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Miller L, Imms C, Cross A, Pozniak K, O'Connor B, Martens R, Cavalieros V, Babic R, Novak-Pavlic M, Rodrigues M, Balram A, Hughes D, Ziviani J, Rosenbaum P. Impact of "early intervention" parent workshops on outcomes for caregivers of children with neurodisabilities: a mixed-methods study. Disabil Rehabil 2023; 45:3900-3911. [PMID: 36404703 DOI: 10.1080/09638288.2022.2143579] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE This study explored the feasibility, impact and parent experiences of ENVISAGE (ENabling VISions And Growing Expectations)-Families, a parent-researcher co-designed and co-led program for parents/caregivers raising children with early-onset neurodisabilities. METHODS Parents/caregivers of a child with a neurodisability aged ≤6 years, recruited in Australia and Canada, participated in five weekly online workshops with other parents. Self-report measures were collected at baseline, immediately after, and 3 months post-ENVISAGE-Families; interviews were done following program completion. Quantitative data were analyzed with generalized estimating equations and qualitative data using interpretive description methodology. RESULTS Sixty-five parents (86% mothers) were recruited and 60 (92%) completed the program. Strong evidence was found of effects on family empowerment and parent confidence (all p ≤ 0.05 after the program and maintained at 3-month follow-up). The ENVISAGE-Families program was relevant to parents' needs for: information, connection, support, wellbeing, and preparing for the future. Participants experienced opportunities to reflect on and/or validate their perspectives of disability and development, and how these perspectives related to themselves, their children and family, and their service providers. CONCLUSIONS ENVISAGE was feasible and acceptable for parent/caregivers. The program inspired parents to think, feel and do things differently with their child, family and the people who work with them.Implications for rehabilitationENVISAGE (ENabling VISions And Growing Expectations)-Families is a co-designed, validated parent/researcher "early intervention and orientation" program for caregivers raising a child with neurodevelopmental disabilities (NDDs).ENVISAGE-Families empowered parents' strengths-based approaches to their child, family, disability, and parenting.ENVISAGE-Families increased caregivers' confidence in parenting children with NDD's and provided them tools to support connection, collaboration, and wellbeing.Raising children with NDD can have a profound impact on caregivers, who can benefit from strengths-based, future focused supports early in their parenting experience.
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Affiliation(s)
- L Miller
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - C Imms
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - A Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - K Pozniak
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - B O'Connor
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - R Martens
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - V Cavalieros
- Murdoch Children's Research Institute, Melbourne, Australia
| | - R Babic
- Murdoch Children's Research Institute, Melbourne, Australia
| | - M Novak-Pavlic
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - M Rodrigues
- Department of Health Research Methods, Evidence and Impact, Health Research Methodology Graduate Program, McMaster University, Hamilton, Canada
| | - A Balram
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - D Hughes
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - J Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - P Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Poret A, Merakou C, Lagoudas G, Schaefers M, Mansour K, Cross A, Goldberg J, Blainey P, Lieberman T, Priebe G. 479: O-antigen loss is adaptive in early stages of chronic Burkholderia dolosa lung infection in cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01903-2] [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: 10/20/2022]
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Berezowska A, Cross A, Hunt E, Price J, Mirfenderesky M. 1595 Instituting Rapid and Semi-rapid COVID-19 Testing Pathways to Facilitate Emergency Surgery. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Defining a patient’s COVID-19 status on admission is essential for optimised patient management, safe bed-placement, and flow across the hospital. Perioperative COVID-19 infection is associated with significantly poorer outcomes and may influence a patient's and/or surgeon's decision to proceed. Rapid PCR tests (1-2 hours) for COVID-19 remain the gold-standard, however most NHS Trust’s either do not have, or have severely limited access to such testing modalities. Our aim was to introduce a surgical triaging algorithm to conserve rapid testing for immediate surgery, whilst developing a semi-rapid pathway with results available in 12-15 hours for surgery within 24-48 hours.
Method
Using quality improvement methodology, based on a ‘PDSA’ model we introduced a surgical triaging algorithm. Testing options were categorised into rapid, semi-rapid or routine (24 hours). Defined outcomes, as well as primary and secondary drivers were identified. Both the pre-analytical and post-analytical testing pathways were characterised, concentrating on electronic requesting, laboratory transportation and reporting. Five ‘PDSA’ cycles were performed with immediate audit and feed-back to surgeons after each round. A vetting procedure was also introduced to improve compliance with requesting.
Results
Turn-around-times for COVID-19 PCR swabs at our institution improved from 23 hrs:13 minutes at baseline, to 9 hrs:38 minutes for semi-rapids, to < 2 hours for rapid swabs.
Conclusions
Adoption of a surgical triaging algorithm ensured prioritisation of rapid and semi-rapid COVID testing based on clinical need. This ensured optimised patient care, safe theatre and anaesthetic Infection Prevention and Control practices, as well as correct post-operative placement.
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Affiliation(s)
- A Berezowska
- North Middlesex University Hospital, London, United Kingdom
| | - A Cross
- North Middlesex University Hospital, London, United Kingdom
| | - E Hunt
- North Middlesex University Hospital, London, United Kingdom
| | - J Price
- North Middlesex University Hospital, London, United Kingdom
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Pipalia NH, Saad SZ, Subramanian K, Cross A, Al-Motawa A, Garg K, Blagg BSJ, Neckers L, Helquist P, Wiest O, Ory DS, Maxfield FR. HSP90 inhibitors reduce cholesterol storage in Niemann-Pick type C1 mutant fibroblasts. J Lipid Res 2021; 62:100114. [PMID: 34481829 PMCID: PMC8517605 DOI: 10.1016/j.jlr.2021.100114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/30/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
Niemann-Pick type C1 (NPC1) disease is a lysosomal lipid storage disorder caused by mutations of the NPC1 gene. More than 300 disease-associated mutations are reported in patients, resulting in abnormal accumulation of unesterified cholesterol, glycosphingolipids, and other lipids in late endosomes and lysosomes (LE/Ly) of many cell types. Previously, we showed that treatment of many different NPC1 mutant fibroblasts with histone deacetylase inhibitors resulted in reduction of cholesterol storage, and we found that this was associated with enhanced exit of the NPC1 protein from the endoplasmic reticulum and delivery to LE/Ly. This suggested that histone deacetylase inhibitors may work through changes in protein chaperones to enhance the folding of NPC1 mutants, allowing them to be delivered to LE/Ly. In this study, we evaluated the effect of several HSP90 inhibitors on NPC1I1061T skin fibroblasts. We found that HSP90 inhibition resulted in clearance of cholesterol from LE/Ly, and this was associated with enhanced delivery of the mutant NPC1I1061T protein to LE/Ly. We also observed that inhibition of HSP90 increased the expression of HSP70, and overexpression of HSP70 also reduced cholesterol storage in NPC1I1061T fibroblasts. However, we did not see correction of cholesterol storage by arimoclomol, a drug that is reported to increase HSP70 expression, at doses up to 0.5 mM. The increase in other chaperones as a consequence of HSP90 improves folding of NPC1 protein and relieves cholesterol accumulation in NPC1 mutant fibroblasts.
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Affiliation(s)
- Nina H Pipalia
- Department of Biochemistry, Weill Cornell Medical College, New York, NY, USA
| | - Syed Z Saad
- Department of Biochemistry, Weill Cornell Medical College, New York, NY, USA
| | - Kanagaraj Subramanian
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Abigail Cross
- Natural Sciences Department, Fordham University, New York, NY, USA
| | - Aisha Al-Motawa
- Department of Biochemistry, Weill Cornell Medical College, New York, NY, USA
| | - Kunal Garg
- Department of Biochemistry, Weill Cornell Medical College, New York, NY, USA
| | - Brian S J Blagg
- Department of Chemistry and Biochemistry, University of Notre Dame, South Bend, IN, USA
| | - Len Neckers
- Urologic Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Paul Helquist
- Department of Chemistry and Biochemistry, University of Notre Dame, South Bend, IN, USA
| | - Olaf Wiest
- Department of Chemistry and Biochemistry, University of Notre Dame, South Bend, IN, USA
| | - Daniel S Ory
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Cross A, Hawkes J, Frankland H, Mediana A, Wright H, Goodson N, Edwards S, Moots R. AB0115 SECUKINUMAB THERAPY DOES NOT AFFECT NEUTROPHIL HOST DEFENCE IN PSORIATIC ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Biologic therapies have revolutionised therapy in inflammatory diseases such as psoriatic arthritis (PsA), driving major improvements in outcomes. Th17 cells appear to play a key role in the pathogenesis of PsA, and IL-17 can trigger the release of chemoattractants such as CXCL8 and CCL20, leading to the further infiltration of other immune cells including neutrophils. Infiltrating activated neutrophils can themselves generate a range of chemoattractants which may amplify and sustain the inflammatory response. Therapeutic targeting of IL-17 with biologics such as secukinumab offers great benefit in PsA by blocking this inflammatory cycle: however the interaction of this agent with neutrophils, key components of host defence as well as potential mediators of this disease, is not known.Objectives:This study aimed to measure key aspects of neutrophil function to determine: a) changes in the functions of circulating neutrophils in PsA patients pre-therapy, compared to age- and sex-matched healthy controls and b) if these functions changed in PsA patients 12-weeks post-secukinumab therapy.Methods:Neutrophils were isolated from venous blood of 16 PsA patients and 10 healthy controls. Key neutrophil functions were measured at baseline and 12 weeks: reactive oxygen species (ROS) production, apoptosis (+/- TNF and GM-CSF), phagocytosis, receptor expression and chemotaxis. Changes in gene expression pre- and 12-weeks post-therapy (n=5 PsA) were measured using RNAseq.Results:PsARC response was observed in 70.6% of participants on secukinumab therapy at 12 weeks. There were no significant differences in ROS production, phagocytosis or chemotaxis in PsA patients at baseline (compared to healthy controls) or during therapy. Chemotaxis towards IL-8 in PsA patients at baseline was decreased compared to that of healthy controls, but this difference did not reach statistical significance. Surface levels of activation markers CD11b/CD18 and CD63 were increased in PsA patients at 12-weeks compared to baseline, while surface levels of CD16 decreased. RNA-seq analysis indicated down-regulation of pathways mediated by IL-17A, oncostatin M, TWEAK (TNFSF12) and CCL2 during therapy, but up-regulated expression of pathways involvingde novoprotein biosynthesis.Conclusion:Therapy with secukimumab in PsA did not significantly affect neutrophil host defence functions. The changes that were seen in circulating neutrophils indicate selective up- and down-regulation of functions that may reflect potential alterations in local or systemic cytokines, and/or an increase in the circulating pool of activated neutrophils that are no longer recruited into sites of inflammation because of the down-regulation of the local IL-17/CXCL8 signalling network.Disclosure of Interests:Andrew Cross: None declared, Jennifer Hawkes: None declared, Helen Frankland: None declared, Ayren Mediana: None declared, Helen Wright Grant/research support from: Novartis supporting this study, Nicola Goodson Grant/research support from: Novartis supporting this research, Steven Edwards Grant/research support from: Novartis supporting this work, Robert Moots Grant/research support from: Novartis supporting this work, Consultant of: a variety of companies including Novartis, Speakers bureau: a variety of companies including Novartis
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Mooi WJ, Krausz T, Kirkland SC, Cross A, Epenetos AA. Accessibility of Antigenic Sites Recognized by AUA1, HMFG1 and HMFG2 Monoclonal Antibodies: Its Influence on Antibody Binding of Live Cells. Int J Biol Markers 2018; 2:57-63. [PMID: 2454274 DOI: 10.1177/172460088700200201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/17/2022]
Abstract
We assessed the immunoreactivity of live and alcohol-fixed monolayers of HRA-19, a rectal adenocarcinoma cell line, to the monoclonal antibodies AUA1, HMFG1 and HMFG2. Differences in staining patterns between live and alcohol-fixed colonies were found. The well-polarized cells forming the centers of the monolayer colonies showed strong membrane staining when the cells were alcohol-fixed prior to AUA1 incubation, but showed no staining when the cells were alive during the incubation. When AUA1 incubation was done both before and after alcohol fixation, membrane staining was again seen, ruling out the possibility of antigenic modulation. Incubation of live cells with AUA1 together with EDTA showed strong staining of dissociating cells. It is concluded that AUA1 antigenic sites, which on polarized cells are basolateral in location, are inaccessible to the antibody-containing culture fluid, which bathes the apical aspects of the cells, but they become accessible after alcohol fixation, or treatment with EDTA. HMFG1 antigenic sites are located on the apical cell membrane, and accordingly, no differences were seen between incubation of live and alcohol-fixed cells when incubated with HMFG1. The antigenic sites of HMFG2 are partly intracellular, and in our monolayer model, the staining of live cells was weaker and more scarce than on alcohol-fixed cells. It is concluded that immunostaining of cytological and histological material of tumours may not adequately predict antibody binding on live cells, and thus, these findings are of importance in the context of selection of monoclonal antibodies for clinical radio-immunotargeting.
