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Kelly E, McCarthy A, O'Connell N, Oce O, Briggs R, O'Donnell D. Medical Student Attitudes to Physician Assisted Death. Ir Med J 2024; 117:944. [PMID: 38682691] [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: 05/01/2024]
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McCarthy A, O'Neill B. COVID-19 Vaccines and Axillary Nerve Dysfunction: A Case Report. Cureus 2023; 15:e49269. [PMID: 38143650 PMCID: PMC10746867 DOI: 10.7759/cureus.49269] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
COVID-19 resulted in a worldwide pandemic and the rapid introduction of vaccines in an attempt to mitigate it. Neuritis and neuropathy after intramuscular injection had been previously seen with influenza vaccines and appear to be a side effect of the COVID-19 vaccine as well. In the following report, we present the case of a 43-year-old female who developed axillary nerve symptoms after administration of the COVID-19 vaccine and her subsequent recovery.
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Affiliation(s)
- Andrea McCarthy
- Trauma and Orthopedic Surgery, St. James's Hospital, Dublin, IRL
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McCarthy A, Fahey E, Kelly J. A Comparison of Arthroplasty Activity Nationally between Mixed and Elective-Only Units. Ir Med J 2023; 116:810. [PMID: 37606237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
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Conneely M, Holmes A, O'Connor M, Leahy A, Gabr A, Saleh A, Okpaje B, Corey G, Barry L, Griffin A, O'Shaughnessy Í, Ryan L, Synott A, McCarthy A, Carroll I, Leahy S, Trepél D, Ryan D, Robinson K, Galvin R. 265 A PHYSIOTHERAPY-LED TRANSITION TO HOME INTERVENTION FOR OLDER ADULTS FOLLOWING EMERGENCY DEPARTMENT DISCHARGE: A PILOT FEASIBILITY RANDOMISED-CONTROLLED TRIAL. Age Ageing 2022. [PMCID: PMC9620307 DOI: 10.1093/ageing/afac218.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Older adults frequently attend the Emergency Department (ED) and experience high rates of adverse outcomes following ED presentation including functional decline, ED re-presentation and unplanned hospital admission. The development of effective interventions to prevent such outcomes is a key priority for research and service provision. A presentation to an ED can be viewed as an opportunity to assess those at risk of adverse outcomes and initiate a care plan in those deemed as ‘high risk'. Our aim was to evaluate the feasibility of a physiotherapy led integrated care intervention for older adults discharged from the ED (ED-PLUS). Methods Older adults presenting to the ED with undifferentiated medical complaints and discharged within 72 hours were computer randomised in a ratio of 1:1:1 to deliver usual care, Comprehensive Geriatric Assessment (CGA) in the ED, or ED-PLUS (Trial registration: NCT04983602). ED-PLUS is an evidence-based and stakeholder-informed intervention to bridge the care transition between the ED and community by initiating a CGA in the ED and implementing a six-week, multi-component, self-management programme in the patient’s own home. Feasibility (recruitment and retention rates) and acceptability of the programme were assessed quantitatively and qualitatively. Functional decline was examined post-intervention using the Barthel Index. All outcomes were assessed by a research nurse blinded to group allocation. Results 29 participants were recruited, indicating 97% of our recruitment target. 90% of participants completed the ED-PLUS intervention. All participants expressed positive feedback about the intervention. The incidence of functional decline at 6 weeks was 10% in the ED-PLUS group versus 70-89% in the usual care and CGA-only groups. Conclusion High adherence and retention rates were observed among participants and preliminary findings indicate a lower incidence of functional decline in the ED-PLUS group. Recruitment challenges existed in the context of COVID-19. Data collection is ongoing for six-month outcomes.
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Affiliation(s)
- M Conneely
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - A Holmes
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - M O'Connor
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Leahy
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Gabr
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Saleh
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - B Okpaje
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - G Corey
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - L Barry
- University of Limerick School of Nursing and Midwifery, Faculty of Education and Health Sciences, , Limerick, Ireland
| | - A Griffin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - Í O'Shaughnessy
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - L Ryan
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A Synott
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - A McCarthy
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - I Carroll
- University Hospital Limerick Department of Ageing and Therapeutics, , Dooradoyle, Limerick, Ireland
| | - S Leahy
- School of Science & Computing, Atlantic Technological University, ATU Galway City Department of Sport, Exercise & Nutrition, , Old Dublin Road, Galway, Ireland
| | - D Trepél
- Trinity College Dublin Trinity Institute of Neurosciences, School of Medicine, , Ireland
| | - D Ryan
- University Hospital Limerick Limerick EM Education Research Training, Emergency Department, , Dooradoyle, Limerick, Ireland
| | - K Robinson
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
| | - R Galvin
- University of Limerick School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, , Limerick, Ireland
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McCarthy A, Smith P, Poch K. 104 Provider involvement in research conversations with patients: Quality improvement. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00795-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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McCarthy A, Murray O, Smith S. P.26 Development of a neurological assessment pathway for obstetric neuraxial analgesia. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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McCarthy A, Black C. Anaesthesia management of a child with aromatic L-amino acid decarboxylase deficiency. Anaesth Rep 2022; 10:e12152. [PMID: 35233534 PMCID: PMC8861587 DOI: 10.1002/anr3.12152] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aromatic L-amino acid decarboxylase deficiency is an autosomal recessive disorder that results in a lack of neurotransmitters including serotonin, dopamine, noradrenaline and adrenaline. It is characterised by developmental delay, severe hypotonia and autonomic disturbance. In patients with this condition, catecholamine deficiency and autonomic dysfunction, resulting in haemodynamic instability under anaesthesia is a primary concern. There is increased sensitivity to exogenous catecholamines and indirect acting agents, such as ephedrine, are ineffective. Hypoglycaemia, difficult airway status and drug interactions such as with monoamine oxidase inhibitors are also of concern, and these patients are at risk of dystonic crises peri-operatively. A 6-year-old boy with aromatic L-amino acid decarboxylase deficiency presented for gastrointestinal endoscopy. Following multidisciplinary discussion, we elected to provide general anaesthesia with a propofol target-controlled infusion, which proceeded without incident. In this report, we describe the precautions taken in this case, and discuss the provision of general anaesthesia for children with rare neurometabolic disorders.
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Affiliation(s)
- A. McCarthy
- Department of AnaesthesiaChildren’s Health Ireland at CrumlinDublinIreland
| | - C. Black
- Department of AnaesthesiaChildren’s Health Ireland at CrumlinDublinIreland
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McGarvey C, Hobson H, Greene S, Cogan N, McCabe D, McCarthy A, Murphy S, O'Dowd S, Walsh R, Coughlan T, O'Neill D, Kennelly S, Mello S, Coveney S, Ryan D, Collins R. 209 NEURO-MEDICAL COMPLICATIONS OF STROKE—TRENDS OVER THE DECADES IN AN ACUTE STROKE UNIT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Neuro-medical complications post-stroke are common and often serious [1]. We first described complications in our stroke cohort in 1998 and sought to assess whether the severity and the nature of neuro-medical complications may have changed over time due to changes in presentation and the processes of care [2].
Methods
Analysis of stroke service database, which captures all neuro-medical complications as part of its portal for the Irish National Audit of Stroke (INAS), was completed. The frequency of each of the 19 complications was expressed as the percentage of patients that developed each complication over a certain year and over 5 years. Historical comparison was made with dataset from 1998, which captured six complications.
Results
Data on 1,283 patients presenting over 5 years between 2015–2019 was collected. The median age of all patients was 71 years (Range 21–101). In all, 19 different post-stroke complications were recorded; 48% (n = 622) had post-stroke pain, while 23.85% (n = 306) had cognitive decline. Data on 100 patients from 1998 was compared for a number of common metrics including; 21.82% (n = 275) of patients developed an LRTI in the 2015–2019 cohort compared with 14%(n = 14) in the 1998 cohort (p = 0.09) while 16.29% (n = 209) of patients developed a swallow disorder compared to 21% (n = 21) in 1998 (p = 0.22).
Conclusion
There are high levels of neuro-medical complications in stroke patients. Twenty years has seen extensive investment in hyperacute stroke care yet post-acute care complications did not appear to reduce significantly between this time, albeit with low numbers. Direction of future funding may consider the full spectrum of stroke care.
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Affiliation(s)
- C McGarvey
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - H Hobson
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Greene
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - N Cogan
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - D McCabe
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - A McCarthy
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - S Murphy
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - S O'Dowd
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - R Walsh
- Department of Neurology, Tallaght University Hospital , Dublin, Ireland
| | - T Coughlan
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - D O'Neill
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Kennelly
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Mello
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - S Coveney
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - D Ryan
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
| | - R Collins
- Department of Age-Related Health Care/Stroke Service and School of Gerontology Trinity College Dublin , Dublin, Ireland
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Synnott A, Ryan C, O'Connell P, Steed F, Reale S, Carey L, English S, Fitzgibbon K, O'Connell Á, Smalle E, Ryan D, Shchetkovsky D, McCarthy A, Moran B, Murphy H, O'Shaughnessy Í. 178 A RETROSPECTIVE EVALUATION OF PROCESS OUTCOMES OF OLDER ADULTS REFERRED TO A COMMUNITY RE-ENABLEMENT TEAM FROM THE EMERGENCY DEPARTMENT. Age Ageing 2021. [DOI: 10.1093/ageing/afab216.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Emergency Departments (ED) are complex and challenging environments to provide care to older adults. There is currently a paucity of high quality methodological research investigating the effectiveness of interventions focused on transitions of care from the ED to primary care services (Hughes et al, 2019). This study aims to evaluate the impact of a collaborative model of care between primary and secondary care services for older adults discharged home following ED index visit.
