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Wan W, Hawkins C, Hemingway J, Hughes D, Duszak R. Enteral access: evolving roles of radiologists and other providers nationally over two decades. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.463] [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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Kroll H, Duszak R, Hemingway J, Hughes D, Wintermark M. Same-Day Sinus and Brain CT Imaging in the Medicare Population: Are Practice Patterns Changing in Association with Medicare Policy Initiatives? AJNR Am J Neuroradiol 2016; 37:1000-4. [PMID: 26822731 DOI: 10.3174/ajnr.a4670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/24/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Monitoring the frequency of same-day sinus and brain CT (Outpatient Measure 14, "OP-14") is part of a recent large Centers for Medicare and Medicaid Services hospital outpatient quality initiative to improve imaging efficiency. This study investigates patient-level claims data in the Medicare population focusing on where same-day sinus and brain CT imaging is performed and how the frequency of same-day studies changed with time before and during OP-14 measure program implementation. MATERIALS AND METHODS Research Identifiable Files were used to identify all sinus and brain CT examinations from 2004 through 2012 for a 5% random patient sample of Medicare fee-for-service beneficiaries. Overall and site of service use rates were calculated for same- and non-same-day examinations. Changes were mapped to policy initiative timetables. RESULTS The number of same-day sinus and brain CT studies from 2004 to 2012 increased 67% from 1.85 (95% CI, 1.78-1.91) per 1000 Medicare beneficiaries in 2004 to 3.08 (95% CI, 3.00-3.15) in 2012. The biggest driver of increased same-day studies was the emergency department setting, from 0.56 (95% CI, 0.53-0.60) per 1000 to 1.78 (95% CI, 1.72-1.84; +215.7%). Overall use of brain CT from 146.0 (95% CI, 145.1-146.9) per 1000 to 176.3 (95% CI, 175.4-177.2; +21%) and sinus CT from 12.6 (95% CI, 12.4-12.8) per 1000 to 15.4 (95% CI, 15.2-15.6; +22%) increased until 2009 and remained stable through 2012. CONCLUSIONS Previously increasing same-day sinus and brain CT in Medicare beneficiaries plateaued in 2009, coinciding with the implementation of targeted measures by the Centers for Medicare and Medicaid Services. Same-day imaging continues to increase in the emergency department setting.
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Griffiths P, Heaton J, Claxton S, Hughes D. P290 Do lung function indices correlate with risk of pneumothorax following CT-guided biopsy? Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.426] [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]
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Schoser B, Byrne B, Eyskens F, Hiwot T, Hughes D, Kissel J, Mengel E, Mozaffar T, Pestronk A, Roberts M, Sivakumar K, Statland J, Young P, Heusner C, Dummer W. An international, phase 3, switchover study of reveglucosidase alfa (BMN 701) in subjects with late-onset Pompe disease. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hughes D, Salim TS, Hennessy B, Collison D, Giblan G, McClelland S, Fitzpatrick N, Hussain H, McAdam BF. 11 Investigating the effectiveness of 1, 3 and 5 day holter monitoring: should it be limited to 24 h. BRITISH HEART JOURNAL 2015. [DOI: 10.1136/heartjnl-2015-308621.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brodie KE, Lane VA, Lee TWJ, Roberts JP, Raghavan A, Hughes D, Godbole PP. Outcomes following 'mini' percutaneous nephrolithotomy for renal calculi in children. A single-centre study. J Pediatr Urol 2015; 11:120.e1-5. [PMID: 26048706 DOI: 10.1016/j.jpurol.2014.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/20/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This retrospective review was undertaken to identify the postoperative outcomes of children undergoing 'mini' percutaneous nephrolithotomy (MPCNL) at a single institution. OBJECTIVE Outcomes measured included: percentage of stone clearance, postoperative analgesia requirements, the need for intraoperative or postoperative blood transfusion, length of stay and morbidity. STUDY DESIGN A total of 46 patients were reviewed over a two-and-a-half-year period; the mean age was 7.3 years (range: 1-16 years). The MPCNL was performed with a radiological-guided peripheral puncture, followed by dilatation of the nephrostomy tract to a maximum Amplatz sheath size of 16-French; an 11-French nephroscope was used. Stone disintegration was achieved either with pneumatic or laser lithotripsy. RESULTS Complete stone clearance was achieved in 35/46 children (76%). The remaining 11 children had a stone clearance rate of over 80%. No patients required intraoperative/postoperative blood transfusion. A total of 39% of patients were managed on simple/non-opiate based analgesia, with 54% requiring opioid analgesia postoperatively for less than 24 h. There were no procedure-related complications and no mortalities. The mean length of stay was 2.24 days. DISCUSSION The management of urolithiasis can be challenging in children. The use of percutaneous nephrolithotomy, is becoming increasingly popular in the treatment of paediatric urolithiasis. The stone clearance rate in children undergoing standard PCNL, has been reported to be 50-98% in the literature [1,2,3,4]. Samad et al. [2] in 2006, reported their experience in 188 consecutive PCNLs, using a 17Fr or 26Fr