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Burns A, Murch S, Layland J, La Gerche A, MacIsaac A, Prior D. Effect of Adenosine on Pulmonary Vascular Resistance in Patients with Pulmonary Hypertension due to Left Heart Disease and Scleroderma. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.034] [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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102
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Leroi I, Chilman E, Andrews M, McDonald K, Byrne J, Burns A. 035 Personality style in Parkinson's disease with impulsivity and apathy. Journal of Neurology, Neurosurgery and Psychiatry 2010. [DOI: 10.1136/jnnp.2010.217554.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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103
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Harbishettar (presenter) V, Leroi I, Andrews M, McDonald K, Byrne J, Burns A. 037 Carer burden and distress in apathy and impulsivity in Parkinson's disease. J Neurol Psychiatry 2010. [DOI: 10.1136/jnnp.2010.217554.37] [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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104
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Andrews (presenter) M, Leroi I, McDonald K, McKie S, Elliott R, Byrne J, Burns A. 016 Cognitive dysfunction in apathy and impulsivity in Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry 2010. [DOI: 10.1136/jnnp.2010.217554.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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105
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Providence C, Gommans J, Burns A. Managing acute medical admissions: a survey of acute medical services and medical assessment and planning units in New Zealand. Intern Med J 2010; 42:51-6. [PMID: 20681959 DOI: 10.1111/j.1445-5994.2010.02331.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To determine the current provision of acute medical services, including the development of medical assessment and planning units (MAPUs), by district health boards (DHBs) throughout New Zealand (NZ). METHODS A questionnaire-based survey about organisation of acute medical services and establishment of MAPUs was sent to all 21 DHBs in NZ. RESULTS All 21 DHBs responded. Seven DHBs serving 42% of the population have established MAPUs since 2003 and a further six have plans to do so over the next 3 years, potentially expanding service to 73% of the NZ population. All seven current MAPUs are in close proximity to and accept patients directly from emergency departments. Each MAPU has a documented target length of stay, four units have referral protocols, five provide guidelines for management of common medical emergencies and five routinely audit unit performance. Five MAPUs have cardiac monitored beds and isolation rooms. Rapid access is available to computed tomography scanning (six units), ultrasound (five) and echocardiography (four). Two units have no nominated physician leadership and two lack dedicated therapy resources. General physicians are involved in provision of acute medical services in 20 of 21 DHBs. CONCLUSIONS Medical assessment and planning units have become an important component of acute medical service provision in NZ. The established units largely comply with Australasian recommendations, although important deficiencies exist. Training of physicians must combine the needs of acute medical patients and clinical roles of physicians within MAPUs with local DHB requirements for services to be most effective.
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106
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Gibney G, Elfiky A, Hoimes CJ, Burns A, Rowen E, McDonough JA, Lampert R, Gross C, Kelly WK. Assessing cardiac risk using heart rate variability in a phase II study of androgen-deprivation therapy and bevacizumab in noncastrate metastatic prostate cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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107
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Gibney G, Elfiky A, Bussom S, Hoimes CJ, Burns A, McDonough JA, Rowen E, Cheng YC, Kelly WK. A phase II study of oral phenoxodiol in castrate and noncastrate prostate cancer patients with associated cytokine changes. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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108
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Anziani H, Burns A, Banks R. P5 Dental management of head and neck radiotherapy patients. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60096-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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109
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Nourhashémi F, Olde Rikkert MG, Burns A, Winblad B, Frisoni GB, Fitten J, Vellas B. Follow-up for Alzheimer patients: European Alzheimer Disease Consortium position paper. J Nutr Health Aging 2010; 14:121-30. [PMID: 20126960 DOI: 10.1007/s12603-010-0023-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND PURPOSE Alzheimer disease (AD) is one of the leading causes of dependence in the elderly. Providing care for patients with AD is complex and the type of care required depends on the stage of the disease and varies over time. The aim of this article is to discuss available care strategies once the AD diagnosis has been made and to propose a follow-up plan as standard of care at a European level. METHODS The proposals developed in this article stem from the collaborative work of a panel of multidisciplinary experts involved in the care of AD patients (European Alzheimer Disease Consortium) based on the results of published scientific studies and on their experience from clinical practice. CONCLUSION Suggestions for follow-up frequency and easily administered and scored assessment tools are provided, thereby increasing efficiency and quality of care for patients with Alzheimer disease.
