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Dyson T, Thomas SJ, Townsend ML, Finch A, South A, Barkus E, Walter E, Mendonca C, Grenyer BFS, Pickard JA. Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention. Front Psychol 2023; 14:1195187. [PMID: 37529315 PMCID: PMC10389657 DOI: 10.3389/fpsyg.2023.1195187] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Background Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment. Methods Participants with BPD (n = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls (n = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels. Results Participants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change. Conclusions This study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018.
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Affiliation(s)
- Tori Dyson
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Susan J. Thomas
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | | | - Adam Finch
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Alexandra South
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Emma Barkus
- Department of Psychology, Northumbria University, Newcastle upon Tyne, North East England, United Kingdom
| | - Emma Walter
- School of Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Carley Mendonca
- School of Psychology, University of Technology Sydney, Sydney, NSW, Australia
| | - Brin F. S. Grenyer
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Judy A. Pickard
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
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2
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Aird R, Wills J, Roby KF, Bénézech C, Stimson RH, Wabitsch M, Pollard JW, Finch A, Michailidou Z. Hypoxia-driven metabolic reprogramming of adipocytes fuels cancer cell proliferation. Front Endocrinol (Lausanne) 2022; 13:989523. [PMID: 36329893 PMCID: PMC9623062 DOI: 10.3389/fendo.2022.989523] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/15/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Obesity increases the risk of certain cancers, especially tumours that reside close to adipose tissue (breast and ovarian metastasis in the omentum). The obesogenic and tumour micro-environment share a common pathogenic feature, oxygen deprivation (hypoxia). Here we test how hypoxia changes the metabolome of adipocytes to assist cancer cell growth. METHODS Human and mouse breast and ovarian cancer cell lines were co-cultured with human and mouse adipocytes respectively under normoxia or hypoxia. Proliferation and lipid uptake in cancer cells were measured by commercial assays. Metabolite changes under normoxia or hypoxia were measured in the media of human adipocytes by targeted LC/MS. RESULTS Hypoxic cancer-conditioned media increased lipolysis in both human and mouse adipocytes. This led to increased transfer of lipids to cancer cells and consequent increased proliferation under hypoxia. These effects were dependent on HIF1α expression in adipocytes, as mouse adipocytes lacking HIF1α showed blunted responses under hypoxic conditions. Targeted metabolomics of the human Simpson-Golabi-Behmel syndrome (SGBS) adipocytes media revealed that culture with hypoxic-conditioned media from non-malignant mammary epithelial cells (MCF10A) can alter the adipocyte metabolome and drive proliferation of the non-malignant cells. CONCLUSION Here, we show that hypoxia in the adipose-tumour microenvironment is the driving force of the lipid uptake in both mammary and ovarian cancer cells. Hypoxia can modify the adipocyte metabolome towards accelerated lipolysis, glucose deprivation and reduced ketosis. These metabolic shifts in adipocytes could assist both mammary epithelial and cancer cells to bypass the inhibitory effects of hypoxia on proliferation and thrive.
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Affiliation(s)
- R. Aird
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
| | - J. Wills
- MRC Institute of Genetics and Molecular Medicine, Edinburgh University, Edinburgh, United Kingdom
| | - K. F. Roby
- University of Kansas Medical Center, Kansas City, Kansas, KS, United States
| | - C. Bénézech
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
| | - R. H. Stimson
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
| | - M. Wabitsch
- University Medical Center Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - J. W. Pollard
- Medical Research Council (MRC) Centre for Reproductive Health, Edinburgh University, Edinburgh, United Kingdom
| | - A. Finch
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Z. Michailidou
- University/British Heart Foundation (BHF) Centre for Cardiovascular Science, Edinburgh University, Edinburgh, United Kingdom
- *Correspondence: Z. Michailidou,
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3
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Pickard JA, Finch A, Huxley E, Townsend ML, Deuchar S, Lewis KL, Pratt J, Grenyer BFS. Assessing the efficacy of a stepped-care group treatment programme for borderline personality disorder: study protocol for a pragmatic trial. Trials 2021; 22:383. [PMID: 34099033 PMCID: PMC8183092 DOI: 10.1186/s13063-021-05327-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
Background Borderline personality disorder (BPD) is a high prevalence and serious mental health disorder that has historically challenged the finite resources of health services. Despite empirical evidence supporting structured psychological therapy as the first line of treatment, there remains significant barriers in providing timely access to evidence-based treatment for this population. The primary aim of this study is to evaluate the effectiveness of providing a stepped-care structured psychological group treatment to individuals with BPD within local mental health services. The secondary aims of the study are to identify the variables that predict the need to step up or down in care and the effectiveness of treatment on psychosocial functioning. Methods Participants seeking treatment at two community mental health services will be invited to participate. Randomised controlled trial assignment will be to either (i) group skills treatment or (ii) treatment as usual. Group treatment will be offered via a stepped-care pathway with participants initially attending a 12-week group with the option of a subsequent 16-week group. The criteria for inclusion in continuing treatment includes meeting > 4 BPD diagnostic criteria or severity on GAF (< 65) at the completion of the 12-week group. Data will be collected at baseline and at five follow-up time points over a 12-month period. Discussion This pragmatic trial will provide valuable information regarding the effectiveness of a progressive stepped-care group treatment for individuals with BPD in the real-world setting of a community mental health service. It will further the current understanding of variables that predict treatment dose and duration. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018
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Affiliation(s)
- Judy A Pickard
- School of Psychology, University of Wollongong, Wollongong, Australia.
| | - Adam Finch
- Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Elizabeth Huxley
- School of Psychology, University of Wollongong, Wollongong, Australia
| | | | | | - Kate L Lewis
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Jason Pratt
- Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Brin F S Grenyer
- School of Psychology, University of Wollongong, Wollongong, Australia
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4
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Miller GJ, Stirling Y, Esnouf MP, Heinrich J, van de Loo J, Kienast J, Wu KK, Morrissey JH, Meade TW, Martin JC, Imeson JD, Cooper JA, Finch A. Factor VII-Deficient Substrate Plasmas Depleted of Protein C Raise the Sensitivity of the Factor VII Bio-Assay to Activated Factor VII: an International Study. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1642382] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryPlasma from healthy individuals, pregnant women and patients on warfarin were distributed to 3 laboratories supporting major cardiovascular surveys (Northwick Park, Muenster and Houston) for assay of factor VII coagulant activity (VIIC) with their own bio-assays. The mean VIIC in 147 samples agreed to within 1% of standard in Northwick Park and Houston, but was 14% of standard lower in Muenster owing to its more potent standard. In samples with an increased VIIC the Northwick Park assay gave a higher result than the other assays owing to its increased responsiveness to activated factor VII (VIIa). Thus when VIIa concentrations were determined directly with a clotting assay which utilises a soluble recombinant tissue factor, the increase in VIIC with increase in VIIa was considerably greater with the Northwick Park assay than the Muenster assay. This feature of the Northwick Park assay was traced to the virtual absence of protein C in its substrate plasma. Factor Va appears rate-limiting for the coagulant expression of VIIa in test plasma. If the thrombotic response to release of tissue factor is determined by the circulating concentration of VIIa, then the Northwick Park factor VII bio-assay may be preferable to other bio-assays currently employed to estimate risk of acute coronary events.