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Affiliation(s)
- W J Mooi
- Department of Histopathology, Royal Postgraduate Medical School, Hammersmith Hospital, England
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Phoomvuthisarn P, Cross A, Glennon-Alty L, Wright HL, Edwards SW. The CDK inhibitor purvalanol A induces neutrophil apoptosis and increases the turnover rate of Mcl-1: potential role of p38-MAPK in regulation of Mcl-1 turnover. Clin Exp Immunol 2018; 192:171-180. [PMID: 29377076 DOI: 10.1111/cei.13107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2018] [Indexed: 12/31/2022] Open
Abstract
Human neutrophils are terminally differentiated cells that do not replicate and yet express a number of enzymes, notably cell cycle-dependent kinases (CDKs), that are associated normally with control of DNA synthesis and cell cycle progression. In neutrophils, CDKs appear to function mainly to regulate apoptosis, although the mechanisms by which they regulate this process are largely unknown. Here we show that the CDK2 inhibitor, purvalanol A, induces a rapid decrease in myeloid cell leukaemia factor-1 (Mcl-1) levels in human neutrophils and peripheral blood mononuclear cells (PBMCs), but only induces apoptosis in neutrophils which are dependent upon expression on this protein for survival. This rapid decrease in cellular Mcl-1 protein levels was due to a purvalanol A-induced decrease in stability, with the half-life of the protein decreasing from approximately 2 h in control cells to just over 1 h after addition of the CDK2 inhibitor: it also blocked the granulocyte-macrophage colony-stimulating factor (GM-CSF)-dependent stabilization of Mcl-1. Purvanalol A blocked GM-CSF-stimulated activation of extracellular-regulated kinase (Erk) and signal transducer and activator of transcription (STAT)-3, and stimulated an additive activation of protein kinase B (Akt) with GM-CSF. Purvalanol A alone stimulated a rapid and sustained activation of p38-mitogen-activated protein kinase (MAPK) and the pan p38-MAPK inhibitor, BIRB796, partly blocked the purvalanol A-induced apoptosis and Mcl-1 loss. These novel effects of purvalanol A may result, at least in part, from blocking GM-CSF-mediated Erk activation. In addition, we propose that purvalanol A-induced activation of p38-MAPK is, at least in part, responsible for its rapid effects on Mcl-1 turnover and acceleration of neutrophil apoptosis.
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Affiliation(s)
- P Phoomvuthisarn
- Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - A Cross
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - L Glennon-Alty
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - H L Wright
- Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - S W Edwards
- Institute of Integrative Biology, University of Liverpool, Liverpool, UK
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Cross A, Rosenbaum P, Grahovac D, Kay D, Gorter JW. Knowledge mobilization to spread awareness of the 'F-words' in childhood disability: lessons from a family-researcher partnership. Child Care Health Dev 2015; 41:947-53. [PMID: 25865031 DOI: 10.1111/cch.12249] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2012, two CanChild researchers published an article in Child: Care, Health and Development titled 'The "F-words" in childhood disability: I swear this is how we should think!' Building on the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework, the article featured key strengths-based ICF themes (i.e. the 'F-words' - Function, Family, Fitness, Fun, Friends and Future). This paper reports on a knowledge mobilization initiative designed to spread awareness of the 'F-words' ideas. METHODS Families and researchers collaborated to develop, disseminate and evaluate an online awareness video. The video used written descriptions, parents' reflections and their pictures, music and graphics to captivate the audience. Posted on the CanChild website in May 2014, information about the video was distributed via various dissemination strategies and evaluated by tracking its views and through an online survey. RESULTS After a 2-month evaluation, there were 715 views and 137 survey responses. Of the survey responses, 89% lived in Canada, 55% had not previously heard of the 'F-words', 98% 'extremely liked'/'liked the ideas' and 88% indicated they would share the video. CONCLUSIONS By creating a short and captivating video, we were able to spread awareness to a wide audience in a short period of time. Engaging families throughout the project was critical to the success of the video. By working together, we hope to continue bridging research and practice and moving the 'F-words' concepts forward one 'word' at a time.
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Affiliation(s)
- A Cross
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - P Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - D Grahovac
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - D Kay
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - J W Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
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Sidhu J, Whitfield A, Mercer I, Cross A, Charlesworth D. Exploring clinicians’ attitude towards the introduction of MET in a metropolitan hospital. Aust Crit Care 2013. [DOI: 10.1016/j.aucc.2013.02.039] [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: 11/15/2022] Open
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Sartor O, Coleman R, Nilsson S, Vogelzang N, Cross A, O'Bryan-Tear C, Staudacher K, Garcia-Vargas J, Zou J, Parker C. Safety of Cytotoxic Chemotherapy Following Radium-223 Chloride (RA-223) Therapy in the Phase 3 Alsympca Study in Patients with Castration-Resistant Prostate Cancer (CRPC) with Bone Metastases. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33496-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Thondam SK, Cross A, Cuthbertson DJ, Wilding JP, Daousi C. Effects of chronic treatment with metformin on dipeptidyl peptidase-4 activity, glucagon-like peptide 1 and ghrelin in obese patients with Type 2 diabetes mellitus. Diabet Med 2012; 29:e205-10. [PMID: 22486277 DOI: 10.1111/j.1464-5491.2012.03675.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 01/22/2023]
Abstract
AIMS Studies investigating the acute effects of metformin have demonstrated actions on the incretin system and appetite regulatory hormones. There are limited data to support that these effects are sustained in the long term. We therefore studied the effects of chronic treatment with metformin on endogenous glucagon-like peptide 1, dipeptidyl peptidase-4 activity and active ghrelin (an orexigenic hormone) in obese patients with Type 2 diabetes mellitus. METHODS Eight subjects [six male, age 58.7 ± 2.6 years, BMI 41.1 ± 2.9 kg/m(2) , HbA(1c) 69 ± 6 mmol/mol (8.5 ± 0.5%), mean ± sem] with drug-naïve Type 2 diabetes were studied for 6 h following a standard mixed meal, before and after at least 3 months of metformin monotherapy (mean dose 1.75 g daily). RESULTS The area under the curve (AUC(0-6 h) ) for active glucagon-like peptide 1 was significantly higher on metformin (pre-metformin 1750.8 ± 640 pmol l(-1) min(-1) vs. post-metformin 2718.8 ± 1182.3 pmol l(-1) min(-1) ; P=0.01). The areas under the curves for dipeptidyl peptidase-4 activity and ghrelin were not significantly different pre- and post-treatment with metformin. CONCLUSION Three months or more of metformin monotherapy in obese patients with Type 2 diabetes was associated with increased postprandial active glucagon-like peptide 1 levels. The effects of metformin on the enteroinsular axis may represent yet another important mechanism underlying its glucose-lowering effects.
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Affiliation(s)
- S K Thondam
- Diabetes and Endocrinology Clinical Research Group, University Hospital Aintree, Clinical Sciences Centre, Liverpool, UK.