nephroscope. Their largest sub group included children aged >5-16 yrs. Within this group, 57% were treated with a 17Fr nephroscope and 43% with the 26Fr nephroscope, achieving stone clearance of only 47% with PCNL monotherapy. In this group the transfusion rate was 3% [2]. Badawy et al., reported their experience of 60 children in 1999, using a 26 or 28Fr Amplatz sheath. They reported an 83.3% stone clearance with single session PCNL, with only one procedure being abandoned due to intraoperative bleeding requiring blood transfusion [3]. In 2007, Bilen et al. reported their experience and compared the use of 26Fr, 20Fr and 14Fr (mini) PCNL. Stone size, previous surgery and the mean haemoglobin drop postoperatively did not change between the groups, however the blood transfusion rate was higher in the 26Fr and 20Fr Amplatz sheath groups. The stone clearance was highest in the 'mini PCNL' group at 90%, compared to 69.5% in the 26Fr and 80% in the 20Fr group [4]. MPCNL has become increasingly popular over recent years, with stone clearance reported as 80-85% [5-7] following a single session of MPCNL as monotherapy. In 2012, Yan et al. reported 85.2% stone clearance with mini PCNL monotherapy (tract size 14-16Fr), with no children requiring blood transfusion [6]. Zeng et al. reported their experience of 331 renal units in children, with stone clearance rates reaching 80.4% and a blood transfusion rate of 3.1% [8]. In our centre, we do not perform postoperative haemoglobin levels as a matter of routine and any investigations are performed on an intention to treat principle. Bilen et al. reported no blood transfusions being required in their cohort of patients undergoing MPCNL [4] and this is supported by Yan et al. [6]. CONCLUSION Mini PCNL is an effective and safe procedure for the treatment of paediatric renal stones. In the present series, all children achieved greater than 80% stone clearance, none received a blood transfusion (intra/postoperatively) and there were no mortalities. Postoperative pain was managed with simple analgesia in 39%; however, the majority required opiate analgesia for less than 24 hours.
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Giraldo P, Zimran A, Mehta A, Hughes D, Hangartnerd T, Wang N, Crombez E, Elstein D. Tolérance et efficacité d’un traitement à long terme par vélaglucérase alfa chez des adultes atteints de la maladie de gaucher de type 1 et naïfs de traitement : résultats issus des études de phase III. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.084] [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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Beck M, Kampmann C, Hughes D, Mehta A, Ramaswami U, Pintos-Morell G, Wijatyk A, Giugliani R. Efficacité à long terme de l’agalsidase alfa dans la maladie de Fabry : analyses issues des données du registre FOS (Fabry Outcome Survey). Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.080] [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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Sarkar U, Tannenbaum S, Carrier R, Chen K, Cirit M, Griffith L, Hughes D, Large E, Wishnok J, Yu J. Assessment of Drug Clearance, Metabolite Profile, and Drug Induced Toxicity in a Coculture of Human 3D Liver and Gut Microphysiological Systems: : Toward developing a perfused human liver‐gut interactome. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.779.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dalley C, Basarir H, Wright JG, Fernando M, Pearson D, Ward SE, Thokula P, Krishnankutty A, Wilson G, Dalton A, Talley P, Barnett D, Hughes D, Porter NR, Reilly JT, Snowden JA. Specialist integrated haematological malignancy diagnostic services: an Activity Based Cost (ABC) analysis of a networked laboratory service model. J Clin Pathol 2015; 68:292-300. [PMID: 25631214 DOI: 10.1136/jclinpath-2014-202624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS) were introduced as a standard of care within the UK National Health Service to reduce diagnostic error and improve clinical outcomes. Two broad models of service delivery have become established: 'co-located' services operating from a single-site and 'networked' services, with geographically separated laboratories linked by common management and information systems. Detailed systematic cost analysis has never been published on any established SIHMDS model. METHODS We used Activity Based Costing (ABC) to construct a cost model for our regional 'networked' SIHMDS covering a two-million population based on activity in 2011. RESULTS Overall estimated annual running costs were £1 056 260 per annum (£733 400 excluding consultant costs), with individual running costs for diagnosis, staging, disease monitoring and end of treatment assessment components of £723 138, £55 302, £184 152 and £94 134 per annum, respectively. The cost distribution by department was 28.5% for haematology, 29.5% for histopathology and 42% for genetics laboratories. Costs of the diagnostic pathways varied considerably; pathways for myelodysplastic syndromes and lymphoma were the most expensive and the pathways for essential thrombocythaemia and polycythaemia vera being the least. CONCLUSIONS ABC analysis enables estimation of running costs of a SIHMDS model comprised of 'networked' laboratories. Similar cost analyses for other SIHMDS models covering varying populations are warranted to optimise quality and cost-effectiveness in delivery of modern haemato-oncology diagnostic services in the UK as well as internationally.
