSE scores improved slightly in both arms (overall, +0.9; P = 0.002). Two-thirds of patients had improvement or no change on the CIBIC-plus at week 12. ADCS-ADL scores did not change significantly from screening in either treatment arm. Galantamine was generally well tolerated; nausea (5.6%) and bradycardia (4.5%) were the most commonly reported adverse events. CONCLUSIONS Patients in whom donepezil is ineffective or poorly tolerated may benefit from a switch to galantamine.
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Kwitt R, Vasconcelos N, Rasiwasia N, Uhl A, Davis B, Häfner M, Wrba F. Endoscopic image analysis in semantic space. Med Image Anal 2012; 16:1415-22. [PMID: 22717411 DOI: 10.1016/j.media.2012.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 04/20/2012] [Accepted: 04/29/2012] [Indexed: 11/20/2022]
Abstract
A novel approach to the design of a semantic, low-dimensional, encoding for endoscopic imagery is proposed. This encoding is based on recent advances in scene recognition, where semantic modeling of image content has gained considerable attention over the last decade. While the semantics of scenes are mainly comprised of environmental concepts such as vegetation, mountains or sky, the semantics of endoscopic imagery are medically relevant visual elements, such as polyps, special surface patterns, or vascular structures. The proposed semantic encoding differs from the representations commonly used in endoscopic image analysis (for medical decision support) in that it establishes a semantic space, where each coordinate axis has a clear human interpretation. It is also shown to establish a connection to Riemannian geometry, which enables principled solutions to a number of problems that arise in both physician training and clinical practice. This connection is exploited by leveraging results from information geometry to solve problems such as (1) recognition of important semantic concepts, (2) semantically-focused image browsing, and (3) estimation of the average-case semantic encoding for a collection of images that share a medically relevant visual detail. The approach can provide physicians with an easily interpretable, semantic encoding of visual content, upon which further decisions, or operations, can be naturally carried out. This is contrary to the prevalent practice in endoscopic image analysis for medical decision support, where image content is primarily captured by discriminative, high-dimensional, appearance features, which possess discriminative power but lack human interpretability.
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Taylor J, Morris M, Weinman J, Davis B, Andrews T, Hewlett S, Flurey C, Morris M, Pollock J, Hughes R, Richards P, Hewlett S, Collins S, Ryan S. Understanding the patient perspective: IP43. Being Diagnosed with an Inflammatory Arthritis: The Patients' Perspective. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hallemeier CL, Karnes RJ, Pisansky TM, Davis B, Gunderson LL, Leibovich BC, Haddock MG, Choo R. Multimodality therapy including surgical resection (SR) and intraoperative electron radiotherapy (IOERT) for locoregionally recurrent (LRR) or advanced primary malignancies of the urinary bladder (UB) or ureter. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
277 Background: For patients (pts) with LRR or advanced primary tumors of the UB or ureter, limited therapeutic options exist. Outcomes of combined SR and IOERT are reported here. Methods: From 1983 to 2009, a total of 17 pts with urothelial (16 pts) or squamous cell carcinoma (1 pt) of the UB (n=13) or ureter (n=4) were treated with SR and IOERT. Pts had LRR after radical cystoprostatectomy or nephroureterectomy (n=15) or advanced primary tumor (n=2). Extent of SR was R0 (microscopic negative margins), R1 (microscopic positive margins), and R2 (gross residual tumor) in 7, 1, and 9 pts, respectively. After maximal SR, IOERT was delivered to the tumor bed. Median IOERT dose and energy delivered were 12.5 Gy (range; 10-20) and 9 MeV (range; 6-18), respectively, with 1 (n=15), 2 (n=1), or 3 (n=1) IOERT fields. Sixteen pts also received perioperative external beam radiotherapy (EBRT) with a median dose of 50.4 Gy (range; 21.6- 60). Five pts received concurrent chemotherapy (CT) with perioperative EBRT. Overall (OS), disease-free survival (DFS) and relapse patterns were estimated from the date of SR and IOERT using the Kaplan-Meier method. Results: The median pt age was 63 years (yrs) (range; 51-76). The median follow-up of surviving pts was 3.6 yrs (range; 1.1-10.0). OS and DFS at 1, 2, and 5 yrs were 53%, 31%, and 16%, and 24%, 18%, and 18%, respectively. Central (within the IOERT field), locoregional (tumor bed or first echelon draining lymphatics), and distant relapse at 2 yrs were 15%, 49%, and 67%, respectively. Seven pts received systemic CT after relapse. Mortality within 30 days of SR and IOERT was 0%. Two pts (12%) experienced grade 4-5 (NCI-CTCAE v. 4) toxicity potentially related to the multimodality therapy. Conclusions: For pts with LRR or advanced primary tumor of the UB or ureter, this multimodality therapy including SR and IOERT resulted in durable OS and DFS in a small but significant number of pts. Both LRR and distant relapse were common, indicating a need for more effective systemic therapy along with more refined locoregional therapy. No significant financial relationships to disclose.
