1
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Lyons C, McElwain J, Young O, O'Gorman DA, Harte BH, Kinirons B, Grady D, Laffey JG, Callaghan M. The effect of high-flow nasal oxygen flow rate on gas exchange in apnoeic patients: a randomised controlled trial. Anaesthesia 2024; 79:576-582. [PMID: 38100148 DOI: 10.1111/anae.16200] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 05/12/2024]
Abstract
High-flow nasal oxygen can be administered at induction of anaesthesia for the purposes of pre-oxygenation and apnoeic oxygenation. This intervention is claimed to enhance carbon dioxide elimination during apnoea, but the extent to which this occurs remains poorly quantified. The optimal nasal oxygen flow rate for gas exchange is also unknown. In this study, 114 patients received pre-oxygenation with high-flow nasal oxygen at 50 l.min-1. At the onset of apnoea, patients were allocated randomly to receive one of three nasal oxygen flow rates: 0 l.min-1; 70 l.min-1; or 120 l.min-1. After 4 minutes of apnoea, all oxygen delivery was ceased, tracheal intubation was performed, and oxygen delivery was recommenced when SpO2 was 92%. Mean (SD) PaCO2 rise during the first minute of apnoea was 1.39 (0.39) kPa, 1.41 (0.29) kPa, and 1.26 (0.38) kPa in the 0 l.min-1, 70 l.min-1 and 120 l.min-1 groups, respectively; p = 0.16. During the second, third and fourth minutes of apnoea, mean (SD) rates of rise in PaCO2 were 0.34 (0.08) kPa.min-1, 0.36 (0.06) kPa.min-1 and 0.37 (0.07) kPa.min-1 in the 0 l.min-1, 70 l.min-1 and 120 l.min-1 groups, respectively; p = 0.17. After 4 minutes of apnoea, median (IQR [range]) arterial oxygen partial pressures in the 0 l.min-1, 70 l.min-1 and 120 l.min-1 groups were 24.5 (18.6-31.4 [12.3-48.3]) kPa; 36.6 (28.1-43.8 [9.8-56.9]) kPa; and 37.6 (26.5-45.4 [11.0-56.6]) kPa, respectively; p < 0.001. Median (IQR [range]) times to desaturate to 92% after the onset of apnoea in the 0 l.min-1, 70 l.min-1 and 120 l.min-1 groups, were 412 (347-509 [190-796]) s; 533 (467-641 [192-958]) s; and 531 (462-681 [326-1007]) s, respectively; p < 0.001. In conclusion, the rate of carbon dioxide accumulation in arterial blood did not differ significantly between apnoeic patients who received high-flow nasal oxygen and those who did not.
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Affiliation(s)
- C Lyons
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - J McElwain
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - O Young
- Department of Ear, Nose and Throat Surgery, Galway University Hospitals, Galway, Ireland
| | - D A O'Gorman
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - B H Harte
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - B Kinirons
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - D Grady
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - J G Laffey
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
- Anaesthesia and Intensive Care Medicine, University of Galway, Galway, Ireland
| | - M Callaghan
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
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2
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Lyons C. Interpreting evidence on 'failed intubation': are we losing airways or losing our minds? Anaesthesia 2024; 79:442-443. [PMID: 38198501 DOI: 10.1111/anae.16232] [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] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Affiliation(s)
- C Lyons
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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3
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Lyons C, El-Boghdadly K. Point-of-care gastric ultrasound: food for thought. Anaesthesia 2024; 79:123-127. [PMID: 38017691 DOI: 10.1111/anae.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Affiliation(s)
- C Lyons
- Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - K El-Boghdadly
- Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- King's College London, London, UK
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4
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Affiliation(s)
- C Lyons
- Great Ormond Street Hospital for Children, London, UK
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5
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Lyons C, Felton PJ, McCabe C. Female cricket pace bowling: kinematic and anthropometric relationships with ball release speed. S Afr J Sports Med 2023; 35:v35i1a15080. [PMID: 38249765 PMCID: PMC10798603 DOI: 10.17159/2078-516x/2023/v35i1a15080] [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] [Indexed: 01/23/2024] Open