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Heathfield S, Parker B, Zeef L, Bruce I, Alexander Y, Collins F, Stone M, Wang E, Williams AS, Wright HL, Thomas HB, Moots RJ, Edwards SW, Bullock C, Chapman V, Walsh DA, Mobasheri A, Kendall D, Kelly S, Bayley R, Buckley CD, Young SP, Rump-Goodrich L, Middleton J, Chen L, Fisher R, Kollnberger S, Shastri N, Kessler BM, Bowness P, Nazeer Moideen A, Evans L, Osgood L, Williams AS, Jones SA, Nowell MA, Mahadik Y, Young S, Morgan M, Gordon C, Harper L, Giles JL, Paul Morgan B, Harris CL, Rysnik OJ, McHugh K, Kollnberger S, Payeli S, Marroquin O, Shaw J, Renner C, Bowness P, Nayar S, Cloake T, Bombardieri M, Pitzalis C, Buckley C, Barone F, Barone F, Nayar S, Cloake T, Lane P, Coles M, Buckley C, Williams EL, Edwards CJ, Cooper C, Oreffo RO, Dunn S, Crawford A, Wilkinson M, Le Maitre C, Bunning R, Daniels J, Phillips KLE, Chiverton N, Le Maitre CL, Kollnberger S, Shaw J, Ridley A, Wong-Baeza I, McHugh K, Keidel S, Chan A, Bowness P, Gullick NJ, Abozaid HS, Jayaraj DM, Evans HG, Scott DL, Choy EH, Taams LS, Hickling M, Golor G, Jullion A, Shaw S, Kretsos K, Bari SF, Rhys-Dillon B, Amos N, Siebert S, Phillips KLE, Chiverton N, Bunning RD, Haddock G, Cross AK, Le Maitre CL, Kate I, Phillips E, Cross A, Chiverton N, Haddock G, Bunning RAD, Le Maitre CL, Ceeraz S, Spencer J, Choy E, Corrigall V, Crilly A, Palmer H, Lockhart J, Plevin R, Ferrell WR, McInnes I, Hutchinson D, Perry L, DiCicco M, Humby F, Kelly S, Hands R, Buckley C, McInnes I, Taylor P, Bombardieri M, Pitzalis C, Mehta P, Mitchell A, Tysoe C, Caswell R, Owens M, Vincent T, Hashmi TM, Price-Forbes A, Sharp CA, Murphy H, Wood EF, Doherty T, Sheldon J, Sofat N, Goff I, Platt PN, Abdulkader R, Clunie G, Ismajli M, Nikiphorou E, Young A, Tugnet N, Dixey J, Banik S, Alcorn D, Hunter J, Win Maw W, Patil P, Hayes F, Main Wong W, Borg FA, Dasgupta B, Malaviya AP, Ostor AJ, Chana JK, Ahmed AA, Edmonds S, Hayes F, Coward L, Borg F, Heaney J, Amft N, Simpson J, Dhillon V, Ayalew Y, Khattak F, Gayed M, Amarasena RI, McKenna F, Amarasena RI, McKenna F, Mc Laughlin M, Baburaj K, Fattah Z, Ng N, Wilson J, Colaco B, Williams MR, Adizie T, Dasgupta B, Casey M, Lip S, Tan S, Anderson D, Robertson C, Devanny I, Field M, Walker D, Robinson S, Ryan S, Hassell A, Bateman J, Allen M, Davies D, Crouch C, Walker-Bone K, Gainsborough N, Gullick NJ, Lutalo PM, Davies UM, Walker-Bone K, Mckew JR, Millar AM, Wright SA, Bell AL, Thapper M, Roussou T, Cumming J, Hull RG, Thapper M, Roussou T, McKeogh J, O'Connor MB, Hassan AI, Bond U, Swan J, Phelan MJ, Coady D, Kumar N, Farrow L, Bukhari M, Oldroyd AG, Greenbank C, McBeth J, Duncan R, Brown D, Horan M, Pendleton N, Littlewood A, Cordingley L, Mulvey M, Curtis EM, Cole ZA, Crozier SR, Georgia N, Robinson SM, Godfrey KM, Sayer AA, Inskip HM, Cooper C, Harvey NC, Davies R, Mercer L, Galloway J, Low A, Watson K, Lunt M, Symmons D, Hyrich K, Chitale S, Estrach C, Moots RJ, Goodson NJ, Rankin E, Jiang CQ, Cheng KK, Lam TH, Adab P, Ling S, Chitale S, Moots RJ, Estrach C, Goodson NJ, Humphreys J, Ellis C, Bunn D, Verstappen SM, Symmons D, Fluess E, Macfarlane GJ, Bond C, Jones GT, Scott IC, Steer S, Lewis CM, Cope A, Mulvey MR, Macfarlane GJ, Symmons D, Lovell K, Keeley P, Woby S, Beasley M, McBeth J, Viatte S, Plant D, Lunt M, Fu B, Parker B, Galloway J, Solymossy C, Worthington J, Symmons D, Dixey J, Young A, Barton A, Williams FM, Osei-Bordom DC, Popham M, MacGregor A, Spector T, Little J, Herrick A, Pushpakom S, Ennis H, McBurney H, Worthington J, Newman W, Ibrahim I, Plant D, Hyrich K, Morgan A, Wilson A, Isaacs J, Barton A, Sanderson T, Hewlett S, Calnan M, Morris M, Raza K, Kumar K, Cardy CM, Pauling JD, Jenkins J, Brown SJ, McHugh N, Nikiphorou E, Mugford M, Davies C, Cooper N, Brooksby A, Bunn D, Symmons D, MacGregor A, Dures E, Ambler N, Fletcher D, Pope D, Robinson F, Rooke R, Hewlett S, Gorman CL, Reynolds P, Hakim AJ, Bosworth A, Weaver D, Kiely PD, Skeoch S, Jani M, Amarasena R, Rao C, Macphie E, McLoughlin Y, Shah P, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Patel Y, Baguley E, Jani M, Halsey J, Severn A, Bukhari M, Selvan S, Price E, Husain MJ, Brophy S, Phillips CJ, Cooksey R, Irvine E, Siebert S, Lendrem D, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Griffiths B, Foggo H, Edgar S, Vadivelu S, Coady D, McHugh N, Ng WF, Dasgupta B, Taylor P, Iqbal I, Heron L, Pilling C, Marks J, Hull R, Ledingham J, Han C, Gathany T, Tandon N, Hsia E, Taylor P, Strand V, Sensky T, Harta N, Fleming S, Kay L, Rutherford M, Nicholl K, Kay L, Rutherford M, Nicholl K, Eyre T, Wilson G, Johnson P, Russell M, Timoshanko J, Duncan G, Spandley A, Roskell S, Coady D, West L, Adshead R, Donnelly SP, Ashton S, Tahir H, Patel D, Darroch J, Goodson NJ, Boulton J, Ellis B, Finlay R, Lendrem D, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, McHugh N, Griffiths B, Foggo H, Edgar S, Ng WF, Murray-Brown W, Priori R, Tappuni T, Vartoukian S, Seoudi N, Picarelli G, Fortune F, Valesini G, Pitzalis C, Bombardieri M, Ball E, Rooney M, Bell A, Merida AA, Isenberg D, Tarelli E, Axford J, Giles I, Pericleous C, Pierangeli SS, Ioannou J, Rahman A, Alavi A, Hughes M, Evans B, Bukhari M, Parker B, Zaki A, Alexander Y, Bruce I, Hui M, Garner R, Rees F, Bavakunji R, Daniel P, Varughese S, Srikanth A, Andres M, Pearce F, Leung J, Lim K, Regan M, Lanyon P, Oomatia A, Petri M, Fang H, Birnbaum J, Amissah-Arthur M, Gayed M, Stewart K, Jennens H, Braude S, Gordon C, Sutton EJ, Watson KD, Gordon C, Yee CS, Lanyon P, Jayne D, Isenberg D, Rahman A, Akil M, McHugh N, Ahmad Y, Amft N, D'Cruz D, Edwards CJ, Griffiths B, Khamashta M, Teh LS, Zoma A, Bruce I, Dey ID, Kenu E, Isenberg D, Pericleous C, Garza-Garcia A, Murfitt L, Driscoll PC, Isenberg D, Pierangeli S, Giles I, Ioannou Y, Rahman A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Segeda I, Shevchuk S, Kuvikova I, Brown N, Bruce I, Venning M, Mehta P, Dhanjal M, Mason J, Nelson-Piercy C, Basu N, Paudyal P, Stockton M, Lawton S, Dent C, Kindness K, Meldrum G, John E, Arthur C, West L, Macfarlane MV, Reid DM, Jones GT, Macfarlane GJ, Yates M, Loke Y, Watts R, MacGregor A, Adizie T, Christidis D, Dasgupta B, Williams M, Sivakumar R, Misra R, Danda D, Mahendranath KM, Bacon PA, Mackie SL, Pease CT. Basic science * 232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes108] [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: 11/13/2022] Open
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Lewington V, Boehmer S, Franzén L, Klijer R, Mellado B, Coleman R, Cross A, Biggin C, Parker C. OC-0367 RADIUM-223 CHLORIDE AND IMPROVED SURVIVAL IN CASTRATION-RESISTANT PROSTATE CANCER PATIENTS WITH BONE METASTASES. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70706-5] [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: 11/25/2022]
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Qian P, Cross A, Naismith R. Pain in Neuromyelitis Optica Is More Common, Disabling, and Refractory Compared to MS (P07.070). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.070] [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: 11/15/2022] Open
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Qian P, Lancia S, Patnaik R, Xu J, Cross A, Wolansky L, Cook S, Cadavid D, Naismith R. Ring-Enhancing Lesions in MS: Longitudinal Quantification by Diffusion Tensor and Magnetization Transfer Imaging (P03.039). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.039] [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: 11/15/2022] Open
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Waubant E, Pelletier D, Mass M, Cohen JA, Kita M, Cross A, Bar-Or A, Vollmer T, Racke M, Stüve O, Schwid S, Goodman A, Kachuck N, Preiningerova J, Weinstock-Guttman B, Calabresi PA, Miller A, Mokhtarani M, Iklé D, Murphy S, Kopetskie H, Ding L, Rosenberg E, Spencer C, Zamvil SS. Randomized controlled trial of atorvastatin in clinically isolated syndrome: the STAyCIS study. Neurology 2012; 78:1171-8. [PMID: 22459680 DOI: 10.1212/wnl.0b013e31824f7fdd] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test efficacy and safety of atorvastatin in subjects with clinically isolated syndrome (CIS). METHODS Subjects with CIS were enrolled in a phase II, double-blind, placebo-controlled, 14-center randomized trial testing 80 mg atorvastatin on clinical and brain MRI activity. Brain MRIs were performed quarterly. The primary endpoint (PEP) was development of ≥ 3 new T2 lesions, or one clinical relapse within 12 months. Subjects meeting the PEP were offered additional weekly interferon β-1a (IFNβ-1a). RESULTS Due to slow recruitment, enrollment was discontinued after 81 of 152 planned subjects with CIS were randomized and initiated study drug. Median (interquartile range) numbers of T2 and gadolinium-enhancing (Gd) lesions were 15.0 (22.0) and 0.0 (0.0) at baseline. A total of 53.1% of atorvastatin recipients (n = 26/49) met PEP compared to 56.3% of placebo recipients (n = 18/32) (p = 0.82). Eleven atorvastatin subjects (22.4%) and 7 placebo subjects (21.9%) met the PEP by clinical criteria. Proportion of subjects who did not develop new T2 lesions up to month 12 or to starting IFNβ-1a was 55.3% in the atorvastatin and 27.6% in the placebo group (p = 0.03). Likelihood of remaining free of new T2 lesions was significantly greater in the atorvastatin group compared with placebo (odds ratio [OR] = 4.34, p = 0.01). Likelihood of remaining free of Gd lesions tended to be higher in the atorvastatin group (OR = 2.72, p = 0.11). Overall, atorvastatin was well tolerated. No clear antagonistic effect of atorvastatin plus IFNβ-1a was observed on MRI measures. CONCLUSION Atorvastatin treatment significantly decreased development of new brain MRI T2 lesion activity, although it did not achieve the composite clinical and imaging PEP. CLASSIFICATION OF EVIDENCE This study provided Class II evidence that atorvastatin did not reduce the proportion of patients with CIS meeting imaging and clinical criteria for starting immunomodulating therapy after 12 months, compared to placebo. In an analysis of a secondary endpoint (Class III), atorvastatin was associated with a reduced risk for developing new T2 lesions.