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Smith K, Bazile-Harrison D, Davis B, Akoda JC, Martin S, Hall D. Hysterosalpingogram Confirmation of Total Tubal Occlusion 42-56 Days Status Post Hysteroscopic Sterilization Via Essure. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.577] [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]
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Horsfield CJ, Rubery MS, Mack JM, Young CS, Herrmann HW, Caldwell SE, Evans SC, Sedilleo TJ, Kim YH, McEvoy A, Milnes JS, Howorth J, Davis B, O'Gara PM, Garza I, Miller EK, Stoeffl W, Ali Z. Development and characterization of sub-100 ps photomultiplier tubes. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2010; 81:10D318. [PMID: 21033844 DOI: 10.1063/1.3475718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We describe the evaluation of a microchannel plate (MCP) photomultiplier tube (PMT), incorporating a 3 μm pore MCP and constant voltage anode and cathode gaps. The use of the small pore size results in PMTs with response functions of the order of 85 ps full-width-half-maximum, while the constant electric field across the anode and cathode gaps produces a uniform response function over the entire operating range of the device. The PMT was characterized on a number of facilities and employed on gas Cherenkov detectors fielded on various deuterium tritium fuel (DT) implosions on the Omega Laser Facility at the University of Rochester. The Cherenkov detectors are part of diagnostic development to measure Gamma ray reaction history for DT implosions on the National Ignition Facility.
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Stransky K, Farley H, Sweeney T, Davis B, Reed J, Mullenix S. 260: Effect of Emergency Department Crowding on Generation of Cases for Performance Improvement Review. Ann Emerg Med 2010. [DOI: 10.1016/j.annemergmed.2010.06.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kronstrom M, Davis B. Immediate Functional Loading of 1 or 2 Dental Implants Supporting a Ball Retained Mandibular Overdenture: Interim Results of a Randomized Prospective Study. J Oral Maxillofac Surg 2010. [DOI: 10.1016/j.joms.2010.06.022] [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]
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85
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Coletti C, Reese C, Reed J, Davis B, Nomura J. 395: Physician Productivity After a Patient Overflow Management Intervention. Ann Emerg Med 2010. [DOI: 10.1016/j.annemergmed.2010.06.451] [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]
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Over K, Hettiarachchy N, Perumalla A, Johnson M, Meullenet JF, Dickson J, Holtzbauer M, Niebuhr S, Davis B. Antilisterial Activity and Consumer Acceptance of Irradiated Chicken Breast Meat Vacuum-Infused with Grape Seed and Green Tea Extracts and Tartaric Acid. J Food Sci 2010; 75:M455-61. [DOI: 10.1111/j.1750-3841.2010.01727.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Birch GF, Cruickshank B, Davis B. Modelling nutrient loads to Sydney estuary (Australia). ENVIRONMENTAL MONITORING AND ASSESSMENT 2010; 167:333-348. [PMID: 19568942 DOI: 10.1007/s10661-009-1053-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Accepted: 06/11/2009] [Indexed: 05/28/2023]
Abstract
Sydney estuary (Australia) catchment is substantially urbanised (80%) and small (480 km2) with a large population (2.5 million) and is therefore highly sensitive to anthropogenic influence. The Model for Urban Stormwater Improvement Conceptualisation used to model nutrient export to the estuary determined an average annual load of 475 t total nitrogen, 63.5 t total phosphorus and 343,000 t total suspended solids. Model verification included intense, short-term water sampling and analysis undertaken in the current project and use of published data spanning 10 years. Under high-rainfall conditions (>50 mm day(-1)), the estuary becomes stratified and nutrients are either removed from the estuary directly in a plume or indirectly by advective/dispersive remobilisation. The majority of the nutrient load is delivered during moderate rainfall (5-50 mm day(-1)) conditions and accumulates close to discharge points and remains in the estuary. To significantly reduce nutrient load, management strategies should aim to minimise low and moderate rainfall pollutant loads.