Methods
This was an observational retrospective study. Participants aged ≥65 years discharged home from the ED of a University Teaching Hospital and referred to a Multidisciplinary Community Intervention Team (MDCIT) were included. Referral pathways were via the OPTIMEND team (Cassarino et al, 2021) and MDCIT, which is a rapid access re-enablement team based in the community and compromises nursing staff, an occupational therapist, physiotherapist, therapy and healthcare assistants. Descriptive statistics were used to profile the baseline characteristics of study participants and to summarise data related to process outcomes. Ethical approval was granted for this study (020/2021).
Results
In the study period, January—December 2020, 54 patients were referred to the MDCIT. The mean age of participants was 80.1 years (SD 8.2), 57% were female, and the most common Manchester Triage System presenting complaint was ‘limb problems’. The median Patient Experience Time within the ED was 7.4 hours (IQR 13.1); 55% of participants were seen in their home within 24 hours of discharge. A mean of 10 interventions were delivered by the MDCIT. A 9.1% incidence rate of 30 day unscheduled hospital readmission was recorded.
Conclusion
Integrated care programmes have been advocated to improve the continuum of care from the ED into the community. This evaluation has demonstrated the feasibility of implementing such a model of care. However, further methodologically robust research is required to advance the evidence base and should also focus on patient outcomes.
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Affiliation(s)
- A Synnott
- Emergency Department, University Hospital Limerick , Limerick, Ireland
- Physiotherapy Department, University Hospital Limerick , Limerick, Ireland
| | - C Ryan
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - P O'Connell
- Physiotherapy Department, University Hospital Limerick , Limerick, Ireland
| | - F Steed
- Medicine Directorate, University Hospital Limerick , Limerick, Ireland
| | - S Reale
- Diagnostics Directorate, University Hospital Limerick , Limerick, Ireland
| | - L Carey
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
| | - S English
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - K Fitzgibbon
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - Á O'Connell
- Multidisciplinary Community Intervention Team Limerick , Limerick, Ireland
| | - E Smalle
- Department of Medical Social Work, University Hospital Limerick , Limerick, Ireland
| | - D Ryan
- Emergency Department, University Hospital Limerick , Limerick, Ireland
| | - D Shchetkovsky
- Emergency Department, University Hospital Limerick , Limerick, Ireland
| | - A McCarthy
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
| | - B Moran
- Physiotherapy Department, University Hospital Limerick , Limerick, Ireland
| | - H Murphy
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
| | - Í O'Shaughnessy
- Emergency Department, University Hospital Limerick , Limerick, Ireland
- Department of Occupational Therapy, University Hospital Limerick , Limerick, Ireland
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Kim J, Zhang J, Wang W, McCarthy A, Oh C, Gerber N. A Dosimetric Comparison of IMRT and 3D-CRT Using Deep Inspiratory Breath Hold (DIBH) and Free-Breathing (FB) Techniques in Gastric Mucosa Lymphoid Tissue Lymphoma (MALT). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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McCarthy A, Muller L, O'Shea K, Keeling P. P27: INTRODUCTION OF A PILOT VIRTUAL FRACTURE CLINIC: A TIME AND COST ANALYSIS. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
The British Orthopaedic Association Standards for Trauma and Orthopaedics(BOAST) have produced guidelines advising that all patients be reviewed by an orthopaedic consultant within 72 hours of presentation. However, data from traditional fracture clinics rarely fulfil this criterion. Furthermore, data from the National Health Service(NHS) has determined that traditional fracture clinics have become unfit for purpose with low patient satisfaction rates, excessive waiting times and over 6.9 million missed appointments every year. Our aim is to test the feasibility of a virtual fracture clinic(VFC) with a view to reducing service costs and improving adherence to BOAST guidelines specified timeline for orthopaedic consultant review.
Method
A retrospective analysis of 103 patients referred to our pilot VFC from January 1st to 31st 2019 was carried out. We included shoulder dislocations, clavicle injuries, simple distal radius fractures, radial head fractures, metacarpal and metatarsal injuries, undisplaced fractures of the medial and lateral malleolus of the ankle and soft tissue injuries. The primary outcome measured time from presentation to review by an orthopaedic consultant. A cost analysis was also performed to estimate the overheads and potential savings associated with VFC introduction. Statistical analysis was done via SPSS.
Result
Following VFC establishment, time from ED presentation to review by orthopaedic consultant reduced from a mean of 229 hours to 72 hours(P=0.0001). Cost analysis demonstrated that the VFC created savings of €3170 per week, amounting to projected savings of €38,040.
Conclusion
VFC has the potential to improve clinical performance while delivering substantial financial savings.
Take-home message
Virtual fracture clinic improves patients review times bringing them in line with BOAST guidelines while providing significant reductions in overheads leading to potential savings of over 38,000 euro.
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Affiliation(s)
| | - L Muller
- St Vincent's University Hospital
| | - K O'Shea
- St Vincent's University Hospital
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Broderick JM, McCarthy A, Hogan N. Osteotomy around the knee: Assessment of quality, content and readability of online information. Knee 2021; 28:139-150. [PMID: 33360380 DOI: 10.1016/j.knee.2020.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/28/2020] [Accepted: 11/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND As knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee. METHODS The first 70 websites returned by the top four search engines were identified using the key words: "knee osteotomy" and "high tibial osteotomy." The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared. RESULTS Of the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as 'poor.' The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores. The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as 'difficult.' Journal websites had the highest RGL. CONCLUSION The information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood. LEVEL OF EVIDENCE Survey of materials - Internet.
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Affiliation(s)
- James M Broderick
- Department of Trauma & Orthopaedics, St. James's Hospital, James's Street, Dublin D08 NHY1, Ireland.
| | - Andrea McCarthy
- Department of Trauma & Orthopaedics, St. James's Hospital, James's Street, Dublin D08 NHY1, Ireland
| | - Niall Hogan
- Department of Trauma & Orthopaedics, St. James's Hospital, James's Street, Dublin D08 NHY1, Ireland
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Broderick JM, McCarthy A, Hogan N. Knee osteotomy: Quality tools and readability data of information on the internet. Data Brief 2020; 34:106624. [PMID: 33354604 PMCID: PMC7744941 DOI: 10.1016/j.dib.2020.106624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022] Open
Abstract
Supplementary data for the article Osteotomy around the Knee: Assessment of Quality, Content and Readability of Online Information is provided. 45 unique websites were evaluated. The DISCERN score, JAMA (Journal of the American Medical Association) benchmark criteria and HONcode (Health On the Net) criteria are provided for reference. Readability of online information was analysed with Readability Studio Professional Edition, Version 2019 (Oleander Software Ltd.). The software assessed readability using eight different instruments: Flesch-Kincaid Reading Grade Level (FKGL), Flesch Reading Ease Score (FRES), Raygor Estimate, SMOG, Coleman- Liau, Fry, FORCAST and Gunning Fog. Data is also provided on the percentage of complex words, long words, Dale-Chall unfamiliar words, Fog words, as well as the number of ‘wordy’ items, overly long sentences and longest sentence length.
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Affiliation(s)
- James M Broderick
- Department of Trauma & Orthopaedics, St. James's Hospital, James's Street, Dublin D08 NHY1, Ireland
| | - Andrea McCarthy
- Department of Trauma & Orthopaedics, St. James's Hospital, James's Street, Dublin D08 NHY1, Ireland
| | - Niall Hogan
- Department of Trauma & Orthopaedics, St. James's Hospital, James's Street, Dublin D08 NHY1, Ireland
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Chew S, Gleeson JP, McCarthy A, Watson GA, O'Dwyer R, Nicholson S, Capra M, Owens C, McDermott M, Daly P, Grant C. Leptomeningeal Relapse of Embryonal Rhabdomyosarcoma after 15 years. Ir Med J 2020; 112:1026. [PMID: 32311247] [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: 06/11/2023]
Abstract
Aim Rhabdomyosarcoma (RMS) is the most common malignant soft tissue tumour of childhood. We present the case of a late relapse of RMS to the leptomeninges after 15 years. Methods A 20 year old male presented with a 3 week history of headaches and nausea. He previously had RMS of his right ear diagnosed at age 5 years which was treated with concurrent chemoradiotherapy. An MRI Brain and Spine confirmed extensive leptomeningeal disease and CSF analysis confirmed the presence of recurrent embryonal RMS. Results He completed two cycles of cyclophosphamide and topotecan followed by 45Gy/25Fr of craniospinal radiotherapy. Conclusion Late relapses beyond five years can be seen in up to 9% of patients, however very late recurrences (>10 years) are exceedingly rare. Molecular based methods such as gene expression profiling can aid risk stratification and survivorship clinics may become increasingly useful in following patients with high risk features.
