1
|
LaFave SE, Bandeen-Roche K, Gee G, Thorpe RJ, Li Q, Crews D, Samuel L, Cooke A, Hladek M, Szanton SL. Quantifying Older Black Americans' Exposure to Structural Racial Discrimination: How Can We Measure the Water In Which We Swim? J Urban Health 2022; 99:794-802. [PMID: 35486285 PMCID: PMC9561453 DOI: 10.1007/s11524-022-00626-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 10/18/2022]
Abstract
The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person's life and the country's history. The purpose of this study was to design a measure of structural racial discrimination that meets those criteria and can be used in large national datasets. To do this, we started with an exploratory mixed-methods instrument design, including qualitative interviews with 15 older Black adults and focus groups with 38 discrimination researchers and other key stakeholders. We then identified 27 indicators of structural racial discrimination across nine theorized discrimination contexts. We matched these with historical administrative data sets to develop an instrument that could quantify older Black Americans' exposure to structural racial discrimination across contexts, the life course, and geographies. These can be mapped to the life course of structural discrimination based on the home addresses of those surveyed. Linking these to available indicators is a promising approach. It is a low burden for participants and enables increasingly multifaceted and focused measurement as more national datasets become available. A flexible, feasible comprehensive measure of structural discrimination could allow not only more thorough documentation of inequities but also allow informed decision making about policies and programs intended to promote racial equity. SIGNIFICANCE STATEMENT: To our knowledge, this is the first study that presents a framework for assessing structural racial discrimination across contexts, life course, and geography that is grounded in theory and in the lived experience of intended participants. Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction. CLASSIFICATION: Social Sciences.
Collapse
Affiliation(s)
- S E LaFave
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - K Bandeen-Roche
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G Gee
- UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - R J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Q Li
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - D Crews
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L Samuel
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - A Cooke
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - M Hladek
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | | |
Collapse
|
2
|
Favara DM, McAdam K, Cooke A, Bordessa-Kelly A, Budriunaite I, Bossingham S, Houghton S, Doffinger R, Ainsworth N, Corrie PG. SARS-CoV-2 Infection and Antibody Seroprevalence among UK Healthcare Professionals Working with Cancer Patients during the First Wave of the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2021; 33:667-675. [PMID: 33941453 PMCID: PMC8064872 DOI: 10.1016/j.clon.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/09/2021] [Accepted: 04/15/2021] [Indexed: 12/30/2022]
Abstract
Aims The proportion of UK oncology healthcare professionals (HCPs) infected with SARS-CoV-2 during the COVID-19 pandemic's first wave is unknown. The primary aim of this study was to determine the SARS-CoV-2 infection and seroprevalence rates among HCPs. Materials and methods Patient-facing oncology HCPs working at three large UK hospitals during the COVID-19 pandemic's first wave underwent polymerase chain reaction (PCR) and antibody testing [Luminex and point-of-care (POC) tests] on two occasions 28 days apart (June–July 2020). Results In total, 434 HCPs were recruited: nurses (58.3%), doctors (21.2%), radiographers (10.4%), administrators (10.1%); 26.3% reported prior symptoms suggestive of SARS-CoV-2. All participants were PCR negative during the study, but 18.4% were Luminex seropositive on day 1, of whom 42.5% were POC seropositive. Nurses had the highest seropositive prevalence trend (21.3%, P = 0.2). Thirty-eight per cent of seropositive HCPs reported previous SARS-CoV-2 symptoms: 1.9 times higher odds than seronegative HCPs (P = 0.01). Of 400 participants retested on day 28, 13.3% were Luminex seropositive (92.5% previously, 7.5% newly). Thirty-two per cent of initially seropositive HCPs were seronegative on day 28. Conclusion In this large cohort of PCR-negative patient-facing oncology HCPs, almost one in five were SARS-CoV-2 antibody positive at the start of the pandemic's first wave. Our findings that one in three seropositive HCPs retested 28 days later became seronegative support regular SARS-CoV-2 PCR and antibody testing until widespread immunity is achieved by effective vaccination.
Collapse
Affiliation(s)
- D M Favara
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, The Queen Elizabeth Hospital, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, Kings Lynn, UK; Department of Oncology, University of Cambridge, Cambridge, UK.
| | - K McAdam
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
| | - A Cooke
- Cambridge Clinical Laboratories, Cambridge, UK
| | - A Bordessa-Kelly
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - I Budriunaite
- Tissue Typing Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - S Bossingham
- Tissue Typing Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - S Houghton
- Department of Immunology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - R Doffinger
- Department of Immunology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - N Ainsworth
- Department of Oncology, The Queen Elizabeth Hospital, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, Kings Lynn, UK
| | - P G Corrie
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
3
|
Kim JO, Hanumanthappa N, Chung YT, Beck J, Koul R, Bashir B, Cooke A, Dubey A, Butler J, Nashed M, Hunter W, Ong A. Does dissemination of guidelines alone increase the use of palliative single-fraction radiotherapy? Initial report of a longitudinal change management campaign at a provincial cancer program. Curr Oncol 2020; 27:190-197. [PMID: 32905177 PMCID: PMC7467795 DOI: 10.3747/co.27.6193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Despite level 1 evidence demonstrating the equivalence of single-fraction radiotherapy (sfrt) and multiple-fraction radiotherapy (mfrt) for the palliation of painful bone metastases, sfrt remains underused. In 2015, to encourage the sustainable use of palliative radiation oncology resources, CancerCare Manitoba disseminated, to each radiation oncologist in Manitoba, guidelines from Choosing Wisely Canada (cwc) that recommend sfrt. We assessed whether dissemination of the guidelines influenced sfrt use in Manitoba in 2016, and we identified factors associated with mfrt. Methods All patients treated with palliative radiotherapy for bone metastasis in Manitoba from 1 January 2016 to 31 December 2016 were identified from the provincial radiotherapy database. Patient, treatment, and disease characteristics were extracted from the electronic medical record and tabulated by fractionation schedule. Univariable and multivariable logistic regression analyses were performed to identify risk factors associated with mfrt. Results In 2016, 807 patients (mean age: 70 years; range: 35-96 years) received palliative radiotherapy for bone metastasis, with 69% of the patients having uncomplicated bone metastasis. The most common primary malignancies were prostate (27.1%), lung (20.6%), and breast cancer (15.9%). In 62% of cases, mfrt was used-a proportion that was unchanged from 2015. On multivariable analysis, a gastrointestinal [odds ratio (or): 5.3] or lung primary (or: 3.3), complicated bone metastasis (or: 4.3), and treatment at a subsidiary site (or: 4.4) increased the odds of mfrt use. Conclusions Dissemination of cwc recommendations alone did not increase sfrt use by radiation oncologists in 2016. A more comprehensive knowledge translation effort is therefore warranted and is now underway to encourage increased uptake of sfrt in Manitoba.