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Budd H, Wimhurst J, Davis B, Hutchinson R. Irreducible posterior subtalar dislocation with incarceration of a fracture of the anterior process of the calcaneum. ACTA ACUST UNITED AC 2010; 92:1025-7. [DOI: 10.1302/0301-620x.92b7.23397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Subtalar dislocation is a significant injury characterised by late complications, including subtalar arthritis. We describe a rare case of irreducible posterior subtalar dislocation due to incarceration of a fracture of the anterior process of the calcaneum in the subtalar joint, and discuss appropriate management.
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Karakostas T, Davis B, Maclagan M, Hsiang S. 170 WALKING AND CONVERSING: GAIT AND SPEECH ADAPTATIONS TO PERTURBING DIRECT QUESTIONS IN DEMENTIA. Parkinsonism Relat Disord 2010. [DOI: 10.1016/s1353-8020(10)70171-1] [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: 11/27/2022]
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Weiselberg L, Gralla R, Horigan J, Davis B, Hollen P, Petersen J, Burg K, Belland A. Determining Issues of Importance for Patients with Breast Cancer: Results of a Web-Based Study in 1072 Patients To Enhance the Content Validity for the Development of a New Health-Related Quality of Life (Ql) Instrument, the Breast Cancer Symptom Scale (BCSS). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-5048] [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
Abstract
Background:Identifying key issues for patients with malignancy is central to assessing QL and patient reported outcomes during all points of the illness trajectory. The involvement of patients in establishing content validity is crucial for instrument development. The conceptual model for the BCSS focuses on areas of importance for patients (Hollen, Supp Care Ca 1994).Methods:We used the established patient base of the web-based NexCura information resource to survey registered patients with breast cancer. Demographic stratifications included disease stage, age, menopausal status, time since diagnosis, prior/current treatment with surgery, RT, chemotherapy, hormonal, targeted, and CAM approaches. 1072 patients (median age 53, 65% stage I, 43% > 2 years since diagnosis) completed the anonymous web-conducted survey. Patients ranked 21 issues on a 5-point scale, assessing the importance of each item. Issues included general, physical, functional, psychosocial and summative items.Results:The 9 highest ranked items are seen below. Results are described by the percent of patients choosing the top category (very important) and the top 2 importance categories. The five lowest ranked items dealt with appetite, breast-specific issues, hot flashes and sexuality. Ratings by breast cancer subsets (newly diagnosed, on treatment, NED, hormonal or non-hormonal treatment, metastatic disease, survivors) showed some differences compared with the whole group.[table1]N=1072Very ImportantVery Important +ImportantGood QL82%99%Maintaning independence75%97%Able to sleep69%97%Able to concentrate65%97%Perfrom normal activities62%97%Being fatigued61%95%Having depression51%85%Being anxious47%85%Having pain46%80% Conclusions:These results represent one of the largest surveys of concerns expressed by patients with breast cancer and support using computer-assisted technology to assess such information for rapid input of large patient samples. This study gives strong support for content validity for the BCSS and provides data on which to base separate QL instruments for specific breast cancer settings.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5048.