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Affiliation(s)
- S Chew
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - J P Gleeson
- Department of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland
| | - A McCarthy
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - G A Watson
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - R O'Dwyer
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
| | - S Nicholson
- Department of Histopathology, St James's Hospital, Dublin 8, Ireland
| | - M Capra
- Department of Medical Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - C Owens
- Department of Medical Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - M McDermott
- Department of Histopathology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - P Daly
- Department of Radiation Oncology, St James's Hospital, Dublin 8, Ireland
| | - C Grant
- Department of Medical Oncology, St James's Hospital, Dublin 8, Ireland
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Dulbecco AB, Moriconi DE, Lynn S, McCarthy A, Juárez MP, Girotti JR, Calderón-Fernández GM. Deciphering the role of Rhodnius prolixus CYP4G genes in straight and methyl-branched hydrocarbon formation and in desiccation tolerance. Insect Mol Biol 2020; 29:431-443. [PMID: 32484986 DOI: 10.1111/imb.12653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/05/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
Insect cuticle hydrocarbons are involved primarily in waterproofing the cuticle, but also participate in chemical communication and regulate the penetration of insecticides and microorganisms. The last step in insect hydrocarbon biosynthesis is carried out by an insect-specific cytochrome P450 of the 4G subfamily (CYP4G). Two genes (CYP4G106 and CYP4G107) have been reported in the triatomines Rhodnius prolixus and Triatoma infestans. In this work, their molecular and functional characterization is carried out in R. prolixus, and their relevance to insect survival is assessed. Both genes are expressed almost exclusively in the integument and have an expression pattern dependent on the developmental stage and feeding status. CYP4G106 silencing diminished significantly the straight-chain hydrocarbon production while a significant reduction - mostly of methyl-branched chain hydrocarbons - was observed after CYP4G107 silencing. Molecular docking analyses using different aldehydes as hydrocarbon precursors predicted a better fit of straight-chain aldehydes with CYP4G106 and methyl-branched aldehydes with CYP4G107. Survival bioassays exposing the silenced insects to desiccation stress showed that CYP4G107 is determinant for the waterproofing properties of the R. prolixus cuticle. This is the first report on the in vivo specificity of two CYP4Gs to make mostly straight or methyl-branched hydrocarbons, and also on their differential contribution to insect desiccation.
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Affiliation(s)
- A B Dulbecco
- Instituto de Investigaciones Bioquímicas de La Plata (CONICET-UNLP), Facultad de Ciencias Médicas, La Plata, Argentina
| | - D E Moriconi
- Instituto de Investigaciones Bioquímicas de La Plata (CONICET-UNLP), Facultad de Ciencias Médicas, La Plata, Argentina
| | - S Lynn
- Centro Regional de Estudios Genómicos (UNLP), Facultad de Ciencias Exactas, La Plata, Argentina
| | - A McCarthy
- Centro Regional de Estudios Genómicos (UNLP), Facultad de Ciencias Exactas, La Plata, Argentina
| | - M P Juárez
- Instituto de Investigaciones Bioquímicas de La Plata (CONICET-UNLP), Facultad de Ciencias Médicas, La Plata, Argentina
| | - J R Girotti
- Instituto de Investigaciones Bioquímicas de La Plata (CONICET-UNLP), Facultad de Ciencias Médicas, La Plata, Argentina
| | - G M Calderón-Fernández
- Instituto de Investigaciones Bioquímicas de La Plata (CONICET-UNLP), Facultad de Ciencias Médicas, La Plata, Argentina
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McCarthy A, Damiran N. Non-communicable disease risk factors among a cohort of mine workers in Mongolia. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Prevalence of non-communicable diseases (NCD) are growing among working populations globally. The World Health Organization (WHO) estimates NCD are responsible for 80% of all premature deaths (Lancet, 2016). The purpose of this study is to determine baseline level of NCD and risk factors among mine workers and to identify intervention strategies based on results. The collected results will be compared with a NCD study on the general population of Mongolia.
Methods
A cross sectional design was used for this study. 684 employees were randomly recruited to the study. We utilised WHO questionnaire to collect anthropogenic measurements, health behaviours, alcohol consumption, smoking, NCD and work related information.. The study focused on four (4) key risk factors of hypertension, obesity, drinking habits and smoking habits. These factors are key contributors to NCD and decreased life expectancy.
Results
Results of the study showed prevalence's of hypertension 12.9%, obesity 64.1%, alcohol users 22.1% and smokers 38.8%. The general population prevalence's are 27.5%, 56.8%, 15.5% and 24.8% respectively. Differences between gender in the study cohort for smoking rate (men = 43.3%, women = 8.9%), alcohol consumption (men = 29.9%, women = 16.1%) and central obesity (men = 78.3%, women = 35.1%) were statistically significant (p < 0.05).
Conclusions
Prevalence of arterial hypertension for the mine worker cohort was lower than general population, however, obesity, drinking and smoking rates were higher. The study findings allow us to target intervention strategies to mitigate the risk of NCD development in the future.
Key messages
Understand the risk factors and control measures available to mitigate the risk of the development of NCD. Comparison of the mine site cohort with the general population to understand similarities and differences.
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Affiliation(s)
- A McCarthy
- Rio Tinto, Oyu Tolgoi, Ulaanbaatar, Mongolia
- Mongolian National Association of Occupational Hygienists, MNAOH, Ulaanbaatar, Mongolia
- Australian Institute of Occupational Hygiene, AIOH, Melbourne, Australia
| | - N Damiran
- Mongolian National Association of Occupational Hygienists, MNAOH, Ulaanbaatar, Mongolia
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17
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Nichols MK, Andrew MK, Ye L, Hatchette TF, Ambrose A, Boivin G, Bowie W, Dos Santos G, Elsherif M, Green K, Haguinet F, Katz K, Leblanc J, Loeb M, MacKinnon-Cameron D, McCarthy A, McElhaney JE, McGeer A, Powis J, Richardson D, Semret M, Sharma R, Shinde V, Smyth D, Trottier S, Valiquette L, Webster D, McNeil SA. The Impact of Prior Season Vaccination on Subsequent Influenza Vaccine Effectiveness to Prevent Influenza-related Hospitalizations Over 4 Influenza Seasons in Canada. Clin Infect Dis 2020; 69:970-979. [PMID: 30508064 DOI: 10.1093/cid/ciy1009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 04/27/2018] [Accepted: 11/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent studies have demonstrated the possibility of negative associations between prior influenza vaccines and subsequent influenza vaccine effectiveness (VE), depending on season and strain. We investigated this association over 4 consecutive influenza seasons (2011-2012 through 2014-2015) in Canada. METHODS Using a matched test-negative design, laboratory-confirmed influenza cases and matched test-negative controls admitted to hospitals were enrolled. Patients were stratified into 4 groups according to influenza vaccine history (not vaccinated current and prior season [referent], vaccinated prior season only, vaccinated current season only, and vaccinated both current and prior season). Conditional logistic regression was used to estimate VE; prior vaccine impact was assessed each season for overall effect and effect stratified by age (<65 years, ≥65 years) and type/subtype (A/H1N1, A/H3N2, influenza B). RESULTS Overall, mainly nonsignificant associations were observed. Trends of nonsignificant decreased VE among patients repeatedly vaccinated in both prior and current season relative to the current season only were observed in the A/H3N2-dominant seasons of 2012-2013 and 2014-2015. Conversely, in 2011-2012, during which B viruses circulated, and in 2013-2014, when A/H1N1 circulated, being vaccinated in both seasons tended to result in a high VE in the current season against the dominant circulating subtype. CONCLUSIONS Prior vaccine impact on subsequent VE among Canadian inpatients was mainly nonsignificant. Even in circumstances where we observed a trend of negative impact, being repeatedly vaccinated was still more effective than not receiving the current season's vaccine. These findings favor continuation of annual influenza vaccination recommendations, particularly in older adults. CLINICAL TRIALS REGISTRATION NCT01517191.
