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Schrobilgen A, Lo A, Chandani B, Foss M, Vesely N, Dunn C, Aneja S, Solomon J. 319 The utilization of 3-dimensional imaging to establish a standardized acne severity scale. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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McKenzie J, Kosmider S, Wong R, To Y, Shapiro J, Dunn C, Burge M, Hong W, Caird S, Lim S, Wong H, Lee B, Gibbs P, Wong V. P-187 Epidermal growth factor receptor inhibitors (EGFRi) in patients with left-side, RAS wildtype metastatic colorectal cancer: Clinician use and outcomes for patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.277] [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] Open
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Jalali A, Gard G, Banks S, Dunn C, Wong HL, Wong R, Lee M, Gately L, Loft M, Shapiro JD, Kosmider S, Tie J, Ananda S, Yeung JM, Jennens R, Lee B, McKendrick J, Lim L, Khattak A, Gibbs P. Initial experience of TAS-102 chemotherapy in Australian patients with Chemo-refractory metastatic colorectal cancer. Curr Probl Cancer 2021; 46:100793. [PMID: 34565601 DOI: 10.1016/j.currproblcancer.2021.100793] [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] [Received: 05/06/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
For patients with refractory metastatic colorectal cancer (mCRC) treatment with Trifluridine/Tipiracil, also known as TAS-102, improves overall survival. This study aims to investigate the efficacy and safety of TAS-102 in a real-world population from Victoria, Australia. A retrospective analysis of prospectively collected data from the Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) registry was undertaken. The characteristics and outcomes of patients receiving TAS-102 were assessed and compared to those enrolled in the registration study (RECOURSE). Across 13 sites, 107 patients were treated with TAS-102. The median age was 60 years (range: 31-83), compared to 63 for RECOURSE. Comparing registry TAS-102-treated and RECOURSE patients, 75% vs 100% were ECOG performance status 0-1, 74% vs 79% had initiated treatment more than 18 months from diagnosis of metastatic disease and 36% vs 49% were RAS wild-type. Median time on treatment was 10.4 weeks (range: 1.7-32). Median progression-free survival (PFS) was 3.3 months compared to 2 months in RECOURSE, while median overall survival was the same at 7.1 months. Two patients (2.3%) had febrile neutropenia and there were no treatment-related deaths, where TAS-102 dose at treatment initiation was at clinician discretion.TRACC registry patients treated with TAS-102 were younger than those from the RECOURSE trial, with similar overall survival observed. Less strict application of RECIST criteria and less frequent imaging may have contributed to an apparently longer PFS.
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Affiliation(s)
- A Jalali
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Latrobe Regional Hospital, VIC, Australia.
| | - G Gard
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - S Banks
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - C Dunn
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - H L Wong
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia
| | - R Wong
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Eastern Health, VIC, Australia; Eastern Health Clinical School, Monash University, VIC, Australia
| | - M Lee
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Eastern Health, VIC, Australia; Eastern Health Clinical School, Monash University, VIC, Australia
| | - L Gately
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - M Loft
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - J D Shapiro
- Department of Medical Oncology, Cabrini Hospital, VIC, Australia
| | - S Kosmider
- Department of Medical Oncology, Western Health, VIC, Australia
| | - J Tie
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia
| | - S Ananda
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia; Department of Medical Oncology, Epworth Health, VIC, Australia
| | - J M Yeung
- Department of Surgery, Western Health, University of Melbourne, VIC, Australia; Western Health Chronic Disease Alliance, Western Health, VIC, Australia
| | - R Jennens
- Department of Medical Oncology, Epworth Health, VIC, Australia
| | - B Lee
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia; Department of Medical Oncology, Northern Health, VIC, Australia
| | - J McKendrick
- Department of Medical Oncology, Eastern Health, VIC, Australia; Department of Medical Oncology, Epworth Health, VIC, Australia
| | - L Lim
- Department of Medical Oncology, Eastern Health, VIC, Australia
| | - A Khattak
- Department of Medical Oncology, Fiona Stanley Hospital, WA, Australia
| | - P Gibbs
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia
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Dunn C, Wong N, Griffin Y, White H, Wiselka M. Image challenge: A complex PUO. Clinical Infection in Practice 2020. [DOI: 10.1016/j.clinpr.2020.100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Pyper K, Brouwers J, Augustijns P, Khadra I, Dunn C, Wilson CG, Halbert GW. Multidimensional analysis of human intestinal fluid composition. Eur J Pharm Biopharm 2020; 153:226-240. [PMID: 32585351 DOI: 10.1016/j.ejpb.2020.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/14/2022]
Abstract
The oral administration of solid dosage forms is the commonest method to achieve systemic therapy and relies on the drug's solubility in human intestinal fluid (HIF), a key factor that influences bioavailability and biopharmaceutical classification. However, HIF is difficult to obtain and is known to be variable, which has led to the development of a range of simulated intestinal fluid (SIF) systems to determine drug solubility in vitro. In this study we have applied a novel multidimensional approach to analyse and characterise HIF composition using a published data set in both fasted and fed states with a view to refining the existing SIF approaches. The data set provided 152 and 172 measurements of five variables (total bile salt, phospholipid, total free fatty acid, cholesterol and pH) in time-dependent HIF samples from 20 volunteers in the fasted and fed state, respectively. The variable data sets for both fasted state and fed state are complex, do not follow normal distributions but the amphiphilic variable concentrations are correlated. When plotted 2-dimensionally a generally ellipsoid shaped data cloud with a positive slope is revealed with boundaries that enclose published fasted or fed HIF compositions. The data cloud also encloses the majority of fasted state and fed state SIF recipes and illustrates that the structured nature of design of experiment (DoE) approaches does not optimally cover the variable space and may examine media compositions that are not biorelevant. A principal component analysis in either fasted or fed state in combination with fitting an ellipsoid shape to enclose the data results in 8 points that capture over 95% of the compositional variability of HIF. The variable's average rate of concentration change in both fasted state and fed state over a short time scale (10 min) is zero and a Euclidean analysis highlights differences between the fasted and fed states and among individual volunteers. The results indicate that a 9-point DoE (8 + 1 central point) could be applied to investigate drug solubility in vitro and provide statistical solubility limits. In addition, a single point could provide a worst-case solubility measurement to define the lowest biopharmaceutical classification boundary or for use during drug development. This study has provided a novel description of HIF composition. The approach could be expanded in multiple ways by incorporation of further data sets to improve the statistical coverage or to cover specific patient groups (e.g., paediatric). Further development might also be possible to analyse information on the time dependent behaviour of HIF and to guide HIF sampling and analysis protocols.
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Affiliation(s)
- Kate Pyper
- Department of Mathematics and Statistics, University of Strathclyde, Livingstone Tower, 26 Richmond Street, Glasgow G1 1XH, United Kingdom
| | - Joachim Brouwers
- Drug Delivery and Disposition, KU Leuven, ON2, Herestraat 49 Box 921, 3000 Leuven, Belgium
| | - Patrick Augustijns
- Drug Delivery and Disposition, KU Leuven, ON2, Herestraat 49 Box 921, 3000 Leuven, Belgium
| | - I Khadra
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom
| | - C Dunn
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom
| | - C G Wilson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom
| | - G W Halbert
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom.