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Over K, Hettiarachchy N, Johnson M, Davis B. Effect of Organic Acids and Plant Extracts on Escherichia coli O157:H7, Listeria monocytogenes, and Salmonella Typhimurium in Broth Culture Model and Chicken Meat Systems. J Food Sci 2009; 74:M515-21. [DOI: 10.1111/j.1750-3841.2009.01375.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wilson T, Davis B, Wiseman G, Federspiel M, Tindall D, Morris J. UP-2.169: A Phase I Clinical Trial of In Situ Gene Therapy with Radioiodine for Locally Recurrent Prostate Cancer Following External Beam Radiotherapy. Urology 2009. [DOI: 10.1016/j.urology.2009.07.388] [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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Ham RO, Thornberry DJ, Regan JF, Butler CM, Lafferty K, Davis B, Roberts VC, Cotton LT. Rehabilitation of the vascular amputee-one method evaluated. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/09593988509163838] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fromm R, Meyer D, Zimmerman J, Boudreaux A, Wun CC, Smalling R, Davis B, Habib G, Roberts R. A double-blind, multicentered study comparing the accuracy of diagnostic markers to predict short- and long-term clinical events and their utility in patients presenting with chest pain. Clin Cardiol 2009; 24:516-20. [PMID: 11444643 PMCID: PMC6654932 DOI: 10.1002/clc.4960240708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Millions of patients present annually with chest pain, but only 10% have myocardial infarction (MI). We recently reported comparative sensitivity and specificity of available markers in the diagnosis of MI; however, optimum interpretation of marker results requires prognostic follow-up data. HYPOTHESIS The study was undertaken to study the accuracy of CK-MB subforms, troponin I and T, myoglobin, and CK-MB in predicting clinical events at 30 days and 6 months. METHODS In all, 955 consecutive patients with chest pain were enrolled in a prospective, multicenter, double-blind study to test the prognostic accuracy of these markers. RESULTS Myocardial infarction was diagnosed in 119 by CK-MB mass criteria and unstable angina (UA) in 203 patients by clinical criteria. Follow-up at 30 days and 6 months was available in 824 and 724 patients, respectively, with mortalities of 2.8 and 4.14%, respectively. Cumulative 6-month mortality was 5.6% in MI, 4.4% in UA, and 3.0% in others. Revascularization was reported in 9.3% of patients by 6 months. A positive test on each of the markers except myoglobin was predictive of revascularization. The composite endpoint of death or revascularization occurred in 107 patients by 6 months and a positive result on each of the markers was predictive of this composite endpoint (p < 0.05). The relative risk of death or revascularization for patients who did not have MI but tested positive on each of the markers was > 1.0 but did not reach statistical significance. CONCLUSIONS With the possible exception of myoglobin, each of the diagnostic markers displayed similar prognostic performance in patients with chest pain presenting to emergency departments. The most appropriate markers to triage patients with chest pain, which has both adequate early diagnostic sensitivity and prognostic accuracy, are the CK-MB subforms.
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Radford S, Carr M, Hehir M, Davis B, Robertson L, Cockshott Z, Tipler S, Hewlett S. 'It's quite hard to grasp the enormity of it': perceived needs of people upon diagnosis of rheumatoid arthritis. Musculoskeletal Care 2008; 6:155-167. [PMID: 18649347 DOI: 10.1002/msc.132] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES The diagnosis of rheumatoid arthritis (RA) brings rapid pharmacological and multidisciplinary team interventions to address inflammatory processes and symptom management. However, people may also need support on the journey to self-management. The aim of this study was to explore what professional support patients feel they receive upon diagnosis, and what support they feel would be most helpful. METHODS Two focus groups comprised patients with at least five years'; disease duration (n = 7), and patients more recently diagnosed (5-18 months, n = 5). The latter had attended at least two appointments in a rheumatology nurse specialist clinic during the previous year, aimed at providing support upon diagnosis. Transcripts were subjected to thematic analysis to identify common issues regarding support needs, which were then grouped into themes. Interviewing and analysis was performed by researchers not involved in clinical care. RESULTS Four overarching themes emerged. 'Information' was needed about the symptoms of RA, its management and personal outcome, while 'Support' related to emotional needs ('It's quite hard to grasp the enormity of it'). Information and Support overlapped, in that patients wanted someone to talk to, and to be listened to. These two themes were underpinned by issues of service delivery: 'Choice' (patient or professional to talk to, groups, one-to-one) and 'Involvement' (holistic care, partnership), which overlapped in terms of the opportunity to decide when and which interventions to access. CONCLUSIONS People with RA report not only informational, but also emotional support needs at diagnosis. The potential for delivering emotional support to patients around the time of diagnosis warrants further exploration.
