76
|
Cullen C, Phelan M, Harney S, Ryan J. FRI0617-HPR An Audit of The Role of A Clinical Specialist Physiotherapist in Rheumatology Triage. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2149] [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]
|
77
|
Healy GM, Redmond CE, Meyer V, Kavanagh R, Killeen RP, Ryan J. Clinical Decision Rules for CT in Minor Head Injury. IRISH MEDICAL JOURNAL 2016; 109:414. [PMID: 27685885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
78
|
Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Gait Biomechanics in Participants, Six Months after First-time Lateral Ankle Sprain. Int J Sports Med 2016; 37:577-83. [DOI: 10.1055/s-0035-1564172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
79
|
Shanahan E, Henderson C, Butler A, Lenehan B, Sheehy T, Costelloe A, Carew S, Peters C, O'Connor M, Lyons D, Ryan J. Dedicated Orthogeriatric Service Saves the HSE a Million Euro. IRISH MEDICAL JOURNAL 2016; 109:385. [PMID: 27685479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Hip fracture is common in older adults and is associated with high morbidity, mortality and significant health care costs. A pilot orthogeriatrics service was established in an acute hospital. We aimed to establish the cost effectiveness of this service. Length of hospital stay, discharge destination and rehabilitation requirements were analysed for a one year period and compared to patients who received usual care prior to the service. We calculated the costs incurred and savings produced by the orthogeriatric service. Median length of stay was reduced by 3 days (p < 0.001) saving €266,976. There was a 19% reduction in rehabilitation requirements saving €192,600. Median rehabilitation length of stay was reduced by 6.5 days saving €171,093. Reductions in long term care requirements led to savings of €10,934 per week. Costs to establish such a service amount to €171,564. The introduction of this service led to improved patient outcomes in a cost effective manner.
Collapse
|
80
|
Biniecka M, Canavan M, McGarry T, Gao W, McCormick J, Cregan S, Gallagher L, Smith T, Phelan JJ, Ryan J, O'Sullivan J, Ng CT, Veale DJ, Fearon U. Dysregulated bioenergetics: a key regulator of joint inflammation. Ann Rheum Dis 2016; 75:2192-2200. [PMID: 27013493 PMCID: PMC5136702 DOI: 10.1136/annrheumdis-2015-208476] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/28/2016] [Accepted: 03/03/2016] [Indexed: 11/09/2022]
Abstract
Objectives This study examines the relationship between synovial hypoxia and cellular bioenergetics with synovial inflammation. Methods Primary rheumatoid arthritis synovial fibroblasts (RASF) were cultured with hypoxia, dimethyloxalylglycine (DMOG) or metabolic intermediates. Mitochondrial respiration, mitochondrial DNA mutations, cell invasion, cytokines, glucose and lactate were quantified using specific functional assays. RASF metabolism was assessed by the XF24-Flux Analyzer. Mitochondrial structural morphology was assessed by transmission electron microscopy (TEM). In vivo synovial tissue oxygen (tpO2 mmHg) was measured in patients with inflammatory arthritis (n=42) at arthroscopy, and markers of glycolysis/oxidative phosphorylation (glyceraldehyde 3-phosphate dehydrogenase (GAPDH), PKM2, GLUT1, ATP) were quantified by immunohistology. A subgroup of patients underwent contiguous MRI and positron emission tomography (PET)/CT imaging. RASF and human dermal microvascular endothelial cells (HMVEC) migration/angiogenesis, transcriptional activation (HIF1α, pSTAT3, Notch1-IC) and cytokines were examined in the presence of glycolytic inhibitor 3-(3-Pyridinyl)-1-(4-pyridinyl)-2-propen-1-one (3PO). Results DMOG significantly increased mtDNA mutations, mitochondrial membrane potential, mitochondrial mass, reactive oxygen species and glycolytic RASF activity with concomitant attenuation of mitochondrial respiration and ATP activity (all p<0.01). This was coupled with altered mitochondrial morphology. Hypoxia-induced lactate levels (p<0.01), which in turn induced basic fibroblast growth factor (bFGF) secretion and RASF invasiveness (all p<0.05). In vivo glycolytic markers were inversely associated with synovial tpO2 levels <20 mm Hg, in contrast ATP was significantly reduced (all p<0.05). Decrease in GAPDH and GLUT1 was paralleled by an increase in in vivo tpO2 in tumour necrosis factor alpha inhibitor (TNFi) responders. Novel PET/MRI hybrid imaging demonstrated close association between metabolic activity and inflammation. 3PO significantly inhibited RASF invasion/migration, angiogenic tube formation, secretion of proinflammatory mediators (all p<0.05), and activation of HIF1α, pSTAT3 and Notch-1IC under normoxic and hypoxic conditions. Conclusions Hypoxia alters cellular bioenergetics by inducing mitochondrial dysfunction and promoting a switch to glycolysis, supporting abnormal angiogenesis, cellular invasion and pannus formation.