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Bonavina L, Boyle N, Dunn C, Horbach T, Knowles TB, Lipham JC, Louie BE, Markar S, Schppmann SF, Zehetner J. Comment on: Systematic review of the introduction and evaluation of magnetic augmentation of the lower oesophageal sphincter for gastro-oesophageal reflux disease. Br J Surg 2020; 107:e209. [PMID: 32320049 DOI: 10.1002/bjs.11567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/03/2020] [Indexed: 01/08/2023]
Affiliation(s)
- L Bonavina
- Deaprtment of Surgery, University of Milan Medical School, Milan, Italy
| | - N Boyle
- London Reflux Centre, Lister Hospital, London, UK
| | - C Dunn
- Division of Upper GI and General Surgery, Department of Surgery, Keck Medical Center of USC, University of Southern California, Los Angeles, California, USA
| | - T Horbach
- General and Abdominal Surgery, Schoen Clinic, Nürnberg Fürth, Germany
| | - T B Knowles
- Swedish Digestive Health Institute, Division of Thoracic Surgery, Swedish Medical Center, Seattle, Washington, USA
| | - J C Lipham
- Division of Upper GI and General Surgery, Department of Surgery, Keck Medical Center of USC, University of Southern California, Los Angeles, California, USA
| | - B E Louie
- London Reflux Centre, Lister Hospital, London, UK
| | - S Markar
- Department of Surgery and Cancer, Imperial College, London, UK
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Dunn C, Moore L. GENETIC TESTING IDENTIFIES CAUSE OF ENTEROPATHY AND GROWTH FAILURE IN A 10 YEAR OLD MALE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.312] [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: 11/25/2022]
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Sheele J, Crandall C, Arko B, Vallabhaneni M, Dunn C, Chang B, Fann P, Bigach M. 183 Accuracy of the OSOM Trichomonas Test Compared with the APTIMA Trichomonas Vaginalis Assay for Diagnosing T. Vaginalis in Men in the Emergency Department. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.188] [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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Al-Abdwani R, Williams CB, Dunn C, Macartney J, Wollny K, Frndova H, Chin N, Stephens D, Parshuram CS. Incidence, outcomes and outcome prediction of unplanned extubation in critically ill children: An 11year experience. J Crit Care 2017; 44:368-375. [PMID: 29289914 DOI: 10.1016/j.jcrc.2017.12.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 11/06/2017] [Accepted: 12/22/2017] [Indexed: 12/27/2022]
Abstract
PURPOSE Unplanned extubation represents loss of control in the ICU, is associated with harm and is used as a measure of quality of care. We evaluated the rates and consequences of unplanned extubation. MATERIALS AND METHODS Eligible patients were intubated, <18years, and in ICU. Patient, care-related and environmental characteristics were compared in patients who did and did not receive positive pressure ventilation in the 24h after events. Rates are expressed per 100 intubation-days. RESULTS The 11,310 eligible patient-admissions identified were intubated for 75,519days; 410 (3.39%) patients had 458 unplanned extubation events (0.61 events/100 intubation-days). Annual rates of unplanned extubation reduced from 0.98 in 2004 to 0.37 in 2014. Consequences occurred in 245 (53.5%) events and included cardiac arrest in 9 (2%), bradycardia 52 (11%), and stridor 63 (14%). Positive pressure was provided after 263 (57%) events, and was independently associated with pre-event sedative and muscle relaxant drugs, non-use of restraints, respiratory reason for intubation and recent care by more nurses. CONCLUSION Unplanned extubation was associated with both significant and no morbidity. Modification of factors including more consistent nurse staffing, restraint use, and increased vigilance in patients with previous events may potentially reduce rates and adverse consequences of unplanned extubation.
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Affiliation(s)
- R Al-Abdwani
- Centre for Safety Research, Department of Critical Care Medicine, Hospital for Sick Children, Canada
| | - C B Williams
- Centre for Safety Research, Department of Critical Care Medicine, Hospital for Sick Children, Canada
| | - C Dunn
- Critical Care Program, Hospital for Sick Children, Canada
| | - J Macartney
- Critical Care Program, Hospital for Sick Children, Canada
| | - K Wollny
- Critical Care Program, Hospital for Sick Children, Canada
| | - H Frndova
- Centre for Safety Research, Critical Care Program, Hospital for Sick Children, Canada
| | - N Chin
- Critical Care Program, Informatics, Hospital for Sick Children, Canada
| | - D Stephens
- Child Health and Evaluation Sciences Program, The Research Institute, Hospital for Sick Children, Canada
| | - C S Parshuram
- Department of Critical Care Medicine, Department of Paediatrics, Child Health and Evaluation Sciences Program, The Research Institute, Centre for Safety Research Hospital for Sick Children, Canada; Department of Pediatrics, Interdepartmental Division of Critical Care Medicine, Department of Health Policy Management and Evaluation, University of Toronto, Canada.
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Scholz C, Jones TG, West M, Ehbair AMS, Dunn C, Freeman C. Constructed wetlands may lower inorganic nutrient inputs but enhance DOC loadings into a drinking water reservoir in North Wales. Environ Sci Pollut Res Int 2016; 23:18192-18199. [PMID: 27263105 DOI: 10.1007/s11356-016-6991-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 05/26/2016] [Indexed: 06/05/2023]
Abstract
The objective of this study was to monitor a newly constructed wetland (CW) in north Wales, UK, to assess whether it contributes to an improvement in water quality (nutrient removal) of a nearby drinking water reservoir. Inflow and outflow of the Free Water Surface (FWS) CW were monitored on a weekly basis and over a period of 6 months. Physicochemical parameters including pH, conductivity and dissolved oxygen (DO) were measured, as well as nutrients and dissolved organic and inorganic carbon (DOC, DIC) concentration. The CW was seen to contribute to water quality improvement; results show that nutrient removal took place within weeks after construction. It was found that 72 % of initial nitrate (N03 (-)), 53 % of initial phosphate (PO4 (3-)) and 35 % of initial biological oxygen demand (BOD) were removed, calculated as a total over the whole sampling period. From our study, it can be concluded that while inorganic nutrients do decline in CWs, the DOC outputs increases. This may suggest that CWs represent a source for DOC. To assess the carbon in- and output a C budget was calculated.
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Affiliation(s)
- C Scholz
- Department of Hydrogeology, Free University of Berlin, 12249, Berlin, Germany.
| | - T G Jones
- School of Biological Sciences, Bangor University, Gwynedd, LL57 2UW, Wales, UK
| | - M West
- School of Biological Sciences, Bangor University, Gwynedd, LL57 2UW, Wales, UK
| | - A M S Ehbair
- School of Biological Sciences, Bangor University, Gwynedd, LL57 2UW, Wales, UK
| | - C Dunn
- School of Biological Sciences, Bangor University, Gwynedd, LL57 2UW, Wales, UK.
| | - C Freeman
- School of Biological Sciences, Bangor University, Gwynedd, LL57 2UW, Wales, UK
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Conrad C, Lymp J, Thompson V, Dunn C, Davies Z, Chatfield B, Nichols D, Clancy J, Vender R, Egan ME, Quittell L, Michelson P, Antony V, Spahr J, Rubenstein RC, Moss RB, Herzenberg LA, Goss CH, Tirouvanziam R. Long-term treatment with oral N-acetylcysteine: affects lung function but not sputum inflammation in cystic fibrosis subjects. A phase II randomized placebo-controlled trial. J Cyst Fibros 2014; 14:219-27. [PMID: 25228446 DOI: 10.1016/j.jcf.2014.08.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/12/2014] [Accepted: 08/24/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the effects of oral N-acetylcysteine (NAC), which replenishes systemic glutathione, on decreasing inflammation and improving lung function in CF airways. METHODS A multicenter, randomized, double-blind proof of concept study in which 70 CF subjects received NAC or placebo orally thrice daily for 24 weeks. ENDPOINTS primary, change in sputum human neutrophil elastase (HNE) activity; secondary, FEV(1) and other clinical lung function measures; and safety, the safety and tolerability of NAC and the potential of NAC to promote pulmonary hypertension in subjects with CF. RESULTS Lung function (FEV(1) and FEF(25-75%)) remained stable or increased slightly in the NAC group but decreased in the placebo group (p=0.02 and 0.02). Log(10) HNE activity remained equal between cohorts (difference 0.21, 95% CI -0.07 to 0.48, p=0.14). CONCLUSIONS NAC recipients maintained their lung function while placebo recipients declined (24 week FEV1 treatment effect=150 mL, p<0.02). However no effect on HNE activity and other selected biomarkers of neutrophilic inflammation were detected. Further studies on mechanism and clinical outcomes are warranted.