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Affiliation(s)
- M K Nichols
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - M K Andrew
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - L Ye
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - T F Hatchette
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - A Ambrose
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - G Boivin
- Centre Hospitalier Universitaire de Québec, Québec City, Canada
| | - W Bowie
- University of British Columbia, Vancouver, Canada
| | - G Dos Santos
- Business and Decision Life Sciences, Bruxelles, Belgium.,Present affiliation: GSK, Wavre, Belgium
| | - M Elsherif
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - K Green
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | - K Katz
- North York General Hospital, Toronto
| | - J Leblanc
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | - M Loeb
- McMaster University, Hamilton
| | - D MacKinnon-Cameron
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
| | | | | | - A McGeer
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - J Powis
- Michael Garron Hospital, Toronto
| | | | - M Semret
- McGill University, Montreal, Québec
| | - R Sharma
- GSK, Mississauga, Ontario, Canada
| | - V Shinde
- GSK, King of Prussia, Pennsylvania.,Present affiliation: Novavax Vaccines, Washington, D.C
| | - D Smyth
- The Moncton Hospital, New Brunswick
| | - S Trottier
- Centre Hospitalier Universitaire de Québec, Québec City, Canada
| | | | - D Webster
- Saint John Hospital Regional Hospital, Dalhousie University, New Brunswick, Canada
| | - S A McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia
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Holton CM, Hanley N, Shanks E, Oxley P, McCarthy A, Eastwood BJ, Murray TK, Nickerson A, Wafford KA. Longitudinal changes in EEG power, sleep cycles and behaviour in a tau model of neurodegeneration. Alzheimers Res Ther 2020; 12:84. [PMID: 32669112 PMCID: PMC7364634 DOI: 10.1186/s13195-020-00651-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/03/2020] [Indexed: 01/13/2023]
Abstract
Background Disturbed sleep is associated with cognitive decline in neurodegenerative diseases such as Alzheimer’s disease (AD) and frontotemporal dementia (FTD). The progressive sequence of how neurodegeneration affects aspects of sleep architecture in conjunction with behavioural changes is not well understood. Methods We investigated changes in sleep architecture, spectral power and circadian rhythmicity in the tet-off rTg4510 mouse overexpressing human P301L tau within the same subjects over time. Doxycycline-induced transgene-suppressed rTg4510 mice, tTa carriers and wild-type mice were used as comparators. Spectral power and sleep stages were measured from within the home cage environment using EEG electrodes. In addition, locomotor activity and performance during a T-maze task were measured. Results Spectral power in the delta and theta bands showed a time-dependent decrease in rTg4510 mice compared to all other groups. After the initial changes in spectral power, wake during the dark period increased whereas NREM and number of REM sleep bouts decreased in rTg4510 compared to wild-type mice. Home cage locomotor activity in the dark phase significantly increased in rTg4510 compared to wild-type mice by 40 weeks of age. Peak-to-peak circadian rhythm amplitude and performance in the T-maze was impaired throughout the experiment independent of time. At 46 weeks, rTG4510 mice had significant degeneration in the hippocampus and cortex whereas doxycycline-treated rTG4510 mice were protected. Pathology significantly correlated with sleep and EEG outcomes, in addition to locomotor and cognitive measures. Conclusions We show that reduced EEG spectral power precedes reductions in sleep and home cage locomotor activity in a mouse model of tauopathy. The data shows increasing mutant tau changes sleep architecture, EEG properties, behaviour and cognition, which suggest tau-related effects on sleep architecture in patients with neurodegenerative diseases.
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Affiliation(s)
- C M Holton
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - N Hanley
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - E Shanks
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - P Oxley
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - A McCarthy
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - B J Eastwood
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - T K Murray
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - A Nickerson
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK
| | - K A Wafford
- Eli Lilly and Company, Erl Wood Manor, Windlesham, Surrey, GU20 6PH, UK.
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McCarthy A, McMeekin P, Anderson G, McCarthy S, Parry SW. 87 Effects of Community Falls Prevention Service Closure on ICD-10 Coded Fracture Rates in Older People: An Interrupted Time Series Approach. Age Ageing 2020. [DOI: 10.1093/ageing/afz193.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Guidelines on falls prevention recommend case ascertainment based on opportunistic case ascertainment and referral in those who have fallen. In October 2009 we implemented a novel multidisciplinary, multifactorial falls, syncope and dizziness service with enhanced case-ascertainment through proactive, primary care-based screening for associated risk factors. In addition to comprehensive geriatric assessment, 25% of 4032 service participants underwent strength and balance training. The baseline outcomes have been previously reported.1 Funding was withdrawn, and the service closed on 31/01/2014. We examined the effect of service-closure on fractures presenting to secondary care with and without the service running.
Methods
An interrupted time series method was used. ICD-10 coded fracture numbers attending secondary care were determined (Hospital Episode Statistics from 01/02/2012-31/05/2017) for all North Tyneside residents ≥60 years at the time of service closure, including 25-months with, and 40-months without, service provision.
Results
There was a 0.9% (p=0.018) monthly reduction in falls over 25-months of service provision which increased during the winter months of a 9.8% (p=0.015) increase. In the month following the service closure there was an initial increase in fractures of 8.5% (p=0.231), followed by an increase in the monthly time trend of 1% (p=0.018). This resulted in a post-service monthly increase in fractures of 0.1%, an estimated extra 625 fractures over the 40-month post-service cessation period. At an average £8600 per fracture, the estimated cost may have been £5,375,000.
Conclusions
In this naturalistic experiment, following an initial drop in fractures, disinvestment in this service resulted in a rise in elders’ fractures presenting to secondary care. The closure of the service may have had a large unintended cost, averaging £1.5 million annually, versus annual running costs of £220,000. Further research is needed to control for patient-level characteristics and to establish the cost-effectiveness of the service.
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Affiliation(s)
| | | | | | | | - S W Parry
- Newcastle University Institute of Ageing
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20
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McCarthy A, McMeekin P, Anderson G, McCarthy S, Parry SW. 74 Effects of Community Falls Prevention Service Closure on Ischaemic Heart Disease Attendances in Secondary Care: An Interrupted Time Series Approach. Age Ageing 2020. [DOI: 10.1093/ageing/afz190.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In 2009 we implemented a novel multidisciplinary, multifactorial falls, syncope and dizziness service model utilising proactive, primary care-based screening (≥60 years). Participants underwent comprehensive geriatric assessment, while 25% of the 4032 service participants had exercise training. All had additional lifestyle advice on exercise, alcohol intake, weight loss and smoking cessation. The preliminary outcomes of this approach have been previously reported, with occult atrial fibrillation, murmurs, ECG-evident ischaemic heart disease (IHD) etc reported to GPs for further action.1 Funding was withdrawn and the service closed on 31/01/2014. We examined IHD secondary care attendances with and without service provision.
Methods
Patients: North Tyneside residents ≥60 years at time of closure of the service in January 2014, who were presented acutely to secondary care with IHD using an interrupted time series method. ICD-10 coded IHD numbers were determined (Hospital Episode Statistics from 01/02/2012[date of a change in coding compared to service commencement in 2009] until 31/05/2017) including 25-months with, and 40-months without, service provision.
Results
The Table summarises the change in IHD +/- service provision; there was a significant reduction in IHD non-elective admissions during both time series’, but the reduction was significantly lower without service provision.
In addition, immediately following the service closure there was an initial increase in IHD complications of 18.4% (p=0.059) followed by an increase in the time trend of 2.7% (p=0.029), resulting in a 0.6% post-service monthly reduction in IHD complications.
Conclusions
Disinvestment in this service resulted in a slowdown in the underlying reduction of IHD diagnoses in secondary care. However, further research is needed to control for patient-level characteristics, the economic impact and to look at the effect of the service on other cardiovascular diseases.
Reference
1. Parry SW. JAGS 2016; 64 (11):2368–2373.
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Affiliation(s)
| | | | | | | | - S W Parry
- Newcastle University Institute of Ageing
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21
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LeBlanc JJ, ElSherif M, Mulpuru S, Warhuus M, Ambrose A, Andrew M, Boivin G, Bowie W, Chit A, Dos Santos G, Green K, Halperin SA, Hatchette TF, Ibarguchi B, Johnstone J, Katz K, Langley JM, Lagacé-Wiens P, Loeb M, Lund A, MacKinnon-Cameron D, McCarthy A, McElhaney JE, McGeer A, Poirier A, Powis J, Richardson D, Semret M, Shinde V, Smyth D, Trottier S, Valiquette L, Webster D, Ye L, McNeil S. Validation of the Seegene RV15 multiplex PCR for the detection of influenza A subtypes and influenza B lineages during national influenza surveillance in hospitalized adults. J Med Microbiol 2020; 69:256-264. [PMID: 31264957 PMCID: PMC7431100 DOI: 10.1099/jmm.0.001032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/16/2019] [Indexed: 01/04/2023] Open
Abstract
Background. The Serious Outcomes Surveillance Network of the Canadian Immunization Research Network (CIRN SOS) has been performing active influenza surveillance since 2009 (ClinicalTrials.gov identifier: NCT01517191). Influenza A and B viruses are identified and characterized using real-time reverse-transcriptase polymerase chain reaction (RT-PCR), and multiplex testing has been performed on a subset of patients to identify other respiratory virus aetiologies. Since both methods can identify influenza A and B, a direct comparison was performed.Methods. Validated real-time RT-PCRs from the World Health Organization (WHO) to identify influenza A and B viruses, characterize influenza A viruses into the H1N1 or H3N2 subtypes and describe influenza B viruses belonging to the Yamagata or Victoria lineages. In a subset of patients, the Seeplex RV15 One-Step ACE Detection assay (RV15) kit was also used for the detection of other respiratory viruses.Results. In total, 1111 nasopharyngeal swabs were tested by RV15 and real-time RT-PCRs for influenza A and B identification and characterization. For influenza A, RV15 showed 98.0 % sensitivity, 100 % specificity and 99.7 % accuracy. The performance characteristics of RV15 were similar for influenza A subtypes H1N1 and H3N2. For influenza B, RV15 had 99.2 % sensitivity, 100 % specificity and 99.8 % accuracy, with similar assay performance being shown for both the Yamagata and Victoria lineages.Conclusions. Overall, the detection of circulating subtypes of influenza A and lineages of influenza B by RV15 was similar to detection by real-time RT-PCR. Multiplex testing with RV15 allows for a more comprehensive respiratory virus surveillance in hospitalized adults, without significantly compromising the reliability of influenza A or B virus detection.