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Affiliation(s)
- E Waubant
- University of California, San Francisco, USA
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Nanka O, Krejci E, Pesevski Z, Sedmera D, Smart N, Rossdeutsch A, Dube KN, Riegler J, Price AN, Taylor A, Muthurangu V, Turner M, Lythgoe MF, Riley PR, Kryvorot S, Vladimirskaya T, Shved I, Schwarzl M, Seiler S, Huber S, Steendijk P, Maechler H, Truschnig-Wilders M, Pieske B, Post H, Caprio C, Baldini A, Chiavacci E, Dolfi L, Verduci L, Meghini F, Cremisi F, Pitto L, Kuan TC, Chen MC, Yang TH, Wu WT, Lin CS, Rai H, Kumar S, Sharma AK, Mastana S, Kapoor A, Pandey CM, Agrawal S, Sinha N, Orlowska-Baranowska EH, Placha G, Gora J, Baranowski R, Abramczuk E, Hryniewiecki T, Gaciong Z, Verschuren JJW, Wessels JAM, Trompet S, Stott DJ, Sattar N, Buckley B, Guchelaar HJ, Jukema JW, Gharanei M, Hussain A, Mee CJ, Maddock HL, Wijnen WJ, Van Den Oever S, Van Der Made I, Hiller M, Tijsen AJ, Pinto YM, Creemers EE, Nikulina SUY, Chernova A, Petry A, Rzymski T, Kracun D, Riess F, Pike L, Harris AL, Gorlach A, Katare R, Oikawa A, Riu F, Beltrami AP, Cesseli D, Emanueli C, Madeddu P, Zaglia T, Milan G, Franzoso M, Pesce P, Sarais C, Sandri M, Mongillo M, Butler TJ, Seymour AML, Ashford D, Jaffre F, Bussen M, Ferrara N, Koch WJ, Leosco D, Akhmedov A, Klingenberg R, Brokopp C, Hof D, Zoller S, Corti R, Gay S, Flohrschutz I, Von Eckardstein A, Hoerstrup SP, Luescher TF, Heijman J, Zaza A, Johnson DM, Rudy Y, Peeters RLM, Volders PGA, Westra RL, Martin GR, Morais CAS, Oliveira SHV, Brandao FC, Gomes IF, Lima LM, Fujita S, Okamoto R, Taniguchi M, Konishi K, Goto I, Engelhardt S, Sugimoto K, Nakamura M, Shiraki K, Buechler C, Ito M, Kararigas G, Nguyen BT, Jarry H, Regitz-Zagrosek V, Van Bilsen M, Daniels A, Munts C, Janssen BJA, Van Der Vusse GJ, Van Nieuwenhoven FA, Montalvo C, Villar AV, Merino D, Garcia R, Llano M, Ares M, Hurle MA, Nistal JF, Dembinska-Kiec A, Beata Kiec-Wilk BKW, Anna Polus AP, Urszula Czech UC, Tatiana Konovaleva TK, Gerd Schmitz GS, Bertrand L, Balteau M, Timmermans A, Viollet B, Sakamoto K, Feron O, Horman S, Vanoverschelde JL, Beauloye C, De Meester C, Martinez E, Martin R, Miana M, Jurado R, Gomez-Hurtado N, Bartolome MV, San Roman JA, Lahera V, Nieto ML, Cachofeiro V, Rochais F, Sturny R, Mesbah K, Miquerol L, Kelly RG, Messaoudi S, Gravez B, Tarjus A, Pelloux V, Samuel JL, Delcayre C, Launay JM, Clement K, Farman N, Jaisser F, Hadyanto L, Castellani C, Vescovo G, Ravara B, Tavano R, Pozzobon M, De Coppi P, Papini E, Vettor R, Thiene G, Angelini A, Meloni M, Caporali A, Cesselli D, Fortunato O, Avolio E, Madeddu P, Beltrami AP, Emanueli C, Schindler R, Simrick S, Brand T, Dube KN, Riley PR, Smart NS, Oikawa A, Katare R, Herman A, Emanueli C, Madeddu P, Roura Ferrer S, Rodriguez Bago J, Soler-Botija C, Pujal JM, Galvez-Monton C, Prat-Vidal C, Llucia-Valldeperas A, Blanco J, Bayes-Genis A, Foldes G, Maxime M, Ali NN, Schneider MD, Harding SE, Reni C, Mangialardi G, Caporali A, Meloni M, Emanueli C, Madeddu P, De Pauw A, Sekkali B, Friart A, Ding H, Graffeuil A, Catalucci D, Balligand JL, Azibani F, Tournoux F, Schlossarek S, Polidano E, Fazal L, Merval R, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C, Buyandelger B, Linke W, Zou P, Kostin S, Ku C, Felkin L, Birks E, Barton P, Sattler M, Knoell R, Schroder K, Benkhoff S, Shimokawa H, Grisk O, Brandes RP, Parepa IR, Mazilu L, Suceveanu AI, Suceveanu A, Rusali L, Cojocaru L, Matei L, Toringhibel M, Craiu E, Pires AL, Pinho M, Pinho S, Sena C, Seica R, Leite-Moreira A, Zaglia T, Milan G, Franzoso M, Dabroi F, Pesce P, Schiaffino S, Sandri M, Mongillo M, Kiseleva E, Krukov N, Nikitin O, Ardatova L, Mourouzis I, Pantos C, Kokkinos AD, Cokkinos DV, Scoditti E, Massaro M, Carluccio MA, Pellegrino M, Calabriso N, Gastaldelli A, Storelli C, De Caterina R, Lindner D, Zietsch C, Schultheiss HP, Tschope C, Westermann D, Everaert BR, Nijenhuis VJ, Reith FCM, Hoymans VY, Timmermans JP, Vrints CJ, Simova I, Mateev H, Katova T, Haralanov L, Dimitrov N, Mironov N, Golitsyn SP, Sokolov SF, Yuricheva YUA, Maikov EB, Shlevkov NB, Rosenstraukh LV, Chazov EI, Radosinska J, Knezl V, Benova T, Slezak J, Urban L, Tribulova N, Virag L, Kristof A, Kohajda ZS, Szel T, Husti Z, Baczko I, Jost N, Varro A, Sarusi A, Farkas AS, Orosz SZ, Forster T, Varro A, Farkas A, Zakhrabova-Zwiauer OM, Hardziyenka M, Nieuwland R, Tan HL, Raaijmakers AJA, Bourgonje VJA, Kok GJM, Van Veen AAB, Anderson ME, Vos MA, Bierhuizen MFA, Benes J, Sebestova B, Sedmera D, Ghouri IA, Kemi OJ, Kelly A, Burton FL, Smith GL, Bourgonje VJA, Vos MA, Ozdemir S, Acsai K, Doisne N, Van Der Nagel R, Beekman HDM, Van Veen TAB, Sipido KR, Antoons G, Harmer SC, Mohal JS, Kemp D, Tinker A, Beech D, Burley DS, Cox CD, Wann KT, Baxter GF, Wilders R, Verkerk A, Fragkiadaki P, Germanakis G, Tsarouchas K, Tsitsimpikou C, Tsardi M, George D, Tsatsakis A, Rodrigues P, Barros C, Najmi AK, Khan V, Akhtar M, Pillai KK, Mujeeb M, Aqil M, Bayliss CR, Messer AE, Leung MC, Ward D, Van Der Velden J, Poggesi C, Redwood CS, Marston S, Vite A, Gandjbakhch E, Gary F, Fressart V, Leprince P, Fontaine G, Komajda M, Charron P, Villard E, Falcao-Pires I, Gavina C, Hamdani N, Van Der Velden J, Stienen GJM, Niessens HWM, Leite-Moreira AF, Paulus WJ, Messer AE, Marston S, Memo M, Leung MC, Bayliss CR, Memo M, Messer AE, Marston SB, Vafiadaki E, Qian J, Arvanitis DA, Sanoudou D, Kranias EG, Elmstedt N, Lind B, Ferm-Widlund K, Westgren M, Brodin LA, Mansfield C, West T, Ferenczi M, Wijnker PJM, Foster DB, Coulter A, Frazier A, Murphy AM, Stienen GJM, Van Der Velden J, Shah M, Sikkel MB, Desplantez T, Collins TP, O' Gara P, Harding SE, Lyon AR, Macleod KT, Ottesen AH, Louch WE, Carlson C, Landsverk OJB, Stridsberg M, Sjaastad I, Oie E, Omland T, Christensen G, Rosjo H, Cartledge J, Clark LA, Ibrahim M, Siedlecka U, Navaratnarajah M, Yacoub MH, Camelliti P, Terracciano CM, Chester A, Gonzalez-Tendero A, Torre I, Garcia-Garcia F, Dopazo J, Gratacos E, Taylor D, Bhandari S, Seymour AM, Fliegner D, Jost J, Bugger H, Ventura-Clapier R, Regitz-Zagrosek V, Carpi A, Campesan M, Canton M, Menabo R, Pelicci PG, Giorgio M, Di Lisa F, Hancock M, Venturini A, Al-Shanti N, Stewart C, Ascione R, Angelini G, Suleiman MS, Kravchuk E, Grineva E, Galagudza M, Kostareva A, Bairamov A, Krychtiuk KA, Watzke L, Kaun C, Demyanets S, Pisoni J, Kastl SP, Huber K, Maurer G, Wojta J, Speidl WS, Varga ZV, Farago N, Zvara A, Kocsis GF, Pipicz M, Csonka C, Csont T, Puskas GL, Ferdinandy P, Klevstigova M, Silhavy J, Manakov D, Papousek F, Novotny J, Pravenec M, Kolar F, Novakova O, Novak F, Neckar J, Barallobre-Barreiro J, Didangelos A, Yin X, Fernandez-Caggiano M, Drozdov I, Willeit P, Domenech N, Mayr M, Lemoine S, Allouche S, Coulbault L, Galera P, Gerard JL, Hanouz JL, Suveren E, Whiteman M, Baxter GF, Studneva IM, Pisarenko O, Shulzhenko V, Serebryakova L, Tskitishvili O, Timoshin A, Fauconnier J, Meli AC, Thireau J, Roberge S, Lompre AM, Jacotot E, Marks AM, Lacampagne A, Dietel B, Altendorf R, Daniel WG, Kollmar R, Garlichs CD, Verduci L, Parente V, Balasso S, Pompilio G, Colombo G, Milano G, Squadroni L, Cotelli F, Pozzoli O, Capogrossi MC, Ajiro Y, Saegusa N, Iwade K, Giles WR, Stafforini DM, Spitzer KW, Sirohi R, Candilio L, Babu G, Roberts N, Lawrence D, Sheikh A, Kolvekar S, Yap J, Hausenloy DJ, Yellon DM, Aslam M, Rohrbach S, Schlueter KD, Piper HM, Noll T, Guenduez D, Malinova L, Ryabukho VP, Lyakin DV, Denisova TP, Montoro-Garcia S, Shantsila E, Lip GYH, Kalaska B, Sokolowska E, Kaminski K, Szczubialka K, Kramkowski K, Mogielnicki A, Nowakowska M, Buczko W, Stancheva N, Mekenyan E, Gospodinov K, Tisheva S, Darago A, Rutkai I, Kalasz J, Czikora A, Orosz P, Bjornson HD, Edes I, Papp Z, Toth A, Riches K, Warburton P, O'regan DJ, Ball SG, Turner NA, Wood IC, Porter KE, Kogaki S, Ishida H, Nawa N, Takahashi K, Baden H, Ichimori H, Uchikawa T, Mihara S, Miura K, Ozono K, Lugano R, Padro T, Garcia-Arguinzonis M, Badimon L, Yin X, Ferraro F, Viner R, Ho J, Cutler D, Mayr M, Matchkov V, Aalkjaer C, Mangialardi G, Katare R, Oikawa A, Madeddu P, Krijnen PAJ, Hahn NE, Kholova I, Sipkens JA, Van Alphen FP, Simsek S, Schalkwijk CG, Van Buul JD, Van Hinsbergh VWM, Niessen HWM, Simova I, Katova T, Haralanov L, Caro CG, Seneviratne A, Monaco C, Hou D, Singh J, Gilson P, Burke MG, Heraty KB, Krams R, Coppola G, Albrecht K, Schgoer W, Wiedemann D, Bonaros N, Steger C, Theurl M, Stanzl U, Kirchmair R, Amadesi S, Fortunato O, Reni C, Katare R, Meloni M, Ascione R, Spinetti G, Cangiano E, Valgimigli M, Madeddu P, Caporali A, Meloni M, Miller AM, Cardinali A, Vierlinger K, Fortunato O, Spinetti