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Affiliation(s)
- G J Miller
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - Y Stirling
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - M P Esnouf
- The Nuffield Department of Clinical Biochemistry, Radcliffe Infirmary, Oxford, England
| | - J Heinrich
- The Institute of Clinical Chemistry and Laboratory Medicine, University of Muenster, Muenster, Germany
| | - J van de Loo
- Department of Internal Medicine, University of Muenster, Muenster, Germany
| | - J Kienast
- Department of Internal Medicine, University of Muenster, Muenster, Germany
| | - K K Wu
- The University of Texas Medical School at Houston, Texas, USA
| | - J H Morrissey
- Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - T W Meade
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J C Martin
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J D Imeson
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J A Cooper
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - A Finch
- The University of Texas Medical School at Houston, Texas, USA
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5
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Newby J, Robins L, Wilhelm K, Smith J, Fletcher T, Gillis I, Ma T, Finch A, Campbell L, Andrews G. Web-Based Cognitive Behavior Therapy for Depression in People With Diabetes Mellitus: A Randomized Controlled Trial. J Med Internet Res 2017; 19:e157. [PMID: 28506956 PMCID: PMC5447827 DOI: 10.2196/jmir.7274] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/20/2022] Open
Abstract
Background Depression is twice as common in diabetes mellitus (DM) as the general population and is associated with adverse health outcomes, but access to evidence-based therapies such as cognitive behavioral therapy (CBT) is limited in routine diabetes care. Past research has shown that generic Internet-based cognitive behavioral therapy (iCBT) is an effective treatment for depression in the general population, but it has never been evaluated in people with comorbid depression and DM. Objective The aim of our study was to examine the efficacy of a generic 6-lesson iCBT delivered over 10 weeks in people with major depressive disorder (MDD) and DM. Methods Participants with comorbid MDD and DM (type 1 or 2) were recruited online and randomized to an iCBT program with therapist support provided by phone and email (n=42) or a treatment as usual (TAU, n=49) control group. Outcomes were assessed through Web-based self-report questionnaires and the trial was Web-based with no face-to-face components. Primary outcomes were self-reported depression (patient health questionnaire-9, PHQ-9), diabetes-related distress (problem areas in diabetes, PAID), and self-reported glycemic control (hemoglobin A1c, HbA1c). Secondary outcomes were general distress (Kessler 10-item psychological distress scale, K-10) and disability (short form 12-item, SF-12), generalized anxiety (generalized anxiety disorder 7-item, GAD-7), and somatization (PHQ-15). The iCBT group was assessed at 3 months. Results A total of 27 participants (66%; 27/41) completed the iCBT program. Analyses indicated between-group superiority of iCBT over TAU at posttreatment on PHQ-9 (g=0.78), PAID (g=0.80), K-10 (g=1.06), GAD-7 (g=0.72), and SF-12 mental well-being scores (g=0.66), but no significant differences in self-reported HbA1c levels (g=0.14), SF-12 physical well-being, or PHQ-15 scores (g=0.03-0.21). Gains were maintained at 3-month follow-up in the iCBT group, and the 87% (27/31) of iCBT participants who were interviewed no longer met criteria for MDD. Clinically significant change following iCBT on PHQ-9 scores was 51% (21/41) versus 18% (9/49) in TAU. Conclusions iCBT for depression is an efficacious, accessible treatment option for people with diabetes. Future studies should explore whether tailoring of iCBT programs improves acceptability and adherence, and evaluate the long-term outcomes following iCBT. Trial Registration Australian and New Zealand Clinical Trials Registry (ACTRN): 12613001198718; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365208&isReview=true (Archived by WebCite at http://www.webcitation.org/6qCR8Fi9V)
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Affiliation(s)
- Jill Newby
- School of Psychology, The University of New South Wales, Randwick, Australia.,The University of New South Wales at St Vincent's Hospital, Clinical Research Unit for Anxiety and Depression, School of Psychiatry, Darlinghurst, Australia
| | - Lisa Robins
- St Vincent's Health Australia, Faces in the Street, Darlinghurst, Australia.,St Vincent's Hospital, Sydney, Consultation Liaison Psychiatry, Darlinghurst, Australia.,Garvan Institute, St Vincent's Hospital, Sydney, Diabetes Centre, Darlinghurst, Australia
| | - Kay Wilhelm
- St Vincent's Health Australia, Faces in the Street, Darlinghurst, Australia.,St Vincent's Hospital, Sydney, Consultation Liaison Psychiatry, Darlinghurst, Australia
| | - Jessica Smith
- School of Psychiatry, Clinical Research Unit for Anxiety and Depression, The University of New South Wales at St Vincent's Hospital, Darlinghurst, Australia
| | - Therese Fletcher
- St Vincent's Health Australia, Faces in the Street, Darlinghurst, Australia
| | - Inika Gillis
- St Vincent's Health Australia, Faces in the Street, Darlinghurst, Australia
| | - Trevor Ma
- St Vincent's Hospital, Sydney, Consultation Liaison Psychiatry, Darlinghurst, Australia
| | - Adam Finch
- St Vincent's Hospital, Sydney, Consultation Liaison Psychiatry, Darlinghurst, Australia
| | - Lesley Campbell
- Garvan Institute, St Vincent's Hospital, Sydney, Diabetes Centre, Darlinghurst, Australia
| | - Gavin Andrews
- School of Psychiatry, Clinical Research Unit for Anxiety and Depression, The University of New South Wales at St Vincent's Hospital, Darlinghurst, Australia
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6
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Philpott HL, Nandurkar S, Thien F, Bloom S, Lin E, Goldberg R, Boyapati R, Finch A, Royce SG, Gibson PR. Seasonal recurrence of food bolus obstruction in eosinophilic esophagitis. Intern Med J 2016; 45:939-43. [PMID: 25871330 DOI: 10.1111/imj.12790] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 04/07/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Eosinophilic esophagitis (EoE) is a newly recognised condition that is apparently increasing in prevalence, and the aetiology is poorly understood. The role of aeroallergens in EoE is controversial, given the success of dietary therapy. Massive aeroallergen exposure leading to food bolus obstruction events (FBOE) has been described, and the diagnosis of EoE by esophageal biopsy noted to be more common in the pollen season according to previous case series. AIM To determine if a seasonal variation and a geographical variation occurred in EoE presenting as FBOE in adults, and to track the prevalence of FBOE and EoE over time. METHOD A retrospective case-control study analysis was performed from January 2002 to January 2012 to identify all FBOE in adults presenting to five tertiary hospitals in Melbourne, Australia. Endoscopy, histopathological reports, case notes and blood tests were examined, and postcodes recorded. Records of pollen counts were obtained. Cases were defined according to esophageal biopsy and grouped based on month of diagnosis. All other causes of FBOE served as controls. RESULTS One thousand, one hundred and thirty-two FBOE were identified. Biopsies were only performed in 278 of these cases, and 85 patients were found to have EoE after biopsy. Patients with EoE were younger (mean age 38 years, range 18-72) compared with those with alternative diagnosis (mean age 64.4 range 22-92), more likely to be male (M : F = 4:1 compared with 1.68:1 ) and had a higher eosinophil count in venous blood. Overall no seasonality was demonstrated in FBOE secondary to any diagnosis, although the six cases of recurrent FBOE secondary to EoE mainly occurred in the grass pollen season in subsequent years. FBOE cases were evenly distributed throughout metropolitan Melbourne irrespective of population density. EoE as a percentage of FBOE increased over time. CONCLUSION Seasonal aeroallergens may be important for a subgroup of patients with EoE presenting as recurrent FBOE. Esophageal biopsies are performed in a minority of patients, representing a significant departure from ideal management and contributing to recurrent unnecessary FBOE. EoE is an increasingly important cause of FBOE.
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Affiliation(s)
- H L Philpott
- Department of Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia.,Department of Gastroenterology, St Vincents Hospital, Melbourne, Victoria, Australia
| | - S Nandurkar
- Department of Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia
| | - F Thien
- Department of Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia
| | - S Bloom
- Department of Gastroenterology, St Vincents Hospital, Melbourne, Victoria, Australia
| | - E Lin
- Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia
| | - R Goldberg
- Department of Gastroenterology, St Vincents Hospital, Melbourne, Victoria, Australia
| | - R Boyapati
- Department of Gastroenterology, The Austin Hospital, Melbourne, Victoria, Australia
| | - A Finch
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - S G Royce
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - P R Gibson
- Department of Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Gastroenterology, The Alfred Hospital, Melbourne, Victoria, Australia
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7
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Finch A, Wang M, Fine A, Atri L, Khalouei S, Pupavac M, Rosen B, Eisen A, Elser C, Charames G, Metcalfe K, Chang MC, Narod SA, Lerner-Ellis J. Genetic testing for BRCA1 and BRCA2 in the Province of Ontario. Clin Genet 2015. [PMID: 26219728 DOI: 10.1111/cge.12647] [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] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In 2001, genetic testing for BRCA1 and BRCA2 was introduced in Ontario, for women at high-risk of breast or ovarian cancer. To date over 30,000 individuals have been tested throughout Ontario. Testing was offered to all Ontario residents who were eligible under any of 13 criteria. We report the results of tests conducted at Mount Sinai Hospital from 2007 to 2014. A total of 4726 individuals were tested, 764 (16.2%) were found to carry a pathogenic variant (mutation). Among 3684 women and men who underwent testing without a known familial BRCA mutation, 331 (9.0%) were found to carry a mutation. Among 1042 women and men tested for a known family mutation, 433 (41.6%) were positive. There were 603 female mutation carriers, of these, 303 were affected with breast or ovarian cancer (50%) and 16 with another cancer (2.3%). Of 284 unaffected female carriers, 242 (85%) were tested for a known family mutation and 42 (15%) were the first person in the family to be tested. By placing greater emphasis on recruiting unaffected female relatives of known mutation carriers for testing, greater than one-half of newly identified carriers will be unaffected.