Collapse
|
81
|
Watson G, Salter N, Ryan J. Spontaneous Pneumothorax; a Collapse in Management? IRISH MEDICAL JOURNAL 2016; 109:372. [PMID: 27685819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Revised guidelines for the management of spontaneous pneumothoraces were published by the British Thoracic Society in 2010, however compliance remains poor. A retrospective review was performed on patients diagnosed with a pneumothorax over a 26 month period (January 2012 to March 2014). Of the 57 patients identified, 43 (75%) were diagnosed with spontaneous pneumothorax. 12 patients (21%) had pre-existing lung disease, and 16 patients (28%) admitted to having had a previously documented pneumothorax. 19 patients (33%) were reported as smokers. The main symptoms reported were chest pain (93%) and shortness of breath (54%). Observation was appropriate in 18 cases (31%), while aspiration alone was performed in 9 (16%) with chest drains required in 25 cases (44%). Five patients (9%) were admitted directly under a medical team. Our study demonstrated good compliance with BTS guidelines. The decision to observe, aspirate, insert a chest drain or directly refer to the medical team was appropriate in the majority of cases studied.
Collapse
|
82
|
Mansell T, Novakovic B, Meyer B, Rzehak P, Vuillermin P, Ponsonby AL, Collier F, Burgner D, Saffery R, Ryan J. The effects of maternal anxiety during pregnancy on IGF2/H19 methylation in cord blood. Transl Psychiatry 2016; 6:e765. [PMID: 27023171 PMCID: PMC4872456 DOI: 10.1038/tp.2016.32] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/01/2016] [Accepted: 02/04/2016] [Indexed: 12/17/2022] Open
Abstract
Compelling evidence suggests that maternal mental health in pregnancy can influence fetal development. The imprinted genes, insulin-like growth factor 2 (IGF2) and H19, are involved in fetal growth and each is regulated by DNA methylation. This study aimed to determine the association between maternal mental well-being during pregnancy and differentially methylated regions (DMRs) of IGF2 (DMR0) and the IGF2/H19 imprinting control region (ICR) in newborn offspring. Maternal depression, anxiety and perceived stress were assessed at 28 weeks of pregnancy in the Barwon Infant Study (n=576). DNA methylation was measured in purified cord blood mononuclear cells using the Sequenom MassArray Platform. Maternal anxiety was associated with a decrease in average ICR methylation (Δ=-2.23%; 95% CI=-3.68 to -0.77%), and across all six of the individual CpG units in anxious compared with non-anxious groups. Birth weight and sex modified the association between prenatal anxiety and infant methylation. When stratified into lower (⩽3530 g) and higher (>3530 g) birth weight groups using the median birth weight, there was a stronger association between anxiety and ICR methylation in the lower birth weight group (Δ=-3.89%; 95% CI=-6.06 to -1.72%), with no association in the higher birth weight group. When stratified by infant sex, there was a stronger association in female infants (Δ=-3.70%; 95% CI=-5.90 to -1.51%) and no association in males. All the linear regression models were adjusted for maternal age, smoking and folate intake. These findings show that maternal anxiety in pregnancy is associated with decreased IGF2/H19 ICR DNA methylation in progeny at birth, particularly in female, low birth weight neonates. ICR methylation may help link poor maternal mental health and adverse birth outcomes, but further investigation is needed.