G, Madeddu P, Emanueli C, Pagano G, Liccardo D, Zincarelli C, Femminella GD, Lymperopoulos A, De Lucia C, Koch WJ, Leosco D, Rengo G, Hinkel R, Husada W, Trenkwalder T, Di Q, Lee S, Petersen B, Bock-Marquette I, Niemann H, Di Maio M, Kupatt C, Nourian M, Yassin Z, Kelishadi R, Nourian M, Kelishadi R, Yassin Z, Memarian SH, Heidari A, Leuner A, Poitz DM, Brunssen C, Ravens U, Strasser RH, Morawietz H, Vogt F, Grahl A, Flege C, Marx N, Borinski M, De Geest B, Jacobs F, Muthuramu I, Gordts SC, Van Craeyveld E, Herijgers P, Weinert S, Poitz DM, Medunjanin S, Herold J, Schmeisser A, Strasser RH, Braun-Dullaeus RC, Wagner AH, Moeller K, Adolph O, Schwarz M, Schwale C, Bruehl C, Nobiling R, Wieland T, Schneider SW, Hecker M, Cross A, Strom A, Cole J, Goddard M, Hultgardh-Nilsson A, Nilsson J, Mauri C, Monaco C, Mitkovskaya NP, Kurak TA, Oganova EG, Shkrebneva EI, Kot ZHN, Statkevich TV, Molica F, Burger F, Matter CM, Thomas A, Staub C, Zimmer A, Cravatt B, Pacher P, Steffens S, Blanco R, Sarmiento R, Parisi C, Fandino S, Blanco F, Gigena G, Szarfer J, Rodriguez A, Garcia Escudero A, Riccitelli MA, Wantha S, Simsekyilmaz S, Megens RT, Van Zandvoort MA, Liehn E, Zernecke A, Klee D, Weber C, Soehnlein O, Lima LM, Carvalho MG, Gomes KB, Santos IR, Sousa MO, Morais CAS, Oliveira SHV, Gomes IF, Brandao FC, Lamego MRA, Lima LM, Fornai L, Angelini A, Kiss A, Giskes F, Eijkel G, Fedrigo M, Valente ML, Thiene G, Heeren RMA, Grdinic A, Vojvodic D, Djukanovic N, Grdinic AG, Obradovic S, Majstorovic I, Rusovic S, Vucinic Z, Tavciovski D, Ostojic M, Lin CS, Kuan TC, Lai SC, Chen MY, Wu HT, Gouweleeuw L, Oberdorf-Maass SU, De Boer RA, Van Gilst WH, Maass AH, Van Gelder IC, Azibani F, Benard L, Schlossarek S, Merval R, Tournoux F, Launay JM, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C, Li C, Warren D, Shanahan CM, Zhang QP, Bye A, Vettukattil R, Aspenes ST, Giskeodegaard G, Gribbestad IS, Wisloff U, Bathen TF, Cubedo J, Padro T, Alonso R, Mata P, Badimon L, Ivic I, Vamos Z, Cseplo P, Kosa D, Torok O, Hamar J, Koller A, Norita K, De Noronha SV, Sheppard MN, Torre I, Amat-Roldan I, Iruretagoiena I, Psilodimitrakopoulos S, Gonzalez-Tendero A, Crispi F, Artigas D, Loza-Alvarez P, Gratacos E, Harrison JC, Smart SD, Besely EH, Kelly JR, Yao Y, Sammut IA, Hoepfner M, Kuzyniak W, Sekhosana E, Hoffmann B, Litwinski C, Pries A, Ermilov E, Fontoura D, Lourenco AP, Vasques-Novoa F, Pinto JP, Roncon-Albuquerque R, Leite-Moreira AF, Oyeyipo IP, Olatunji LA, Usman TO, Olatunji VA, Bacova B, Radosinska J, Viczenczova C, Knezl V, Dosenko V, Benova T, Goncalvesova E, Vanrooyen J, Tribulova N, Maulik SK, Seth S, Dinda AK, Jaiswal A, Mearini G, Khajetoorians D, Kraemer E, Gedicke-Hornung C, Precigout G, Eschenhagen T, Voit T, Garcia L, Lorain S, Carrier L, Mendes-Ferreira P, Maia-Rocha C, Adao R, Lourenco AP, Cerqueira RJ, Mendes MJ, Castro-Chaves P, De Keulenaer GW, Leite-Moreira AF, Bras-Silva C, Ruiter G, Wong YY, Lubberink M, Knaapen P, Raijmakers P, Lammertsma AA, Marcus JT, Westerhof N, Van Der Laarse WJ, Vonk-Noordegraaf A, Poitz DM, Steinbronn N, Koch E, Steiner G, Strasser RH, Berezin A, Lisovaya OA, Soldatova AM, Kuznetcov VA, Yenina TN, Rychkov AYU, Shebeko PV, Altara R, Hessel MHM, Hermans JJR, Janssen BJA, Blankesteijn WM, Soldatova AM, Kuznetcov VA, Yenina TN, Rychkov AYU, Shebeko PV, Berezin A, Berezina TA, Seden V, Bonanad C, Nunez J, Navarro D, Chilet MF, Sanchis F, Bodi V, Minana G, Chaustre F, Forteza MJ, Llacer A, Femminella GD, Rengo G, Galasso G, Zincarelli C, Liccardo D, Pagano G, De Lucia C. Poster session 3. Cardiovasc Res 2012. [DOI: 10.1093/cvr/cvr336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Crewther S, Cross A, Lourenco T, Laycock R. Dorsal stream involvement in object recognition with temporal salience, but not when temporal salience is reduced. J Vis 2011. [DOI: 10.1167/11.11.867] [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: 11/24/2022] Open
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Cross A, Hayward E. Susan Marie Hayward (nee Moss). West J Med 2011. [DOI: 10.1136/bmj.d314] [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: 11/03/2022]
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Shalhoub J, Cross A, Allin D, Davies A, Monaco C. Intra-plaque production of M1-type cytokines and matrix metalloproteinases differentiate stable from unstable carotid atherosclerosis. Atherosclerosis 2010. [DOI: 10.1016/j.atherosclerosis.2010.08.041] [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: 11/30/2022]
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Newton WP, Stone K, Dent GA, Shaheen NJ, Byerley J, Gilliland KO, Rao K, Farrell T, Cross A. The University of North Carolina at Chapel Hill School of Medicine. Acad Med 2010; 85:S424-S429. [PMID: 20736600 DOI: 10.1097/acm.0b013e3181ea36cd] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Shalhoub J, Cross A, Allin D, Essex D, Davies AH, Monaco C. BAS/BSCR38 Cytokine profiling in culture reveals a predominance of M1 macrophage polarisation in symptomatic carotid plaques. Heart 2010. [DOI: 10.1136/hrt.2010.205781.49] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Polk C, Forrest G, Cross A. Cellulitis in a Patient with Leukemia. Clin Infect Dis 2007. [DOI: 10.1086/513425] [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: 11/03/2022] Open
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Goodman AD, Cohen JA, Cross A, Vollmer T, Rizzo M, Cohen R, Marinucci L, Blight AR. Fampridine-SR in multiple sclerosis: a randomized, double-blind, placebo-controlled, dose-ranging study. Mult Scler 2007; 13:357-68. [PMID: 17439905 DOI: 10.1177/1352458506069538] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.4] [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: 11/16/2022]
Abstract
Objective To determine the safety of sustained-release 4-aminopyridine in subjects with mutiple sclerosis (MS) and to examine dose-related efficacy up to 40 mg twice daily. Method Multicenter, randomized, double-blind, placebo-controlled, study. Following a 4-week baseline peroid, subjects were randomly assigned to receive Fampridine-SR (n=25, doses from 10 to 40 mg twice daily, increasing in 5 mg increments weekly) or placebo (n=11). A battery of assessments was performed weekly, including the MS Functional Composite (MSFC), fatigue questionnaires, and lower extremity manual muscle testing. Results The most common adverse events were dizziness, insomnia, paresthesia, asthenia, nausea, headache, and tremor. Five subjects were discontinued from Fampridine-SR because of adverse events at doses greater than 25 mg, and these included convulsions in two subjects at doses of 30 and 35 mg twice daily. Improvement were seen in lower extremity muscle strength (prospective analysis) and walking speed (post-hoc analysis) in the Fampridine-SR group compared to placebo (unadjusted p-values of 0.01 and 0.03, respectively). There were no significant differences in other MSFC measure or fatigue scores. Conclusions Future studies should employ doses up to 20 mg twice daily with lower extremity strength and walking speed as potential outcome measures. Multiple Sclerosis 2007; 13: 357-368. http://msj.sagepub.com
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Affiliation(s)
- A D Goodman
- Department of Neurology, University of Rochester, Rochester, NY 14642, USA. andrew_goodman@u rmc.rochester.edu
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De Man R, Mutimer D, Gish R, Chang T, Zhu J, Cross A, Brett-Smith H. P.090 Entecavir (ETV) treatment through 96 weeks results in substantial virologic and biochemical improvement and HBeAg seroconversion in HBeAg(+) chronic hepatitis B (CHB) patients (study ETV-022). J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80273-8] [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: 10/24/2022]
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Affiliation(s)
- A Cross
- Department of Child Health, St George's Hospital, London, UK
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Jain M, Titanji R, Rapoport AP, Wang W, Gocke C, Cross A, Akpek G. A fatal Clostridium infection in an allogeneic stem cell transplant recipient. Bone Marrow Transplant 2005; 36:455-7. [PMID: 15995716 DOI: 10.1038/sj.bmt.1705052] [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: 11/09/2022]
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Stadtmauer EA, Rapoport AP, Levine BL, Badros A, Porter DL, Luger SM, Mann D, Cross A, June CH. Co-stimulated autologous T-cell infusion after autologous stem cell transplantation (SCT) for myeloma accelerates lymphocyte recovery and augments response to pneumoccal vaccine: Results of a randomized trial. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6534] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E. A. Stadtmauer