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Duong M, Cockcroft D, Boulet LP, Ahmed T, Iverson H, Atkinson DC, Stahl EG, Watson R, Davis B, Milot J, Gauvreau GM, O'Byrne PM. The effect of IVX-0142, a heparin-derived hypersulfated disaccharide, on the allergic airway responses in asthma. Allergy 2008; 63:1195-201. [PMID: 18699936 DOI: 10.1111/j.1398-9995.2008.01707.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND IVX-0142 is a heparin-derived hypersulfated disaccharide devoid of anticoagulant activity while possessing anti-allergic and anti-inflammatory activity in preclinical studies. In a proof-of-concept study, the allergen inhalation challenge model was used to investigate the effect of IVX-0142 in mild atopic asthma. METHODS Nineteen subjects, not on controller medications, were randomized to an evaluator-blind, placebo-controlled, cross-over study. The effect of a single nebulized dose of IVX-0142 (80 mg) or placebo administered 30 min prior to allergen inhalation was evaluated on the allergic airway responses, airway responsiveness, and airway inflammation. RESULTS When compared with placebo, 14 and 13 subjects experienced a relatively smaller maximum fall in forced expiratory volume in 1 s (maxFEV(1)%) for the early airway response (EAR) and late airway response (LAR) with IVX-0142, respectively (P < 0.01). The degree of attenuation in the EAR [maxFEV(1)% (mean +/- SE) 26.5 +/- 2.8%vs placebo 31.0 +/- 2.8%, P = 0.059] and LAR (15.6 +/- 2.9%vs placebo 19.0 +/- 2.9%, P = 0.24) with IVX-0142, however, was small and did not reach statistical significance compared with placebo. Similarly, a trend in the attenuation of allergen-induced increase in the absolute sputum cell counts was also observed. No difference in the allergen-induced increase in airway hyper-responsiveness and exhaled nitric oxide was noticed. CONCLUSIONS The majority of mild atopic asthmatics demonstrated a reduction in the EAR and LAR to IVX-0142. However, the treatment effect observed with a single prechallenge dose of IVX-0142 was small and heterogeneous. The potential anti-allergic and anti-inflammatory effects using multiple higher doses need to be evaluated.
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Budiharto T, Musat E, Poortmans P, Hurkmans C, Monti A, Bar-Deroma R, Bernstein Z, Tienhoven GV, Collette L, Duclos F, Davis B, Aird E. Profile of European radiotherapy departments contributing to the EORTC Radiation Oncology Group (ROG) in the 21st century. Radiother Oncol 2008; 88:403-10. [PMID: 18538427 DOI: 10.1016/j.radonc.2008.05.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Accepted: 05/13/2008] [Indexed: 11/26/2022]
Abstract
PURPOSE Since 1982, the Radiation Oncology Group of the EORTC (EORTC ROG) has pursued an extensive Quality Assurance (QA) program involving all centres actively participating in its clinical research. The first step is the evaluation of the structure and of the human, technical and organisational resources of the centres, to assess their ability to comply with the current requirements for high-tech radiotherapy (RT). MATERIALS AND METHODS A facility questionnaire (FQ) was developed in 1989 and adapted over the years to match the evolution of RT techniques. We report on the contents of the current FQ that was completed online by 98 active EORTC ROG member institutions from 19 countries, between December 2005 and October 2007. RESULTS Similar to the data collected previously, large variations in equipment, staffing and workload between centres remain. Currently only 15 centres still use a Cobalt unit. All centres perform 3D Conformal RT, 79% of them can perform IMRT and 54% are able to deliver stereotactic RT. An external reference dosimetry audit (ERDA) was performed in 88% of the centres for photons and in 73% for electrons, but it was recent (<2 years) in only 74% and 60%, respectively. CONCLUSION The use of the FQ helps maintain the minimum quality requirements within the EORTC ROG network: recommendations are made on the basis of the analysis of its results. The present analysis shows that modern RT techniques are widely implemented in the clinic but also that ERDA should be performed more frequently. Repeated assessment using the FQ is warranted to document the future evolution of the EORTC ROG institutions.