Collapse
|
83
|
Kelly ME, Heeney A, Redmond CE, Costelloe J, Nason GJ, Ryan J, Brophy D, Winter DC. Incidental findings detected on emergency abdominal CT scans: a 1-year review. ACTA ACUST UNITED AC 2016; 40:1853-7. [PMID: 25576049 DOI: 10.1007/s00261-015-0349-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In recent years, there has been a substantial rise in the use of computed tomography (CT) in the emergency medicine setting. Accordingly, with increased CT usage there has been an upsurge in incidental pathology detection. METHODS A retrospective review of all emergency CT abdominal scans performed at a university teaching hospital was examined. The frequency of incidental findings, their clinical significance and workload effect for the radiology department was assessed. RESULTS 1155 patients had an emergency abdominal CT scan of which 700 had incidental findings detected. Of the incidental findings, 143 were deemed indeterminate requiring urgent investigations. Twenty-four occult neoplasms were confirmed subsequently. Additionally, 259 patients were recommended for additional diagnostics. The cumulative effect of the initial emergency abdominal CT was 15,015 relative value units (RVU). Subsequent imaging of incidental findings resulted in another 1674 RVU workload for radiology. CONCLUSION Incidental findings cause considerable debate and concern over which patients require significant follow-up, investigations, and/or surveillance. This exerts significant pressures on sub-specialties for their expert input, with increased workload and implications on healthcare service provision.
Collapse
|
84
|
Januar V, Ancelin ML, Ritchie K, Saffery R, Ryan J. BDNF promoter methylation and genetic variation in late-life depression. Transl Psychiatry 2015; 5:e619. [PMID: 26285129 PMCID: PMC4564567 DOI: 10.1038/tp.2015.114] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/15/2015] [Accepted: 06/25/2015] [Indexed: 12/15/2022] Open
Abstract
The regulation of the brain-derived neurotrophic factor (BDNF) is important for depression pathophysiology and epigenetic regulation of the BDNF gene may be involved. This study investigated whether BDNF methylation is a marker of depression. One thousand and twenty-four participants were recruited as part of a longitudinal study of psychiatric disorders in general population elderly (age ⩾ 65). Clinical levels of depression were assessed using the Mini International Neuropsychiatric Interview for the diagnosis of major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder IV criteria, and the Centre for Epidemiologic Studies Depression Scale (CES-D) for assessment of moderate to severe depressive symptoms. Buccal DNA methylation at the two most widely studied BDNF promoters, I and IV, was investigated using the Sequenom MassARRAY platform that allows high-throughput investigation of methylation at individual CpG sites within defined genomic regions. In multivariate linear regression analyses adjusted for a range of participant characteristics including antidepressant use, depression at baseline, as well as chronic late-life depression over the 12-year follow-up, were associated with overall higher BDNF methylation levels, with two sites showing significant associations (promoter I, Δ mean = 0.4%, P = 0.0002; promoter IV, Δ mean = 5.4%, P = 0.021). Three single-nucleotide polymorphisms (rs6265, rs7103411 and rs908867) were also found to modify the association between depression and promoter I methylation. As one of the largest epigenetic studies of depression, and the first investigating BDNF methylation in buccal tissue, our findings highlight the potential for buccal BDNF methylation to be a biomarker of depression.