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Hughes D, Domaschenz R, Vlahovich N, Byrne N, Gray B, Singh MF, Brown M, Tajouri L. Steering specific sports training programs – The genetics of exercise-induced injuries involving tendon and bone. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Drew M, Wallis M, Hughes D. The AIS consensus statement on the definition of injury and illness. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.197] [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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Hughes D, Jeanneret M, Johansson F, Sherring K, Restrick L. P283 Chronic Obstructive Pulmonary Disease (copd) Case-finding And Tobacco Dependence On Long Stay Psychiatric Wards. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.401] [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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Karlsberg SS, Sussex J, Hughes D, Devlin N. Opportunity Costs of Implementing Nice Decisions in NHS Wales. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2014; 17:A422. [PMID: 27201077 DOI: 10.1016/j.jval.2014.08.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Barber W, Scriven P, Turner D, Hughes D, Wyld D. Epithelioid angiosarcoma: Use of angiographic embolisation and radiotherapy to control recurrent haemorrhage. J Surg Case Rep 2014; 2010:7. [PMID: 24946325 PMCID: PMC3649120 DOI: 10.1093/jscr/2010.5.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Epithelioid angiosarcoma is a rare, highly malignant tumour with a poor prognosis. We present the case of a 75 year old man who underwent an incision biopsy to diagnose the soft tissue tumour and suffered from surgically uncontrollable haemorrhage. The case report demonstrates the value of interventional radiology for acute bleeding and radiotherapy for more chronic tumour bleeding.
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Metcalfe HJ, Lea S, Hughes D, Khalaf R, Abbott-Banner K, Singh D. Effects of cigarette smoke on Toll-like receptor (TLR) activation of chronic obstructive pulmonary disease (COPD) macrophages. Clin Exp Immunol 2014; 176:461-72. [PMID: 24528166 DOI: 10.1111/cei.12289] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2014] [Indexed: 01/08/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by an abnormal innate immune response. We have investigated the changes in the innate immune response of COPD alveolar macrophages exposed to both cigarette smoke and Toll-like receptor (TLR) stimulation. COPD and control alveolar macrophages were exposed to cigarette smoke extract (CSE) followed by TLR-2, -4 and -5 ligands [Pam3CSK4, lipopolysaccharide (LPS) and phase I flagellin (FliC), respectively] or non-typeable Haemophilus influenzae (NTHi). CSE exposure suppressed TLR-induced tumour necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 and regulated on activation, normal T cell expressed and secreted (RANTES) production in both COPD and control alveolar macrophages, but had no effect on interleukin 8 (CXCL8) production. Similarly, CSE suppressed NTHi-induced TNF-α but not NTHi-induced CXCL8 production in COPD alveolar macrophages. Gene expression analysis showed that CSE suppressed LPS-induced TNF-α transcription but not CXCL8 transcription in COPD alveolar macrophages. The dampening effect of CSE on LPS-induced cytokine production was associated with a reduction in p38, extracellular signal regulated kinase (ERK) and p65 activation. In conclusion, CSE caused a reduced innate immune response in COPD alveolar macrophages, with the exception of persistent CXCL8 production. This could be a mechanism by which alveolar macrophages promote neutrophil chemotaxis under conditions of oxidative stress and bacterial exposure.