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Affiliation(s)
- J. J. LeBlanc
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - M. ElSherif
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - S. Mulpuru
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - M. Warhuus
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - A. Ambrose
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - M. Andrew
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - G. Boivin
- Centre Hospitalier Universitaire de Québec, QC, Canada
| | - W. Bowie
- University of British Columbia, Vancouver, BC, Canada
| | - A. Chit
- Sanofi Pasteur, Swiftwater, PA, USA
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - G. Dos Santos
- Business & Decision Life Sciences (on behalf of GSK), Bruxelles, Belgium
- Present address: GSK, Wavre, Belgium
| | - K. Green
- Mount Sinai Hospital, Toronto, ON, Canada
| | - S. A. Halperin
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - T. F. Hatchette
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - B. Ibarguchi
- GSK, Mississauga, ON, Canada
- Present address: Bayer, Inc., Mississauga, Ontario, Canada
| | - J. Johnstone
- Public Health Ontario and University of Toronto, Toronto, ON, Canada
| | - K. Katz
- North York General Hospital, Toronto, ON, Canada
| | - J. M. Langley
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - M. Loeb
- Public Health Ontario and University of Toronto, Toronto, ON, Canada
| | - A. Lund
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - D. MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - A. McCarthy
- Ottawa Hospital General, Ottawa, Ontario, Canada
| | - J. E. McElhaney
- Health Sciences North Research Institute, Sudbury, ON, Canada
| | - A. McGeer
- Mount Sinai Hospital, Toronto, ON, Canada
| | - A. Poirier
- Centre Intégré Universitaire de Santé et Services Sociaux, Quebec, QC, Canada
| | - J. Powis
- Toronto East General Hospital, Toronto, ON, Canada
| | | | - M. Semret
- McGill University, Montreal, QC, Canada
| | - V. Shinde
- GSK, King of Prussia, PA, USA
- Present address: Novavax Vaccines, Washington, DC, USA
| | - D. Smyth
- The Moncton Hospital, Moncton, NB, Canada
| | - S. Trottier
- Centre Hospitalier Universitaire de Québec, QC, Canada
| | | | | | - L. Ye
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - S. A. McNeil
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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de Oliveira P, Loomis S, McCarthy A, Wafford K, Gilmour G, Dijk DJ, Winsky-Sommerer R. Chronic trazodone treatment alters REMS structure in a mouse model of tauopathy. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Araujo D, Wang A, Torti D, Huang J, Leon A, Marsh K, McCarthy A, Berman H, Spreafico A, Hansen A, Razak A, Bedard P, Wang L, Plackmann E, Chow H, Bao H, Wu X, Pugh T, Siu L. Blood-based TMB (bTMB) correlates with tissue-based TMB (tTMB) in a multi-cancer phase I IO cohort. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Teruel J, Taneja S, McCarthy A, Galavis P, Malin M, Osterman S, Gerber N, Barbee D, Hitchen C. Robust VMAT-based Total Body Irradiation (TBI) Treatment Planning Assisted by Eclipse Scripting. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Shaikh F, Tam M, Barbee D, Hitchen C, McCarthy A, Huppert N, Perez C, Gerber N. Coverage of Axillary Lymph Nodes with High Tangents in the Prone Position. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Singer GAC, Fahner NA, Barnes JG, McCarthy A, Hajibabaei M. Comprehensive biodiversity analysis via ultra-deep patterned flow cell technology: a case study of eDNA metabarcoding seawater. Sci Rep 2019; 9:5991. [PMID: 30979963 PMCID: PMC6461652 DOI: 10.1038/s41598-019-42455-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/01/2019] [Indexed: 11/09/2022] Open
Abstract
The characterization of biodiversity is a crucial element of ecological investigations as well as environmental assessment and monitoring activities. Increasingly, amplicon-based environmental DNA metabarcoding (alternatively, marker gene metagenomics) is used for such studies given its ability to provide biodiversity data from various groups of organisms simply from analysis of bulk environmental samples such as water, soil or sediments. The Illumina MiSeq is currently the most popular tool for carrying out this work, but we set out to determine whether typical studies were reading enough DNA to detect rare organisms (i.e., those that may be of greatest interest such as endangered or invasive species) present in the environment. We collected sea water samples along two transects in Conception Bay, Newfoundland and analyzed them on the MiSeq with a sequencing depth of 100,000 reads per sample (exceeding the 60,000 per sample that is typical of similar studies). We then analyzed these same samples on Illumina's newest high-capacity platform, the NovaSeq, at a depth of 7 million reads per sample. Not surprisingly, the NovaSeq detected many more taxa than the MiSeq thanks to its much greater sequencing depth. However, contrary to our expectations this pattern was true even in depth-for-depth comparisons. In other words, the NovaSeq can detect more DNA sequence diversity within samples than the MiSeq, even at the exact same sequencing depth. Even when samples were reanalyzed on the MiSeq with a sequencing depth of 1 million reads each, the MiSeq's ability to detect new sequences plateaued while the NovaSeq continued to detect new sequence variants. These results have important biological implications. The NovaSeq found 40% more metazoan families in this environment than the MiSeq, including some of interest such as marine mammals and bony fish so the real-world implications of these findings are significant. These results are most likely associated to the advances incorporated in the NovaSeq, especially a patterned flow cell, which prevents similar sequences that are neighbours on the flow cell (common in metabarcoding studies) from being erroneously merged into single spots by the sequencing instrument. This study sets the stage for incorporating eDNA metabarcoding in comprehensive analysis of oceanic samples in a wide range of ecological and environmental investigations.
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Affiliation(s)
- G A C Singer
- Centre for Environmental Genomics Applications, eDNAtec Inc., St. John's, NL, Canada
| | - N A Fahner
- Centre for Environmental Genomics Applications, eDNAtec Inc., St. John's, NL, Canada
| | - J G Barnes
- Centre for Environmental Genomics Applications, eDNAtec Inc., St. John's, NL, Canada
| | - A McCarthy
- Centre for Environmental Genomics Applications, eDNAtec Inc., St. John's, NL, Canada
| | - M Hajibabaei
- Centre for Environmental Genomics Applications, eDNAtec Inc., St. John's, NL, Canada.
- Centre for Biodiversity Genomics & Department of Integrative Biology, University of Guelph, Guelph, ON, Canada.
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Cronin C, Lucas M, McCarthy A, Boland F, Varadarajan R, Premnath N, Gillen P. Are we reaping what we sow? Gender diversity in surgery: a survey of medical students. Postgrad Med J 2019; 95:119-124. [DOI: 10.1136/postgradmedj-2018-136136] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/17/2019] [Accepted: 03/04/2019] [Indexed: 11/04/2022]
Abstract
BackgroundA survey of medical students from the Royal College of Surgeons in Ireland (RCSI) at Dublin, Perdana and Penang in Malaysia was undertaken in an attempt to explore attitudes towards a career in surgery and document potential differences between male and female students’ perceptions of a surgical career.MethodA hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.ResultsA total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.ConclusionAccording to our study, preference for a career in surgery declines with advancing years in medical school for both males and females. Medical students report high levels of feeling intimidated or ignored during their surgical placements, and enthusiasm for surgery reduces during medical school with exposure to this. These findings, along with the importance of role modelling, add further urgency to the need to address factors which make surgery less appealing to female medical graduates.
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McCarthy A, Cyr M, Fernet M, Hébert M. Maternal Emotional Support following the Disclosure of Child Sexual Abuse: A Qualitative Study. J Child Sex Abus 2019; 28:259-279. [PMID: 30388947 DOI: 10.1080/10538712.2018.1534919] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
Non-offending maternal (NOM) support is considered one of the most important protective factors in facilitating better victim adjustment following the disclosure of child sexual abuse (CSA). However, recent findings have led authors to conclude that NOM support has yet to be properly conceptualized and operationalized within the CSA literature. Emotional support is one dimension that has consistently emerged in studies attempting to reconceptualize NOM support but is a concept which also requires further theoretical investigation. Researchers interviewed 22 mothers of children aged 6-12 years about their experience and provision of emotional support following their child's disclosure of CSA. Data were analyzed using a method inspired by grounded theory. Mothers reported feeling initially overwhelmed and lost about how to emotionally support their child but described an improvement in their support capabilities following conjoint therapy. Furthermore, three overarching categories emerged outlining maternal emotional support strategies, each serving a specific emotional function: (a) elaborating, encouraged children to talk about their CSA experience; (b) soothing, attempted to comfort children's distress; and (c) orienting, attempted to guide children's recovery process. Authors discuss implications for offering improved and more rapid clinical services following the disclosure of CSA, and considerations for the operationalization of NOM emotional support.