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Affiliation(s)
- C Conrad
- Lucile Packard Children's Hospital, Center of Excellence in Pulmonary Biology, 770 Welch Rd., #350, Stanford University, Palo Alto, CA 94304, United States
| | - J Lymp
- CFFT Therapeutics Development Network Coordinating Center, Seattle, WA. 2001 8th Avenue, Seattle, WA 98121, United States
| | - V Thompson
- CFFT Therapeutics Development Network Coordinating Center, Seattle, WA. 2001 8th Avenue, Seattle, WA 98121, United States
| | - C Dunn
- Lucile Packard Children's Hospital, Center of Excellence in Pulmonary Biology, 770 Welch Rd., #350, Stanford University, Palo Alto, CA 94304, United States
| | - Z Davies
- Lucile Packard Children's Hospital, Center of Excellence in Pulmonary Biology, 770 Welch Rd., #350, Stanford University, Palo Alto, CA 94304, United States
| | - B Chatfield
- University of Utah Pediatric Pulmonology, 100N. Mario Capecchi Dr., Salt Lake City, UT 84113, United States
| | - D Nichols
- National Jewish Health, 1400 Jackson St., Adult CF Center, Denver, CO 80206, United States
| | - J Clancy
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Pulmonary Medicine, OSB 5, Cincinnati, OH 45229, United States
| | - R Vender
- Pennsylvania State University/Milton S. Hershey Medical Center, PO Box 850, Hershey, PA 17033, United States
| | - M E Egan
- Yale University School of Medicine, Yale University School of Medicine, 333 Cedar St., Rm. FMP 526, New Haven, CT 06520, United States
| | - L Quittell
- Morgan Stanley Children's Hospital of New York, Division of Pediatric Pulmonology, Columbia University Medical Center, 3959 Broadway CHC 7-701, New York, NY 10032, United States
| | - P Michelson
- St. Louis Children's Hospital, 660 Euclid Ave., CF Center, 10th Floor NW Tower, St. Louis, MO 63110, United States
| | - V Antony
- University of Alabama at Birmingham, 422 Tinsley Harrison Tower, 1900 University Blvd, Birmingham, AL 35294-0006, United States
| | - J Spahr
- Children's Hospital of Pittsburgh of UPMC, 4221 Penn Avenue, AOB Suite 3300, Pittsburgh, PA 15224, United States
| | - R C Rubenstein
- The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Abramson Research Center, Room 410A, Philadelphia, PA 19104, United States
| | - R B Moss
- Lucile Packard Children's Hospital, Center of Excellence in Pulmonary Biology, 770 Welch Rd., #350, Stanford University, Palo Alto, CA 94304, United States
| | - L A Herzenberg
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305-5318, United States
| | - C H Goss
- CFFT Therapeutics Development Network Coordinating Center, Seattle, WA. 2001 8th Avenue, Seattle, WA 98121, United States
| | - R Tirouvanziam
- Emory+Children's Center for CF and Airways Disease Research, 2015 Uppergate Dr., Rm. 344, Emory University School of Medicine, Atlanta, GA 30322, United States
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Maas JC, Dallmeijer AJ, Huijing PA, Brunstrom-Hernandez JE, van Kampen PJ, Bolster EAM, Dunn C, Herndon K, Jaspers RT, Becher JG. A randomized controlled trial studying efficacy and tolerance of a knee-ankle-foot orthosis used to prevent equinus in children with spastic cerebral palsy. Clin Rehabil 2014; 28:1025-38. [DOI: 10.1177/0269215514542355] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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]
Abstract
Objective: To examine whether using a knee-ankle-foot orthosis helps maintain ankle-foot dorsiflexion range of motion over time. Design: A multicentre randomized controlled trial. Setting: Two hospitals and one rehabilitation centre in the Netherlands and the USA. Subjects: Children (4-16 years old) with spastic cerebral palsy who were able to walk. Intervention: Use of a knee-ankle-foot orthosis, equipped with an Ultraflex® ankle power unit, for at least 6 hours every other night for one year. Main measures: Primary outcome measure: ankle-foot dorsiflexion range of motion. Secondary outcome measures: ankle-foot and knee angle in gait and gross motor function. Wearing time was also measured. Measurements were taken at baseline and at 3, 6, 9 and 12 months. Results: 28 children (experimental group: n=15, control group: n=13) participated in the study. 11 participants (experimental: n=4, control: n=7) did not complete all five measurements, as they needed additional treatment. No significant difference was found in the decrease of ankle-foot dorsiflexion range of motion between the experimental and control groups (difference: −1.05°, 95% confidence interval: −4.71° – 2.61°). In addition, secondary outcome measures did not show differences between groups. Despite good motivation, knee-ankle-foot orthosis wearing time was limited to a mean±SD of 3.2±1.9 hours per prescribed night due to discomfort. Conclusions: Knee-ankle-foot orthosis with dynamic ankle and fixed knee are poorly tolerated and are not beneficial in preventing a reduction in ankle-foot dorsiflexion range of motion in children with spastic cerebral palsy, at least with limited use.