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Affiliation(s)
- A Finch
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Sunnybrook Odette Cancer Centre, Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada
| | - M Wang
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - A Fine
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - L Atri
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - S Khalouei
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - M Pupavac
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - B Rosen
- Department of Obstetrics and Gynecology, University of Toronto and Gynecologic Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - A Eisen
- Sunnybrook Odette Cancer Centre, Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada
| | - C Elser
- Division of Medical Oncology and Hematology, Department of Medicine, Mount Sinai Hospital and The Princess Margaret Cancer Center
| | - G Charames
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - K Metcalfe
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - M C Chang
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - S A Narod
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - J Lerner-Ellis
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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8
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Fleming N, Walters J, Grounds J, Fife L, Finch A. Acute response to barefoot running in habitually shod males. Hum Mov Sci 2015; 42:27-37. [DOI: 10.1016/j.humov.2015.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 04/16/2015] [Accepted: 04/18/2015] [Indexed: 10/23/2022]
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Robins L, Newby J, Wilhelm K, Smith J, Fletcher T, Ma T, Finch A, Campbell L, Andrews G. Internet-delivered cognitive behaviour therapy for depression in people with diabetes: study protocol for a randomised controlled trial. BMJ Open Diabetes Res Care 2015; 3:e000144. [PMID: 26688735 PMCID: PMC4679816 DOI: 10.1136/bmjdrc-2015-000144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/09/2015] [Accepted: 10/20/2015] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Depression substantially contributes to the personal burden and healthcare costs of living with diabetes mellitus (DM). Comorbid depression and DM are associated with poorer quality of life, poorer self-management and glycemic control, increased risk for DM complications and higher mortality rates, and higher health service utilization. Depression remains under-recognized and undertreated in people with DM, which may, in part, result from barriers associated with accessing face-to-face treatment. This study will examine the efficacy of an internet-based cognitive behaviour therapy programme for major depressive disorder (iCBT-MDD) in people with DM. METHODS AND ANALYSIS A CONSORT 2010 compliant, registered randomised controlled trial of the intervention (iCBT-MDD) versus a treatment as usual control group will be conducted. The study will include 100 adults aged 18 years and over with a diagnosis of type 1 or type 2 DM and self-reported symptoms that satisfy MDD which will enable us to detect a statistically significant difference with a group effect size of 0.6 at a power of 80% and significance level of p=0.05. Participants will be randomised to receive the iCBT-MDD programme immediately, or to wait 10 weeks before accessing the programme. Primary outcomes will be self-reported depression severity, DM-related distress, and glycemic control (glycosylated hemoglobin). Secondary outcomes will be general distress and disability, generalized anxiety, lifestyle behaviours, somatization, eating habits, alcohol use, and acceptability of the iCBT programme to participants, and practicality for clinicians. Data will be analyzed with linear mixed models for each outcome measure. ETHICS AND DISSEMINATION The Human Research Ethics Committee of St Vincent's Hospital Australia have given ethics approval (HREC/13/SVH/291). Results will be disseminated via peer-reviewed publication and social media channels of Australian Diabetes Consumer Representative Bodies. TRIAL REGISTRATION NUMBER The trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12613001198718).
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Affiliation(s)
- Lisa Robins
- Faces in the Street, St Vincent's Health Australia, Sydney, New South Wales, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales (UNSW), Darlinghurst, New South Wales, Australia
- Consultation Liaison Psychiatry, St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Jill Newby
- Faculty of Medicine, School of Psychiatry, University of New South Wales (UNSW), Darlinghurst, New South Wales, Australia
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Kay Wilhelm
- Faces in the Street, St Vincent's Health Australia, Sydney, New South Wales, Australia
- Faculty of Medicine, School of Psychiatry, University of New South Wales (UNSW), Darlinghurst, New South Wales, Australia
- Consultation Liaison Psychiatry, St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Jessica Smith
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Therese Fletcher
- Faces in the Street, St Vincent's Health Australia, Sydney, New South Wales, Australia
| | - Trevor Ma
- Consultation Liaison Psychiatry, St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Adam Finch
- Consultation Liaison Psychiatry, St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Lesley Campbell
- Diabetes Centre, Garvan Institute, St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
| | - Gavin Andrews
- Faculty of Medicine, School of Psychiatry, University of New South Wales (UNSW), Darlinghurst, New South Wales, Australia
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St Vincent's Health Australia, Darlinghurst, New South Wales, Australia
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10
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Finch A, Bacopulos S, Rosen B, Fan I, Bradley L, Risch H, McLaughlin J, Lerner-Ellis J, Narod S. Preventing ovarian cancer through genetic testing: a population-based study. Clin Genet 2013; 86:496-9. [DOI: 10.1111/cge.12313] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 10/23/2013] [Accepted: 11/04/2013] [Indexed: 01/17/2023]
Affiliation(s)
- A. Finch
- Women's College Research Institute; University of Toronto; Toronto ON Canada
| | - S. Bacopulos
- Women's College Research Institute; University of Toronto; Toronto ON Canada
| | - B. Rosen
- Department of Gynecology, Princess Margaret Hospital; University of Toronto; Toronto ON Canada
| | - I. Fan
- Samuel Lunenfeld Research Institute; Mount Sinai Hospital; Toronto ON Canada
| | - L. Bradley
- Samuel Lunenfeld Research Institute; Mount Sinai Hospital; Toronto ON Canada
| | - H. Risch
- Yale School of Public Health; New Haven CT USA
| | | | - J. Lerner-Ellis
- Department of Laboratory Medicine and Pathobiology; University of Toronto; Toronto ON Canada
- Advanced Molecular Diagnostics, Department of Pathology and Laboratory Medicine; Mount Sinai Hospital; Toronto ON Canada
- Genome Technologies; Ontario Institute for Cancer Research; Toronto ON Canada
| | - S.A. Narod
- Women's College Research Institute; University of Toronto; Toronto ON Canada
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11
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Froghi S, Ahmed K, Finch A, Fitzpatrick JM, Khan MS, Dasgupta P. REPLY. BJU Int 2012. [DOI: 10.1111/j.1464-410x.2012.11234_4.x] [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: 11/29/2022]
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12
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Affiliation(s)
- Saied Froghi
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, King's College London, UK
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13
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Finch A, Metcalfe KA, Chiang JK, Elit L, McLaughlin J, Springate C, Demsky R, Murphy J, Rosen B, Narod SA. The impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual function in women who carry a BRCA mutation. Gynecol Oncol 2011; 121:163-8. [PMID: 21216453 DOI: 10.1016/j.ygyno.2010.12.326] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 12/01/2010] [Accepted: 12/06/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Prophylactic salpingo-oophorectomy is recommended to women who carry a BRCA1 or BRCA2 mutation to reduce the risks of breast, ovarian and fallopian tube cancer. We measured the impact of prophylactic salpingo-oophorectomy on menopausal symptoms and sexual functioning in women with a BRCA mutation. METHODS Women who underwent prophylactic salpingo-oophorectomy between October 1, 2002 and June 26, 2008 for a known BRCA1 or BRCA2 mutation were invited to participate. Participants completed questionnaires before prophylactic surgery and again one year after surgery. Measures of sexual functioning and menopausal symptoms before and after surgery were compared. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy was evaluated. RESULTS 114 women who underwent prophylactic surgery completed questionnaires before and one year after surgery. Subjects who were premenopausal at the time of surgery (n=75) experienced a significant worsening of vasomotor symptoms (hot flashes, night sweats and sweating) and a decline in sexual functioning (desire, pleasure, discomfort and habit). The increase in vasomotor symptoms and the decline in sexual functioning were mitigated by HRT, but symptoms did not return to pre-surgical levels. HRT decreased vaginal dryness and dyspareunia; however, the decrease in sexual pleasure was not alleviated by HRT. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy remained high regardless of increased vasomotor symptoms and decreased sexual function. CONCLUSIONS Women who undergo prophylactic salpingo-oophorectomy prior to menopause experience an increase in vasomotor symptoms and a decrease in sexual functioning. These symptoms are improved by HRT, but not to pre-surgical levels.