Collapse
Affiliation(s)
- J O Kim
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | | | - Y T Chung
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg
| | - J Beck
- Medical Physics, CancerCare Manitoba, Winnipeg
| | - R Koul
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - B Bashir
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - A Cooke
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - A Dubey
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - J Butler
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - M Nashed
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - W Hunter
- Radiation Oncology, Western Manitoba Cancer Centre, Brandon, MB
| | - A Ong
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| |
Collapse
|
4
|
Bowen M, Kinderman P, Cooke A. Stigma: a linguistic analysis of the UK red-top tabloids press’ representation of schizophrenia. Perspect Public Health 2019; 139:147-152. [DOI: 10.1177/1757913919835858] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods: Using corpus linguistic methods, a sample of newspaper articles over a 24-month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, while supported by statistical tests (log-likelihood) to compare the data sets and identify words with a high relative frequency. Results: Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. ‘schizo’) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency ( n = 108) and most commonly to name individuals who had committed acts of violence. Discussion: The study suggests that while the press has largely avoided the use of words that press guidance has steered them away from (e.g. ‘schizo’ and ‘psycho’), they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend with.
Collapse
Affiliation(s)
- M Bowen
- Faculty of Health and Social Care, University of Chester, Castle Drive, Chester CH1 1SL, UK
| | | | - A Cooke
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Canterbury, UK
| |
Collapse
|
5
|
Hoyle A, Ali A, James N, Parker C, Cooke A, Attard G, Chowdhury S, Cross W, Dearnaley D, De Bono J, Gilson C, Gillessen S, Jones R, Matheson D, Mason M, Ritchie A, Russell M, Douis H, Parmer M, Sydes M, Clarke N. The role of abiraterone acetate plus prednisone/prednisolone in high- and low-risk metastatic hormone sensitive prostate cancer. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)31004-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Chittock J, Cooke A, Lavender T, Brown K, Wigley A, Victor S, Cork MJ, Danby SG. Development of stratum corneum chymotrypsin-like protease activity and natural moisturizing factors from birth to 4 weeks of age compared with adults. Br J Dermatol 2016; 175:713-20. [PMID: 26994359 DOI: 10.1111/bjd.14568] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND From birth, the functional properties of the neonatal epidermal barrier mature whereby the stratum corneum (SC) hydrates and the skin surface acidifies. The identification of a thinner infant SC compared with adults suggests underdeveloped mechanisms underlying differentiation and desquamation. OBJECTIVES To assess the functional properties of the neonatal SC from birth, in conjunction with the quantification of superficial chymotrypsin-like protease activity [kallikrein-7 (KLK-7)] and filaggrin-derived natural moisturizing factors (NMF). METHODS A total of 115 neonates recruited to the Oil in Baby SkincaRE (OBSeRvE) randomized controlled trial underwent a full evaluation of the SC at birth (< 72 h old) and at 4 weeks of age (n = 39, no oil control group) using minimally invasive instrumentation and methodology. A cohort of 20 unrelated adults was recruited for comparison. RESULTS At birth NMF levels correlated with SC hydration (r = 0·50) and skin-surface pH (r = -0·54). From birth to 4 weeks, transepidermal water loss (TEWL), superficial KLK-7 activity and filaggrin-derived NMF significantly elevated. Impaired epidermal barrier function at birth (> 75th percentile TEWL) was accompanied by significantly elevated chymotrypsin-like protease activity and reduced levels of NMF. CONCLUSIONS The biophysical, biological and functional properties of the developing neonatal SC are transitional from birth to 4 weeks of age and differ significantly from adults. The presence of impaired barrier function with elevated protease activity and reduced NMF at birth suggests why certain infants are predisposed to epidermal barrier breakdown and the development of atopic dermatitis.
Collapse
Affiliation(s)
- J Chittock
- The Academic Unit of Dermatology Research, Department of Infection and Immunity, Faculty of Medicine, Dentistry and Health, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K..
| | - A Cooke
- School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, U.K
| | - T Lavender
- School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, U.K
| | - K Brown
- The Academic Unit of Dermatology Research, Department of Infection and Immunity, Faculty of Medicine, Dentistry and Health, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K
| | - A Wigley
- The Academic Unit of Dermatology Research, Department of Infection and Immunity, Faculty of Medicine, Dentistry and Health, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K
| | - S Victor
- Institute of Human Development, The University of Manchester, Manchester, U.K.,Sidra Neonatology Center of Excellence, Sidra Medical and Research Center, Doha, Qatar
| | - M J Cork
- The Academic Unit of Dermatology Research, Department of Infection and Immunity, Faculty of Medicine, Dentistry and Health, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K.,The Pediatric Dermatology Clinic, Sheffield Children's Hospital, Sheffield, U.K
| | - S G Danby
- The Academic Unit of Dermatology Research, Department of Infection and Immunity, Faculty of Medicine, Dentistry and Health, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K
| |
Collapse
|
7
|
White TS, Alexander R, Callow G, Cooke A, Harris S, Sargent J. A Mobile Climbing Robot for High Precision Manufacture and Inspection of Aerostructures. Int J Rob Res 2016. [DOI: 10.1177/0278364905055701] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this paper we describe the design, development, and experimental trials of a climbing robot for manufacturing and inspection applications within the aerospace industry. We describe the mechanical platform, which utilizes vacuum for attachment to vertical and overhanging surfaces, and a traction system that enables rapid movement of the robot over planar and curved surfaces of any orientation. The main applications considered during the research were the manufacturing processes for large external surface structures such as wings and the post-manufacturing and in-service inspection of such structures. The design of suitable tool packages for manufacturing and non-destructive testing is considered in the paper. The first tool package to be implemented and tested was a five-axis high precision drill, which is described. The control system is described within this paper along with the software architecture. The software architecture for the robot was generalized, allowing different robot configurations to be described and implemented rapidly through structured configuration files. Particular attention is paid to the robot’s localization and navigation system, which provides tool point precision to aircraft manufacturing tolerances. The localization system uses data from several different types of sensors and combines these with information provided by a surface model to derive six-degrees-of-freedom position and orientation using an extended Kalman filter to fuse the state information from the different sources. Tool point position is calculated through direct kinematic transformations. Improvements to this work are described, which utilize one of the initial releases of Lieca’s new six-degrees-of-freedom precision measurement instruments, the Lieca LTD-800. We also summarize the experimental trials and the initial performance in terms of tool point precision and climbing performance. The concept of application of the robot and details of the technologies included in the robot that are outlined in this paper are the subject of separate pending patent applications filed by BAE SYSTEMS plc.