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La Gerche A, Burns A, Mooney D, Taylor A, Heidbüchel H, MacIsaac A, Prior D. Intense Prolonged Exercise (IPE) Causes Acute Right Ventricular (RV) Injury Which may not Always be Completely Reversible. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.672] [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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111
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La Gerche A, Burns A, Mooney D, Inder W, Taylor A, Heidbüchel H, MacIsaac A, Prior D. Disproportionate Right Ventricular Load and Remodelling in Endurance Athletes: A Comparison with the Left Ventricle Using a Novel Minimally Invasive Method of Calculating End-systolic Wall Stress. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.640] [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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112
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La Gerche A, Burns A, Mooney D, Inder W, Heidbüchel H, MacIsaac A, Prior D. Exercise-Induced Dilation of the Pulmonary Microvasculature, Demonstrated by Agitated Contrast Transit, Predicts Right Ventricular Afterload and Function. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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113
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Andrews M, Leroi I, McDonald K, Elliott R, Byrne J, Burns A. P1.022 Cognitive dysfunction in apathy and impulsivity in Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70144-0] [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: 10/20/2022]
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114
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Rayson D, Payne JI, Abdolell M, Barnes PJ, Burns A, MacIntosh R, Foley T, Younis T, Caines J. Clinical-pathologic characteristics and outcomes of true interval compared to screen-detected breast cancer among participants in a Canadian breast screening program: A nested case-control study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6528] [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
6528 Background: It has been hypothesized that, compared to screen-detected breast cancer (Scr), true interval breast cancers (Int) are associated with adverse prognostic factors and outcomes. Data has remained controversial due to failure to control for age at diagnosis and screening interval as well as lack of information regarding adjuvant therapies and inclusion of other categories of interval cancers (e.g., missed or noncompliant). Methods: A case-control study nested among participants of the population-based Nova Scotia Breast Screening Program diagnosed with invasive disease between the ages 40–69 in the period 1991–2006 was performed. Ints were validated by blinded review of the pre-diagnostic screening mammogram by 3 mammographers, 2 or 3 of whom had to agree that it was negative for inclusion as a true Int. Scrs were matched to Ints on a 2:1 basis by 5 year age group at diagnosis and screening interval (40–49 yo, annual; 50–69 yo + family history, annual; 50–69 yo - family history, biennial). Results: 243 true Ints were observed and matched to 485 Scrs. The Table presents (i) univariate analysis of selected pathology variables for the entire cohort of Ints vs Scrs (ii) multivariate analysis of these selected variables. In addition to standard adjuvant hormonal, radiation and trastuzumab therapies, 62.4% of Ints received standard adjuvant chemotherapy (adjC) vs. 30.6% of Scrs. 5 year disease-free (DFS) and overall (OS) survival rates for Int vs Scr were 82.6% vs 92.3% and 87.2% vs 93.3% respectively. Cox proportional hazards modeling for (i) DFS shows HR=1.96 (p=0.0024) for Int vs Scr, dropping to HR=1.57 (p=0.0556) after adjusting for adjC received and (ii) OS shows HR=1.99 (p=0.0028) for Int vs Scr, dropping to 1.61 (p=0.0487) after adjusting for adjC received. Conclusions: True Ints present with more adverse prognostic factors compared to Scrs. Despite more use of adjC, outcomes are significantly poorer. [Table: see text] No significant financial relationships to disclose.
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Geddes A, Burns A. What not to wear? A survey into patient opinion of “Bare Below the Elbows”. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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116
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Crossling MC, Banks R, Burns A. A survey of alcohol and tobacco consumption in patients and their partners following diagnosis and treatment for head and neck squamous cell carcinoma. Br J Oral Maxillofac Surg 2008. [DOI: 10.1016/j.bjoms.2008.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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117
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Burns A, Ibach B, Bernabei R, Bullock R, Cruz Jentoft A, Frölich L, Hock C, Triau E, Vandewoude M, Wimo A, Came E, van Baelen B, van Oene J, Schwalen S. Die SERAD Studie: Galantamin verbessert die Kognition bei Heimpatienten mit schwerer Alzheimerdemenz. AKTUELLE NEUROLOGIE 2008. [DOI: 10.1055/s-0028-1086751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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118
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Banks R, Harlow N, Crossling M, Burns A. P.127 Composite free tissue transfer and its long term survival. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71915-2] [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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119
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Garfield M, Ridley S, Kong A, Burns A, Blunt M, Gunning K. Seasonal variation in admission rates to intensive care units. Anaesthesia 2008. [DOI: 10.1111/j.1365-2044.2001.01984.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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120
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Burns A. Arteriovenous Malformations. Semin Plast Surg 2008. [DOI: 10.1055/s-2008-1080421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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121
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Oman TK, Stewart MC, Burns A, Lang TF. Topical choline salicylates implicated in Reye’s syndrome. BMJ : BRITISH MEDICAL JOURNAL 2008. [DOI: 10.1136/bmj.39462.656736.ad] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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122
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Searson R, Hendry AM, Ramachandran R, Burns A, Purandare N. Activities enjoyed by patients with dementia together with their spouses and psychological morbidity in carers. Aging Ment Health 2008; 12:276-82. [PMID: 18389409 DOI: 10.1080/13607860801956977] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Caring for a spouse with dementia is stressful and respite care is sometimes used to reduce this burden. Spouses may find some aspects of caring rewarding but the literature on positive aspects of caring is limited. To describe activities enjoyed by patients with dementia together with their spouses, and examine their relationship with psychological morbidity in carers. A convenience sample of 46 patients with mild to moderate dementia (91% with Alzheimer's disease, AD) and their spouses were interviewed at home. Spouses completed the Pleasant Events Schedule (PES-AD) to identify activities enjoyed by patients and spouses on their own and together. Psychological morbidity in spouses was assessed using the General Health Questionnaire (GHQ-12). Cognitive functions, and non-cognitive symptoms were also assessed in patients. Multiple regression analysis using age, Mini-Mental State Examination, Cornell Scale for Depression in Dementia, Revised Memory and Behaviour Problems (RMBP) checklist frequency, and PES-AD- together scores as independent variables found PES-AD-together and RMBP-frequency to be independent predictors of GHQ-12 scores in spouses, but the model could explain only 28% of variance. Facilitating activities that are enjoyed by both patients with dementia and spouses may be an alternative intervention strategy to reduce carer burden.