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Affiliation(s)
- A Finch
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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14
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Affiliation(s)
- Adam Finch
- Wiley-Blackwell, 9600 Garsington Road, Oxford, OX4 4DQ, UK.
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15
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Finch A, Metcalfe K, Lui J, Springate C, Demsky R, Armel S, Rosen B, Murphy J, Elit L, Sun P, Narod S. Breast and ovarian cancer risk perception after prophylactic salpingo-oophorectomy due to an inherited mutation in theBRCA1orBRCA2gene. Clin Genet 2009; 75:220-4. [DOI: 10.1111/j.1399-0004.2008.01117.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Metcalfe KA, Finch A, Poll A, Horsman D, Kim-Sing C, Scott J, Royer R, Sun P, Narod SA. Breast cancer risks in women with a family history of breast or ovarian cancer who have tested negative for a BRCA1 or BRCA2 mutation. Br J Cancer 2008; 100:421-5. [PMID: 19088722 PMCID: PMC2634722 DOI: 10.1038/sj.bjc.6604830] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Genetic testing for mutations in BRCA1 and BRCA2 is available in Canada for women with a significant family history of breast cancer. For the majority of tested women, a BRCA1 or BRCA2 mutation is not found, and counselling regarding breast cancer risk is based on the review of the pedigree. In this prospective study, we estimate breast cancer risks in women with a family history of breast cancer and for whom the proband tested negative for a mutation in BRCA1 or BRCA2. Families with two or more breast cancers under the age of 50 years, or with three cases of breast cancer at any age, and who tested negative for a BRCA1 or BRCA2 mutation were identified. Follow-up information on cancer status was collected on all first-degree relatives of breast cancer cases. The standardised incidence ratios (SIRs) for breast cancer were calculated by dividing the observed numbers of breast cancer by the expected numbers of breast cancers, based on the rates in the provincial cancer registries. A total of 1492 women from 365 families were included in the analyses. The 1492 first-degree relatives of breast cancer cases contributed 9109 person-years of follow-up. Sixty-five women developed breast cancer, compared to 15.2 expected number (SIR=4.3). The SIR was highest for women under the age of 40 (SIR=14.9) years and decreased with increasing age. However, the absolute risk was higher for women between the age of 50 and 70 (1% per year) years than for women between 30 and 50 (0.4% per year) years of age. There was no elevated risk for ovarian, colon or any other form of cancer. Women with a significant family history of breast cancer (ie, two or more breast cancers under the age of 50 years, or three or more breast cancers at any age), but who test negative for BRCA mutations have approximately a four-fold risk of breast cancer. Women in these families may be candidates for tamoxifen chemoprevention and/or intensified breast screening with an MRI.
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Affiliation(s)
- K A Metcalfe
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
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17
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Metcalfe KA, Poll A, O'Connor A, Gershman S, Armel S, Finch A, Demsky R, Rosen B, Narod SA. Development and testing of a decision aid for breast cancer prevention for women with a BRCA1 or BRCA2 mutation. Clin Genet 2007; 72:208-17. [PMID: 17718858 DOI: 10.1111/j.1399-0004.2007.00859.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [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: 11/29/2022]
Abstract
For women who carry a mutation in BRCA1 or BRCA2, the risk of breast cancer is up to 87% by the age of 70. There are options available to reduce the risk of breast cancer; however, each option has both risks and benefits, which makes decision making difficult. The objective is to develop and pilot test a decision aid for breast cancer prevention for women with a BRCA1 or BRCA2 mutation. The decision aid was developed and evaluated in three stages. In the first stage, the decision aid was developed and reviewed by cancer genetics experts. The second stage was a review of the decision aid by women with a BRCA1 or BRCA2 mutation for acceptability and feasibility. The final stage was a pre-test--post-test evaluation of the decision aid. Twenty-one women completed the pre-test questionnaire and 20 completed the post-test questionnaire. After using the decision aid, there was a significant decline in mean decisional conflict scores (p = 0.001), a significant improvement in knowledge scores (p = 0.004), and fewer women uncertain about prophylactic mastectomy (p = 0.003) and prophylactic oophorectomy (p = 0.009). Use of the decision aid decreased decisional conflict to levels suggestive of implementation of a decision. In addition, knowledge levels increased and choice predisposition changed with fewer women being uncertain about each option. This has significant clinical implications as it implies that with greater uptake of cancer prevention options by women with a BRCA1 or BRCA2 mutation, fewer women will develop and/or die of hereditary breast cancer.
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Affiliation(s)
- K A Metcalfe
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada M5T 1P8.
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18
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Katz L, Nauriyal V, Nagaraj S, Finch A, Sproule C, Farrel A, Rich P, IR Research Group. Infrared Imaging for Detection of Compartment Syndrome. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.805] [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: 11/10/2022]
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19
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Wilhelm K, Finch A, Kotze B, Arnold K, McDonald G, Sternhell P, Hudson B. The Green Card Clinic: overview of a brief patient-centred intervention following deliberate self-harm. Australas Psychiatry 2007; 15:35-41. [PMID: 17464632 DOI: 10.1080/10398560601083068] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to present an overview of the Green Card Clinic, a novel brief intervention service for patients presenting to the emergency department following deliberate self-harm (DSH) or with suicidal ideation, to examine its effectiveness in terms of service utilization, and patient and clinician feedback, and to explore the correlates of repeated DSH. METHOD The aims and structure of the Green Card Clinic are described. We highlight our patient-centred approach involving self-identification of difficulties from a list of problem areas, coupled with tailored intervention strategies. Relevant data are presented and characteristics of repeat DSH patients are compared to the first-episode group. RESULTS Between 1998 and 2005, 456 DSH patients were referred to the clinic. Of these, 75% (n = 344) attended the first session, 43% (n = 197) the second session, 26% (n = 117) the third session, and 16% (n = 73) completed a 3-15 month follow-up. Clinic attenders (mean age 31.6 years, 57% female) reported a diverse range of self-identified problems and repeat DSH patients reported worse depression, poorer health-related behaviours, and a greater number of problems than those presenting after first-episode DSH. CONCLUSIONS The clinic achieved high rates of first session attendance. This may have been attributable to the use of a few specific strategies aimed at increasing compliance, such as the green card, next-day appointments and assertive follow-up of non-attenders. For repeat self-harmers, we advocate an approach aimed at 'lifestyle change' rather than based on current psychological stressors. The Green Card Clinic service, involving a range of interventions tailored to meet the multitude of presenting needs, appears to be an acceptable and flexible approach to brief intervention for DSH.
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Affiliation(s)
- Kay Wilhelm
- School of Psychiatry, University of NSW, Sydney, NSW, Australia.
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20
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Baikie KA, Wilhelm K, Johnson B, Boskovic M, Wedgwood L, Finch A, Huon G. Expressive writing for high-risk drug dependent patients in a primary care clinic: a pilot study. Harm Reduct J 2006; 3:34. [PMID: 17112389 PMCID: PMC1679799 DOI: 10.1186/1477-7517-3-34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2005] [Accepted: 11/19/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has shown that expressive writing is beneficial in terms of both physical and emotional health outcomes. This study aimed to investigate the effectiveness and acceptability of a brief expressive writing intervention for high-risk drug dependent patients in a primary care clinic, and to determine the relationship between linguistic features of writing and health outcomes. METHODS Participants completed four 15-minute expressive writing tasks over a week, in which they described their thoughts and feelings about a recent stressful event. Self-report measures of physical (SF-12) and psychological health (DASS-21) were administered at baseline and at a two-week follow-up. Fifty-three participants were recruited and 14 (26%) completed all measures. RESULTS No statistically significant benefits in physical or psychological health were found, although all outcomes changed in the direction of improvement. The intervention was well-received and was rated as beneficial by participants. The use of more positive emotion words in writing was associated with improvements in depression and stress, and flexibility in first person pronoun use was associated with improvements in anxiety. Increasing use of cognitive process words was associated with worsening depressive mood. CONCLUSION Although no significant benefits in physical and psychological health were found, improvements in psychological wellbeing were associated with certain writing styles and expressive writing was deemed acceptable by high-risk drug dependent patients. Given the difficulties in implementing psychosocial interventions in this population, further research using a larger sample is warranted.