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - A. P. Rapoport
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - B. L. Levine
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - A. Badros
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - D. L. Porter
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - S. M. Luger
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - D. Mann
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - A. Cross
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
| | - C. H. June
- Univ of Pennsylvania Cancer Ctr, Philadelphia, PA; Univ of Maryland, Baltimore, MD
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Roghmann M, Taylor KL, Gupte A, Zhan M, Johnson JA, Cross A, Edelman R, Fattom AI. Epidemiology of capsular and surface polysaccharide in Staphylococcus aureus infections complicated by bacteraemia. J Hosp Infect 2005; 59:27-32. [PMID: 15571850 DOI: 10.1016/j.jhin.2004.07.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [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] [Received: 09/09/2003] [Accepted: 07/09/2004] [Indexed: 10/26/2022]
Abstract
Staphylococcus aureus is a leading cause of serious hospital- and community-acquired infections. The discovery of serologically distinct capsular polysaccharides on the surface of clinical isolates has allowed the development of vaccines and passive protective immunity. We have studied patient characteristics, infection characteristics and the surface and capsular polysaccharide serotype distribution in patients with S. aureus infections complicated by bacteraemia admitted to VA hospitals in Maryland between 1995 and 2000. Nine hundred and ninety-three blood cultures from 331 patients were positive for S. aureus. Thirty-eight percent of patients had diabetes, 11% had end-stage renal failure, and 23% were injection drug users. Forty-two percent of infections were caused by methicillin-resistant strains (MRSA), and 60% were acquired during hospitalization. Serotyping of the first available isolate per patient (N=234 isolates) using polyclonal antibodies showed three major phenotypes--42%, type 8 (T8) capsule; 50%, type 5 (T5) capsule; and 8%, 336 polysaccharide. MRSA isolates were significantly more likely to be T5 than methicillin-susceptible isolates (66% vs. 39%, P<0.001). The proportion of T5 MRSA increased significantly (years 1-2: 41%; years 3-4: 65%; years 5-6: 90%, P<0.001). This large sample of patients with serious S. aureus infection confirms that capsular polysaccharides T5 and T8 cause most human infections, and together with serotype 336, account for nearly all those with bacteraemia.
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Affiliation(s)
- M Roghmann
- Epidemiology Section, Medical Care Clinical Center, VA Maryland Health Care System, Baltimore, MD, USA.
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Camporota L, Corkhill A, Long H, Lordan J, Stanciu L, Tuckwell N, Cross A, Stanford JL, Rook GAW, Holgate ST, Djukanovic R. The effects of Mycobacterium vaccae on allergen-induced airway responses in atopic asthma. Eur Respir J 2003; 21:287-93. [PMID: 12608443 DOI: 10.1183/09031936.03.00042103] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [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: 11/05/2022]
Abstract
T-helper (Th)2 cytokines play a central role in asthma. Therefore, a double-blind randomised study was conducted to investigate whether heat-killed Mycobacterium vaccae (SRL172), a potent downregulator of Th2 cytokines, can reduce allergen-induced airway responses in patients with atopic asthma. A total 24 male asthmatics participated in this study. A bronchial allergen challenge was performed along with early (EAR) and late asthmatic responses (LAR) 2 weeks before and 3 weeks after a single intradermal injection of SRL172 or placebo. Before and after treatment, serum immunoglobulin (Ig)E levels and in vitro production of interleukin (IL)-5 by peripheral blood lymphocytes were studied. Neither treatment affected the EAR. SRL172 caused a mean 34% reduction of the area under the curve of the forced expiratory volume in one second (FEV1) changes during the LAR, which failed to reach conventional statistical significance when compared with placebo. SRL172 also caused a mean 25% decrease in the maximum fall in FEV1 during LAR, but this was not significantly different from placebo. SRL172 caused a reduction in serum IgE and IL-5 synthesis in vitro 3 weeks post-treatment (p = 0.07). This study shows a trend toward significance for the effects of heat-killed Mycobacterium vaccae (SRL172) on allergen-induced airway responses. Further clinical trials, involving multiple dosing, are needed.
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Affiliation(s)
- L Camporota
- Division of Respiratory Cell and Molecular Biology, Southampton General Hospital, Southampton, UK
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Menzinger M, Tzalmona A, Armstrong RL, Cross A, Lemaire C. Dynamics of convective instability of waves in the Belousov-Zhabotinskii reaction as measured by magnetic resonance imaging. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100191a001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Fassas AB, Bolaños-Meade J, Buddharaju LN, Rapoport A, Cottler-Fox M, Chen T, Lovchik JC, Cross A, Tricot G. Cytomegalovirus infection and non-neutropenic fever after autologous stem cell transplantation: high rates of reactivation in patients with multiple myeloma and lymphoma. Br J Haematol 2001; 112:237-41. [PMID: 11167810 DOI: 10.1046/j.1365-2141.2001.02487.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [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: 11/20/2022]
Abstract
In a retrospective study, we examined the association between cytomegalovirus (CMV) infection and non-neutropenic fever immediately following autologous peripheral blood stem cell transplantation for a variety of haematological malignancies and solid tumours. Sixty non-neutropenic febrile episodes (41 in CMV-seropositive and 19 in CMV-seronegative patients) were evaluated. CMV reactivation, documented by CMV antigenaemia, was detected in 16 out of 41 (39%) seropositive patients compared with 0 out of 19 seronegative patients. In 12 of these 16 patients, CMV infection was considered the sole cause of fever. Thirteen patients had maximum antigenaemia levels > 5 cells/slide. Specific antiviral treatment led to the resolution of the fever in all, but two, patients, who developed fatal CMV pneumonia. Patients with multiple myeloma and lymphoma, possibly owing to a combination of disease-related characteristics and prior immunosuppressive treatment, had high rates of CMV reactivation and may require more frequent diagnostic evaluation and prompt therapeutic intervention.
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Affiliation(s)
- A B Fassas
- Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA.
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37
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Abstract
Angiotensin II and norepinephrine (NE) have been implicated in the neurohumoral response to pressure overload and the development of left ventricular hypertrophy. The purpose of this study was to determine the temporal sequence for activation of the renin-angiotensin and sympathetic nervous systems in the rat after 3-60 days of pressure overload induced by aortic constriction. Initially on pressure overload, there was transient activation of the systemic renin-angiotensin system coinciding with the appearance of left ventricular hypertrophy (day 3). At day 10, there was a marked increase in AT(1) receptor density in the left ventricle, increased plasma NE concentration, and elevated cardiac epinephrine content. Moreover, the inotropic response to isoproterenol was reduced in the isolated, perfused heart at 10 days of pressure overload. The affinity of the beta(2)-adrenergic receptor in the left ventricle was decreased at 60 days. Despite these alterations, there was no decline in resting left ventricular function, beta-adrenergic receptor density, or the relative distribution of beta(1)- and beta(2)-receptor sites in the left ventricle over 60 days of pressure overload. Thus activation of the renin-angiotensin system is an early response to pressure overload and may contribute to the initial development of cardiac hypertrophy and sympathetic activation in the compensated heart.