Collapse
Affiliation(s)
- T. S. White
- Advanced Information Processing Department, BAE SYSTEMS Advanced Technology Centre, Bristol, UK,
| | - R. Alexander
- Advanced Information Processing Department, BAE SYSTEMS Advanced Technology Centre, Bristol, UK
| | - G. Callow
- Advanced Information Processing Department, BAE SYSTEMS Advanced Technology Centre, Bristol, UK
| | - A. Cooke
- Advanced Information Processing Department, BAE SYSTEMS Advanced Technology Centre, Bristol, UK
| | - S. Harris
- Advanced Information Processing Department, BAE SYSTEMS Advanced Technology Centre, Bristol, UK
| | - J. Sargent
- Advanced Information Processing Department, BAE SYSTEMS Advanced Technology Centre, Bristol, UK
| |
Collapse
|
8
|
Mills TA, Ricklesford C, Heazell AEP, Cooke A, Lavender T. Marvellous to mediocre: findings of national survey of UK practice and provision of care in pregnancies after stillbirth or neonatal death. BMC Pregnancy Childbirth 2016; 16:101. [PMID: 27154170 PMCID: PMC4859965 DOI: 10.1186/s12884-016-0891-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 04/30/2016] [Indexed: 05/07/2023] Open
Abstract
Background Pregnancy after stillbirth or neonatal death is an emotionally challenging life-event for women and adequate emotional support during pregnancy should be considered an essential component of quality maternity care. There is a lack of evidence surrounding the role of UK maternity services in meeting womens’ emotional and psychological needs in subsequent pregnancies. This study aimed to gain an overview of current UK practice and womens’ experiences of care in pregnancy after the death of a baby. Methods Online cross-sectional surveys, including open and closed questions, were completed on behalf of 138 United Kingdom (UK) Maternity Units and by 547 women who had experience of UK maternity care in pregnancy after the death of a baby. Quantitative data were analysed descriptively using SPSS software. Open textual responses were managed manually and analysed using the framework method. Results Variable provision of care and support in subsequent pregnancies was identified from maternity unit responses. A minority had specific written guidance to support care delivery, with a focus on antenatal surveillance and monitoring for complications through increased consultant involvement and technological surveillance (ultrasound/cardiotocography). Availability of specialist services and professionals with specific skills to provide emotional and psychological support was patchy. There was a lack of evaluation/dissemination of developments and innovative practice. Responses across all UK regions demonstrated that women engaged early with maternity care and placed high value on professionals as a source of emotional support. Many women were positive about their care, but a significant minority reported negative experiences. Four common themes summarised womens’ perceptions of the most important influences on quality and areas for development: sensitive communication and conduct of staff, appropriate organisation and delivery of services, increased monitoring and surveillance and perception of standard vs. special care. Conclusions These findings expose likely inequity in provision of care for UK parents in pregnancy after stillbirth or neonatal death. Many parents do not receive adequate emotional and psychological support increasing the risk of poor health outcomes. There is an urgent need to improve the evidence base and develop specific interventions to enhance appropriate and sensitive care pathways for parents.
Collapse
Affiliation(s)
- T A Mills
- School of Nursing, Midwifery and Social Work, The University of Manchester, Room 4.334, Jean McFarlane Building, Oxford Rd, Manchester, M13 9PL, UK. .,Manchester Academic Health Sciences Centre, Manchester, UK.
| | - C Ricklesford
- Central Manchester Foundation NHS Trust, Manchester, UK.,Manchester Academic Health Sciences Centre, Manchester, UK
| | - A E P Heazell
- Institute of Human Development, The University of Manchester, Manchester, UK.,Central Manchester Foundation NHS Trust, Manchester, UK.,Manchester Academic Health Sciences Centre, Manchester, UK
| | - A Cooke
- School of Nursing, Midwifery and Social Work, The University of Manchester, Room 4.334, Jean McFarlane Building, Oxford Rd, Manchester, M13 9PL, UK.,Manchester Academic Health Sciences Centre, Manchester, UK
| | - T Lavender
- School of Nursing, Midwifery and Social Work, The University of Manchester, Room 4.334, Jean McFarlane Building, Oxford Rd, Manchester, M13 9PL, UK.,Manchester Academic Health Sciences Centre, Manchester, UK
| |
Collapse
|
9
|
Holzer K, Ori A, Winkler J, Cooke A, Eiteneuer E, Beck M, Schirmacher P, Singer S. 537: Nup155 is linked to the p53 pathway in hepatocellular carcinoma. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
10
|
Mills TA, Ricklesford C, Cooke A, Heazell AEP, Whitworth M, Lavender T. Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis. BJOG 2014; 121:943-50. [DOI: 10.1111/1471-0528.12656] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2013] [Indexed: 11/27/2022]
Affiliation(s)
- TA Mills
- School of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| | - C Ricklesford
- Central Manchester University Hospitals NHS Trust; Manchester UK
| | - A Cooke
- School of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| | - AEP Heazell
- Central Manchester University Hospitals NHS Trust; Manchester UK
- Maternal and Fetal Health Research Group; Institute of Human Development; The University of Manchester; Manchester Academic Health Sciences Centre; Manchester UK
| | - M Whitworth
- Central Manchester University Hospitals NHS Trust; Manchester UK
- Maternal and Fetal Health Research Group; Institute of Human Development; The University of Manchester; Manchester Academic Health Sciences Centre; Manchester UK
| | - T Lavender
- School of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| |
Collapse
|
11
|
Lydall G, Muchemenye O, Williams A, Brehaut K, Peters C, Cooke A, Tullett R. EPA-0861 – Patterns of drug misuse on guernsey, british channel islands. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78193-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
12
|
|
13
|
Cooke A, Bruemmer-Smith S, McLoughlin J, McCaffrey J. Survey of echocardiography provision and practice in ICUs in the United Kingdom. Crit Care 2011. [PMCID: PMC3061656 DOI: 10.1186/cc9446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
14
|
Donnelly SC, Joshi NG, Thorburn D, Cooke A, Reid G, Neilson M, Capell H, Stanley AJ. Prevalence of genetic haemochromatosis and iron overload in patients attending rheumatology and joint replacement clinics. Scott Med J 2010; 55:14-6. [PMID: 20218273 DOI: 10.1258/rsmsmj.55.1.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Genetic Haemochromatosis (GH) is common in North European and Celtic populations and is associated with arthropathy. We aimed to measure the frequency of the common GH mutations (C282Y and H63D), the carrier frequency of C282Y and markers of iron overload in patients who were referred to our rheumatology and joint replacement clinics. METHODS Unselected patients attending these clinics were anonymously tested for the described mutations. Transferrin saturation and serum ferritin were also measured and if elevated, the patients had predictive counselling then named GH mutation testing. The carrier and mutation frequencies were also determined in 340 local controls. RESULTS One hundred and sixty-one unselected patients attending these clinics were studied. The C282Y mutation carrier frequency was 1 in 5.2 in patients compared with 1 in 8.1 in controls (p < 0.005). The overall mutation frequencies were similar in patients and controls. One patient was found to be a homozygous for the C282Y mutation and eight were compound heterozygotes. Seven other patients had a raised ferritin, one of whom was a C282Y heterozygote. CONCLUSION The C282Y carrier frequency is significantly higher in patients attending rheumatology and joint replacement clinics than in controls. Screening of these patients for GH should be considered.
Collapse
Affiliation(s)
- S C Donnelly
- Department of Gastroenterology, Glasgow Royal Infirmary
| | | | | | | | | | | | | | | |
Collapse
|
15
|
McWilliam C, Cooke A, Lobo D, Warner J, Taylor M, Tolmie JL. Semi-dominant X-chromosome linked learning disability with progressive ataxia, spasticity and dystonia associated with the novel MECP2 variant p.V122A: akin to the new MECP2 duplication syndrome? Eur J Paediatr Neurol 2010; 14:267-9. [PMID: 19592282 DOI: 10.1016/j.ejpn.2009.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 06/10/2009] [Accepted: 06/15/2009] [Indexed: 10/20/2022]
Abstract
A novel X-chromosome linked phenotype is reported. Three affected males had learning disability in early childhood and subsequently developed progressive ataxia, dystonia, and spasticity with death at ages 9, 14 and 19 years. Two female obligate carriers had learning difficulties with psychosis in one case. A third, possible carrier had learning difficulties and epilepsy. A family study indicates that this inherited syndrome is most likely due to an unreported MECP2 variant, p.V122A, located in the methyl binding domain of the MECP2 protein. The clinical features are similar to those present in the newly reported MECP2 duplication syndrome. Non-progressive neuropsychiatric symptoms in female relatives of a male child with learning disability, ataxia and progressive spasticity may constitute a clue to inherited, MECP2 pathogenesis.