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Kunheri B, Arjunan A, Krishnan P, Pillai B, Prasad S, Bernier-Chastagner V, Desandes E, Carrie C, Alapetite C, Hankinson T, Jones D, Handler M, Foreman N, Liu A, Smiley NP, Alden T, Hartsell W, Fangusaro J, Hill-Kayser CE, Lustig RA, Minturn JE, Both S, Waanders AJ, Belasco JB, Armstrong C, Phillips PC, Fisher MJ, Hill-Kayser CE, Paltin I, Lustig RA, Fisher MJ, Both S, Belasco JB, Cole KA, Waanders AJ, Phillips PC, Minturn JE, Wells E, Vezina G, Kilburn L, Rood B, Crozier F, Hwang E, Packer R, Janssens GO, van den Bosch S, van Kollenburg PG, Gidding CE, Schieving JH, Kaanders JH, van Lindert EJ, Kramer K, Pandit-Taskar N, Souweidane MM, Wolden S, DeSelm C, Cheung NKV, Lassen-Ramshad Y, Hansen J, Seiersen K, Petersen JBB, Mahajan A, Grosshans D, Ris D, Chintagumpala M, Okcu F, McAleer MF, Moore B, Stancel H, Minard C, Guffey D, Kahalley L, Blomgren K, Zhou K, Xie C, Zhu C, McAleer MF, Zhao Z, Weinberg J, Sandberg D, Hughes D, Mahajan A, Anderson P, Guha-Thakurta N, Muller K, Hoffmann M, Seidel C, Warmuth-Metz M, Pietsch T, Kordes U, Sander A, Rossler J, Graf N, Scheithauer H, Kortmann RD, Kramm CM, von Bueren AO, Gunther J, Sato M, Chintagumpala M, Jo E, Paulino A, Adesina A, Ketonen L, Jones J, Su J, Okcu F, Khatua S, Dauser R, Whitehead W, Weinberg J, Mahajan A, Gandola L, Pecori E, Biassoni V, Chiruzzi C, Schiavello E, Meroni S, Spreafico F, Pignoli E, Massimino M, Jalali R, Krishna U, Gupta T, Goswami S, Deodhar J, Dutta D, Kannan S, Goel A, Sarin R, Sastry J, Ronghe M, Murphy D, Forbes K, Jones R, Cowie F, Brown J, Indelicato D, Goksel EO, Tezcanli E, Bilge H, Yasemin, Yarar Y, Sato M, Gunther J, Mahajan A, Jo E, Paulino A, Adesina A, Jones J, Ketonen L, Su J, Okcu M, Khatua S, Dauser R, Whitehead W, Weinberg J, Chintagumpala M, Paulino A, Jo E, Sato M, Su J, Okcu MF, Mahajan A, Dauser R, Whitehead W, Adesina A, Chintagumpala M, Danielsson A, Tisell M, Rydenhag B, Caren H. RADIATION ONCOLOGY. Neuro Oncol 2014; 16:i117-i122. [PMCID: PMC4046296 DOI: 10.1093/neuonc/nou080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
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Horsley A, Marshall H, Smith L, Hughes D, Horn F, Armstrong L, Parra-Nobles J, Cunningham S, Aldag I, Wild J, Taylor C. WS13.5 Visualising ventilation heterogeneity in mild CF using hyperpolarised 3He MRI, and comparison with lung clearance index (LCI). J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60086-2] [Citation(s) in RCA: 2] [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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Munch F, Retel J, Jeuthe S, van Rossum B, Oh-Ici D, Berger F, Kuhne T, Oschkinat H, Messroghli D, Rodriguez Palomares J, Gutierrez Garcia Moreno L, Maldonado G, Garcia G, Otaegui I, Garcia Del Blanco B, Barrabes J, Gonzalez Alujas M, Evangelista A, Garcia Dorado D, Barison A, Del Torto A, Chiappino S, Del Franco A, Pugliese N, Aquaro G, Positano V, Passino C, Emdin M, Masci P, Fischer K, Guensch D, Shie N, Friedrich M, Captur G, Zemrak F, Muthurangu V, Chunming L, Petersen S, Kawel-Boehm N, Bassett P, Elliott P, Lima J, Bluemke D, Moon J, Pontone G, Bertella E, Loguercio M, Baggiano A, Mushtaq S, Aquaro G, Salerni S, Rossi C, Andreini D, Masci P, Ucar E, Baydes R, Ngah N, Kuo Y, Dabir D, Cummins C, Higgins D, Schaeffter T, Gaddum N, Chowienczyk P, Carr-White G, Marber M, Ucar S, Baydes R, Ngah N, Kuo Y, Dabir D, Cummins C, Higgins D, Schaeffter T, Gaddum N, Chowienczyk P, Carr-White G, Marber M, Reinstadler S, Klug G, Feistritzer H, Greber K, Mair J, Schocke M, Franz