Collapse
|
85
|
Touzeau C, Ryan J, Guerriero J, Moreau P, Chonghaile TN, Le Gouill S, Richardson P, Anderson K, Amiot M, Letai A. BH3 profiling identifies heterogeneous dependency on Bcl-2 family members in multiple myeloma and predicts sensitivity to BH3 mimetics. Leukemia 2015; 30:761-4. [PMID: 26174630 PMCID: PMC4714955 DOI: 10.1038/leu.2015.184] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
86
|
Youngstein T, Lane T, Rowczenio D, Ozdogan H, Ugurlu S, Hoffmann P, Riminton S, Headley A, Ryan J, Harty L, Roesler J, Blank N, Michler C, Hawkins P, Lachmann H. SAT0553 Anti-Interleukin-1 Therapies and Pregnancy Outcome: an International Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5960] [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]
|
87
|
Ryan J, Sgromo B, Magee C, Pavlides M, Ainsworth M, Collier J, Barnes E, Cobbold J. Prevalence of NASH cirrhosis in morbidly obese patients undergoing bariatric surgery. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
88
|
O'Connor M, Ryan J, Foley S. A review of cross-sectional imaging, ultrasound and nuclear medicine utilization patterns in paediatric patients in Ireland, 2003-12. Br J Radiol 2015; 88:20140767. [PMID: 25655008 DOI: 10.1259/bjr.20140767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Recent trends in paediatric imaging have been examined in Australia and the USA. Such literature in Europe is sparse, incomprehensive and outdated. This research investigated (1) population-based trends in the use of advanced medical imaging in children in Ireland from 2003 to 2012; (2) its use across age and gender; and (3) the most commonly performed examinations within each modality. METHODS A retrospective cohort analysis study was carried out within Irish paediatric hospitals. All CT, MRI, ultrasound and nuclear medicine (NM) annual examination data from 2003 to 2012 was obtained from radiology information systems. RESULTS 224,173 imaging procedures were carried out on 84,511 patients, 68% of which were ultrasound, 15% were MRI, 11% were CT and 6% were NM. Between 2003 and 2012, MRI (+280%) and CT (+80%) saw the largest increases in use, followed by ultrasound (+67%) and NM (+10%). Almost half of the study population were less than 3 years old. CT imaging was more frequent than MR in 2005. By 2012, MR rates were twice that of CT. CT imaging rates were the lowest in the youngest age categories. CONCLUSION Advanced imaging use, particularly MRI, has risen substantially over the past 10 years. The utilization of non-ionizing modalities increased between 2003 and 2012, especially in brain, spinal and abdominal imaging. MR is now used at twice the frequency of CT. ADVANCES IN KNOWLEDGE Longitudinal advanced imaging utilization trends, including CT trends, have been established in the Irish paediatric population.
Collapse
|
89
|
Wiltink S, Nelson B, Velthorst E, Wigman J, Lin A, Baksheev G, Cosgrave E, Ross M, Ryan J, Yung A. The relationship between personality traits and psychotic like experiences in a large non-clinical adolescent sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2014.09.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
90
|
Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Single-leg drop landing movement strategies 6 months following first-time acute lateral ankle sprain injury. Scand J Med Sci Sports 2014; 25:806-17. [DOI: 10.1111/sms.12390] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2014] [Indexed: 01/10/2023]
|
91
|
Bah N, Maillet L, Ryan J, Dubreil S, Gautier F, Letai A, Juin P, Barillé-Nion S. Erratum: Bcl-xL controls a switch between cell death modes during mitotic arrest. Cell Death Dis 2014. [PMCID: PMC4649526 DOI: 10.1038/cddis.2014.436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
92
|
Letai A, Chonghaile T, Hogdal L, Bhola P, Montero J, Touzeau C, Ryan J. Targeting the Bcl-2 Pathway. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu301.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
93
|
Marchette SA, Vass LK, Ryan J, Epstein RA. For familiar landmarks, parahippocampal cortex represents place identity, not just perceptual features. J Vis 2014. [DOI: 10.1167/14.10.1129] [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] Open
|
94
|
Pratschke KM, Ryan J, McAlinden A, McLauchlan G. Pancreatic surgical biopsy in 24 dogs and 19 cats: postoperative complications and clinical relevance of histological findings. J Small Anim Pract 2014; 56:60-6. [PMID: 25132255 PMCID: PMC7167179 DOI: 10.1111/jsap.12262] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/15/2014] [Accepted: 05/19/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To assess the immediate postoperative complications associated with pancreatic biopsy in dogs and cats and review the clinical relevance of biopsy findings. METHODS Retrospective review of clinical records from two referral institutions for cases undergoing pancreatic biopsy between 2000 and 2013. RESULTS Twenty‐four dogs and 19 cats that had surgical pancreatic biopsy had sufficient detail in their clinical records and fulfilled the inclusion criteria. Postoperative complications were seen in 10 cases of which 5 were suggestive of post‐surgical pancreatitis. Two patients were euthanased within 10 days of surgery because of the underlying disease; neither suffered postoperative complications. Pancreatic pathology was found in 19 cases, 7 cases showed no change other than benign pancreatic nodular hyperplasia, and no abnormalities were seen in 18 cases. CLINICAL SIGNIFICANCE Complications may be encountered following surgical pancreatic biopsy, although the risk should be minimal with good surgical technique. Pancreatic biopsy may provide a useful contribution to case management but it is not clear whether a negative pancreatic biopsy should be used to rule out pancreatic disease. Dogs were more likely to have no significant pathology found on pancreatic biopsy than cats, where chronic pancreatitis was the most common finding.