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Affiliation(s)
- Andrea McCarthy
- a Department of Psychology , Université de Montréal , Montréal , Canada
| | - Mireille Cyr
- a Department of Psychology , Université de Montréal , Montréal , Canada
| | - Mylène Fernet
- b Department of Sexology , Université de Québec à Montréal , Montréal , Canada
| | - Martine Hébert
- b Department of Sexology , Université de Québec à Montréal , Montréal , Canada
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McCarthy A, Carson S, Ampaw P, Sarfo S, Geduld J. Severe malaria in Canada 2014-2017: report from the Canadian malaria network. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bélanger V, McCarthy A, Marcil V, Marchand V, Boctor DL, Rashid M, Noble A, Avinashi V, Davidson B, Groleau V, Spahis S, Levy E. Assessment of Malnutrition Risk in Canadian Pediatric Hospitals: A Multicenter Prospective Cohort Study. J Pediatr 2019; 205:160-167.e6. [PMID: 30529137 DOI: 10.1016/j.jpeds.2018.09.045] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/16/2018] [Accepted: 09/14/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the prevalence, causes, and consequences of malnutrition, as well as the evolution of nutritional status, in Canadian pediatric health care institutions. STUDY DESIGN In this multicenter prospective cohort study, a total of 371 patients were recruited from pediatric hospitals in 5 Canadian provinces. Subjects were aged 1 month to 18 years; admitted to a medical, surgical, or oncology ward; and had a planned hospital stay of >48 hours. Data on demographics, medical condition, anthropometric measures, and dietary intake were collected. The Screening Tool Risk on Nutritional Status and Growth (STRONGkids) and Subjective Global Nutritional Assessment (SGNA) were applied at admission. Malnutrition was defined as a weight-for-age, height-for-age, body mass index-for-age, or weight-for-length/height z score <-2 SD. RESULTS Among 307 subjects (median age, 5.3 years; median length of stay, 5 days), 19.5% were malnourished on admission. Both STRONGkids and SGNA classifications were associated with baseline nutritional status. Mean weight-for-age z score was lower at discharge compared with admission (-0.14 vs -0.09; P < .01), and nearly one-half of all patients lost weight during their hospital stay. Only one-half of the children who were malnourished or screened as high risk of malnutrition were visited by a dietitian during their stay. The percentage of patients who lost weight during hospitalization was significantly greater in the group not visited by a dietitian (76.5 vs 23.5%; P < .01). CONCLUSION Nutritional status deterioration and malnutrition are common in hospitalized Canadian children. Screening tools, anthropometric measurements, and dietitian consultation should be used to establish adequate nutritional support.
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Affiliation(s)
- Véronique Bélanger
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada; Department of Nutrition Université de Montréal, Montreal, Quebec, Canada
| | - Andrea McCarthy
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada; Department of Nutrition Université de Montréal, Montreal, Quebec, Canada
| | - Valérie Marcil
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada; Department of Nutrition Université de Montréal, Montreal, Quebec, Canada
| | - Valérie Marchand
- Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Dana L Boctor
- University of Calgary and Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Mohsin Rashid
- Dalhousie University and IWK Health Center, Halifax, Nova Scotia, Canada
| | - Angela Noble
- Kingston General Hospital Research Institute, Kingston, Ontario, Canada
| | - Vishal Avinashi
- Division of Gastroenterology, Hepatology, and Nutrition, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Véronique Groleau
- Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Schohraya Spahis
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada; Department of Nutrition Université de Montréal, Montreal, Quebec, Canada
| | - Emile Levy
- Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada; Department of Nutrition Université de Montréal, Montreal, Quebec, Canada.
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McCarthy A, Delvin E, Marcil V, Belanger V, Marchand V, Boctor D, Rashid M, Noble A, Davidson B, Groleau V, Spahis S, Roy C, Levy E. Prevalence of Malnutrition in Pediatric Hospitals in Developed and In-Transition Countries: The Impact of Hospital Practices. Nutrients 2019; 11:nu11020236. [PMID: 30678232 PMCID: PMC6412458 DOI: 10.3390/nu11020236] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/02/2019] [Accepted: 01/13/2019] [Indexed: 01/04/2023] Open
Abstract
Presently, undernutrition still goes undetected in pediatric hospitals despite its association with poor clinical outcomes and increased annual hospital costs, thus affecting both the patient and the health care system. The reported prevalence of undernutrition in pediatric patients seeking care or hospitalized varies considerably, ranging from 2.5 to 51%. This disparity is mostly due to the diversity of the origin of populations studied, methods used to detect and assess nutritional status, as well as the lack of consensus for defining pediatric undernutrition. The prevalence among inpatients is likely to be higher than that observed for the community at large, since malnourished children are likely to have a pre-existent disease or to develop medical complications. Meanwhile, growing evidence indicates that the nutritional status of sick children deteriorates during the course of hospitalization. Moreover, the absence of systematic nutritional screening in this environment may lead to an underestimation of this condition. The present review aims to critically discuss studies documenting the prevalence of malnutrition in pediatric hospitals in developed and in-transition countries and identifying hospital practices that may jeopardize the nutritional status of hospitalized children.
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Affiliation(s)
- Andrea McCarthy
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Nutrition, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Edgard Delvin
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Biochemistry, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Valerie Marcil
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Nutrition, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Veronique Belanger
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Nutrition, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Valerie Marchand
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Pediatrics, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Dana Boctor
- Pediatric Gastroenterology, Alberta Children's Hospital, University of Calgary, Calgary, AL T2N 1N4, Canada.
| | - Mohsin Rashid
- Dalhousie University and IWK Health Center, Halifax, NS B3H 1S6, Canada.
| | - Angela Noble
- Dalhousie University and IWK Health Center, Halifax, NS B3H 1S6, Canada.
| | | | - Veronique Groleau
- Departments of Pediatrics, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Schohraya Spahis
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Nutrition, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Claude Roy
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Pediatrics, University of Montreal, Montreal, QC H3C 3J7, Canada.
| | - Emile Levy
- Research Centre, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada.
- Departments of Nutrition, University of Montreal, Montreal, QC H3C 3J7, Canada.
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Chowdary P, Angchaisuksiri P, Dimsits J, Iorio A, Kavakli K, Lentz SR, Mahlangu J, McCarthy A, Kessler C. Haemophilia clinical care and research needs: Assessing priorities. Haemophilia 2018; 24:e270-e273. [PMID: 30004622 DOI: 10.1111/hae.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
- P Chowdary
- The Katherine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free Hospital, London, UK
| | - P Angchaisuksiri
- Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - A Iorio
- Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - K Kavakli
- Faculty of Medicine, Children's Hospital, Ege University, Izmir, Turkey
| | - S R Lentz
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - J Mahlangu
- Faculty of Health Science, University of the Witwatersrand, Johannesburg and NHLS, Johannesburg, South Africa
| | - A McCarthy
- The Katherine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free Hospital, London, UK
| | - C Kessler
- Georgetown University Medical Center, Washington, DC, USA
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D'Alton M, Coughlan T, Cogan N, Greene S, McCabe DJH, McCarthy A, Murphy S, Walsh R, O’Neill D, Kennelly S, Ryan D, Collins R. Patterns of mortality in modern stroke care. Ir Med J 2018; 111:750. [PMID: 30489045] [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: 06/09/2023]
Abstract
Background Stroke is a leading cause of death. We looked at the causes (direct and indirect) of in-hospital mortality in a modern stroke unit over a two-year period. Methods We reviewed medical charts of stroke deaths in hospital from 2014-2015 inclusive. Data on stroke type, aetiology, age, length of stay, comorbidities, and documented cause of death were recorded. All patients were included. Results 518 patients were admitted acutely to the stroke service. Overall death rate was 7.5% (n=39). Of fatal strokes 29 (74%) were ischaemic. Average age 78.6 years. Mean survival was 26.4 days (range 1-154). 19 (49%) patients had atrial fibrillation. Forty-nine percent of deaths were due to pneumonia, and 33% were due to raised intracranial pressure. Discussion Mortality rate in our stroke service has decreased from 15% in 1997, and now appears dichotomised into early Secondary Stroke Related Cerebral Events (SSRCEs) and later infections.