Collapse
Affiliation(s)
- Catherine McWilliam
- West of Scotland Regional Genetics Service, Yorkhill Hospitals, Glasgow G3 8 SJ, UK
| | | | | | | | | | | |
Collapse
|
16
|
Isaacs J, Courtenay B, Cooke A, Gupta M. Open reduction and internal fixation for concomitant talar neck, talar body, and medial malleolar fractures: a case report. J Orthop Surg (Hong Kong) 2009; 17:112-5. [PMID: 19398807 DOI: 10.1177/230949900901700125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fractures of the talus are rare and generally associated with severe trauma. The mechanism of injury is usually forced dorsiflexion or a fall from a height. Severe talar fractures pose a challenge for surgeons as they are often associated with complications such as avascular necrosis, collapse, malunion, secondary osteoarthritis and pain. This has led some institutions to advocate primary arthrodesis for these injuries. We report an unusual complex fracture of the talus that was successfully managed with open reduction and internal fixation. By restoring a near-normal range of motion and function to a fit, young male, the severely limiting effects of arthrodesis were avoided or at least delayed. We use this case to highlight that primary arthrodesis should only be reserved for cases that fail to respond to open reduction and internal fixation or deteriorate to the point where it is the only reasonable and justifiable alternative.
Collapse
Affiliation(s)
- J Isaacs
- Royal North Shore Hospital, Sydney, NSW, Australia.
| | | | | | | |
Collapse
|
17
|
Mangalore Devdas J, Campbell-Hewson Q, Friswell M, Gupta A, Featherstone T, Cooke A, DeKiewiet G, Hopper NW. Lateral deviation of toes requires lateral thinking. Arch Dis Child 2009; 94:69. [PMID: 19103790 DOI: 10.1136/adc.2008.149658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
18
|
Bhagwat S, Crew A, Gokhale P, Cooke A, Kahler J, Yao Y, Chan A, Arnold L, Wild R, Pachter J. 320 POSTER Cellular characterization of OXA-01, a potent and selective dual mTORC1 and mTORC2 kinase inhibitor. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)72254-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
19
|
Cooke A, O'Neill O, Shields M, Mulholland D. 643. Transversus Abdominis Blocks in Elective Abdominal Surgery. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
20
|
Rosenfeld-Franklin M, Silva S, Pirritt C, Cooke A, Bittner M, Wolf J, Epstein D, Wild R. Antitumor efficacy of OSI-930 and the molecular targeted agent erlotinib in preclinical xenograft models. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.14596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
21
|
Cooke A, Ferraccioli GF, Herrmann M, Romani L, Schulze C, Zampieri S, Doria A. Induction and protection of autoimmune rheumatic diseases. The role of infections. Clin Exp Rheumatol 2008; 26:S1-S7. [PMID: 18570747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
It is thought that in genetically predisposed individuals, autoimmune diseases can be promoted and/or exacerbated by viruses, bacteria, or parasitic infectious agents. Pathogens can activate innate immune response interacting with Toll-like receptors that recognize pathogen-associated molecules. As a consequence of infections, a prolonged inflammatory response may occur leading to chronic inflammation with activation of adaptive immune response. In addition, the defective clearance of apoptotic infected cells, which progress- es to secondary necrosis, can foster the autoimmune reactions. Although numerous data from humans and/or animal models support the hypothesis of a direct contribution of pathogens to the induction of the disease, some infectious agents are able to prevent autoimmune disorders. In this review, data on the innate and adaptive immune response induced by pathogens are summarized, focusing on the possible protective or non-protective role of infections in the development of autoimmune diseases.
Collapse
Affiliation(s)
- A Cooke
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | |
Collapse
|
22
|
Edwards A, Bennett D, Carswell E, Cooke A, Nimz O. Design, Structure Activity Relationships and X-Ray Co-Crystallography of Non-Steroidal LXR Agonists. Curr Med Chem 2008; 15:195-209. [DOI: 10.2174/092986708783330584] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
23
|
Owen T, Nugent Z, El-Guptan A, Cooke A. Risk of Locoregional Recurrence in Post-Mastectomy Breast Cancer Patients With 1–3 Positive Nodes. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
24
|
Roitt IM, Cooke A. Manipulation of idiotype networks in autoimmunity. Ciba Found Symp 2007; 129:209-22. [PMID: 3315503 DOI: 10.1002/9780470513484.ch14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The spontaneous occurrence of anti-idiotypes associated with the amelioration of disease activity in some autoimmune disorders encourages the view that one may be able to develop a therapeutic strategy based upon manipulation of idiotype networks. Attempts to abrogate autoimmunity by using heterologous anti-idiotype reagents have been rather disappointing and there may well be an expansion of idiotype-negative antibody clones. We argue that idiotypic reagents based on T cells or antibodies derived from the species being treated are more likely to lead to success because they interact more profoundly with the individual's own networks than do heterologous antibodies.
Collapse
Affiliation(s)
- I M Roitt
- Department of Immunology, Middlesex Hospital Medical School, London, UK
| | | |
Collapse
|
25
|
Stewart W, Traynor JP, Cooke A, Griffiths S, Onen NF, Balsitis M, Shah AA, Upadhyaya M, Tobias ES. Gastric carcinoid: germline and somatic mutation of the neurofibromatosis type 1 gene. Fam Cancer 2007; 6:147-52. [PMID: 16944271 DOI: 10.1007/s10689-006-9002-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Accepted: 07/18/2006] [Indexed: 10/24/2022]
Abstract
Neurofibromatosis type 1 (NF1) is one of the most common autosomal dominantly inherited conditions. A range of complications has been described, including gastrointestinal manifestations. Gastric carcinoid tumours are associated with multiple endocrine neoplasia, atrophic gastritis and pernicious anaemia but have not been reported in NF1 in the absence of other predisposing factors. We report the occurrence and investigation of a gastric carcinoid tumour in a 23-year-old woman with previously uncomplicated NF1. Analysis of the tumour tissue revealed loss of heterozygosity at the NF1 gene locus but a normal karyotype and an absence of microsatellite instability. A germline NF1 gene nonsense mutation in exon 37 was detected by denaturing high-performance liquid chromatography and DNA sequence analysis. This is the first reported occurrence of a gastric carcinoid tumour in a patient with NF1 in the absence of other predisposing factors such as pernicious anaemia. The analyses indicate that the carcinoid arose through NF1 gene inactivation but in the absence of an inherited NF1 gene microdeletion. This case adds to the range of gastrointestinal tumours that may be encountered in patients with NF1, particularly in those who present with upper gastrointestinal haemorrhage.