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Hehir M, Carr M, Davis B, Radford S, Robertson L, Tipler S, Hewlett S. Nursing support at the onset of rheumatoid arthritis: Time and space for emotions, practicalities and self-management. Musculoskeletal Care 2008; 6:124-134. [PMID: 17922490 DOI: 10.1002/msc.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Following a diagnosis of rheumatoid arthritis (RA), patients have to adapt to lifelong, unpredictable but repeated episodes of pain and disability, potentially leading to permanent loss of function and its consequences on their lives. We established nurse clinics with the aim of supporting newly diagnosed RA patients in adapting to and managing their long-term condition. The aim of this study was to explore the content of clinic discussions in this new clinical service, in order to ascertain patients' needs upon diagnosis. METHODS All clinic letters from the nurse to the family doctor were analysed. Every topic mentioned was systematically coded independently by a researcher and a patient research partner, who compared and agreed codes. Codes were organized into categories, and, finally, into overarching themes. RESULTS Twenty-four patients had 74 appointment letters. A total of 79 codes were identified, from which ten categories emerged, and, finally, three overarching themes. The first theme related to 'Emotional support', which underpinned the other two themes and was discussed in almost all appointments. Issues included discussions about the emotional consequences of RA, needing time to adjust, frustration and fears for the future. The second theme 'Practicalities of the treatment of RA', included subordinate themes relating to the nature of RA, such as identity, cause, timeline, consequences and treatment. Medication issues were discussed and referrals to the multidisciplinary team were made. The final theme related to the 'Self-management of RA', and included discussions on physical symptoms and their management. CONCLUSIONS The offer to attend a nurse clinic soon after diagnosis allowed RA patients to discuss a wide range of practical and self-management issues. However, most patients also took the opportunity and time to discuss emotional reactions and adaptations to diagnosis. The data suggest an unmet need for emotional support that a nurse clinic might be able to provide.
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Nadel JA, Davis B. Regulation of Na+ and Cl- transport and mucous gland secretion in airway epithelium. CIBA FOUNDATION SYMPOSIUM 2008:133-47. [PMID: 248008 DOI: 10.1002/9780470720356.ch7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Ussing's short-circuit technique was applied to canine airway epithelium in vitrol and a net flux of Cl- towards the airway lumen was demonstrated, with a smaller net flux of Na+ in the opposite direction. Furosemide decreased and acetylcholine, terbutaline, and histamine increased net ion transport towards the airway lumen. Associated changes in water content in the airway lumen could affect mucociliary clearance, and therefore inhibition of ion transport may play a role in disease states. To study secretions from submucosal glands in vivo, two techniques were used to identify the duct openings in the exposed canine tracheal epithelium. (a) The exposed mucosal surface was coated with powdered tantalum; accumulated secretions produced elevations under which the duct openings were located. (b) A vital dye (0.1% Neutral red) was placed on the exposed mucosal surface; the dye stained the duct openings. With these techniques, the innervation of the submucosal glands and the autonomic regulation of their secretions were studied. Micropuncture techniques were used to sample the secretions from the glands and ducts.
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Davis B, Toivio-Kinnucan M, Schuller S, Boudreaux M. Mutation inβ1-TubulinCorrelates with Macrothrombocytopenia in Cavalier King Charles Spaniels. J Vet Intern Med 2008; 22:540-5. [DOI: 10.1111/j.1939-1676.2008.0085.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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