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Affiliation(s)
- M D'Alton
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - T Coughlan
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - N Cogan
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - S Greene
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - D J H McCabe
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - A McCarthy
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - S Murphy
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - R Walsh
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - D O’Neill
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - S Kennelly
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - D Ryan
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
| | - R Collins
- Age-Related Health Care/Stroke-Service, Tallaght Hospital
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S. loomis, McCarthy A, Gilmour G, Dijk DJ, Winksy-Sommerer R. Competing drives of hunger and sleep on performance in sleep-restricted rats. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cooper B, Mah D, Chen C, McCarthy A, Darwish H, Cahlon O, Tsai H, Chon B. Hypofractionated Proton Therapy for Early Stage Non–small Cell Lung Cancer: Clinical Outcomes and Comparative Dosimetric Analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shaikh F, Tam M, Perez C, Huppert N, Hitchen C, McCarthy A, Maisonet O, Formenti S, Gerber N. High Tangents in the Prone Position: A Pilot Report on Its Feasibility. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2338] [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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Lobet S, McCarthy A, Hermans C, Peerlinck K, Matricali GA, Staes F, Deschamps K. Biomechanical markers and theoretical concepts related to haemophilic ankle and subtalar joint arthropathy: introducing the term ‘haemophilic tarsal pan-arthropathy’. Haemophilia 2017; 23:e250-e258. [DOI: 10.1111/hae.13202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Affiliation(s)
- S. Lobet
- Secteur des Sciences de la Santé; Institut de Recherche Expérimentale et Clinique; Computer Assisted Robotic Surgery (CARS); Université catholique de Louvain; Brussels Belgium
- Cliniques universitaires Saint-Luc; Service d'hématologie; Brussels Belgium
- Cliniques universitaires Saint-Luc; Service de médecine physique et réadaptation; Brussels Belgium
| | - A. McCarthy
- Katharine Dormandy Haemophilia & Thrombosis Centre; Royal Free Hospital; London UK
| | - C. Hermans
- Cliniques universitaires Saint-Luc; Service d'hématologie; Brussels Belgium
| | - K. Peerlinck
- Centre for Molecular and Vascular Biology; KU Leuven; Leuven Belgium
| | - G. A. Matricali
- Department of Development & Regeneration; KU Leuven; Leuven Belgium
- Department of Orthopaedics; Foot & Ankle Unit; University Hospitals Leuven; KU Leuven; Leuven Belgium
- Institute of Orthopaedic Research & Training; KU Leuven; Leuven Belgium
| | - F. Staes
- Department of Rehabilitation Sciences; Musculoskeletal Rehabilitation Research Group; KU Leuven; Leuven Belgium
| | - K. Deschamps
- Department of Rehabilitation Sciences; Musculoskeletal Rehabilitation Research Group; KU Leuven; Leuven Belgium
- Department of Podiatry; Artevelde University College; Ghent Belgium
- Department of Podiatry; Parnasse-ISEI; Haute Ecole Leonard de Vinci; Bruxelles Belgium
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Franzon J, Berry N, Ullah S, Versace V, McCarthy A, Atherton J, Roder D, Koczwara B, Coghlan D, Clark R. Heart Failure Following Blood Cancer Therapy in Paediatric and Adult Populations. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.211] [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: 11/17/2022]
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Katz L, Shin S, McCarthy A, Schiff P. The Use of Stereotactic Body Radiation Therapy Treatment for Lung Cancer in the Primary and Salvage Settings: Defining a New Clinical Niche. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bacon S, Kyithar MP, Rizvi SR, Donnelly E, McCarthy A, Burke M, Colclough K, Ellard S, Byrne MM. Successful maintenance on sulphonylurea therapy and low diabetes complication rates in a HNF1A-MODY cohort. Diabet Med 2016; 33:976-84. [PMID: 26479152 DOI: 10.1111/dme.12992] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 02/06/2023]
Abstract
AIMS HNF1A gene mutations are the most common cause of maturity-onset diabetes of the young (MODY) in the UK. Persons with HNF1A-MODY display sensitivity to sulphonylurea therapy; however, the long-term efficacy is not established. There is limited literature as to the prevalence of micro- and macrovascular complications in this unique cohort. The aim of this study was to determine the natural progression and clinical management of HNF1A-MODY diabetes in a dedicated MODY clinic. METHODS Sixty patients with HNF1A-MODY and a cohort of 60 BMI-, age-, ethnicity- and diabetes duration-matched patients with Type 1 diabetes mellitus participated in the study. All patients were phenotyped in detail. Clinical follow-up of the HNF1A-MODY cohort occurred on a bi-annual basis. RESULTS Following a genetic diagnosis of MODY, the majority of the cohort treated with sulphonylurea therapy remained insulin independent at 84-month follow-up (80%). The HbA1c in the HNF1A-MODY group treated with sulphonylurea therapy alone improved significantly over the study period [from 49 (44-63) mmol/mol, 6.6 (6.2-7.9)% to 41 (31-50) mmol/mol, 5.9 (5-6.7)%; P = 0.003]. The rate of retinopathy was significantly lower than that noted in the Type 1 diabetes mellitus group (13.6 vs. 50%; P = 0.0001).There was also a lower rate of microalbuminuria and cardiovascular disease in the HNF1A-MODY group compared with the Type 1 diabetes mellitus group. CONCLUSIONS This study demonstrates that the majority of patients with HNF1A-MODY can be maintained successfully on sulphonylurea therapy with good glycaemic control. We note a significantly lower rate of micro- and macrovascular complications than reported previously. The use of appropriate therapy at early stages of the disorder may decrease the incidence of complications.
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Affiliation(s)
- S Bacon
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M P Kyithar
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - S R Rizvi
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - E Donnelly
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A McCarthy
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Burke
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Colclough
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
| | - S Ellard
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - M M Byrne
- Department of Diabetes & Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland
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Barbee D, McCarthy A, Galavis P, Xu A. SU-F-T-241: Reduction in Planning Errors Via a Process Control Developed Using the Eclipse Scripting API. Med Phys 2016. [DOI: 10.1118/1.4956381] [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: 11/07/2022] Open
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Lorenzo-Betancor O, Ogaki K, Soto-Ortolaza AI, Labbe C, Walton RL, Strongosky AJ, van Gerpen JA, Uitti RJ, McLean PJ, Springer W, Siuda J, Opala G, Krygowska-Wajs A, Barcikowska M, Czyzewski K, McCarthy A, Lynch T, Puschmann A, Rektorova I, Sanotsky Y, Vilariño-Güell C, Farrer MJ, Ferman TJ, Boeve BF, Petersen RC, Parisi JE, Graff-Radford NR, Dickson DW, Wszolek ZK, Ross OA. DNAJC13 p.Asn855Ser mutation screening in Parkinson's disease and pathologically confirmed Lewy body disease patients. Eur J Neurol 2016; 22:1323-5. [PMID: 26278106 DOI: 10.1111/ene.12770] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 12/22/2014] [Accepted: 04/06/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Recently, a novel mutation in exon 24 of DNAJC13 gene (p.Asn855Ser, rs387907571) has been reported to cause autosomal dominant Parkinson's disease (PD) in a multi-incident Mennonite family. METHODS In the present study the mutation containing exon of the DNAJC13 gene has been sequenced in a Caucasian series consisting of 1938 patients with clinical PD and 838 with pathologically diagnosed Lewy body disease (LBD). RESULTS Our sequence analysis did not identify any coding variants in exon 24 of DNAJC13. Two previously described variants in intron 23 (rs200204728 and rs2369796) were observed. CONCLUSION Our results indicate that the region surrounding the DNAJC13 p.Asn855Ser substitution is highly conserved and mutations in this exon are not a common cause of PD or LBD among Caucasian populations.
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Affiliation(s)
| | - K Ogaki
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - C Labbe
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - R L Walton
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - A J Strongosky
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - J A van Gerpen
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - R J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - P J McLean
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - W Springer
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - J Siuda
- Department of Neurology, Medical University of Silesia, Katowice, Poland
| | - G Opala
- Department of Neurology, Medical University of Silesia, Katowice, Poland
| | - A Krygowska-Wajs
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - M Barcikowska
- Department of Neurodegenerative Disorders, Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - K Czyzewski
- Department of Neurology, Central Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - A McCarthy
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - T Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - A Puschmann
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - I Rektorova
- School of Medicine, Central European Institute of Technology and First Department of Neurology, Masaryk University, Brno, Czech Republic
| | - Y Sanotsky
- Lviv Regional Clinical Hospital, Lviv, Ukraine
| | - C Vilariño-Güell
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - M J Farrer
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - T J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - B F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - R C Petersen
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J E Parisi
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - D W Dickson
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA.,Department of Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Z K Wszolek
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - O A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
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Bettinger JA, Rouleau I, Gariépy MC, Bowie WR, Valiquette L, Vanderkooi OG, Kellner JD, Coleman BL, McNeil SA, McCarthy A, De Serres G. Successful methodology for large-scale surveillance of severe events following influenza vaccination in Canada, 2011 and 2012. Euro Surveill 2015; 20:21189. [DOI: 10.2807/1560-7917.es2015.20.29.21189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - I Rouleau
- Centre de Recherche du CHU de Québec, Laval University, Canada
| | - M C Gariépy
- Centre de Recherche du CHU de Québec, Laval University, Canada
| | - W R Bowie
- Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - L Valiquette
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - O G Vanderkooi
- Alberta Children’s Hospital, University of Calgary, Calgary, Alberta, Canada
| | - J D Kellner
- Alberta Children’s Hospital, University of Calgary, Calgary, Alberta, Canada
| | - B L Coleman
- Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - S A McNeil
- Canadian Center for Vaccinology, IWK Health Centre, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada
| | - A McCarthy
- Ottawa Hospital, Ottawa, Ontario, Canada
| | - G De Serres
- Centre de Recherche du CHU de Québec, Laval University, Canada
- Institut National de Santé Publique du Quebec, Quebec City, Quebec, Canada
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Abstract
BACKGROUND Meningococcal meningitis occurs globally and the predominant serogroups vary by geographic region. Vaccines against serogroups A, B, C, Y and W-135 are available in Canada. OBJECTIVE To provide guidance to health care professionals for the prevention of invasive meningococcal disease in international travellers from Canada. METHODS This Statement was developed by the Committee to Advise on Tropical Medicine and Travel (CATMAT) to compliment the Canadian Immunization Guide. It considers the need for protection and the potential for adverse effects of vaccination. RESULTS Meningococcal vaccine recommendations vary by traveller characteristics and travel destination. Meningococcal meningitis occurs globally and the predominant serogroup varies by geographic region. Areas of particular risk are the "meningitis belt" in Sub-Saharan Africa, Saudi Arabia during the Hajj and Umrah pilgrimages and places with current epidemics or heightened disease activity. For healthy travellers see the Canadian Immunization Guide. Quadrivalent vaccine should be given to individuals at increased risk for invasive meningococcal disease due to medical conditions with booster doses every five years. Meningococcal B vaccine should be considered. CONCLUSION Vaccination is the most effective measure for preventing invasive meningococcal disease. The Government of Canada's travel health notices identify areas of new and recent meningococcal activity and are updated regularly.