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MESH Headings
- Adrenergic beta-Antagonists/metabolism
- Adrenergic beta-Antagonists/pharmacology
- Angiotensin II/blood
- Animals
- Aorta
- Echocardiography
- Hypertrophy, Left Ventricular/diagnostic imaging
- Hypertrophy, Left Ventricular/physiopathology
- Imidazoles/pharmacology
- Iodine Radioisotopes
- Iodocyanopindolol/metabolism
- Iodocyanopindolol/pharmacology
- Male
- Myocardium/metabolism
- Myocardium/pathology
- Norepinephrine/blood
- Rats
- Rats, Sprague-Dawley
- Receptor, Angiotensin, Type 1
- Receptor, Angiotensin, Type 2
- Receptors, Adrenergic, beta/metabolism
- Receptors, Angiotensin/metabolism
- Renin-Angiotensin System/physiology
- Sympathetic Nervous System/physiology
- Ventricular Pressure/physiology
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Affiliation(s)
- W S Akers
- Division of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, USA
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38
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Moulton P, Martin H, Ainger A, Cross A, Hoare C, Doel J, Harrison R, Eisenthal R, Hancock J. The inhibition of flavoproteins by phenoxaiodonium, a new iodonium analogue. Eur J Pharmacol 2000; 401:115-20. [PMID: 10924915 DOI: 10.1016/s0014-2999(00)00454-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Iodonium compounds, especially diphenylene iodonium and iodonium diphenyl are used extensively as inhibitors of NADH-ubiquinone reductase and NADPH oxidase activity. Here, the use of a new iodonium compound, phenoxaiodonium is reported. The IC(50) of neutrophil superoxide production, measured using the superoxide dismutase inhibitable rate of cytochrome c reduction, was approximately 0.75 microM, while 50% inhibition of mitochondrial respiration, measured by the rate of oxygen uptake using a Clark type oxygen electrode, was at approximately 20 microM. The inhibition of oxidation of xanthine to urate by xanthine oxidase was also studied, giving a K(i) of 0.2 microM. Inhibition of nitric oxidase synthase (NOS: from rat brain) by 0.2 microM phenoxaiodonium was equivalent to 1 mM N(G)-nitro-L-arginine methyl ester HCl (L-NAME), that is total abolition of activity. We conclude that phenoxaiodonium is an extremely good inhibitor of flavo-enzymes, but like diphenylene iodonium and iodonium diphenyl, will be of limited use as a pharmacological tool for the elucidation of the involvement of such enzymes in specific cellular functions.
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Affiliation(s)
- P Moulton
- Department of Biological and Biomedical Sciences, University of the West of England, Coldharbour Lane, BS16 1QY, Bristol, UK
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Ejidokun OO, Killalea D, Cooper M, Holmyard S, Cross A, Kemp C. Four linked outbreaks of Salmonella enteritidis phage type 4 infection--the continuing egg threat. Commun Dis Public Health 2000; 3:95-100. [PMID: 10902250] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Four outbreaks of Salmonella enteritidis phage type (PT) 4 occurred among guests at functions for which a single commercial caterer supplied food. Retrospective cohort studies were used to describe the epidemiology of three of these outbreaks and identify the vehicle(s) responsible. Of 172 guests at these three events, 47 fitted the clinical case definition for illness and 24 cases were confirmed to have S. enteritidis PT4 infection. Food containing raw egg was identified epidemiologically as the likely vehicle of infection in two of the three outbreaks (odds ratios (OR) and 95% confidence intervals 9.1 (2.2-39.9) and 6.9 (1.2-46.4)). Logistic regression analysis yielded OR = 10.7 (p = 0.0022) and OR = 9.3 (p = 0.015) for egg consumption in two of the outbreaks. These outbreaks highlighted the continuing need to remind the public and commercial caterers of the potential high risks of contracting salmonella from shell eggs. Education of caterers includes advice to obtain eggs and other products from reputable and identifiable suppliers.
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Affiliation(s)
- O O Ejidokun
- Department of Public Health Medicine, Dudley Health Authority.
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Papka M, Calabresi P, Myers G, Counihan T, Cross A. Clinical Diagnosis and Management of Alzheimer's Disease, Second Edition. Neurology 1999. [DOI: 10.1212/wnl.53.6.1377] [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: 11/15/2022] Open
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41
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Abstract
Peripheral neuropathy has been recognized as a dose-limiting adverse effect in Phase I studies of didanosine (ddI) therapy for HIV infection. To study the effect of the currently recommended lower dose of ddI, the databases of 4 randomized, controlled trials were used to assess the frequency of dose-limiting peripheral neuropathy during treatment with ddI 500 or 750 mg/d, compared with zidovudine (ZDV) monotherapy or combination therapy with ddI/ZDV or zalcitabine/ZDV. No between-group differences in risk factors for neuropathy (eg, infectious and metabolic factors, malignancy, concurrent medications) were observed in the individual trials, and the presence of these risk factors appeared to have no increased treatment effect on the occurrence of neuropathy. No significant between-group differences were observed in the individual studies with regard to the incidence or time to onset of peripheral neuropathy. Analysis of the combined results by treatment regimen showed no significant difference in the incidence of neuropathy between recipients of ddI 500 mg/d, ddI 750 mg/d, or ZDV and no significant difference in the cumulative dose received until the onset of neuropathy between the ddI 500- and 750-mg regimens. Entry CD4+ cell counts were significantly predictive of neuropathy, with each 100-cell/microL decrement associated with a 17% increase in risk (P = 0.002); a CD4+ cell count of <50 cells/microL was highly predictive of neuropathy (P = 0.0001). In summary, the risk for peripheral neuropathy was not increased by treatment with ddI versus comparator regimens or by treatment with ddI at the dosages used in studies conducted more recently than the Phase I trials. Peripheral neuropathy seems more likely to be associated with advanced HIV infection and lower CD4+ cell counts (particularly counts <50 cells/microL) than with ddI therapy at the currently recommended dose.
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Affiliation(s)
- T Kelleher
- Biostatistics and Data Management, Bristol-Meyers Squibb Company, Wallingford, Connecticut 06492, USA
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42
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Cross A. The participation of the hemes of flavocytochrome b245 in the electron transfer process in NADPH oxidase. Blood 1999; 93:4449. [PMID: 10391701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
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43
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Parker EA, Eng E, Laraia B, Ammerman A, Dodds J, Margolis L, Cross A. Coalition building for prevention: lessons learned from the North Carolina Community-Based Public Health Initiative. J Public Health Manag Pract 1998; 4:25-36. [PMID: 10186731 DOI: 10.1097/00124784-199803000-00005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [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: 11/26/2022]
Abstract
This article examines the four-year development of the North Carolina Community-Based Public Health Initiative consortium (NC CBPHI). The NC CBPHI consisted of four separate county coalitions and differed in both its agenda and membership from the many examples of coalitions described in the literature. This article presents and describes evaluation findings that identify six factors as important in coalition functioning and success in the CBPHI coalitions. These factors are: participation, communication, governance and rules for operation, staff/coalition member relationships, technical assistance and skills training, and conflict recognition and containment. Selected CBPHI coalition activities are also described and implications for public health practitioners are presented.
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Affiliation(s)
- E A Parker
- University of Michigan School of Public Health, Ann Arbor, USA
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Raboud JM, Montaner JS, Rae S, Kahn J, Hammer SM, Katzenstein DA, Pavia A, Dolin R, Hughes MD, Cross A, Beltangady M, Gatell J, Dunkle L, Smaldone L. Meta-analysis of five randomized controlled trials comparing continuation of zidovudine versus switching to didanosine in HIV-infected individuals. Antivir Ther 1997; 2:237-47. [PMID: 11327443] [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: 02/19/2023]
Abstract
A meta-analysis of the original data from 2411 patients in the ACTG 116A, ACTG116B/117, ACTG175, BMS010 and CTN002 trials was conducted to improve the estimate of the effect of switching from zidovudine to didanosine on rates of clinical progression, to better quantify the rates of neurological events (including AIDS dementia and peripheral neuropathy) and to examine the effects of switching from zidovudine to didanosine among women and racial subgroups. In total, 1012 patients received zidovudine therapy, 557 received high-dose didanosine and 842 received didanosine. The median duration of follow-up was 15 months. Ninety-one percent of patients were male, 78% were white, mean age was 36.5 years. The median CD4 count was 195 cells/mm3 (range: 0-762) and the median duration of prior zidovudine therapy was 14 months (range: 0.1-94). There were 336 deaths and 686 new AIDS-defining illnesses (ADIs) or deaths. After stratification by study and adjusting for baseline CD4 count and presence of an AIDS diagnosis prior to baseline, the relative risks of death associated with switching from zidovudine to high-dose didanosine or to didanosine were 0.94 (P = 0.64) and 0.77 (P = 0.07), respectively. The relative risks of a new ADI or death associated with switching from zidovudine to high-dose didanosine and didanosine were 0.78 (P = 0.01) and 0.66 (P = 0.0001), respectively. There were 21 documented cases of AIDS dementia complex (ADC) during the entire follow-up period. The rates per 100 person years of follow-up were 0.70, 0.65 and 0.41 for the zidovudine, high-dose didanosine and didanosine arms, respectively. There were no significant differences in risks of ADC between treatment arms (zidovudine versus high-dose didanosine: P = 0.30, zidovudine versus didanosine: P = 0.97, didanosine versus high-dose didanosine: P = 0.41). Our data confirm a clinical benefit and CD4 increase associated with a switch from zidovudine to didanosine therapy. No statistical differences were detected between doses of didanosine with respect to survival or progression to a new ADI or death. Furthermore, there was no statistical difference in the frequency of ADC between treatment arms.
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Affiliation(s)
- J M Raboud
- University of British Columbia, St. Paul's Hospital, Vancouver, Canada.