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Affiliation(s)
- JC Maas
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands
| | - AJ Dallmeijer
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands
| | - PA Huijing
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, the Netherlands
| | - JE Brunstrom-Hernandez
- Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, USA
| | - PJ van Kampen
- Medical Rehabilitation Center Groot Klimmendaal, the Netherlands
| | - EAM Bolster
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands
| | - C Dunn
- Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, USA
| | - K Herndon
- Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis Children’s Hospital, St. Louis, USA
| | - RT Jaspers
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, the Netherlands
| | - JG Becher
- Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands
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Dunn C, Davies Z, Kim L, Zirbes J, Everson C, Milla C. 215 Comparison of acute effects of conventional high frequency chest oscillation (HFCWO) and hand held percussor (Electro-Flo 5000) for airway clearance in cystic fibrosis patients. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60356-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Moss R, Waters J, Dunn C, Davies Z, Everson C, Tirouvanziam R, Tameresis J, Herzenberg L, Gernez Y. WS22.1 Basophil activation is a reliable biomarker of allergic bronchopulmonary aspergillosis (ABPA) in CF: Interim results of a longitudinal cohort study. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60138-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Duggal MS, Abudiak H, Dunn C, Tong HJ, Munyombwe T. Effect of CD4+ lymphocyte count, viral load, and duration of taking antiretroviral treatment on presence of oral lesions in a sample of South African children with HIV+/AIDS. Eur Arch Paediatr Dent 2012; 11:242-6. [DOI: 10.1007/bf03262755] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gernez Y, Everson C, Mitsunaga E, Dunn C, Herzenberg L, Tirouvanziam R, Moss R. Specific Induction Of CD203c Expression In Blood Basophils Discriminates Between CF patients With Aspergillus Colonization And Those With CF-ABPA. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.466] [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: 10/14/2022]
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Harris N, Briley A, Collier D, Dunn C, Crawford Y, Henes S, Kinner S, Kolasa K, Lutes L, Scripture L. “Take off 4-Health”: Innovative Strategies to Improve Wellness in Adolescents. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.jada.2010.06.337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mee T, Whatmough P, Broad L, Dunn C, Maslanyj M, Allen S, Muir K, McKinney PA, van Tongeren M. Occupational exposure of UK adults to extremely low frequency magnetic fields. Occup Environ Med 2009; 66:619-27. [DOI: 10.1136/oem.2008.040329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Allegrini F, Ebert RW, Alquiza J, Broiles T, Dunn C, McComas DJ, Silva I, Valek P, Westlake J. A mass analysis technique using coincidence measurements from the Interstellar Boundary Explorer-Hi (approximately 0.3- approximately 6 keV) detector. Rev Sci Instrum 2008; 79:096107. [PMID: 19044461 DOI: 10.1063/1.2987691] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
NASA's Interstellar Boundary Explorer (IBEX) mission, scheduled to launch in October 2008, will make the first observations of charge exchange energetic neutral atoms (ENAs) produced near the edge of the heliosphere. IBEX will measure these ENAs with two ultra-high sensitivity, single-pixel ENA sensors in the energy range of approximately 0.01- approximately 2 keV (IBEX-Lo) and approximately 0.3- approximately 6 keV (IBEX-Hi), respectively. The primary purpose of IBEX is to measure hydrogen ENAs from the outer heliosphere, but it will also be sensitive to heavier species of ENAs produced anywhere throughout the solar system. For this study, we measured the coincidence response of the IBEX-Hi detector section to H, He, N, and O ions. Based on these results, we have developed an innovative technique in estimating the hydrogen to heavy ion ratio in the signal. This new technique can be applied more widely than the IBEX-Hi detector section, and the basic principle may be useful for other, future space and ground-based measurements.
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Affiliation(s)
- F Allegrini
- Space Science and Engineering Division, Southwest Research Institute, San Antonio, Texas 78238, USA
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21
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Dunn C, Garton L, Lynch K. 7. THE CHLAMYDIA PROJECT IMPROVING KNOWLEDGE OF, AND TESTING RATES FOR CHLAMYDIA AMONG YOUNG PEOPLE IN A REMOTE ABORIGINAL SETTING. Sex Health 2007. [DOI: 10.1071/shv4n4ab7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The Kimberley region has some of the highest rates of Chlamydia infection in Australia. NCHS obtained funding to initiate and establish a Chlamydia Project aimed at increasing screening rates amongst indigenous youth aged 15 to 30 in the Fitzroy Valley. Population for the Valley is approximately 3000, predominately Aboriginal, covering more than 40 remote communities and the town of Fitzroy Crossing. The community has a strong belief in traditional values therefore observation of cultural protocols is paramount, especially when working in the area of sexual health. This can present challenges when setting up a sexual health program that is culturally appropriate, accepted and sustainable.
The aim of the project is to encourage young people to attend for STI screening when they are asymptomatic. The project will also endeavour to increase awareness of Chlamydia and other sexual health issues relevant to the age group.
Methods used, include setting up screening clinics in town and remote communities, involving young people in making decisions about how the clinics are run, holding Feel Good Nights that promote discussion and information sharing about sexual health, peer education and encouraging young people to participate in resource production.
Anecdotally, results so far have shown a greater number of young people are accessing sexual health services and there is an increase in knowledge of Chlamydia and sexual health in general amongst the target population. This project will run until May 2008. This paper will present the progress of the project so far, and some of the highlights and challenges of setting up a sexual health program in a remote community setting.
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Drake-Lee AB, Hughes RG, Dunn C. Serum IgA and IgG functional antibodies and their subclasses to Streptococcus pneumoniae capsular antigen found in two aged-matched cohorts of children with and without otitis media with effusion. Clin Otolaryngol Allied Sci 2003; 28:335-40. [PMID: 12871248 DOI: 10.1046/j.1365-2273.2003.00717.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The relationship between acute otitis media and otitis media with effusion (OME) is uncertain and the aetiology of OME is multifactorial. Otitis media with effusion may be an inflammatory condition; both bacteria and viral infections could play a part in this inflammation. The four bacteria Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus and Branhamella catarrhalis cause 60% of the infections whereas S. pneumoniae accounts for up to 35%. IgA provides the dominant surface response to polysaccharide and lipopolysaccharide antigens, of which IgA2 is the main subclass. Once the mucosa has been breached, most protection is provided by IgG. IgG2 acts mainly against bacterial capsular antigens. This study looked at two groups of 50 children with and without OME who were aged between 3 and 10 years. The aims were to determine if, firstly, the levels of the serum immunoglobulins were different in the two groups, secondly whether these children made the appropriate antibody response to the capsular antigen to S. pneumoniae (PCP), and finally if there was a delay in the maturity of the IgA response. The total IgG, IgA and all subclass levels were measured using radial immunodiffusion. Levels of functional IgA and IgG were measured using ELISAs (25 patients in each group). The results were analysed with non-parametric tests. The immunoglobulin levels were within the normal levels for both groups. There were very good correlations between the IgG total anti-PCP and the IgG2 anti-PCP (R > 0.9, p = 0.001). There was a good correlation between the levels of both IgG total and IgG2 anti-PCP against IgA total anti-PCP in both groups (R > 0.85, p > 0.01). This confirms a normal antibody response between both groups of patients. The ages of the controls and patients (50 samples) were correlated with increasing titres of circulating functional antibodies (P = 0.001). This is highly suggestive of a normal age-related response. In conclusion, the findings were contradictory to our original hypothesis that there is a subtle difference in surface protection between children with and without OME. We believe that a previous history of recurrent acute otitis media is unrelated to the development of OME after 3 years of age.
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Affiliation(s)
- A B Drake-Lee
- The Department of Otorhinolaryngology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
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Abstract
A 20-year-old woman developed gross surgical emphysema tracking down to the chest after an episode of nose blowing. Fortunately there were no ocular complications and the patient settled with conservative management. Follow-up showed no recurrence. The case presented illustrates the very rare complication of orbital fracture following nose blowing.
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Affiliation(s)
- C Dunn
- Department of Otolaryngology, City Hospital, Birmingham, UK
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Abstract
The aim of this study was to assess attitudes to neonatal genetic screening for hereditary hemochromatosis. A total of 135 consecutive, pregnant women and their partners attending a hospital antenatal clinic in the Australian Capital Territory were given detailed written and verbal information about potential risks and benefits of neonatal genetic screening. Issues such as uncertainty of disease expression, confidentiality, genetic discrimination, and storage of genetic data were addressed. Attitudes were assessed by interview and questionnaire. There was a high level of acceptance for neonatal genetic screening in general (99%) and for hemochromatosis in particular (91.5%). There was no association of prior knowledge of hemochromatosis, family history of hemochromatosis, ethnicity, age, education, or occupation class with nonacceptance. Of the subjects, 39.5% reported feeling "a little anxious" about the prospect of screening their infants, although only 5.4% reported feeling "very anxious." Reasons given for nonacceptance of screening included inability of the child to give informed consent, insufficient evidence that diagnosis of hemochromatosis in childhood is beneficial, risk of discrimination on genetic grounds, lack of agreement between partners, and privacy issues. These data suggest that an Australian neonatal genetic screening program for hemochromatosis is likely to be accepted by this and similar groups of subjects, but there should be an opportunity for parents who object to screening to opt out of any such program.