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Affiliation(s)
- A McCarthy
- The Ottawa Hospital General Campus, Ottawa, Ontario
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Muscatiello N, McCarthy A, Kielb C, Hsu WH, Hwang SA, Lin S. Classroom conditions and CO2 concentrations and teacher health symptom reporting in 10 New York State Schools. Indoor Air 2015; 25:157-167. [PMID: 24920413 DOI: 10.1111/ina.12136] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 05/24/2014] [Indexed: 06/03/2023]
Abstract
This study assessed the relationship between teacher-reported symptoms and classroom carbon dioxide (CO2 ) concentrations. Previous studies have suggested that poor indoor ventilation can result in higher levels of indoor pollutants, which may affect student and teacher health. Ten schools (9 elementary, 1 combined middle/high school) in eight New York State school districts were visited over a 4-month period in 2010. Carbon dioxide concentrations were measured in classrooms over 48-h, and teachers completed surveys assessing demographic information and self-reported symptoms experienced during the current school year. Data from 64 classrooms (ranging from 1 to 9 per school) were linked with 68 teacher surveys (for four classrooms, two surveys were returned). Overall, approximately 20% of the measured classroom CO2 concentrations were above 1000 parts per million (ppm), ranging from 352 to 1591 ppm. In multivariate analyses, the odds of reporting neuro-physiologic (i.e., headache, fatigue, difficulty concentrating) symptoms among teachers significantly increased (OR = 1.30, 95% CI = 1.02-1.64) for every 100 ppm increase in maximum classroom CO2 concentrations and were non-significantly increased in classrooms with above-median proportions of CO2 concentrations greater than 1000 ppm (OR = 2.26, 95% CI = 0.72-7.12).
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Affiliation(s)
- N Muscatiello
- New York State Department of Health Empire State Plaza, Center for Environmental Health, Albany, NY, USA
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Marx W, Ried K, Sali A, Vitetta L, McKavanagh D, McCarthy A, Isenring E. Ginger – Mechanism of action in chemotherapy-induced nausea and vomiting: A review. Journal of Nutrition & Intermediary Metabolism 2014. [DOI: 10.1016/j.jnim.2014.10.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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McCarthy A, Mohan S, Saeed A, Kumaran M. Mediastinal lymphadenopathy, a review of nodal anatomy, pathology and sampling techniques. Imaging 2014. [DOI: 10.1259/img.20120003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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McCarthy A, Moore A, Redhead L, McLaughlin P, Iorio A, Chowdary P. Development of haemophilic arthropathy of the ankle: results of a Delphi consensus survey on potential contributory factors. Haemophilia 2014; 21:116-23. [DOI: 10.1111/hae.12500] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2014] [Indexed: 12/26/2022]
Affiliation(s)
- A. McCarthy
- The Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free London NHS Foundation Trust; London UK
| | - A. Moore
- Centre for Health Research; University of Brighton; Eastbourne UK
| | - L. Redhead
- School of Health Professions; University of Brighton; Eastbourne UK
| | - P. McLaughlin
- The Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free London NHS Foundation Trust; London UK
| | - A. Iorio
- Clinical Epidemiology and Biostatistics Department, and Hamilton-Niagara Hemophilia Program; McMaster University; Hamilton ON Canada
- Department of Medicine; McMaster University; Hamilton ON Canada
| | - P. Chowdary
- The Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free London NHS Foundation Trust; London UK
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Wilsey J, LaParl M, Casale R, Adamczyk L, McCarthy A, Legnard T, Whiting A, Williams M, Wickham C. Sleep Apnea: A Wake Up Call…For Nurses. J Perianesth Nurs 2014. [DOI: 10.1016/j.jopan.2014.08.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Boggild AK, Geduld J, Libman M, Ward BJ, McCarthy A, Hajek J, Ghesquiere W, Vincelette J, Kuhn S, Freedman DO, Kain KC. Travel-acquired infections in Canada: CanTravNet 2011-2012. Can Commun Dis Rep 2014; 40:313-325. [PMID: 29769859 PMCID: PMC5864452 DOI: 10.14745/ccdr.v40i16a01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Important gaps remain in our knowledge of the infectious diseases people acquire while travelling and the impact of pathogens imported by Canadian travellers. OBJECTIVE To provide a surveillance update of illness in a cohort of returned Canadian travellers and new immigrants. METHODS Data on returning Canadian travellers and new immigrants presenting to a CanTravNet site between September 2011 and September 2012 were extracted and analyzed by destination, presenting symptoms, common and emerging infectious diseases and disease severity. RESULTS During the study period, 2283 travellers and immigrants presented to a CanTravNet site, 88% (N=2004) of whom were assigned a travel-related diagnosis. Top three destinations for non-immigrant travellers were India (N=132), Mexico (N=103) and Cuba (N=89). Fifty-one cases of malaria were imported by ill returned travellers during the study period, 60% (N=30) of which were Plasmodium falciparum infections. Individuals travelling to visit friends and relatives accounted for 83% of enteric fever cases (15/18) and 41% of malaria cases (21/51). The requirement for inpatient management was over-represented among those with malaria compared to those without malaria (25% versus 2.8%; p<0.0001) and those travelling to visit friends and relatives versus those travelling for other reasons (12.1% versus 2.4%; p<0.0001). Nine new cases of HIV were diagnosed among the cohort, as well as one case of acute hepatitis B. Emerging infections among travellers included hepatitis E virus (N=6), chikungunya fever (N=4) and cutaneous leishmaniasis (N=16). Common chief complaints included gastrointestinal (N=804), dermatologic (N=440) and fever (N=287). Common specific causes of chief complaint of fever in the cohort were malaria (N=47/51 total cases), dengue fever (14/18 total cases), enteric fever (14/17 total cases) and influenza and influenza-like illness (15/21 total cases). Animal bites were the tenth most common diagnosis among tourist travellers. INTERPRETATION Our analysis of surveillance data on ill returned Canadian travellers provides a recent update to the spectrum of imported illness among travelling Canadians. Preventable travel-acquired illnesses and injuries in the cohort include malaria, enteric fever, HIV, hepatitis B, hepatitis A, influenza and animal bites. Strategies to improve uptake of preventive interventions such as malaria chemoprophylaxis, immunizations and arthropod/animal avoidance may be warranted.
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Affiliation(s)
- AK Boggild
- Tropical Disease Unit, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON
- Public Health Ontario Laboratories, Public Health Ontario, Toronto, ON
| | - J Geduld
- Travel and Migration Health Division, Public Health Agency of Canada, Ottawa, ON
| | - M Libman
- Division of Infectious Diseases, McGill University Health Centre, Montreal, QC
| | - BJ Ward
- Division of Infectious Diseases, McGill University Health Centre, Montreal, QC
| | - A McCarthy
- Tropical Medicine and International Health Clinic, Ottawa Hospital and the University of Ottawa, Ottawa, ON
| | - J Hajek
- Division of Infectious Diseases, Vancouver General Hospital and University of British Columbia, Vancouver, BC
| | - W Ghesquiere
- Infectious Diseases, Vancouver Island Health Authority and University of British Columbia, Victoria, BC
| | - J Vincelette
- Hôpital Saint-Luc du CHUM and Université de Montréal, Montréal, QC
| | - S Kuhn
- Division of Pediatric Infectious Diseases, Alberta Children’s Hospital and the University of Calgary, Calgary, AB
| | - DO Freedman
- Gorgas Center for Geographic Medicine, University of Alabama Birmingham, Birmingham, AL
| | - KC Kain
- Tropical Disease Unit, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON
- SAR Laboratories, Sandra Rotman Centre for Global Health, Toronto, ON
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