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Marsden HS, McLean GW, Barnard EC, Francis GJ, MacEachran K, Murphy M, McVey G, Cross A, Abbotts AP, Stow ND. The catalytic subunit of the DNA polymerase of herpes simplex virus type 1 interacts specifically with the C terminus of the UL8 component of the viral helicase-primase complex. J Virol 1997; 71:6390-7. [PMID: 9261356 PMCID: PMC191912 DOI: 10.1128/jvi.71.9.6390-6397.1997] [Citation(s) in RCA: 44] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The herpes simplex virus type 1 (HSV-1) UL8 DNA replication protein is a component of a trimeric helicase-primase complex. Sixteen UL8-specific monoclonal antibodies (MAbs) were isolated and characterized. In initial immunoprecipitation experiments, one of these, MAb 804, was shown to coprecipitate POL, the catalytic subunit of the HSV-1 DNA polymerase, from extracts of insect cells infected with recombinant baculoviruses expressing the POL and UL8 proteins. Coprecipitation of POL was dependent on the presence of UL8 protein. Rapid enzyme-linked immunosorbent assays (ELISAs), in which one protein was bound to microtiter wells and binding of the other protein was detected with a UL8- or POL-specific MAb, were developed to investigate further the interaction between the two proteins. When tested in the ELISAs, five of the UL8-specific MAbs consistently inhibited the interaction, raising the possibility that these antibodies act by binding to epitopes at or near a site(s) on UL8 involved in its interaction with POL. The epitopes recognized by four of the inhibitory MAbs were approximately located by using a series of truncated UL8 proteins expressed in mammalian cells. Three of these MAbs recognized an epitope near the C terminus of UL8, which was subjected to fine mapping with a series of overlapping peptides. The C-terminal peptides were then tested in the ELISA for their ability to inhibit the POL-UL8 interaction: the most potent exhibited a 50% inhibitory concentration of approximately 5 microM. Our findings suggest that the UL8 protein may be involved in recruiting HSV-1 DNA polymerase into the viral DNA replication complex and also identify a potential new target for antiviral therapy.
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Affiliation(s)
- H S Marsden
- MRC Virology Unit, University of Glasgow, United Kingdom.
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46
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Abstract
The efficiency and selectivity of tumour targeting by several tetra-n-propylporphycene (TPPn) and tetrakis(methoxyethyl)porphycene (TMPn) derivatives have been studied by administering 3.76 micromol/kg of aqueous or liposomal porphycene formulations to BALB/c mice bearing an i.m. implanted MS-2 fibrosarcoma. These 2 parameters have been studied as a function of the type of substituents linked to the 9-position of the macrocycle by amide, ester or ether functional groups. The pharmacokinetic properties appear to be controlled mainly by the degree of porphycene hydrophobicity, as evaluated by measuring their retention times in a C 18 column for HPLC. Thus, the post-injection time (T50) at which the porphycene concentration in the plasma decreases to 50% of the initial value ranged from a few minutes for the less hydrophobic to several hours for the more hydrophobic porphycenes. An increase in hydrophobicity also was accompanied by an enhanced efficiency and selectivity of tumour targeting. The less hydrophobic porphycenes showed a maximum tumour uptake of 0.5-2 nmol/g of tissue at 10-20 min after administration with a tumour/peri-tumoural concentration ratio around 2-3, while those with higher hydrophobicity reached tumour concentrations of 7-8 nmol/g at 24-48 hr after administration with concentration ratios higher than 20.
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Affiliation(s)
- A Segalla
- Department of Biology, University of Padova, Italy
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Everett RD, Meredith M, Orr A, Cross A, Kathoria M, Parkinson J. A novel ubiquitin-specific protease is dynamically associated with the PML nuclear domain and binds to a herpesvirus regulatory protein. EMBO J 1997; 16:1519-30. [PMID: 9130697 PMCID: PMC1169756 DOI: 10.1093/emboj/16.7.1519] [Citation(s) in RCA: 309] [Impact Index Per Article: 11.4] [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: 02/04/2023] Open
Abstract
Herpes simplex virus type 1 immediate-early protein Vmw110 is a non-specific activator of gene expression and is required for efficient initiation of the viral lytic cycle. Since Vmw110-deficient viruses reactivate inefficiently in mouse latency models it has been suggested that Vmw110 plays a role in the balance between the latent and lytic states of the virus. The mechanisms by which Vmw110 achieves these functions are poorly understood. Vmw110 migrates to discrete nuclear structures (ND10) which contain the cellular PML protein, and in consequence PML and other constituent proteins are dispersed. In addition, Vmw110 binds to a cellular protein of approximately 135 kDa, and its interactions with the 135 kDa protein and ND10 contribute to its ability to stimulate gene expression and viral lytic growth. In this report we identify the 135 kDa protein as a novel member of the ubiquitin-specific protease family. The protease is distributed in the nucleus in a micropunctate pattern with a limited number of larger discrete foci, some of which co-localize with PML in ND10. At early times of virus infection, the presence of Vmw110 increases the proportion of ND10 which contain the ubiquitin-specific protease. These results identify a novel, transitory component of ND10 and implicate a previously uncharacterized ubiquitin-dependent pathway in the control of viral gene expression.
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Affiliation(s)
- R D Everett
- Medical Research Council Virology Unit, Glasgow, UK
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Drew WL, Lalezari J, Jordan C, Jensen P, Moe A, Reynolds L, Mohanty S, Cross A, Dunkle L. In vivo anti-cytomegalovirus (CMV) activity and safety of oral lobucavir in HIV infected patients. Antiviral Res 1997. [DOI: 10.1016/s0166-3542(97)83156-7] [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: 10/17/2022]
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49
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Spruance SL, Pavia AT, Mellors JW, Murphy R, Gathe J, Stool E, Jemsek JG, Dellamonica P, Cross A, Dunkle L. Clinical efficacy of monotherapy with stavudine compared with zidovudine in HIV-infected, zidovudine-experienced patients. A randomized, double-blind, controlled trial. Bristol-Myers Squibb Stavudine/019 Study Group. Ann Intern Med 1997; 126:355-63. [PMID: 9054279 DOI: 10.7326/0003-4819-126-5-199703010-00003] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [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: 02/03/2023] Open
Abstract
BACKGROUND Stavudine is a promising antiretroviral agent, but its clinical efficacy has not been determined. OBJECTIVE To evaluate the clinical effect of stavudine (2',3'-didehydro-3'-deoxythymidine) monotherapy in patients with human immunodeficiency virus (HIV) infection. DESIGN Randomized, controlled, double-blind trial. SETTING 56 outpatient clinics in private practices, universities, and contract research organizations in the United States, France, and Italy. PATIENTS 822 HIV-infected adults who had 50 to 500 CD4+ cells/mm3 and had previously received at least 6 months of zidovudine treatment. INTERVENTION Monotherapy with peroral stavudine capsules or peroral zidovudine capsules. MEASUREMENTS The primary end point was clinical progression, which was defined as all occurrences of acquired immunodeficiency syndrome (AIDS)-defining events or death. RESULTS Patients receiving stavudine reached clinical end points at a rate of 26 per 100 person-years, compared with 32 per 100 person-years for patients receiving zidovudine (relative risk, 0.75 [95% CI, 0.58 to 0.98]; P = 0.03). The risk for death alone was 26% lower in the stavudine group than in the zidovudine group, but the comparison was not statistically significant (relative risk, 0.74 [CI, 0.53 to 1.02]; P = 0.066). The benefit of stavudine therapy was seen in all CD4+ cell strata (< or = 100 cells/mm3, 101 to 300 cells/mm3, and > 300 cells/mm3) and clinical stages of HIV disease (asymptomatic, symptomatic, and AIDS). Four weeks after treatment began, CD4+ cell counts were 30 cells/mm3 higher in the stavudine group than in the zidovudine group; this difference was sustained for 96 weeks (P < 0.001). Nausea and vomiting were more common in patients receiving zidovudine (P < 0.01), and neuropathy occurred more frequently in those receiving stavudine (12% in the stavudine group compared with 4% in the zidovudine group; P < 0.001). Neuropathy resolved completely in many patients (63%) after interruption of stavudine treatment; these patients could resume stavudine therapy at a lower dose. CONCLUSIONS Stavudine was well tolerated and delayed progression of HIV disease in patients who had previously received 6 or more months of zidovudine treatment. Benefits were apparent in all CD4+ cell strata and clinical stages of HIV disease. Stavudine is an important agent to consider for trials of combination chemotherapy.
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Affiliation(s)
- S L Spruance
- Health Sciences AIDS Center, University of Utah School of Medicine, Salt Lake City 84132, USA
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50
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Everett RD, Meredith M, Orr A, Cross A, Kathoria M, Parkinson J. A novel ubiquitin-specific protease is dynamically associated with the PML nuclear domain and binds to a herpesvirus regulatory protein. EMBO J 1997; 16:566-77. [PMID: 9034339 PMCID: PMC1169660 DOI: 10.1093/emboj/16.3.566] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.7] [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: 02/03/2023] Open
Abstract
Herpes simplex virus type 1 immediate-early protein Vmw110 is a non-specific activator of gene expression and is required for efficient initiation of the viral lytic cycle. Since Vmw110-deficient viruses reactivate inefficiently in mouse latency models it has been suggested that Vmw110 plays a role in the balance between the latent and lytic states of the virus. The mechanisms by which Vmw110 achieves these functions are poorly understood. Vmw110 migrates to discrete nuclear structures (ND10) which contain the cellular PML protein, and in consequence PML and other constituent proteins are dispersed. In addition, Vmw110 binds to a cellular protein of approximately 135 kDa, and its interactions with the 135 kDa protein and ND10 contribute to its ability to stimulate gene expression and viral lytic growth. In this report we identify the 135 kDa protein as a novel member of the ubiquitin-specific protease family. The protease is distributed in the nucleus in a micropunctate pattern with a limited number of larger discrete foci, some of which co-localize with PML in ND10. At early times of virus infection, the presence of Vmw110 increases the proportion of ND10 which contain the ubiquitin-specific protease. These results identify a novel, transitory component of ND10 and implicate a previously uncharacterized ubiquitin-dependent pathway in the control of viral gene expression.
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Affiliation(s)
- R D Everett
- Medical Research Council Virology Unit, Glasgow, UK
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