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Kuzniecky R, Pan J, Burns A, Devinsky O, Hetherington H. Levetiracetam has no acute effects on brain gamma-aminobutyric acid levels. Epilepsy Behav 2008; 12:242-4. [PMID: 18286712 PMCID: PMC3657745 DOI: 10.1016/j.yebeh.2007.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The mechanism of action of levetiracetam (LEV), an antiepileptic drug, is related to a novel binding site, SV2, but LEV acts on GABA-A receptors. The objective of the study described here was to determine if LEV modulates brain GABA in vivo. METHODS Concentrations of cerebral GABA and serum LEV were obtained in seven healthy individuals using 1H magnetic resonance spectroscopy at baseline and 3 and 6 hours following oral administration of 1 g of LEV. RESULTS Brain cerebral GABA acutely concentrations did not change from baseline. CONCLUSION The results indicate that LEV does not increase human cerebral GABA concentrations acutely in healthy individuals.
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Abstract
BACKGROUND Delirium is now the preferred term to describe acute confusional states. It is experienced by 10 to 30% of all hospital inpatients. Delirium is potentially reversible and is related to several adverse outcomes, including increased hospital length of stay, poor functional status, persistent cognitive impairment, need for institutional care and probably mortality. Disruption of the cholinergic system has been proposed as a key mechanism of delirium. Cholinesterase inhibitors enhance the cholinergic system and there have been reports that they might be beneficial in treating delirium. OBJECTIVES To assess the efficacy and safety of cholinesterase inhibitors in the treatment of delirium. SEARCH STRATEGY The Cochrane Dementia and Cognitive Improvement Group's Register of Clinical Trials (which includes records from MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, LILACS and other databases) was searched for relevant randomised controlled trials using the terms: donepezil or aricept, galantamine or reminyl, rivastigmine OR exelon and tacrine OR cognex on 19 April 2005. As this Specialised Register only contains trials relating to dementia and cognitive impairment, in addition all years of MEDLINE, EMBASE, PsycINFO and CINAHL were searched for trials of cholinesterase inhibitors for delirium in non-demented people. SELECTION CRITERIA Unconfounded, blinded randomised controlled trials, published or unpublished in which treatment with cholinesterase inhibitors was administered and compared with alternative interventions in patients with delirium are included. DATA COLLECTION AND ANALYSIS Two reviewers (RO, SK) independently assessed the quality of the studies according to parameters such as randomisation, blinding and how dropouts were managed. Each cholinesterase inhibitor was to be examined separately and together as a group. The primary outcome measures of interest are length of delirium, severity of delirium and presence and severity of behavioural symptoms (e.g. agitation and hallucinations). Other outcomes of interest include: cognition, need for institutionalisation, length of hospital admission and adverse effects. MAIN RESULTS There was one included trial of donepezil compared with placebo in 15 patients. No significant difference between the treatment and placebo groups was found in the duration of delirium. The mean duration of postoperative delirium for the donepezil group was 1.0 day (Standard Error 0.0) while for the placebo group it was 1.3 days (Standard Error 0.19). No other outcomes were measured for the patients who developed delirium. AUTHORS' CONCLUSIONS There is currently no evidence from controlled trials that donepezil is effective in the treatment of delirium. Further trials using cholinesterase inhibitors for the treatment of delirium are needed.
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Purandare N, Oude Voshaar RC, McCollum C, Jackson A, Burns A. Paradoxical embolisation and cerebral white matter lesions in dementia. Br J Radiol 2008; 81:30-4. [DOI: 10.1259/bjr/90498392] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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