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Affiliation(s)
- M Bassett
- Gastroenterology Unit, The Canberra Hospital, Canberra Clinical School, University of Sydney, Australia.
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Abstract
AIMS To examine the effectiveness of brief behavioral interventions adapting the principles and techniques of Motivational Interviewing (MI) to four behavioral domains: substance abuse, smoking, HIV risk and diet/exercise. DESIGN We conducted a systematic review of 29 randomized trials of MI interventions. Data on methodological quality were extracted and tabulated. Between-group behavior change effect sizes and confidence intervals were calculated for each study. FINDINGS Due to varying intervention time lengths, targeted problem behaviors, settings and interventionists' backgrounds and skill levels, outcomes were not combined meta-analytically. Sixty per cent of the 29 studies yielded at least one significant behavior change effect size. No significant association between length of follow-up time and magnitude of effect sizes was found across studies. There was substantial evidence that MI is an effective substance abuse intervention method when used by clinicians who are non-specialists in substance abuse treatment, particularly when enhancing entry to and engagement in more intensive substance abuse treatment treatment-as-usual. Data were inadequate to judge the effect of MI in the other domains. Client attribute-treatment interactions were understudied and the sparse and inconsistent findings revealed little about the mechanism by which MI works or for whom it works best. CONCLUSION To determine more effectively how well MI works in domains other than substance abuse and for whom it works best in all domains, researchers should study MI with risk behaviors other than substance abuse, while examining both interactions and the theoretical components of MI.
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Affiliation(s)
- C Dunn
- Department of Psychiatry, University of Washington, USA.
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Abstract
The authors provide an overview of 21 articles from several countries focusing on families with deaf members published in the literary issues of the American Annals of the Deaf from 1996 to 2000. Four categories were identified: Interaction and Involvement, Support Services, Stress and Coping, and Decision Making. The articles represent a commendable expansion of focus from the mother-child dyad to increased attention to fathers, siblings, extended family members, and significant nonfamily members such as deaf adults. The heterogeneity of families was a striking factor, even within those studies dealing with relatively homogeneous populations. Services appeared to be most effective within middle-class, educated family units, illustrating the need for more comprehensive services sensitive to the needs of families from less affluent backgrounds and with lower levels of education. In general, services to families with deaf children may be characterized as better than in the past but still in need of significant sensitivity and improvement. The presence of a deaf child in a family with hearing parents may cause stress, but parents have the flexibility to respond in a positive and beneficial way, especially when provided adequate information and support. The idea that hearing parents go through a grieving process involving the identification of deafness in their child seems to be an overstatement.
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Affiliation(s)
- D F Moores
- Department of Education, Gallaudet University, Washington, DC, USA
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Abstract
In this paper we explore how the presence of hazardous industry may affect the identity of a place and the people who live there. Drawing on Goffman's seminal work on stigma - together with recent debates on environmental and technological stigma - we extend the concepts of difference and spoiled identity from the individual to place. The paper is based on a qualitative study which explored public perceptions of the risks to health from air pollution in Teesside, a heavily industrialised area in north-east England. We did not set out to study stigma per se in this study, but emergent themes produced by grounded theory analysis highlighted the way in which the presence of technologies, air pollution, poor health and social exclusion may be used as 'discrediting' characteristics, to stigmatise one place, whilst confirming the usualness of another. We demonstrate place stigma as a complex, multiple and re-inforcing concept.
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Affiliation(s)
- J Bush
- Department of Epidemiology and Public Health, The Medical School, University of Newcastle, NE2 4HH, Newcastle Upon Tyne, UK.
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Dunn C. The efficacy of a pre-procedural antiseptic mouthwash against bacterial aerosols. J N Z Soc Periodontol 2000:21-3. [PMID: 10823049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Rose ML, Cattley RC, Dunn C, Wong V, Li X, Thurman RG. Dietary glycine prevents the development of liver tumors caused by the peroxisome proliferator WY-14,643. Carcinogenesis 1999; 20:2075-81. [PMID: 10545408 DOI: 10.1093/carcin/20.11.2075] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Previous studies demonstrated that dietary glycine prevents elevated rates of cell proliferation following treatment with the peroxisome proliferator and liver carcinogen WY-14,643. Since increased cell replication is associated with the development of hepatic cancer caused by peroxisome proliferators, glycine may have anti-cancer properties. Therefore, experiments were designed to test the hypothesis that dietary glycine would inhibit the hepatocarcinogenic effect of WY-14,643. Male F344 rats were fed four different NIH 07-based diets: 5% glycine; 5% valine for nitrogen balance (control); 0.1% WY-14,643 + 5% valine (WY-14,643); 0.1% WY-14,643 + 5% glycine (WY-14,643 + glycine). Food consumption did not differ among the groups, but WY-14,643-fed rats weighed 10-25% less than expected based on previous studies. Serum glycine levels were elevated 4-5-fold by glycine-containing diets; however, the 10-fold increase in peroxisomal enzyme activity caused by WY-14,643 was unaffected by the addition of 5% glycine to the diet. After 22 weeks, livers from rats fed WY-14,643 had a similar incidence and multiplicity of proliferative lesions (foci and adenomas) to those fed WY-14,643 + glycine. Moreover, cell proliferation in the surrounding 'normal' parenchyma (labeling index approximately 4%) and foci (labeling index approximately 50%) did not differ between WY-14,643 and WY-14,643 + glycine-fed rats. However, after 51 weeks of dietary exposure to WY-14,643, glycine prevented formation of small (0-5 mm diameter) tumors by 23% and inhibited the development of medium size (5-10 mm) tumors by 64%. Furthermore, glycine prevented the formation of the largest tumors (>10 mm) by nearly 80%. Thus, glycine did not inhibit early foci formation; however, it significantly decreased their ability to progress to tumors. Moreover, the inhibitory effect of glycine was greater with increasing tumor size. These studies demonstrate that dietary glycine prevents the development of hepatic tumors caused by the peroxisome proliferator WY-14,643 consistent with the idea that it may be an effective chemopreventive agent.
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Affiliation(s)
- M L Rose
- Laboratory of Hepatobiology and Toxicology, Department of Pharmacology, and Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC 27599-7365, USA
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Dunn C, Wilde M, Paterson R. Agents in development for the treatment of hepatitis C. Summary and table. Drugs R D 1999; 2:259-64. [PMID: 10659405 DOI: 10.2165/00126839-199902040-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- C Dunn
- Adis International Limited, Auckland, New Zealand
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Richards B, Karpilow J, Dunn C, Zharkikh L, Maxfield A, Kamb A, Teng DH. Creation of a stable human reporter cell line suitable for FACS-based, transdominant genetic selection. Somat Cell Mol Genet 1999; 25:191-205. [PMID: 11586787 DOI: 10.1023/a:1019206625658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Quality bioassays are central to all approaches directed at understanding or perturbing the function of proteins. One type of cell-based bioassay involves an engineered reporter whose transcriptional activity serves as a readout for upstream signals of a biochemical pathway(s) that feeds into the reporter. We describe a general strategy for creating a mammalian reporter line with attributes suitable for a high complexity, en masse transdominant genetic screen. The basic criteria required of the mammalian cells engineered with the reporter include ease of maintenance, ease of sorting by FACS, ability to be transduced by retroviruses, and high expression of transduced peptides or cDNAs. For maximal enrichment during selection, the reporter line should have a relatively homogeneous response and a high signal-to-background ratio. We use a melanoma cell line transduced with a retinoic-acid-responsive promoter coupled to a GFP reporter as a case study to demonstrate the strategy. We characterize an optimized retinoic-acid-responsive reporter clone to determine the kinetics of reporter induction and decay in the presence and absence of retinoids. Dose-response studies reveal that the reporter responds to all-trans retinoic acid with an EC50 of approximately 1 nM. The strategy described is general and may be applied to create other reporter lines that respond to a specific stimulus.