W, Metzler B, Moschetti K, Petersen S, Pilz G, Wasserfallen J, Lombardi M, Korosoglou G, Van Rossum A, Bruder O, Mahrholdt H, Schwitter J, Rodriguez Palomares J, Garcia Del Blanco B, Ferreira Gonzalez I, Otaegui I, Pineda V, Ruiz Salmeron R, San Roman A, Evangelista A, Fernandez Aviles F, Garcia Dorado D, Winkler S, Allison T, Conn H, Bandettini P, Shanbhag S, Kellman P, Hsu L, Arai A, Klug G, Reinstadler S, Feistritzer H, Pernter B, Mair J, Schocke M, Franz W, Metzler B, Pica S, Sado D, Maestrini V, Fontana M, White S, Treibel T, Anderson S, Piechnik S, Robson M, Lachmann R, Murphy E, Mehta A, Hughes D, Elliott P, Moon J, Ferreira V, Dall'Armellina E, Piechnik S, Karamitsos T, Francis J, Choudhury R, Banning A, Channon K, Kharbanda R, Forfar C, Ormerod O, Prendergast B, Kardos A, Newton J, Friedrich M, Robson M, Neubauer S, Barison A, Del Franco A, Vergaro G, Mirizzi G, Del Torto A, Chiappino S, Masci P, Passino C, Emdin M, Aquaro G, Florian A, Ludwig A, Rosch S, Sechtem U, Yilmaz A, Greulich S, Kitterer D, Latus J, Bentz K, Birkmeier S, Alscher M, Sechtem U, Braun N, Mahrholdt H, Barison A, Pugliese N, Masci P, Del Franco A, Vergaro G, Del Torto A, Passino C, Perfetto F, Emdin M, Aquaro G, Secchi F, Petrini M, Cannao P, Di Leo G, Sardanelli F, Lombardi M, Yoshihara H, Bastiaansen J, Berthonneche C, Comment A, Schwitter J, Gerber B, Noppe G, Marquet N, Buchlin P, Vanoverschelde J, Bertrand L, Horman S, Dorota P, Piotr W, Marek G, Almeida A, Cortez-Dias N, de Sousa J, Carpinteiro L, Magalhaes A, Silva G, Bernardes A, Pinto F, Nunes Diogo A. These abstracts have been selected for presentation in 4 sessions throughout the meeting. Please refer to the PROGRAM for more details. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu083] [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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Molugu C, Fisher G, Hirons B, Hughes D, Raftery S. P151 V-DimERS Study - Value of D-Dimers in Estimating Risk of Significant Pulmonary Embolism and Deep Vein Thrombosis: Abstract P151 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Marshall H, Horsley A, Smith L, Hughes D, Horn F, Armstrong L, Parra-Robles J, Cunningham S, Aldag I, Taylor C, Wild J. S8 Hyperpolarised 3He MRI is superior to lung clearance index in detection of ventilation abnormalities in young children with mild CF. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.14] [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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Holley D, Theriault A, Kamara S, Anewenter V, Hughes D, Johnson MJ. Restoring ADL function after wrist surgery in children with cerebral palsy: a novel Bilateral robot system design. IEEE Int Conf Rehabil Robot 2013; 2013:6650463. [PMID: 24187280 DOI: 10.1109/icorr.2013.6650463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cerebral palsy is a leading cause of disability in children and reducing its effects on arm function will improve quality of life. Our goal is to train children with CP after wrist tendon transfer surgery using a robotic therapy system consisting of two robot arms and wrist robots. The therapeutic goal is to determine if the robot training combined with surgery intervention improved functional outcomes significantly more than surgery alone. To accomplish this long-term goal we have developed a Bilateral ADL Exercise Robot, BiADLER aimed at training children with CP in reach to grasp coordination on ADLs. Specifically, the robot will provide active training using an assist-as-needed. This paper presents the design concepts.