Collapse
Affiliation(s)
- W Stewart
- Department of Pathology, Crosshouse Hospital, Kilmarnock KA2 0BE, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
|
27
|
Abstract
The debate on whether infection precipitates or prevents autoimmunity remains a contentious one. Recently the suggestion that some unknown microbe can be at the origin of some chronic inflammatory diseases has been countered by accumulating evidence that decreasing infection rates might have an important role to play in the rising prevalence of autoimmune disorders. The 'Hygiene Hypothesis' was initially postulated to explain the inverse correlation between the incidence of infections and the rise of allergic diseases, particularly in the developed world. Latterly, the Hygiene Hypothesis has been extended to also incorporate autoimmune diseases in general. Amongst the various infectious agents, a particular emphasis has been put on the interaction between parasitic worms and humans. Worm parasites have co-evolved with the mammalian immune system for many millions of years and during this time, they have developed extremely effective strategies to modulate and evade host defences and so maintain their evolutionary fitness. It is therefore reasonable to conclude that the human immune system has been shaped by its relationship with parasitic worms and this may be a necessary requirement for maintaining our immunological health. Fully understanding this relationship may lead to novel and effective treatments for a host of deleterious inflammatory reactions.
Collapse
Affiliation(s)
- P Zaccone
- Department of Pathology, Tennis Court Road, Cambridge, UK
| | | | | | | | | |
Collapse
|
28
|
St-Hilaire S, Ellis T, Cooke A, North BP, Turnbull JF, Knowles T, Kestin S. Fin erosion on rainbow trout on commercial trout farms in the United Kingdom. Vet Rec 2006; 159:446-50. [PMID: 17012609 DOI: 10.1136/vr.159.14.446] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Fish weighing less than 30 g and more than 100 g were sampled from 38 rearing units on 10 commercial farms growing rainbow trout for the table market. A fin index was calculated for each of the eight rayed fins on 949 trout by dividing their length by the standard length of the fish. There was a large range in the indices of all eight fins. The fin indices of the small and large fish were compared, controlling for farm effect. With the exception of the dorsal fin, all the indices were larger for the small fish than for the large fish, but the magnitude of the difference was greater for some fins than others. In comparison with the fins of wild fish, the pectoral and dorsal fins appeared to be most eroded and the damage to these fins was evident even in the small fish. The erosion of the caudal, anal and ventral (or pelvic) fins was more prominent in the larger fish. Variations in the fin indices of the caudal, anal and ventral fins suggested that there was little variation between rearing units on the same farm, but that there was significant variation between individual fish in the same rearing units, and between fish on different farms.
Collapse
Affiliation(s)
- S St-Hilaire
- CEFAS Weymouth Laboratory, Barrack Road, The Nothe, Weymouth DT4 8UB
| | | | | | | | | | | | | |
Collapse
|
29
|
Koul R, Dufan T, Russell C, Guenther W, Cooke A. 96 The efficacy of complete decongestive therapy and manual lymphatic drainage on treatment related lymphedema in breast cancer. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
30
|
Thompson C, Pomeranz Krummel DA, Jacobsen H, Nagai K, Cooke A. Identification of nuclear spliceosomal antigens targeted by NOD mouse antibodies following sodium iodide intake. Autoimmunity 2006; 39:99-106. [PMID: 16698665 DOI: 10.1080/08916930600597276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The non-obese diabetic (NOD) mouse spontaneously develops a range of autoreactive responses including an autoantibody response to nuclear antigens. As elevated dietary iodine has been shown to increase thyroid autoimmune pathology in NOD mice, the effect of sodium iodide (NaI) on the development of anti-nuclear antibodies (ANA) was assessed. Interestingly, the NaI symporter is expressed in both thyroid and salivary glands. Elevated dietary iodine was found to increase the percentage of male NOD mice developing autoantibodies. Specifically, the nuclear autoantibodies that develop in NOD mice were shown to target specific spliceosomal components. The target specificity of the autoantibodies was determined using recombinant spliceosomal proteins and shown to include U1A, U170K, U2B'', U2A', as well as the Sm proteins D1, D2, and B. The autoantibody isotypes most consistently represented were IgG2a and IgG2b.
Collapse
Affiliation(s)
- C Thompson
- University of Cambridge, Department of Pathology, Tennis Court Road, Cambridge, CB2 1QP, UK
| | | | | | | | | |
Collapse
|
31
|
O'Shea H, Yousaf N, Altmann D, Fehervari Z, Tonks P, Hetherington C, Harach S, Bland C, Cooke A, Lund T. Effect of X- and Y-box deletions on the development of diabetes in H-2Ealpha-chain transgenic nonobese diabetic mice. Scand J Immunol 2006; 63:17-25. [PMID: 16398697 DOI: 10.1111/j.1365-3083.2006.001701.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The development of type 1 diabetes in nonobese diabetic (NOD) mice is influenced by major histocompatibility complex (MHC) class II genes. The NOD-E transgenic mouse, which expresses H2-E as a result of the introduction of an Ead gene, is protected from development of type 1 diabetes. While the mechanism of protection remains unclear, the effect has been regarded as a model system for MHC protection from autoimmunity. We have investigated the effect of deletions of the Ea promoter region, which, in turn, affect H2-E expression patterns in transgenic NOD mice. We have constructed transgenic NOD mice where the X (DeltaX) and Y (DeltaY) boxes of the Ead gene have, respectively, been functionally deleted. Previous reports, using X- or Y-box-deleted H2-E transgenic mice, made by crossing the appropriate transgenes onto the NOD background from C57BL/6 transgenic mice, indicated that promoter mutation abrogated the H2-E-mediated protection seen in NOD-E. The NOD DeltaX and NOD DeltaY transgenic mice generated in the present study differ in susceptibility to diabetes from wild-type NOD mice. NOD DeltaY1 animals are protected from diabetes development, while DeltaX mice remain susceptible, albeit to a lesser extent than the parental NOD strain.
Collapse
Affiliation(s)
- H O'Shea
- Division of Immunology, Department of Pathology, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Garton A, Kahler J, Castaldo L, Yao Y, Franks A, Henninger D, Srebernak M, Cooke A, Bittner M, Crew A. 413 Pharmacokinetic/pharmacodynamic analysis of OSI-930, a novel selective tyrosine kinase inhibitor with anti-tumor activity. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80420-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
33
|
Grossman M, Cooke A, DeVita C, Lee C, Alsop D, Detre J, Gee J, Chen W, Stern MB, Hurtig HI. Grammatical and resource components of sentence processing in Parkinson's disease: an fMRI study. Neurology 2003; 60:775-81. [PMID: 12629232 DOI: 10.1212/01.wnl.0000044398.73241.13] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sentence comprehension requires linguistic processing as well as cognitive resources such as working memory (WM) and information-processing speed (IPS). The authors hypothesize that sentence comprehension difficulty in patients with mild PD is due to degradation of the large-scale neural network that supports cognitive resources during sentence processing. OBJECTIVE To understand the neural basis for sentence comprehension difficulty in PD. METHOD Regional brain activity with blood oxygenation level-dependent fMRI was monitored while seven PD patients and nine healthy seniors answered a simple probe about written sentences that vary in their grammatical and cognitive resource properties. RESULTS Healthy seniors recruited posterolateral temporal and ventral inferior frontal regions of the left hemisphere, brain regions associated with grammatical processing that were also activated by PD patients. Healthy seniors also recruited left dorsal inferior frontal, right posterolateral temporal, and striatal regions that are associated with cognitive resources during sentence processing. Direct contrasts showed that striatal, anteromedial prefrontal, and right temporal regions are recruited to a significantly lesser degree in PD, but these patients have increased activation of right inferior frontal and left posterolateral temporal-parietal areas during sentence comprehension. CONCLUSION These findings associate impaired sentence comprehension in PD with interruption of a large-scale network important for cognitive resources during sentence processing. These results also imply compensatory up-regulation of cortical activity that allows patients with mild PD to maintain sentence comprehension accuracy.