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Affiliation(s)
- B Richards
- Arcaris, Inc, 615 Arapeen Drive, Suite 300, Salt Lake City, Utah 84108, USA
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32
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Abstract
The monoclonal antibody (mAb) SV5-Pk is used widely in a variety of procedures to detect recombinant proteins tagged with the Pk tag, a 14 amino acid sequence derived from the P and V proteins of the paramyxovirus Simian Virus 5. Here we report on the isolation and characterisation of four additional SV5-Pk mAbs (termed SV5-Pk2 to 5) that bind the Pk tag. All the SV5-Pk mAbs can detect Pk tagged recombinant proteins in a variety of immunological procedures, including ELISA and immunofluorescence. Using SPOT technology, the minimal binding epitope of each SV5-Pk mAb was defined by one-sided terminal truncation analysis from either the amino- or carboxy-ends of the Pk peptide. Each mAb recognises slightly different epitopes within the Pk tag, ranging from 5 to 9 amino acids in length. The equilibrium dissociation constants (Kd) of the mAbs, as measured by surface plasmon resonance, ranged from approximately 20 to 60 pmol. Cysteine scanner mutations throughout the Pk tag revealed that some amino acids within the minimal binding epitopes were critical for mAb binding, while others could readily be substituted with little or no effect on antibody binding. The development of the Pk tag as a spacer arm for site-directed chemical coupling, and the use of the mAbs to monitor purification and coupling procedures, is discussed.
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Affiliation(s)
- C Dunn
- School of Biomedical Sciences, North Haugh, University of St. Andrews, Fife, UK
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33
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Dunn C. Clinically effective leg ulcer care. Nurs Times 1998; 94:61-3. [PMID: 9934155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Leg ulcers are a common and debilitating problem. Despite the presence of evidence to suggest that certain treatments can provide effective management, there are widespread variations in the provision of care. The project examined here brought together staff from both acute hospital and community settings. As a result the availability of education, training and materials to ensure evidence-based practice was improved.
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Affiliation(s)
- C Dunn
- Royal Berkshire and Battle Hospitals NHS Trust, Reading
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Abstract
The objective of this investigation was to measure the bronchodilator effect of aerosolized albuterol on infants with respiratory syncytial virus (RSV)-induced respiratory failure. Infants who required intubation and mechanical ventilator support for RSV disease were eligible for this prospective, nonrandomized study. Pulmonary function tests, including respiratory mechanics by least mean square analysis, small airway function by rapid thoraco-abdominal compression, and functional residual capacity by nitrogen washout were performed before and 20 min after inhalation of 20-40 breaths of undiluted (0.5%) albuterol solution via a small-volume nebulizer. Analysis of maximum expiratory flow at functional residual capacity (V'maxFRC) before and after albuterol administration was performed using a t-test for paired comparisons. A two-tailed P-value of less than 0.05 was considered statistically significant. Twenty-five infants (mean +/-SD postconceptional age = 45 +/- 5 weeks) were enrolled. Thirteen of the 25 infants had a prior history of prematurity and/or cardiorespiratory disease. After aerosolized albuterol, mean V'maxFRC increased significantly from 48 +/- 46 ml/sec to 65 +/- 59 ml/sec (P = 0.03); however, only three patients had an increase into the normal range. Three patients had a substantial (40-50%) decrease in V'maxFRC. These findings suggest that during the acute phase of severe RSV respiratory infection some of this group of very young infants had airway reactivity that improved in response to inhaled albuterol.
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Affiliation(s)
- M Derish
- Department of Pediatrics, Stanford University Medical Center, Palo Alto, California, USA
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Pless-Mulloli T, Phillimore P, Moffatt S, Bhopal R, Foy C, Dunn C, Tate J. Lung cancer, proximity to industry, and poverty in northeast England. Environ Health Perspect 1998; 106:189-96. [PMID: 9485483 PMCID: PMC1532971 DOI: 10.1289/ehp.98106189] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study assesses whether deprived populations living close to industry experience greater mortality from lung cancer than populations with comparable socioeconomic characteristics living farther away. Mortality data, census data, a postal survey of living circumstances, historic and contemporary data on air quality and a historic land-use survey were used. Analysis was based on two conurbations in England, Teesside and Sunderland. Housing estates in Teesside were selected based on socioeconomic criteria and distinguished by proximity to steel and chemical industries; they were grouped into three zones: near (A), intermediate (B), and farther (C), with a single zone in Sunderland. We included 14,962 deaths in 27 estates. Standardized mortality ratios (SMR) for lung cancer [International Classification of Diseases #9 (ICD-9) 162] and cancers other than lung (ICD-9 140-239, excluding 162), and sex ratios were calculated. Mortality from lung cancer was well above national levels in all zones. For men, a weak gradient corresponding with proximity to industry at younger ages reversed at older ages. In women 0-64 years of age, stronger gradients in lung cancer mortality corresponded with proximity to industry across zones A, B, and C (SMR = 393, 251, 242, respectively). Overall rates in Teesside were higher than Sunderland rates for women aged 0-64 years (SMR = 287 vs. 185) and 65-74 years (SMR = 190 vs. 157). The association between raised lung cancer mortality and proximity to industry in women under 75 years of age could not be explained by smoking, occupation, socioeconomic factors, or artifact. Explanations for differences between men and women may include gender-specific occupational experiences and smoking patterns. Our judgment is that the observed gradient in women points to a role for industrial air pollution.
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Affiliation(s)
- T Pless-Mulloli
- Department of Epidemiology and Public Health, School of Health Sciences, University of Newcastle, Newcastle upon Tyne, United Kingdom
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Davidhizar R, Dunn C. Nutrition and the client with AIDS. J Pract Nurs 1998; 48:16-25; quiz 26-8. [PMID: 9573975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The nutritional problems that go along with HIV infection and AIDS are significant and in fact contribute to death. Nutrition not only affects overall health but one's ability to respond to therapies and quality of life. Malnutrition and "wasting syndrome" result from compromised nutritional status. Early detection and intervention can decrease the dramatic problems caused by these conditions. Regardless of the stage of illness, Medical Nutrition Therapy needs to be individualized and prioritized as an integral part of one's total care.
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37
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Kendall B, Dunn C, Solanki P. A comparison of the effectiveness of malignancy detection in body fluid examination by the cytopathology and hematology laboratories. Arch Pathol Lab Med 1997; 121:976-9. [PMID: 9302931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Body fluid specimens in many institutions are submitted for cytologic examination as well as for examination in a clinical microscopy or hematology laboratory. The cytology laboratory is generally seen as the standard for detection of malignancy, whereas the clinical microscopy laboratory is often depended on predominantly for cell counting and categorization. METHODS To analyze the effectiveness of the hematology laboratory at detecting malignant fluids, this study retrospectively analyzed reports on 397 body fluid specimens (cerebrospinal, pericardial, peritoneal, and pleural) that were concurrently submitted over a 12-month period to both the cytopathology laboratory and the hematology laboratory. RESULTS Thirty-seven (9.3%) of the cases were diagnosed as malignant by at least one of the two examinations. The cytopathology examination reported 27 (73%) of the 37 malignant cases as malignant and 30 (81.1%) as at least atypical (27 malignant and 3 inconclusive), and the hematology examination reported 34 (91.9%) as malignant and 36 (97.3%) as at least atypical. A concordant malignant diagnosis was given by both laboratories in 24 (64.9%) of the 37 cases. CONCLUSIONS These results show that examination of specimens by the hematology laboratory can provide a highly sensitive diagnostic evaluation in addition to its more customary role of providing timely cell counts.