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Affiliation(s)
- Karen A Baikie
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Kay Wilhelm
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Beverley Johnson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Mary Boskovic
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Lucinda Wedgwood
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Adam Finch
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Gail Huon
- The Graduate Research School, The Australian National University, Canberra, ACT, Australia
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21
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Wilhelm K, Mitchell PB, Niven H, Finch A, Wedgwood L, Scimone A, Blair IP, Parker G, Schofield PR. Life events, first depression onset and the serotonin transporter gene. Br J Psychiatry 2006; 188:210-5. [PMID: 16507960 DOI: 10.1192/bjp.bp.105.009522] [Citation(s) in RCA: 199] [Impact Index Per Article: 11.1] [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: 11/23/2022]
Abstract
BACKGROUND A relationship between the serotonin transporter gene, adverse events and onset of major depression has been reported. AIMS To replicate a gene x environment interaction in a cohort with longitudinal data for life events, experience of depression, parental bonding and neuroticism. METHOD At the 25-year follow-up, genomic DNA was obtained from 127 cohort members (mean age 48 years) to determine the genotype of the serotonin transporter gene-linked promoter region (5-HTTLPR). Associations were investigated between the 5-HTTLPR genotype, positive and adverse life events and the gene x environment interaction, and also between the 5-HTTLPR genotype and risk factors for depression. RESULTS No relationship was found between 5-HTTLPR genotype and either risk factors for depression or positive life events. Adverse life events had a significantly greater impact on the onset of depression for individuals with the s/s genotype. CONCLUSIONS The 5-HTTLPR genotype is a significant predictor of onset of major depression following multiple adverse events. This is one of the more robust findings concerning specific biological risk factors for depression.
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Affiliation(s)
- Kay Wilhelm
- Consultation Liaison Psychiatry, Level 4, DeLacy Building, St Vincent's Hospital, Victoria Street, Sydney, New South Wales 2010, Australia.
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22
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Wilhelm K, Peel G, Sutton V, Finch A, Sved-Williams A. Small groups for supporting GPs' professional development in mental health disease--an evaluation. Aust Fam Physician 2005; 34:791-4. [PMID: 16184216] [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: 05/04/2023]
Abstract
BACKGROUND Small groups provide opportunities for education, information sharing, development of clinical skills and peer support. They have been promoted in general practice in Australia, especially for mental health disease, and often by divisions of general practice. METHODS Minutes from a series of small groups supervised by psychiatrists were analysed to observe the content and themes over 5 years. Additionally, focus groups of general practitioner participants were asked to comment on what they found most valuable. RESULTS Forty-two GPs attended small groups (mean size 2-3) over 3 years, about half for 10-49 sessions. The most discussed diseases were depression (most frequently at 157 times), psychosis (137), personality disorders (79), drug and alcohol abuse (73), anxiety disorders (68) and suicide (42). Discussion of doctor-patient interpersonal and doctor self care issues increased from under 2% of all statements in 1995 to nearly 10% in 2000. Participating GPs found the small groups empowering, confidence increasing, and useful for addressing psychological and interpersonal issues at work. DISCUSSION Participating GPs found small groups useful and provided helpful recommendations based on their experiences.
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Affiliation(s)
- Kay Wilhelm
- School of Psychiatry and Black Dog Institute, University of New South Wales, Australia..
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23
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Evan GI, Christophorou M, Lawlor EA, Ringshausen I, Prescott J, Dansen T, Finch A, Martins C, Murphy D. Oncogene-dependent tumor suppression: using the dark side of the force for cancer therapy. Cold Spring Harb Symp Quant Biol 2005; 70:263-73. [PMID: 16869762 DOI: 10.1101/sqb.2005.70.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Cancers arise by an evolutionary process that involves the protracted acquisition by somatic cells of suites of interlocking mutations that uncouple proliferation, survival, migration, and damage responses from the mechanisms (selective pressures) that normally restrain or restrict them in time and space. The relative rareness of cancer cells within the soma, in the face of huge numbers of available cell targets, substantial rates of mutation, and an abundance of proto-oncogenes and tumor suppressor gene targets, indicates that the evolutionary space available to incipient tumor cells is highly restricted. The principal way in which this is achieved is through intrinsic tumor suppression pathways-innate growth arrest and apoptotic programs that fulfill an essentially analogous functional role to checkpoints in the cell cycle machinery by antagonizing the tumorigenic potential of oncogenic mutations. Using switchable transgenic and knockin mouse models, it is possible to identify these various tumor suppressor programs and establish where, when, how, and why they act to forestall neoplasia in each tissue type and, consequently, how and why their failure leads to cancer.
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Affiliation(s)
- G I Evan
- Cancer Research Institute and Department of Cellular and Molecular Pharmacology, University of California, San Francisco, 94143-0875, USA
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Abstract
BACKGROUND Studies investigating the psychological correlates of types of occupation have focused on such disorders as stress, depression, suicide and substance abuse. There have also been some models proposed to allow understanding of factors common to different types of occupations. We sought to provide an overview of research related to work and mental health and consider future research directions. METHODS A literature search was conducted using the Medline, PsycInfo, Embase and PubMed databases. The key words "occupation" or "work" were searched in combination with the key words "mental health", "risk factors", "disorders", "depression", "suicide", "trauma", "stress" or "substance use". RESULTS Studies of "stress" tend to be more applicable to specific workplace issues. While some of the studies relating to onset of depression, suicide, substance abuse and trauma pertain to specific occupational issues and results are often not generalizable, they have progressed our understanding of risk factors to those disorders. There are workplace factors involving exposure to danger and crisis that lead to posttraumatic stress disorder (PTSD), substance abuse (including stimulants) and depersonalization. Workplace risk factors for depression involve situations promoting lack of autonomy, and involving "caring" for others as part of the work role, particularly where there is dependence on others for their livelihood. Risk factors for alcohol abuse include workplaces with access to alcohol and where use of alcohol is sanctioned. There appears to be a bi-directional relationship between personality and work, so that people are drawn to particular occupations, but the occupations then have an effect on them. An interactional model is proposed to consider this. CONCLUSION The research questions pertaining to mental health are varied and will determine what mental health issues are of interest and the models of work applicable. There need to be more longitudinal studies and consideration of factors which the worker brings to the workplace (psychosocial issues, personality traits), as well as interpersonal issues and consideration of systemic, organizational, political and economic factors, including leadership styles.
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Affiliation(s)
- Kay Wilhelm
- School of Psychiatry and Black Dog Institute, University of New South Wales, Randwick, Sydney, NSW, Australia.
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25
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Ceron P, Finch A, Frey J, Kerrigan J, Parsons T, Urry G, Schlesinger H. Diboron Tetrachloride and Tetrafluoride as Reagents for the Synthesis of Organoboron Compounds. II. The Behavior of the Diboron Tetrahalides toward Unsaturated Organic Compounds1. J Am Chem Soc 2002. [DOI: 10.1021/ja01533a007] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Finch A, Davis W, Carter WG, Saklatvala J. Analysis of mitogen-activated protein kinase pathways used by interleukin 1 in tissues in vivo: activation of hepatic c-Jun N-terminal kinases 1 and 2, and mitogen-activated protein kinase kinases 4 and 7. Biochem J 2001; 353:275-81. [PMID: 11139391 PMCID: PMC1221569 DOI: 10.1042/0264-6021:3530275] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The effects of interleukin 1 (IL-1) are mediated by the activation of protein kinase signalling pathways, which have been well characterized in cultured cells. We have investigated the activation of these pathways in rabbit liver and other tissues after the systemic administration of IL-1alpha. In liver there was 30-40-fold activation of c-Jun N-terminal kinase (JNK) and 5-fold activation of both JNK kinases, mitogen-activated protein kinase (MAPK) kinase (MKK)4 and MKK7. IL-1alpha also caused 2-3-fold activation of p38 MAPK and degradation of the inhibitor of nuclear factor kappaB ('IkappaB'), although no activation of extracellular signal-regulated protein kinase (ERK) (p42/44 MAPK) was observed. The use of antibodies against specific JNK isoforms showed that, in liver, short (p46) JNK1 and long (p54) JNK2 are the predominant forms activated, with smaller amounts of long JNK1 and short JNK2. No active JNK3 was detected. A similar pattern of JNK activation was seen in lung, spleen, skeletal muscle and kidney. Significant JNK3 activity was detectable only in the brain, although little activation of the JNK pathway in response to IL-1alpha was observed in this tissue. This distribution of active JNK isoforms probably results from a different expression of JNKs within the tissues, rather than from a selective activation of isoforms. We conclude that IL-1alpha might activate a more restricted set of signalling pathways in tissues in vivo than it does in cultured cells, where ERK and JNK3 activation are often observed. Cultured cells might represent a 'repair' phenotype that undergoes a broader set of responses to the cytokine.