Collapse
Affiliation(s)
- M Grossman
- Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Redlick F, Cooke A, Gomez M, Banfield J, Cartotto RC, Fish JS. A survey of risk factors for burns in the elderly and prevention strategies. J Burn Care Rehabil 2002; 23:351-6; discussion 341. [PMID: 12352138 DOI: 10.1097/00004630-200209000-00009] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Elderly burn patients suffer from greater morbidity and mortality than younger patients with similar burn extents. The purpose of this study was to identify risk factors for burn injuries in the elderly to develop an effective preventive program. A cross-sectional survey was conducted among 20 elderly (> or =65 years of age) burn survivors on the circumstances surrounding their burn injury and on burn prevention. A control group of 20 nonburned elderly completed a similar survey only on burn prevention. The majority of burned subjects believed that their injury was preventable (85%). The home was the commonest location for burn injury (70%), and scalds (50%) and flame burns (25%) were the most common etiologies. Most subjects felt that a burn prevention program would be useful (95%) and television, news, and posters were the preferred sources of prevention information. Compared with the burn group, the control group had more risk factors for burn injury. However, the control group also took more active preventive measures. Burn prevention campaigns for elderly should focus on reducing flame and scald burns that occur in the home, preferably using television, news, and poster media.
Collapse
Affiliation(s)
- F Redlick
- Ross Tilley Burn Centre, Sunnybrook & Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5
| | | | | | | | | | | |
Collapse
|
35
|
|
36
|
Abstract
Nurses' job action during the spring and summer 2001 taught us much in British Columbia. Post job action de-briefing with non-contract staff confirmed for the Capital Health Region in Victoria that the workload of patient care managers, along with their scope of responsibility was contributing to dissatisfaction, both on the part of patient care managers as well as nursing staff who they are intended to serve. Further, it was becoming increasingly apparent that the success of most of the organizational initiatives depended greatly on the presence, availability and support of patient care managers. Supported by the senior leadership team, the Chief Nursing Officer for the Capital Health Region agreed to have a look at unit based leadership--see what was being discussed across the country and in the literature and draw on her own experience in three provinces. The result would be a discussion paper that would circulate broadly throughout the organization and would provide the organization with broad input to help it decide collectively "What do we need to do? Where do we need to go from here? And how will we get there?" This article is an adaptation of that discussion paper.
Collapse
Affiliation(s)
- A Cooke
- Capital Health Region in Victoria, BC
| |
Collapse
|
37
|
Abstract
BDC2.5/nonobese diabetic (NOD) transgenic mice express a TCR from a diabetogenic T cell clone yet do not spontaneously develop diabetes at high incidence. Evidence exists showing that in the absence of endogenous TCR alpha-chain rearrangements this transgenic mouse spontaneously develops diabetes and that CTLA-4 negatively regulates diabetes onset. This strongly suggests that onset of diabetes in BDC2.5/NOD mice is governed by T cell regulation. We addressed the mechanism of immune regulation in BDC2.5/NOD mice. We find that activated spleen cells from young, but not old, BDC2.5/NOD mice are able to transfer diabetes to NOD-scid recipients. We have used anti-IL-10R to show that the failure of splenocytes from older mice to transfer diabetes is due to dominant regulation. We furthermore found that diabetes developed following anti-IL-10R treatment of 6-wk old BDC2.5/NOD mice indicating that endogenous IL-10 plays a key role in the regulation of diabetes onset in this transgenic mouse.
Collapse
MESH Headings
- Adoptive Transfer
- Aging/genetics
- Aging/immunology
- Animals
- Antibody Specificity/genetics
- Cells, Cultured
- Cytokines/biosynthesis
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/immunology
- Diabetes Mellitus, Type 1/metabolism
- Female
- Immune Sera/physiology
- Interleukin-10/metabolism
- Lymphocyte Activation/genetics
- Male
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Mice, Transgenic
- Receptors, Antigen, T-Cell/genetics
- Receptors, Interleukin/antagonists & inhibitors
- Receptors, Interleukin/immunology
- Receptors, Interleukin/metabolism
- Receptors, Interleukin/physiology
- Receptors, Interleukin-10
- Receptors, Interleukin-2/biosynthesis
- Spleen/cytology
- Spleen/transplantation
Collapse
Affiliation(s)
- J M Phillips
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | | | | | | |
Collapse
|
38
|
Anderson A, Belelli D, Bennett DJ, Buchanan KI, Casula A, Cooke A, Feilden H, Gemmell DK, Hamilton NM, Hutchinson EJ, Lambert JJ, Maidment MS, McGuire R, McPhail P, Miller S, Muntoni A, Peters JA, Sansbury FH, Stevenson D, Sundaram H. Alpha-amino acid phenolic ester derivatives: novel water-soluble general anesthetic agents which allosterically modulate GABA(A) receptors. J Med Chem 2001; 44:3582-91. [PMID: 11606122 DOI: 10.1021/jm010903i] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In the search for a novel water-soluble general anesthetic agent the activity of an alpha-amino acid phenolic ester lead, identified from patent literature, was markedly improved. In addition to improving in vivo activity in mice, good in vitro activity at GABA(A) receptors was also conferred. Within the series of compounds good enantioselectivity for both in vitro and in vivo activity was found, supporting a protein-mediated mechanism of action for anesthesia involving allosteric modulation of GABA(A) receptors. alpha-Amino acid phenolic ester 19, as the hydrobromide salt Org 25435, was selected for clinical evaluation since it retained the best overall anesthetic profile coupled with improved stability and water solubility. In the clinic it proved to be an effective intravenous anesthetic in man with rapid onset of and recovery from anesthesia at doses of 3 and 4 mg/kg.
Collapse
Affiliation(s)
- A Anderson
- Organon Research, Newhouse, Lanarkshire ML1 5SH, Scotland, U.K
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
A variety of therapeutic strategies have been developed to tolerize autoreactive T cells and prevent autoimmune pathology. In terms of type 1 diabetes, prevention strategies can inhibit the priming and expansion of autoreactive T cells; however, a cure for diabetes would require tolerance to be established in the presence of primed effector cells together with replacement of the destroyed beta cell mass. Replacement of beta cells could be accomplished by transplantation of islets or stem cells or through islet regeneration. We will focus here on tolerogenic strategies that have been used to prevent onset of type 1 diabetes and discuss the potential for a cure.