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Affiliation(s)
- B Kendall
- Department of Pathology, Wilford Hall Medical Center, Lackland Air Force Base, Tex 78236, USA
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Allen D, McDonald L, Dunn C, Doyle T. Changing care staff approaches to the prevention and management of aggressive behaviour in a residential treatment unit for persons with mental retardation and challenging behaviour. Res Dev Disabil 1997; 18:101-112. [PMID: 9172279 DOI: 10.1016/s0891-4222(96)00043-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The impact of a new training procedure aimed at improving staff skills in the preventative and reactive management of severely challenging behaviours was investigated within a six-place residential treatment unit. The results showed that there was some evidence to support the notion that the training reduced the number of behavioural incidents for most residents. The rates of major reactive strategy use (restraint and emergency medication) also declined over time, as did rates of staff and resident injury. Although only a limited number of these changes showed statistically significant correlations with time, it is argued that they were clinically significant when viewed against the complexity of the client group under study.
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Affiliation(s)
- D Allen
- Welsh Centre for Learning Disabilities, Cardiff, Wales, UK
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39
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Abstract
Home care nurses daily work with elderly patients who have various nutritional problems. This article discusses the factors that contribute to malnutrition in the elderly and suggests interventions that can be used by the patient and the family to improve the patient's nutritional status.
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40
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Smack DP, Harrington AC, Dunn C, Howard RS, Szkutnik AJ, Krivda SJ, Caldwell JB, James WD. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial. JAMA 1996; 276:972-7. [PMID: 8805732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the effect of white petrolatum vs bacitracin ointment on wound infection incidence, allergic contact dermatitis incidence, and healing characteristics. DESIGN Randomized, double-blind, prospective trial comparing white petrolatum with bacitracin ointment in postprocedure wound care. SETTING A general outpatient dermatology clinic and a tertiary referral advanced surgical procedure clinic at Walter Reed Army Medical Center, Washington, DC. PATIENTS A total of 922 patients who had dermatologic surgery with a total of 1249 wounds. MAIN OUTCOME MEASURES The incidence of infection and allergic contact dermatitis during a follow-up period of 4 weeks. Healing characteristics were secondary outcomes. RESULTS Of the 922 patients enrolled, 440 in the white petrolatum group and 444 in the bacitracin group were evaluable for clinical response. The 2 treatment groups had comparable baseline characteristics. Thirteen patients developed postprocedure infection (1.5%), 9 (2.0%) in the white petrolatum group vs 4 (0.9%) in the bacitracin group (95% confidence interval for difference, -0.4% to 2.7%; P=.37). Eight infections (1.8%) in the white petrolatum group were due to Staphylococcus aureus vs none in the bacitracin group (P=.004). No patient in the group using white petrolatum developed allergic contact dermatitis vs 4 patients (0.9%) in the group using bacitracin (P=.12). Additionally, there were no clinically significant differences in healing between the treatment groups on day 1 (P=.98), day 7 (P=.86), or day 28 (P=.28) after the procedure. CONCLUSIONS White petrolatum is a safe, effective wound care ointment for ambulatory surgery. In comparison with bacitracin, white petrolatum possesses an equally low infection rate and minimal risk for induction of allergy.
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Affiliation(s)
- D P Smack
- Department of Dermatology, Walter Reed Army Medical Center, Washington, DC, USA
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41
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Abstract
Prolonged exposure to certain alkylating chemicals induces glial and meningeal tumours in rats, probably resulting from DNA damage to dividing neural cells. The present work evaluated DNA synthesis in the brains of untreated, young adult male F344 rats in order to define a BrdUrd infusion protocol to more adequately assess proliferation in slowly dividing neural cell populations. BrdUrd (2.5 to 160 mg/ml) was administered for 6 days via subcutaneous osmotic pumps. Clinical toxicity was not observed at any dose. The labelling index (LI; % of cells per brain area that incorporated BrdUrd) and unit length labelling index (ULLI; % of cells per meningeal length that incorporated BrdUrd) were calculated for selected regions by counting labelled neural cells in defined areas of the right hemisphere in coronal brain sections. Intensely stained cells were numerous in the cerebral subependymal layer (LI = 35.8%); scattered in cerebral white matter tracts (e.g. corpus callosum and internal capsule; LI = 6.2%) as well as cerebral (ULLI = 4.2%) and cerebellar (ULLI = 3.6%) meninges; and rare in the hippocampus (LI > 0.1%). Mildy stained cells were dispersed in the pons (LI = 2.1%), deep cerebral (LI = 1.8%) and cerebellar (LI = 1.0%) grey matter, and thalamus (LI = 0.3%). Phenotypically, BrdUrd-positive cells in neuropil were glial cell precursors and their progeny, while those associated with meninges were usually located in the superficial subarachnoid space and appeared to be fibrocytes. Using BrdUrd infusion, LI for glial precursors at these sites ranged from two- to 10-fold higher than those reported previously after a brief parenteral pulse dose. These data indicate that continuous BrdUrd infusion for 6 days by subcutaneous osmotic pump is an efficient means of labelling neural cells throughout the brain.
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Affiliation(s)
- B Bolon
- Chemical Industry Institute of Toxicology (CIIT), Research Triangle Park, North Carolina 27709, USA.
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42
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Kieburtz K, Feigin A, McDermott M, Como P, Abwender D, Zimmerman C, Hickey C, Orme C, Claude K, Sotack J, Greenamyre JT, Dunn C, Shoulson I. A controlled trial of remacemide hydrochloride in Huntington's disease. Mov Disord 1996; 11:273-7. [PMID: 8723144 DOI: 10.1002/mds.870110310] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We conducted a randomized, double-blind, placebo-controlled tolerability study of a N-methyl-D-aspartate (NMDA) glutamate receptor ion-channel blocker, remacemide hydrochloride, in 31 independently ambulatory patients (18 men, 13 women) with Huntington's disease (HD). Subjects were randomized to receive either placebo or active remacemide at dosages of 200 mg/day or 600 mg/day. The primary outcome measure was the proportion of subjects able to complete the study with the assigned treatment. Remacemide was generally well tolerated, and no significant differences between the treatment arms were found in the primary outcome measure. A trend toward improvement in chorea was observed among subjects administered remacemide 200 mg/day. Based on the tolerability and safety demonstrated during this short-term trial, remacemide warrants more extended controlled investigation in patients with HD.