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Affiliation(s)
- A Finch
- Kennedy Institute of Rheumatology Division, Imperial College School of Medicine, 1 Aspenlea Road, Hammersmith, London W6 8LH, U.K
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27
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Sakuma J, Deki K, Finch A, Ohsako Y, Yokota T. All-solid-state, high-power, deep-UV laser system based on cascaded sum-frequency mixing in CsLiB6O10 crystals. Appl Opt 2000; 39:5505-5511. [PMID: 18354547 DOI: 10.1364/ao.39.005505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We report on an efficient use of CsLiB6O10 (CLBO) crystals employed for an all-solid-state deep-UV laser system operated at 5 kHz. We obtained greater than 3 W of UV radiation around 242 nm by mixing the 349-nm third harmonic of a Nd:YLF laser with the tunable output from a Ti:sapphire laser in a CLBO crystal. This UV radiation was subsequently mixed with the residual 1047-nm output from the Nd:YLF laser in a second CLBO crystal. The system produced 1.5 W of deep-UV radiation at 196.3 nm, which is, to our knowledge, the highest deep-UV power below 200 nm generated in a nonlinear optical crystal. Additionally, the bandwidth of both outputs was estimated to be less than 200 MHz.
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Affiliation(s)
- J Sakuma
- Ushio Research Institute of Technology, Incorporated, 1-90 Komakado, Gotenba, Shizuoka 412-0038, Japan.
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28
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Abstract
Essential to the construction, maintenance and repair of tissues is the ability to induce suicide of supernumerary, misplaced or damaged cells with high specificity and efficiency. Study of three principal organisms--the nematode, fruitfly and mouse--indicate that cell suicide is implemented through the activation of an evolutionarily conserved molecular programme intrinsic to all metazoan cells. Dysfunctions in the regulation or execution of cell suicide are implicated in a wide range of developmental abnormalities and diseases.
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Affiliation(s)
- P Meier
- Signal Transduction Laboratory, Imperial Cancer Research Fund, London, UK.
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29
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Lasa M, Mahtani KR, Finch A, Brewer G, Saklatvala J, Clark AR. Regulation of cyclooxygenase 2 mRNA stability by the mitogen-activated protein kinase p38 signaling cascade. Mol Cell Biol 2000; 20:4265-74. [PMID: 10825190 PMCID: PMC85794 DOI: 10.1128/mcb.20.12.4265-4274.2000] [Citation(s) in RCA: 333] [Impact Index Per Article: 13.9] [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] Open
Abstract
A tetracycline-regulated reporter system was used to investigate the regulation of cyclooxygenase 2 (Cox-2) mRNA stability by the mitogen-activated protein kinase (MAPK) p38 signaling cascade. The stable beta-globin mRNA was rendered unstable by insertion of the 2, 500-nucleotide Cox-2 3' untranslated region (3' UTR). The chimeric transcript was stabilized by a constitutively active form of MAPK kinase 6, an activator of p38. This stabilization was blocked by SB203580, an inhibitor of p38, and by two different dominant negative forms of MAPK-activated protein kinase 2 (MAPKAPK-2), a kinase lying downstream of p38. Constitutively active MAPKAPK-2 was also able to stabilize chimeric beta-globin-Cox-2 transcripts. The MAPKAPK-2 substrate hsp27 may be involved in stabilization, as beta-globin-Cox-2 transcripts were partially stabilized by phosphomimetic mutant forms of hsp27. A short (123-nucleotide) fragment of the Cox-2 3' UTR was necessary and sufficient for the regulation of mRNA stability by the p38 cascade and interacted with a HeLa protein immunologically related to AU-rich element/poly(U) binding factor 1.
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Affiliation(s)
- M Lasa
- Kennedy Institute of Rheumatology, Imperial College School of Medicine, Hammersmith, London W6 8LH, United Kingdom
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30
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Saklatvala J, Dean J, Finch A. Protein kinase cascades in intracellular signalling by interleukin-I and tumour necrosis factor. Biochem Soc Symp 1999; 64:63-77. [PMID: 10207621] [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: 02/11/2023]
Abstract
Interleukin 1 (IL-1) and tumour necrosis factor (TNF) are major mediators of inflammation, with similar actions. Their receptor mechanisms and downstream pathways are reviewed. They activate several protein kinases in fibroblasts, including the three types of mitogen-activated protein kinase (MAPK), the kinase of the inhibitor of nuclear factor-kappa B (I kappa BK), and the TNF-/IL-1-activated beta-casein kinase. Cultured cells show a broader spectrum of kinase activation by IL-1 than tissues in vivo, suggesting that the receptors connect to more pathways in proliferating cells than in resting differentiated cells. The c-Jun N-terminal kinase (JNK) is strongly activated by IL-1 in tissues. In rabbit liver this is mediated by MAPK kinase 7; the upstream kinase is unidentified. Little is known of downstream MAPK targets in inflammation. Inhibitor experiments suggest that p38MAPK mediates induction of cyclo-oxygenase-2 and metalloproteinases by IL-1, and of TNF, IL-1 and cyclo-oxygenase-2 by endotoxin (in monocytes). p38MAPK is needed for induction of the mRNAs (except IL-1 mRNA).
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Affiliation(s)
- J Saklatvala
- Division of Cell Signalling, Kennedy Institute of Rheumatology, Hammersmith, London, U.K
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Abstract
A study was undertaken to identify the variation of entrance skin doses (ESDs) in mobile neonatal chest radiography with regard to the European Commission (EC) reference dose and to examine potential relationships with image quality and radiographic techniques. Five sites from the former North West Thames region participated. All mobile neonatal radiographic techniques were surveyed. Dose-area product per examination was directly measured and the ESD calculated. Image quality criteria were developed from those published by the EC. Image quality was graded by two independent observers. Over the five sites, 144 examinations were recorded. Calculated ESDs ranged up to 160 microGy, with an appreciable variation not only between sites but also within sites. A clear relationship between actual rather than nominal speed and dose over all sites was demonstrated (r = -0.95, p = 0.013). No correlation between image quality and dose was noted (r = -0.044, p = 0.665). Neonatal imaging systems at participating sites, within the North Thames region, comply with EC guidelines on patient dose and image quality for mobile chest X-rays. Significant variation in ESDs was encountered between sites with no discernible relationship with image quality or the employed radiographic techniques as described by the EC. The strong inverse relationship between ESDs and actual rather than nominal speed suggests a neglected aspect of radiation protection.
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Affiliation(s)
- A Lowe
- Division of Radiography, Faculty of Health and Human Science, University of Hertfordshire, Hatfield, UK
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Abstract
Activation of jun N-terminal kinase (JNK)/stress-activated protein kinase (SAPK) by interleukin-1 (IL-1) has been reported in many cells and in rabbit liver. Here we report selective activation of JNK/SAPK, without activation of p38 or p42 mitogen-activated protein kinases (MAPKs), by IL-1 in rabbit liver. We identified an IL-1 regulated JNK/SAPK activator present in rabbit liver using S Sepharose chromatography. It was purified and immunoprecipitated by two antisera to MAP kinase kinase 7 (MKK7). It was not recognised by an antibody to MKK4. We conclude that MKK7 is the activator of JNK/SAPK activated by IL-1 in liver and that JNK/SAPK is the only MAPK activated by IL-1 in liver.
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Affiliation(s)
- A Finch
- Kennedy Institute of Rheumatology, London, UK
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Abstract
A review of the evidence relating to the use of Therapeutic Touch in nursing, with particular reference to wound healing.
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Finch A. Dogged pursuer. Interview by Janet Snell. Nurs Times 1997; 93:40. [PMID: 9348942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
AIMS/BACKGROUND While a primary association of HLA-B51 with Behçet's disease (BD) in Japanese and Mediterranean patients supports an immunogenetic predisposition, this link is unclear in north western Europe. This study assessed HLA associations with BD, and HLA-B51 with certain clinical characteristics, in the Republic of Ireland, which has an ethnically homogeneous population. METHODS HLA-A, HLA-B, and HLA-DR typing was performed in 24 BD patients, conforming to International Study Group criteria, and in blood donors, as controls. Patient records were retrospectively reviewed and patients reassessed clinically. RESULTS A highly significant HLA-B51 association (corrected exact p value = 0.002, relative risk = 6.3) with BD was determined, despite a low B51 prevalence (25%) in patients. No other HLA type was associated. There was a significant B51 link with male sex in BD patients but no association with age at first manifestation/diagnosis, eye involvement, cyclosporin A therapy, or poor visual acuity was determined. CONCLUSIONS This study supports a HLA-B51 immunogenetic predisposition, similar to Japanese patients, in Irish BD in an ethnically homogeneous population in north western Europe. However, owing to a low prevalence of B51 positivity in BD patients in Ireland, a multifactorial pathogenesis is suggested.