Collapse
Affiliation(s)
- A Cooke
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.
| | | | | |
Collapse
|
40
|
Tobias ES, Bryce G, Farmer G, Barton J, Colgan J, Morrison N, Cooke A, Tolmie JL. Absence of learning difficulties in a hyperactive boy with a terminal Xp deletion encompassing the MRX49 locus. J Med Genet 2001; 38:466-70. [PMID: 11474655 PMCID: PMC1757174 DOI: 10.1136/jmg.38.7.466] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
41
|
Knowling M, Browman G, Siu L, Khoo K, Cooke A, Tannock I, Klaassen D, Cripps C, Goss G, Matthews S, Clarke R, Seymour L. A National Cancer Institute of Canada clinical trials group phase II study of eniluracil (776C85) and oral 5-fluorouracil in patients with advanced squamous cell head and neck cancer. Ann Oncol 2001; 12:919-22. [PMID: 11521795 DOI: 10.1023/a:1011141530545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
UNLABELLED BACKGROUND/PATIENTS AND METHODS: Thirty-two patients with recurrent head and neck cancer (HNC) following radiotherapy and/or surgery were treated with eniluracil (10 mg/m2) and 5-fluorouracil (5-FU) (1 mg/m2) (E5F) orally twice daily for 28 days followed by a seven-day treatment free period. Thirty-five-day cycles were repeated until disease progression, unacceptable toxicity or patient refusal. Doses were modified for toxicity. Standard toxicity and response criteria were used. RESULTS Thirty-two patients were accrued; thirty-two and twenty-eight patients were evaluable for toxicity and response, respectively. Twelve patients received three or more cycles of E5F. Drug related toxicities were usually grade 1-2 intensity and included lethargy, nausea or diarrhea (> or = 25% of patients), and anorexia, rash or itch, stomatitis or vomiting (12%-24% of patients). Hematologic toxicity was generally mild; two patients experienced grade 3-5 leukopenia or thrombocytopenia. No significant biochemical toxicity was seen. One patient was withdrawn (severe nausea and vomiting) and one patient died because of drug related toxicity (thrombocytopenia). In the final analysis there were one complete and four partial responses for a 15.6% overall response. CONCLUSIONS E5F demonstrates activity in chemotherapy naïve patients with advanced HNC cancer with acceptable toxicity profile. Further investigation of E5F with other active agents is warranted in HNC.
Collapse
Affiliation(s)
- M Knowling
- National Cancer Institute of Canada Clinical Trials Group, Kingston, Ontario.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Isenberg D, Katz D, Maddison P, Watts R, Tucker L, Cooke A. Induction of anti-DNA antibodies: commentary on article by Satake et al. Lupus 2001; 10:63-5. [PMID: 11243512 DOI: 10.1191/096120301667736481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
43
|
Dundar M, Gordon TM, Ozyazgan I, Oguzkaya F, Ozkul Y, Cooke A, Wilkinson AG, Holloway S, Goodman FR, Tolmie JL. A novel acropectoral syndrome maps to chromosome 7q36. J Med Genet 2001; 38:304-9. [PMID: 11333865 PMCID: PMC1734869 DOI: 10.1136/jmg.38.5.304] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
F syndrome (acropectorovertebral syndrome) is a dominantly inherited skeletal dysplasia affecting the hands, feet, sternum, and lumbosacral spine, which has previously been described in only two families. Here we report a six generation Turkish family with a related but distinct dominantly inherited acropectoral syndrome. All 22 affected subjects have soft tissue syndactyly of all fingers and all toes and 14 also have preaxial polydactyly of the hands and/or feet. In addition, 14 have a prominent upper sternum and/or a blind ending, inverted U shaped sinus in the anterior chest wall. Linkage studies and haplotype analysis carried out in 16 affected and nine unaffected members of this family showed that the underlying locus maps to a 6.4 cM interval on chromosome 7q36, between EN2 and D7S2423, a region to which a locus for preaxial polydactyly and triphalangeal thumb-polysyndactyly has previously been mapped. Our findings expand the range of phenotypes associated with this locus to include total soft tissue syndactyly and sternal deformity, and suggest that F syndrome may be another manifestation of the same genetic entity. In mice, ectopic expression of the gene Sonic hedgehog (Shh) in limb buds and lateral plate mesoderm during development causes preaxial polydactyly and sternal defects respectively, suggesting that misregulation of SHH may underlie the unusual combination of abnormalities in this family. A recently proposed candidate gene for 7q36 linked preaxial polydactyly is LMBR1, encoding a novel transmembrane receptor which may be an upstream regulator of SHH.
Collapse
Affiliation(s)
- M Dundar
- Departments of Medical Genetics, Plastic and Reconstructive Surgery, and Thoracic Surgery, Erciyes University Medical Faculty, 38039 Kayseri, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Cooke A, Anderson A, Buchanan K, Byford A, Gemmell D, Hamilton N, McPhail P, Miller S, Sundaram H, Vijn P. Water-soluble propofol analogues with intravenous anaesthetic activity. Bioorg Med Chem Lett 2001; 11:927-30. [PMID: 11294393 DOI: 10.1016/s0960-894x(01)00088-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Propofol (2,6-diisopropylphenol) is a widely used intravenous anaesthetic that is formulated as an emulsion since it lacks water solubility. We report a range of water-soluble analogues of propofol, containing a para-alkylamino substituent, which retain good intravenous anaesthetic activity in rodents.
Collapse
Affiliation(s)
- A Cooke
- Department of Medicinal Chemistry and Pharmacology, Organon Laboratories Ltd., Newhouse, Scotland, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Cooke A. Clinical governance on the Internet. Clin Perform Qual Health Care 2001; 8:58-9. [PMID: 11183969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- A Cooke
- Royal Free and University College Medical School of UCL, London.
| |
Collapse
|
46
|
Cooke A. Critical response to dyslexia, literacy and psychological assessment. (report by a working party of the division of educational and child psychology of the British psychological society). A view from the chalk face. Dyslexia 2001; 7:47-52. [PMID: 11305231 DOI: 10.1002/dys.181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- A Cooke
- Dyslexia Unit, School of Psychology, University of Wales, Bangor, Gwynedd LL57 2DG, UK
| |
Collapse
|
47
|
van Halteren AG, Mosselman B, Roep BO, van Eden W, Cooke A, Kraal G, Wauben MH. T cell reactivity to heat shock protein 60 in diabetes-susceptible and genetically protected nonobese diabetic mice is associated with a protective cytokine profile. J Immunol 2000; 165:5544-51. [PMID: 11067908 DOI: 10.4049/jimmunol.165.10.5544] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Spontaneous onset of pancreatic beta cell destruction in the nonobese diabetic (NOD) mouse is preceded by the induction of autoreactive T cells, which recognize a variety of autoantigens. The 60-kDa endogenous (murine) heat shock protein 60 (hsp60) has been proposed to be one of the key autoantigens. Here we demonstrate that subcutaneous immunization of normoglycemic NOD mice with highly homologous mycobacterial or murine hsp60 activates T cells in the spleen that produce high levels of IL-10 upon restimulation in vitro with either hsp60 protein. In time, increasing levels of hsp60-induced IL-10 could be detected in NOD mice, but not in age- and MHC class II-matched BiozziABH mice, which lack any sign of pancreatic inflammation. These results suggest that the IL-10 responses in NOD mice are primarily driven by endogenous inflammation. Genetically protected NOD-asp mice, showing a less progressive development of insulitis, demonstrated a similar increase in hsp60-induced IL-10 in time compared with wild-type NOD mice. Taken together, our results suggest that endogenous hsp60 is not a primary autoantigen in diabetes but is possibly associated with regulation of insulitis. Moreover, the capacity to respond to (self) hsp60 is independent of the MHC class II-associated genetic predisposition to diabetes.