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Affiliation(s)
- K Kieburtz
- Department of Neurology, University of Rochester Medical Center, New York 14642, USA
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43
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Elliott S, Chang D, Delorme E, Dunn C, Egrie J, Giffin J, Lorenzini T, Talbot C, Hesterberg L. Isolation and characterization of conformation sensitive antierythropoietin monoclonal antibodies: effect of disulfide bonds and carbohydrate on recombinant human erythropoietin structure. Blood 1996; 87:2714-22. [PMID: 8639887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We have isolated and characterized three anti-recombinant human erythropoietin (rHuEPO) monoclonal antibodies (MoAbs) that recognize nonoverlapping epitopes on rHuEPO. Anti-EPO MoAb D11 neutralizes rHuEPO activity whereas MoAbs F12 and 9G8A do not. This suggests that D11 may bind to the rHuEPO active site. MoAbs F12 and D11 recognize conformation dependent epitopes whereas 9G8A does not. Immunoassays were developed for each monoclonal. The 9G8A immunoassay was novel and useful because immunoreactivity increased when rHuEPO was denatured. Disruption of disulfide bonds or removal of carbohydrate increased 9G8A immunoreactivity, which suggests that these elements are important for rHuEPO structure or stability.
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Affiliation(s)
- S Elliott
- Amgen Inc, Thousand Oaks, CA 92320, USA
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44
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Abstract
Traditional approaches in environmental spatial epidemiology have relied on assessing postulated links between environmental pollution and ill health, often as a response to a perceived public health problem; clearly it may be necessary to go beyond this stage in order to establish the nature of potential causal mechanisms. Different disciplines approach this issue in different ways. Many toxicologists favour approaches based on air quality monitoring, where raised levels of candidate pollutants may subsequently generate hypotheses about adverse health effects. Epidemiologists, however, assess the health of a population and then look for an associated cause. This paper suggests that neither approach is completely satisfactory and that a combination of both is needed. If spatially referenced data are available for both health status and air quality, then geographical analysis is needed to examine possible links, by using techniques such as atmospheric dispersion modelling and Geographical Information Systems. We discuss the benefits and constraints of these approaches, using empirical examples of environmental epidemiology studies for northern England. Taking into account the problems involved in such studies, allied to the high costs incorporated, the paper asks the question: Are we searching for the impossible?
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Affiliation(s)
- C Dunn
- Department of Geography, University of Durham, England
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45
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Abstract
The predominant focus of the transition movement has been on individuals with moderate and severe disabilities. Only recently have professionals begun to comprehensively address the transition needs of individuals with learning disabilities. Although certain transition planning components are applicable to all youth, regardless of disability, the unique needs of specific disability categories must be recognized. The purpose of this article is to provide a review of transition as it relates to students with learning disabilities. Specifically, it provides (a) an overview of state and federal mandates and initiatives that influence transition practices, and (b) a discussion of transition practices for individuals with learning disabilities.
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Affiliation(s)
- C Dunn
- Department of Rehabilitation and Special Education, Auburn University, AL 36849-5226, USA
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46
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Yue G, Sun FF, Dunn C, Yin K, Wong PY. The 21-aminosteroid tirilazad mesylate can ameliorate inflammatory bowel disease in rats. J Pharmacol Exp Ther 1996; 276:265-70. [PMID: 8558441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The 21-aminosteroid tirilazad mesylate (U74006F) is a lipophilic antioxidant and free radical scavenger that has been reported to attenuate brain or spinal cord injury caused by trauma, stroke, ischemia and reperfusion injury. In this study, we have examined the effect of U74006F in reducing the inflammatory parameters of trinitrobenzene sulfonic acid (TNBS)-induced inflammatory bowel disease (IBD) in rats. To induce IBD, rats were given ethanolic TNBS intracolonically. Rats received either 1) TNBS and U74006F 2) TNBS and vehicle or 3) saline and vehicle. Rats were sacrificed 1, 2 and 3 weeks after IBD induction. Colon to body weight ratio (an index of tissue edema) was markedly increased in the vehicle-treated IBD rats after 1 week of administration of TNBS. The ratio was significantly lower after U74006F treatment and the trend remained even after 3 weeks of chronic inflammation. Myeloperoxidase (MPO) activity in vehicle-treated IBD rats was substantially increased compared with controls during the entire 3 weeks of the experiment. U74006F-treated animals had significantly reduced MPO activity (60% lower) when compared with vehicle-treated animals at the end of the second and third weeks. These observations were confirmed by histopathology studies showing reduced granulocyte infiltration after drug treatment. U74006F treatment decreased basal (by 70%) and fMLP stimulated (by 75%) superoxide generation from colonic tissue from IBD rats compared with vehicle treatment after 2 weeks, but there was no apparent difference in superoxide generation among all three groups after 3 weeks. The results of this study suggested that administration of U74006F effectively reduces the inflammatory parameters in this chronic rat model of IBD. As such, U74006F may be therapeutically beneficial for the treatment of IBD in humans.
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Affiliation(s)
- G Yue
- Department of Cell Biology, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Stratford, USA
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47
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Pearson N, Gunnell DJ, Dunn C, Beswick T, Hill A, Ley B. Antibiotic prophylaxis for bacterial meningitis: overuse and uncertain efficacy. J Public Health Med 1995; 17:455-8. [PMID: 8639346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is little evidence supporting the efficacy of prophylactic antibiotics in preventing secondary cases of bacterial meningitis, and recent guidance extended the use of prophylactic antibiotics amongst children who attend pre-school groups. METHODS We examined the volume of rifampicin prescribed, and that recommended to contacts of cases of meningococcal and Hib meningitis in Somerset over a three-year period using case note records of the Consultant for Communicable Disease Control (CCDC) and PACT data. RESULTS There was evidence of excessive prescribing over and above that recommended by the CCDC. CONCLUSIONS Excessive prescribing increases the chance of serious drug side effects and the development of antibiotic resistance. It is suggested that both meningitis contacts and information about early symptoms of meningitis, as well as an explanation of the rationale behind the prescribing of antibiotic prophylaxis to contacts. This may reduce the likelihood of unnecessary prescribing and subsequent complications.
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Dunn C. Investment wins interest. Nurs Manag (Harrow) 1995; 2:14-5. [PMID: 7551722 DOI: 10.7748/nm.2.5.14.s11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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49
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Kieburtz K, McDermott M, Marshall FJ, Feigin A, Como P, Abwender D, Zimmerman C, Hickey C, Orme C, Bordwell K, Sotack J, Greenamyre JT, Dunn C, Shoulson I. 335P: Evaluation of the Glutamate Antagonist Remacemide Hydrochloride in Huntington's Disease. Neurology 1995. [DOI: 10.1212/wnl.45.7.1417-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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50
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Abstract
PURPOSE With the link between peritoneal adhesions and infertility well established, it is critical that materials used in pelvic surgery be tested for their adhesion-forming properties. The current study examined the adhesion-inducing properties of two dyes routinely used for visualization during pelvic surgery. DESIGN In vivo and in vitro examination of the effects of the dyes methylene blue and indigo carmine on adhesion formation in a mouse model. METHOD A series of three experiments was conducted. In the first, dyes were injected directly into the peritoneal cavity. The mice were then sacrificed at one of two time points and the peritoneal cavity examined for adhesion formation. In addition, because of their purposed role in adhesion formation, macrophages from the cavity were examined for signs of dye-induced activation. Further studies of macrophage activation were then conducted in vitro to determine the effects of dye concentration and exposure time on the activation process. RESULTS Both methylene blue and indigo carmine appeared to induce adhesion formation as well as macrophage activation in vivo. Further, long-term exposure to visual concentrations of both dyes appeared to induce macrophage activation. However, only those macrophages exposed to methylene blue exhibited signs of activation when the exposure time was limited to times equivalent to those which might be expected during surgery. CONCLUSION Of the two dyes tested, indigo carmine might be the dye of choice in surgeries where fertility is to be maintained.
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Affiliation(s)
- S D Prien
- Department of Obstetrics and Gynecology, Texas Tech University HSC, Lubbock 79430, USA
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