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Affiliation(s)
- D J Kilmartin
- Institute of Ophthalmology, University College Dublin, Mater Misericordiae Hospital, Ireland
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36
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Kim KS, Maxted W, Nanda NC, Coggins K, Roychoudhry D, Espinal M, Fan P, Camino A, Sanyal R, Finch A, Kirklin J, Pacifico A. Comparison of multiplane and biplane transesophageal echocardiography in the assessment of aortic stenosis. Am J Cardiol 1997; 79:436-41. [PMID: 9052346 DOI: 10.1016/s0002-9149(96)00782-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of the study was to compare the accuracy of multiplane transesophageal echocardiography (TEE) with the more conventional biplane technique in the direct assessment of aortic valve area in patients with aortic stenosis. Short-axis images of the aortic valve adequate for measuring aortic valve area were obtained in all 81 patients studied by multiplane TEE but in only 56 of 64 patients (88%) using the biplane approach. The correlation coefficient for aortic valve area determined by multiplane TEE (r = 0.89; SEE = 0.04 cm2) was higher (p < 0.01) than biplane TEE (r = 0.74; SEE = 0.06 cm2). Correlations were higher for bicuspid valves (multiplane, r = 0.93; biplane, r = 0.75) than tricuspid valves (multiplane, r = 0.87; biplane, r = 0.75). Our study has demonstrated the superiority of multiplane TEE to both biplane TEE and transthoracic echocardiography (TTE) in the direct evaluation of aortic valve area in patients with aortic stenosis.
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Affiliation(s)
- K S Kim
- Division of Cardiovascular Disease, University of Alabama at Birmingham 35233, USA
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37
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Finch A. Commentary: radiation protection supervisors. Br J Radiol 1996; 69:791-2. [PMID: 8983580 DOI: 10.1259/0007-1285-69-825-791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- A Finch
- Department of Radiography, University of Hertfordshire, Hatfield, UK
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Abstract
AIMS/BACKGROUND To identify an HLA association with pseudoexfoliation of the lens capsule to support the hypothesis that there is a genetic predisposition to pseudoexfoliation. A randomised trial would be ideal for establishing a relation but is more costly and time consuming to conduct. Case-control studies provide an alternative method of establishing a relation. METHODS The study group comprised 128 subjects who presented to a major eye centre with pseudoexfoliation. Data from blood donors representative of the population of Ireland were used to form a control group. RESULTS An HLA association with pseudoexfoliation is identified for 14 antigens. Eleven antigens (HLA A1, A33, B8, B47, B51, B53, B57, B62, DR3, DR12, and DR13) are significantly more common in the pseudoexfoliation group while three antigens (HLA B12, B17, and DR2) are significantly less common. Four HLA antigens are strongly associated, with odds ratios of over 7.5. CONCLUSION The strength of this HLA association is supportive evidence for a genetic component to the development of pseudoexfoliation of the lens capsule.
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Affiliation(s)
- J S FitzSimon
- Department of Ophthalmology, University College Dublin
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39
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McManus R, Moloney M, Borton M, Finch A, Chuan YT, Lawlor E, Weir DG, Kelleher D. Association of celiac disease with microsatellite polymorphisms close to the tumor necrosis factor genes. Hum Immunol 1996; 45:24-31. [PMID: 8655356 DOI: 10.1016/0198-8859(95)00144-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [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: 02/01/2023]
Abstract
Celiac disease is tightly linked to the MHC class II region on chromosome 6. We have studied two highly polymorphic microsatellite loci, TNFa and b, near the TNF genes in the class III region of the MHC, for evidence of their association to CD, as compared to a control population. Our findings show that the microsatellite allele most significantly associated with the disease is TNFb3, which is found in 86.3% of CD patients versus 24.5% of controls, with allele frequencies of 0.5392 and 0.1290, respectively (p < 0.001). The TNFa2 allele had a frequency of 0.6122 in CD patients and 0.2627 in controls (p < 0.001), with phenotype frequencies of 87.8% and 50.0%, respectively. TNFa6 and -a11 and TNFb5 have significantly reduced frequencies in CD patients. TNFb3 shows a maximal level of linkage disequilibrium with HLA-DQB1*0201 in celiac patients. However, while the DQB1*0201/TNFa2 haplotype was strongly associated with CD, DQB1*0201 was not significantly in linkage disequilibrium with TNFa2, suggesting that TNFa2 is independently associated with CD. This association could have functional significance as TNFa2 has been correlated with high TNF production.
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Affiliation(s)
- R McManus
- Department of Clinical Medicine and Gastroenterology, Trinity College, Dublin, Ireland
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41
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Finch A. Book reviewsFriend or Foe? Radiation Protection in Perspective. Video, 25 mins, 1994 (Cedric Maggs Film and Video Productions, Devon EX12 3BP), £100.00 +VAT. Br J Radiol 1995. [DOI: 10.1259/0007-1285-68-809-563-a] [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: 11/05/2022] Open
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42
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Conlan MG, Folsom AR, Finch A, Davis CE, Marcucci G, Sorlie P, Wu KK. Antithrombin III: associations with age, race, sex and cardiovascular disease risk factors. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Thromb Haemost 1994; 72:551-6. [PMID: 7878631] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Antithrombin III (AT III) is a major inhibitor of blood coagulation, and hereditary deficiency is associated with venous thrombotic disease. The Atherosclerosis Risk in Communities (ARIC) Study, a prospective study of 15,800 middle-aged men and women, measured AT III in its baseline examination. AT III levels were significantly higher in women than men, and in blacks than whites. AT III decreased with age in men but increased with age in women. In age- and race-adjusted analyses, AT III was positively associated with smoking, HDL-cholesterol, triglycerides (men only), and in women, with diabetes and lipoprotein(a). AT III was negatively associated with educational level, body mass index in men, and use of female hormones in women. Most of these associations were confirmed in multivariate analysis. These correlations between AT III and other risk factors must be considered when evaluating AT III as a risk factor for venous or arterial thrombosis.
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Affiliation(s)
- M G Conlan
- University of Texas Medical School, Division of Hematology-Oncology, Houston
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43
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Murphy KM, O’Brien F, Madden M, Collins JK, Lee G, Fitzgerald E, Crowley M, Morgan J, Shanahan F, O’Sullivan G, Khan MI, Cherukuri AK, Farrell RJ, Farrell J, Quinn P, Noonan N, Kanduru C, Keeling PWN, Keely SJ, Stack WA, Skelly MM, Stack M, O’Donoghue DP, Baird AW, Barry MC, Condron C, Watson RWG, Redmond HP, Watson RGK, Bouchier-Hayes D, McManus R, Moloney M, Borton M, Chuan YT, Finch A, Weir DG, Kelleher D, Watson RGP, McMillan SA, McMaster D, Evans A, Merriman R, MacMathuna P, Frazier I, Crowe J, Lennon J, Fan XG, Fan XJ, Xia H, Madrigal L, Feighery C, O’Donoghue D, Whelan CA, O’Farrelly C, Crowley MJ, O’Leary P, Devereux C, White P, Clarke E, Norris S, Crosbie O, Traynor O, McEntee G, Hegarty J, Marshall SG, Spence RAJ, Parks TG, Barrett J, O’Brien M, Sullivan GCO, Walsh TN, Mealy K, Hennessey TPJ, Donnelly VS, O’Herlihy C, O’Connell PR, Morrissey D, Lynch D, Caldwell MTP, Byrne PJ, Marks P, Hennessy TPJ, Maguire D, Harvey B, Wang JH, Mahmud N, McDonald GSA, Windle HJ, Neary P, Reid S, Horgan P, Hyland J, Graham D, Yeoh PL, Kelly P, Gibbons D, Mulcahy H, McCarthy P, Duffy MJ, Parfrey NA, Sheahan K, Husain A, O’Suilleabhain CB, Waldron D, Kelly J, O’Riordain M, Kirwan WO, Parks RW, Spencer EFA, Mcllrath EM, Johnson GW, Carton J, Lynch S. Irish society of gastroenterology. Ir J Med Sci 1994. [DOI: 10.1007/bf02942130] [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: 10/21/2022]
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44
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Conlan MG, Folsom AR, Finch A, Davis CE, Sorlie P, Wu KK. Correlation of plasma protein C levels with cardiovascular risk factors in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Thromb Haemost 1993; 70:762-7. [PMID: 8128432] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To evaluate the association of plasma protein C levels with constitutional, socioeconomic, life-style and biochemical factors important in cardiovascular diseases, we measured protein C levels in 12,290 middle aged (45-64 years) subjects participating in the ARIC study. Protein C levels had a normal distribution with a mean value of 3.17 micrograms/ml. They were higher in women than men and in whites than blacks; higher in postmenopausal women and further increased by hormonal supplements. The age influence was inconsistent and was considered to be inconsequential. Protein C levels were positively correlated with body mass index, LDL-cholesterol, HDL-cholesterol, and triglycerides and negatively associated with cigarette smoking. These factors should be taken into consideration when establishing normal protein C levels and when analyzing the relation between protein C and arterial and venous thrombotic disorders.