Collapse
Affiliation(s)
- A G van Halteren
- Department of Cell Biology and Immunology, Medical Faculty, Vrije Universiteit Amsterdam, Amsterdam.
| | | | | | | | | | | | | |
Collapse
|
48
|
Phillips JM, Harach SZ, Parish NM, Fehervari Z, Haskins K, Cooke A. Nondepleting anti-CD4 has an immediate action on diabetogenic effector cells, halting their destruction of pancreatic beta cells. J Immunol 2000; 165:1949-55. [PMID: 10925277 DOI: 10.4049/jimmunol.165.4.1949] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The induction of tolerance in a primed immune system is a major aim for therapy in autoimmunity and transplant rejection. In this paper, we investigate the action of the nondepleting anti-CD4 Ab, YTS 177. Although this Ab is nondepleting, we have demonstrated a direct action in vivo on activated effector cells. We show that the Ab inhibits transfer of insulin-dependent diabetes mellitus by the CD4+ Th1 clone BDC2.5 to nonobese diabetic mice. Furthermore, we show that this Ab acts directly on diabetogenic effector cells because it prevented BDC2.5-induced insulin-dependent diabetes mellitus in nonobese diabetic-scid recipients in the absence of other T cells. The Ab halts the diabetic process even when it is administered after the BDC2.5 cells have infiltrated the pancreas and destruction of islets is already underway. This is accompanied by an immediate decrease in proinflammatory cytokine production with cessation of beta cell destruction and disappearance of infiltrating cells from the pancreas, leaving any remaining beta cells intact. These data suggest that Abs such as this may be effective not only because they induce regulatory T cells but also because they are able to directly prevent effector cell function.
Collapse
MESH Headings
- Adoptive Transfer
- Animals
- Animals, Newborn/immunology
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/pharmacology
- CD4 Antigens/immunology
- Cell Movement/immunology
- Clone Cells/immunology
- Clone Cells/transplantation
- Cytotoxicity, Immunologic/immunology
- Diabetes Mellitus, Type 1/immunology
- Diabetes Mellitus, Type 1/pathology
- Diabetes Mellitus, Type 1/prevention & control
- Enzyme Inhibitors/administration & dosage
- Enzyme Inhibitors/pharmacology
- Epithelium/immunology
- Epithelium/metabolism
- Female
- Growth Inhibitors/administration & dosage
- Growth Inhibitors/pharmacology
- Histocompatibility Antigens Class II/biosynthesis
- Immunosuppressive Agents/administration & dosage
- Immunosuppressive Agents/pharmacology
- Injections, Intraperitoneal
- Interferon-gamma/antagonists & inhibitors
- Interferon-gamma/biosynthesis
- Interferon-gamma/genetics
- Interleukin-2/antagonists & inhibitors
- Interleukin-2/biosynthesis
- Interleukin-2/genetics
- Islets of Langerhans/enzymology
- Islets of Langerhans/immunology
- Islets of Langerhans/pathology
- Lymphocyte Activation/immunology
- Lymphocyte Depletion
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Nitric Oxide Synthase/antagonists & inhibitors
- Nitric Oxide Synthase/biosynthesis
- Nitric Oxide Synthase/genetics
- Nitric Oxide Synthase Type II
- Pancreatic Ducts/immunology
- Pancreatic Ducts/metabolism
- RNA, Messenger/antagonists & inhibitors
- RNA, Messenger/biosynthesis
- T-Lymphocytes/immunology
- T-Lymphocytes/transplantation
Collapse
Affiliation(s)
- J M Phillips
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
| | | | | | | | | | | |
Collapse
|
49
|
Abstract
The purpose of this literature review is to identify those factors which might affect the research capacity of departments of nursing based in higher education, and to make recommendations based upon the findings to enable departments to develop their capacity to undertake research. There is a dearth of published research which directly addresses this issue and therefore publications were reviewed which related to: the impact on nurse educators of the integration of nursing into higher education; nurse educators' attitudes towards research and their research role; analysis of the results of the 1992 and 1996 Research Assessment Exercises and commentaries on them; developing research within nursing generally; and factors affecting research productivity within nursing and related disciplines. The papers were analysed according to the following themes: academic qualifications; research skills; time available for research; motivation to undertake research; a culture of research; subject specialization; subject areas for research; research quality; and a nursing research council. The conclusions are first, that whilst there is a dearth of literature which relates directly to research capacity development in academic departments of nursing, there is much advice which can be drawn upon. Second, the article concludes that the factors affecting research capacity development are numerous and complex and it is not something which can only take place at the departmental level. There are also issues which require consideration nationally, as well as factors which depend upon the individual academic, and these impact upon the research capacity of academic departments of nursing. The factors are summarized at the end of the paper in the conclusions and recommendations.
Collapse
Affiliation(s)
- A Cooke
- School of Health Science, University of Wales Swansea, Swansea, Wales
| | | |
Collapse
|
50
|
Fowkes FG, Lee AJ, Hau CM, Cooke A, Connor JM, Lowe GD. Methylene tetrahydrofolate reductase (MTHFR) and nitric oxide synthase (ecNOS) genes and risks of peripheral arterial disease and coronary heart disease: Edinburgh Artery Study. Atherosclerosis 2000; 150:179-85. [PMID: 10781649 DOI: 10.1016/s0021-9150(99)00366-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Hyperhomocysteinaemia and reduced nitric oxide synthesis may each result in endothelial dysfunction predisposing to atherogenesis. Genetic variants of methylene tetrahydrofolate reductase (MTHFR) and endothelial nitric oxide synthase (ecNOS) influence homocysteine metabolism and nitric oxide synthesis, respectively and might thus be determinants of the risk of atherosclerotic disease. The aim of our study was to identify, in a general population sample, the risks of peripheral arterial disease and of coronary heart disease related to MTHFR (175;198) and ecNOS (4;5) polymorphisms. In the Edinburgh Artery Study, which is a population based cohort study, 940 men and women aged 60-79 years, who had previously been selected at random from the general population, had DNA extracted from a venous blood sample. Based on a clinical examination at baseline and follow up investigations, three groups of subjects were identified: those with peripheral arterial disease (n=80), those with coronary heart disease (n=137), and healthy controls who had no evidence of cardiovascular disease (n=300). The distributions of the ecNOS and MTHFR genotypes did not differ significantly between the groups with and without cardiovascular disease. However, the ecNOS-4 allele (frequency 0.13) was related to the occurrence of coronary heart disease in non smokers, OR=2.47 (95% CI [1.42, 4.34], P=0.02). No association was found with peripheral arterial disease. The MTHFR-175 allele (frequency 0.31) was not related to coronary heart disease, but was associated with a reduced risk of peripheral arterial disease, OR=0.54 (95% CI [0.32, 0.90], P=0.02). Neither the ecNOS-4 allele or MTHFR-175 allele was related to the ankle brachial pressure index in the whole study population. In conclusion, the ecNOS-4 allele was associated with a slightly increased risk of coronary heart disease in non-smokers, but otherwise the MTHFR and ecNOS genotypes appeared to have little influence on the risks of peripheral arterial disease and coronary heart disease in this older population.
Collapse
Affiliation(s)
- F G Fowkes
- Department of Public Health Sciences, Wolfson Unit for Prevention of Peripheral Vascular Diseases, University of Edinburgh, Teviot Place, Edinburgh, UK.
| | | | | | | | | | | |
Collapse
|