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Hickman RA, Hughes D, Cars T, Malmberg C, Cars O. Cell-wall-inhibiting antibiotic combinations with activity against multidrug-resistant Klebsiella pneumoniae and Escherichia coli. Clin Microbiol Infect 2013; 20:O267-73. [PMID: 24118201 DOI: 10.1111/1469-0691.12374] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 08/07/2013] [Accepted: 08/12/2013] [Indexed: 11/29/2022]
Abstract
The increasing prevalence of hospital and community-acquired infections caused by multidrug-resistant (MDR) bacterial pathogens is rapidly limiting the options for effective antibiotic therapy. Systematic studies on combinations of already available antibiotics that could provide an effective treatment against MDR bacteria are needed. We tested combinations of antibiotics that target one important physiological function (peptidoglycan synthesis) at several steps, and studied Enterobacteriaceae (Klebsiella pneumoniae and Escherichia coli) for which multidrug resistance associated with ESBL-producing plasmids has become a major problem. To measure the effectiveness of antibiotics alone and in combination, we used checkerboard assays, static antibiotic concentration time-kill assays, and an improved in-vitro kinetic model that simulates human pharmacokinetics of multiple simultaneously administered antibiotics. The target strains included an MDR K. pneumoniae isolate responsible for a recent major hospital outbreak. A double combination (fosfomycin and aztreonam) and a triple combination (fosfomycin, aztreonam and mecillinam) were both highly effective in reducing bacterial populations in all assays, including the in vitro kinetic model. These combinations were effective even though each of the MDR strains was resistant to aztreonam alone. Our results provide an initial validation of the potential usefulness of a combination of antibiotics targeting peptidoglycan synthesis in the treatment of MDR Gram-negative bacteria. We suggest that a combination of fosfomycin with aztreonam could become a useful treatment option for such infections and should be further studied.
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Pieri F, Katsoyiannis A, Martellini T, Hughes D, Jones KC, Cincinelli A. Occurrence of linear and cyclic volatile methyl siloxanes in indoor air samples (UK and Italy) and their isotopic characterization. ENVIRONMENT INTERNATIONAL 2013; 59:363-71. [PMID: 23892293 DOI: 10.1016/j.envint.2013.06.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 05/06/2023]
Abstract
The occurrence of linear- and cyclic-volatile methyl siloxanes (lVMSs and cVMSs, respectively) in various indoor environments, occupational and domestic, in Italy and in the United Kingdom was studied. The results show that the cVMSs are the most abundant, detected in average concentrations that in some cases were as high as 170μgm(-3). Our study highlights the differences that can be observed between various indoor environments (e.g. domestic like bathrooms, bedrooms, or occupational) and between two countries. In most cases, the concentrations found in the UK are higher than in the respective indoor environments in Italy. The assessment of exposure to these two countries for adults and children revealed significant differences both not only in the levels of exposure, but also in the patterns. In Italy, the biggest part of the exposure to VMSs takes place domestically, whereas in the UK, it is observed for occupational environments. Additionally, the compound specific isotopic analysis was employed as a source identification technique. The results are promising mainly for D5 that occurs in higher concentrations, but not for the less abundant lVMSs and cVMSs.
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Barber TJ, Bradshaw D, Hughes D, Leonidou L, Margetts A, Ratcliffe D, Thornton S, Pozniak A, Asboe D, Mandalia S, Boffito M, Davies N, Gazzard B, Catalan J. Screening for HIV-related neurocognitive impairment in clinical practice: challenges and opportunities. AIDS Care 2013; 26:160-8. [PMID: 23869661 DOI: 10.1080/09540121.2013.819401] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
With increasingly successful management of HIV, focus has shifted away from AIDS-related complications to other chronic co-morbidities. For HIV-related cognitive problems, the true aetiopathogenesis and epidemiology remains unclear. Rather than a systematic review, this paper presents the challenges and the opportunities we faced in establishing our own clinical service. Papers were identified using Pubmed and the terms "screening", "HIV" and "neurocognitive". This article covers the background of HIV-associated neurocognitive disorders (HAND) with a focus on HIV-related neurocognitive impairment (NCI), detailing classification, prevalence, diagnostic categories and diagnostic uncertainties. Screening is discussed, including a comparison of the available screening tools for cognitive deficits in HIV-infected patients and the importance of practice effects. Discussed also are the normal ranges and the lack thereof and potential investigations for those found to have impairments. We conclude by discussing the role of NCI screening in routine clinical care at the current time.
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