Collapse
|
95
|
Ryan J, Faragher I. Not all patients need to be discussed in a colorectal cancer MDT meeting. Colorectal Dis 2014; 16:520-6. [PMID: 24617857 DOI: 10.1111/codi.12581] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/09/2013] [Indexed: 02/08/2023]
Abstract
AIM It is recommended that patients with cancer should be managed in the context of a multidisciplinary team (MDT). Alternatively, proponents of the standard model of care propose that the well-informed treating doctor is able to make the appropriate plan for each patient, making the need for a MDT meeting redundant. We compared the management plans made within a colorectal cancer MDT with routine care. METHOD Consecutive cases presenting to the colorectal MDT were prospectively assessed. Before the meeting management plans were made, based on routine care pathways. These were compared with plans made at the MDT meeting and discrepancies recorded. The number of patients who generated beneficial discussion was recorded. RESULTS There were 261 discussions regarding the care of 197 patients. In the 203 cases where the pathways were relevant, patient management was consistent with the pathway in 94% of the cases discussed. Discussion of routine cases of colon cancer rarely changed management (3.4%). Conversely, management changed after MDT discussion in 50% of complex cases (the preoperative management of rectal cancer, recurrence, metastatic disease and malignant polyps). The postoperative discussion of pathology findings rarely generated beneficial discussion. CONCLUSION Discussion of routine cases of colon cancer in our MDT rarely changed management, but it did change the decisions regarding complex cases or in patients with unusual pathology. We propose a two-tiered approach to the MDT where all patients are listed for a MDT meeting but only patients with complex pathology are discussed in detail.
Collapse
|
96
|
Chong B, Babiker H, Frakes D, Ryan J, Gonzalez F. E-061 Towards the Pre-Surgical Treatment Planning of Cerebral Aneurysms Using High Fidelity Simulations. J Neurointerv Surg 2014. [DOI: 10.1136/neurintsurg-2014-011343.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
97
|
Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Single-leg drop landing motor control strategies following acute ankle sprain injury. Scand J Med Sci Sports 2014; 25:525-33. [PMID: 24975875 DOI: 10.1111/sms.12282] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2014] [Indexed: 12/26/2022]
Abstract
No research currently exists investigating the effect of acute injury on single-limb landing strategies. The aim of the current study was to analyze the coordination strategies of participants in the acute phase of lateral ankle sprain (LAS) injury. Thirty-seven participants with acute, first-time LAS and 19 uninjured participants completed a single-leg drop landing task on both limbs. Three-dimensional kinematic (angular displacement) and sagittal plane kinetic (moment-of-force) data were acquired for the joints of the lower extremity from 200 ms pre-initial contact (IC) to 200 ms post-IC. The peak magnitude of the vertical component of the ground reaction force (GRF) was also computed. Injured participants displayed a bilateral increase in hip flexion, with altered transverse plane kinematic profiles at the knee and ankle for both limbs (P < 0.05). This coincided with a reduction in the net-supporting flexor moment of the lower extremity (P < 0.05) and magnitude of the peak vertical GRF for the injured limb (21.82 ± 2.44 N/kg vs 24.09 ± 2.77 N/kg; P = 0.013) in injured participants compared to control participants. These results demonstrate that compensatory movement strategies are utilized by participants with acute LAS to successfully reduce the impact forces of landing.