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Affiliation(s)
- M G Conlan
- Division of Hematology and Vascular Biology Research Center, University of Texas Medical School, Houston 77030
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45
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Harding EA, Finch A, Dunne MJ. Blockade of K+ channels in insulin-secreting cells by the 'potassium channel opener' SDZ PCO 400. Biochem Soc Trans 1993; 21:402S. [PMID: 8131978 DOI: 10.1042/bst021402s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- E A Harding
- Department of Biomedical Science, The University, Western Bank, Sheffield
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46
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Chambless LE, McMahon R, Finch A, Sorlie P, Heiss G, Lyles R, Wu KK. ARIC hemostasis study--III. Quality control. Atherosclerosis Risk in Communities. Thromb Haemost 1993; 70:588-94. [PMID: 8115984] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Methods and results from the quality assurance program of the Atherosclerosis Risk in Communities (ARIC) Study regarding hemostasis variables are presented, following up previous reports in this journal on standardized procedures for blood collection and processing (7) and an organized plan for the performance of those procedures (8). Efforts were made to control for and assess all sources of variability, from venipuncture to laboratory analysis, including also local field center processing and sample shipping. The quality control program included (a) a standardized protocol for blood collection and processing; (b) training, certification, and annual recertification of field center personnel for blood collection and processing; (c) monitoring of fasting times, phlebotomy times, processing times, and shipping problems; (d) hemostatic laboratory internal quality control; (e) a replicate blood sample program; (f) an intraindividual variability study; and (g) continual monitoring of quality control and study participants' data. This paper focused on items (c), (d), and (e). Measures of variation, generally standard deviations and coefficients of variation, are estimated for replicate blood sampling and internal quality control data, for activated partial thromboplastin time, fibrinogen, factor VII and VIII activity, von Willebrand factor, antithrombin-III, and protein C. The results demonstrate that it is possible to reliably measure these hemostatic variables in a large multicenter study.
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Affiliation(s)
- L E Chambless
- Department of Biostatistics, University of North Carolina, Chapel Hill 27514
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47
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Conlan MG, Folsom AR, Finch A, Davis CE, Sorlie P, Marcucci G, Wu KK. Associations of factor VIII and von Willebrand factor with age, race, sex, and risk factors for atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) Study. Thromb Haemost 1993; 70:380-5. [PMID: 8259533] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Several coagulation proteins have been implicated as possible risk factors for the development of atherosclerotic diseases, among which are factor VIII and von Willebrand factor. As part of the Atherosclerosis Risk in Communities (ARIC) Study, a prospective study designed to assess risk factors for the development of atherosclerotic diseases, baseline measurements of factor VIII and von Willebrand factor (vWF) were performed to determine their relationship to the development of atherosclerosis. We herein report the associations of factor VIII and vWF with constitutional, lifestyle, and biochemical factors. Factor VIII and vWF were strongly correlated with each other (r = 0.73), and, therefore, had similar associations with risk factors. Mean levels of both factors were higher in women than in men, in blacks than in whites, and increased with age. In univariate analysis, both were positively associated with diabetes, body mass index, waist-to-hip ratio, serum insulin, and plasma triglycerides. Both were negatively associated with alcohol intake, educational level, physical activity (with some exceptions), and HDL-cholesterol. No correlations were observed between factor VIII or vWF and plasma LDL-cholesterol or lipoprotein(a). Although factor VIII was negatively associated with smoking in both sexes, vWF was not associated with smoking status. Most of these associations were confirmed in multivariate analysis. The strongest associations observed were of factor VIII and vWF with race and diabetes. In multivariate analysis, blacks had factor VIII and vWF levels 15 to 18 percentage points higher than whites, and diabetics had factor VIII and vWF levels 11 to 18 percentage points higher than non-diabetics.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M G Conlan
- University of Texas Medical School, Division of Hematology-Oncology, Houston
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48
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Chambless LE, McMahon R, Wu K, Folsom A, Finch A, Shen YL. Short-term intraindividual variability in hemostasis factors. The ARIC Study. Atherosclerosis Risk in Communities Intraindividual Variability Study. Ann Epidemiol 1992; 2:723-33. [PMID: 1342324 DOI: 10.1016/1047-2797(92)90017-k] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.3] [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: 12/26/2022]
Abstract
Recent epidemiologic studies found that there is a strong association of hemostatic factors with ischemic heart disease. The Atherosclerosis Risk in Communities (ARIC) Intraindividual Variability (IIV) Study was conducted to estimate the various components of variation in hemostasis factors measured in the ARIC Study and to estimate the measures of repeatability of these factors. A total of 39 subjects (16 men, 23 women) were studied. Each had blood collected three times, with a 1- to 2-week interval between each visit. The contributions of between-person variability, within-person (biologic) variability, and processing and assay variability were estimated. Then the reliability coefficient R was estimated as the proportion of total variance accounted for by between-person variance. The reliability coefficient can be interpreted as the correlation between measures made at repeat visits. Among the various analytes, the reliability coefficients were quite high for activated partial thromboplastin time and plasma factor VIII (R = 0.92, 0.86, respectively). Low repeatability was obtained for antithrombin III activity and protein C (R = 0.42, 0.56, respectively). The lack of repeatability for these variables derives mostly from the processing (field center and laboratory) variation. Other analytes--fibrinogen, plasma factor VII, and von Willebrand factor--were intermediate in repeatability. In comparing the analyte-specific high-level to low-level groups, no substantial difference of within-person plus method coefficient of variation between the two groups was found for any analyte except for factor VIII, whereas the corresponding variance components for most analytes were higher for the higher analyte level. Reliability coefficients from this ARIC IIV study are generally higher than those found in other studies, and this is related to the relative variations in populations studied and to the time between measurements.
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Affiliation(s)
- L E Chambless
- Department of Biostatistics, University of North Carolina, Chapel Hill 27514
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49
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Finch A. Dogged determination. Nurs Times 1992; 88:41. [PMID: 1502059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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50
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O'Riordan J, Finch A, Lawlor E, McCann SR. Probability of finding a compatible sibling donor for bone marrow transplantation in Ireland. Bone Marrow Transplant 1992; 9:27-30. [PMID: 1531937] [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: 12/27/2022]
Abstract
This study was undertaken to ascertain the frequency of compatible sibling donors for individuals requiring bone marrow transplantation (BMT) in Ireland. During the study period 1984-89, a total of 392 patients were HLA typed. Of these, 218 (55.6%) had a compatible sibling donor. Among the latter there were 4 degrees of compatibility: 168 (42.9%) were HLA-A,B,DR identical MLC unreactive: three (0.8%) were HLA-A,B,DR identical MLC reactive: 12 (3.0%) were HLA-A,B,DR identical (no MLC performed) and 35 (8.9%) were HLA-A, B identical (no DR or MLC performed). The leukaemias and aplastic anaemia comprised 82.9% of all requests. The majority of patients with acute myeloid leukaemia (64.4%), acute lymphoblastic leukaemia (51.2%), chronic myeloid leukaemia (73.9%) and aplastic anaemia (77.3%) had a potential sibling donor. Subsequently 144 of these patients had an allogeneic BMT, 79.9% of which were for patients with leukaemia (acute and chronic). This study found that there was a higher probability of finding a donor within the family than reported in most series. A clear relationship was demonstrated between family size and the likelihood of obtaining a HLA-identical sibling donor.
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Affiliation(s)
- J O'Riordan
- Department of Haematology, St James's Hospital, Dublin, Ireland
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