Collapse
|
98
|
Bah N, Maillet L, Ryan J, Dubreil S, Gautier F, Letai A, Juin P, Barillé-Nion S. Bcl-xL controls a switch between cell death modes during mitotic arrest. Cell Death Dis 2014; 5:e1291. [PMID: 24922075 PMCID: PMC4611724 DOI: 10.1038/cddis.2014.251] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/28/2014] [Accepted: 05/06/2014] [Indexed: 02/03/2023]
Abstract
Antimitotic agents such as microtubule inhibitors (paclitaxel) are widely used in cancer therapy while new agents blocking mitosis onset are currently in development. All these agents impose a prolonged mitotic arrest in cancer cells that relies on sustained activation of the spindle assembly checkpoint and may lead to subsequent cell death by incompletely understood molecular events. We have investigated the role played by anti-apoptotic Bcl-2 family members in the fate of mitotically arrested mammary tumor cells treated with paclitaxel, or depleted in Cdc20, the activator of the anaphase promoting complex. Under these conditions, a weak and delayed mitotic cell death occurs that is caspase- and Bax/Bak-independent. Moreover, BH3 profiling assays indicate that viable cells during mitotic arrest are primed to die by apoptosis and that Bcl-xL is required to maintain mitochondrial integrity. Consistently, Bcl-xL depletion, or treatment with its inhibitor ABT-737 (but not with the specific Bcl-2 inhibitor ABT-199), during mitotic arrest converts cell response to antimitotics to efficient caspase and Bax-dependent apoptosis. Apoptotic priming under conditions of mitotic arrest relies, at least in part, on the phosphorylation on serine 62 of Bcl-xL, which modulates its interaction with Bax and its sensitivity to ABT-737. The phospho-mimetic S62D-Bcl-xL mutant is indeed less efficient than the corresponding phospho-deficient S62A-Bcl-xL mutant in sequestrating Bax and in protecting cancer cells from mitotic cell death or yeast cells from Bax-induced growth inhibition. Our results provide a rationale for combining Bcl-xL targeting to antimitotic agents to improve clinical efficacy of antimitotic strategy in cancer therapy.
Collapse
|
99
|
Ukor E, Ryan J, Brown K, Haworth C, Auton K, Floto R. 227 Detecting early markers of CF-related pulmonary exacerbations using home telemetry and sputum biomarkers. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60362-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
100
|
Ryan J, Scali J, Carrière I, Amieva H, Rouaud O, Berr C, Ritchie K, Ancelin ML. Impact of a premature menopause on cognitive function in later life. BJOG 2014; 121:1729-39. [PMID: 24802975 DOI: 10.1111/1471-0528.12828] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To determine whether premature menopause (≤40 years) can have long-lasting effects on later-life cognition and investigate whether this association varies depending on the type of menopause and use of hormone treatment (HT). DESIGN Population-based cohort study. SETTING The French Three-City Study. POPULATION Four thousand eight hundred and sixty-eight women aged at least 65 years. METHODS Multivariable-adjusted logistic regression models were used to determine the association between age at menopause, type of menopause (surgical, natural), and the use of menopausal HT and later-life cognitive function. MAIN OUTCOME MEASURES Performance on a cognitive test battery (at baseline and over 7 years) and clinical dementia diagnosis. RESULTS Menopause at or before the age of 40 years, both premature bilateral ovariectomy and premature ovarian failure (non-surgical loss of ovarian function), was associated with worse verbal fluency (OR 1.56, 95%CI 1.12-1.87, P=0.004) and visual memory (OR 1.39, 95%CI 1.09-1.77, P=0.007) in later life. HT at the time of premature menopause appeared beneficial for later-life visual memory but increased the risk of poor verbal fluency. Type of menopause was not significantly associated with cognitive function. Premature menopause was associated with a 30% increased risk of decline in psychomotor speed and global cognitive function over 7 years. CONCLUSION Both premature surgical menopause and premature ovarian failure were associated with long-term negative effects on cognitive function, which are not entirely offset by menopausal HT. In terms of surgical menopause, these results suggest that the potential long-term effects on cognitive function should form part of the risk/benefit ratio when considering ovariectomy in younger women.
Collapse
|