Abstract
Background Despite an increase in the professionalism and participation of female cricket, the coaching of female pace bowling is still reliant on male-derived knowledge. Objectives To investigate the association between key male-derived kinematic and anthropometric parameters and ball release speed (BRS) in female pace bowlers. Methods Eleven female pace bowlers participated in this study. BRS, and four anthropometric and five kinematic parameters were determined. Stepwise linear regression and Pearson Product Moment correlations were used to identify anthropometric and kinematic parameters linked to BRS. Results The best predictor of BRS explaining 89% of the observed variance was the bowling shoulder angle at ball release. The best anthropometric predictor of BRS was height explaining 53% of the observed variance. Other parameters correlated with BRS included: run-up speed (r = 0.75, p = 0.013) and arm length (r = 0.61, p = 0.046). When height was controlled for, the front knee angle at front foot contact was also correlated to BRS (r = 0.68, p = 0.044). No relationship was found between trunk flexion and BRS. Conclusion Faster BRS were characterised by faster run-up speeds, straighter front knees, and delayed arm circumduction similar to male pace bowlers. The lack of relationship between trunk flexion and BRS may highlight female pace bowlers adopting a bowling technique where BRS is contributed to by trunk rotation as well as trunk flexion. This knowledge is likely to be useful in the talent identification and coaching of female pace bowlers.
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Affiliation(s)
- C Lyons
- School of Sport, Ulster University, Belfast, Northern
Ireland
| | - PJ Felton
- School of Science & Technology, Nottingham Trent University,
England
| | - C McCabe
- School of Sport, Ulster University, Belfast, Northern
Ireland
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6
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Lyons C, Harte BH. Universal videolaryngoscopy: take care when crossing the Rubicon. Anaesthesia 2023; 78:688-691. [PMID: 36794782 DOI: 10.1111/anae.15977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Affiliation(s)
- C Lyons
- Department of Anaesthesia, Great Ormond Street Hospital for Children, London, UK
| | - B H Harte
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
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7
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Okonkwo N, Rwema JOT, Lyons C, Liestman B, Nyombayire J, Olawore O, Nsanzimana S, Mugwaneza P, Kagaba A, Sullivan P, Allen S, Karita E, Baral S. The Relationship Between Sexual Behavior Stigma and Depression Among Men Who have Sex with Men and Transgender Women in Kigali, Rwanda: a Cross-sectional Study. Int J Ment Health Addict 2022; 20:3228-3243. [PMID: 36532817 PMCID: PMC9754158 DOI: 10.1007/s11469-021-00699-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/27/2022] Open
Abstract
To evaluate the role of sexual behavior stigma as a determinant of depressive symptoms among men who have sex with men (MSM) and transgender women (TGW) in Kigali, Rwanda. MSM/TGW aged ≥18 years were recruited using respondent-driven sampling (RDS) between March-August, 2018. Mental health was assessed using the Patient Health Questionnaire (PHQ-9). Sexual behavior stigma from friends and family, healthcare workers, and community members was assessed using a validated instrument. Multinomial logistic regression models were used to determine the association between sexual behavior stigma and depressive symptoms and depression. Secondary analyses further compared depression and depressive symptoms among MSM and TGW. Among the 736 participants included, 14% (106/736) identified as TGW. Depression 8.9% (RDS-adjusted, 7.6%; 95% CI, 4.6-10.6) and mild/moderate symptoms of depression 26.4% (RDS-adjusted, 24.1%; 95% CI, 19.4-28.7) were common and higher among TGW compared to MSM (p < 0.001). Anticipated (41%), perceived (36%), and enacted (45%) stigmas were highly prevalent, and were also significantly higher among TGW (p < 0.001). In multivariable RDS-adjusted analysis, anticipated (relative risk ratio (RRR), 1.88; 95% CI, 1.11-3.19) and perceived (RRR, 2.06; 95% CI, 1.12-3.79) stigmas were associated with a higher prevalence of depressive symptoms. Anticipated (RRR, 4.78; 95% CI, 1.74-13.13) and enacted (RRR, 3.09; 95% CI, 1.61-5.93) stigmas were also associated with a higher prevalence of depression. In secondary analyses, the significant differences between MSM and TGW were lost after adjusting for stigma. These data demonstrate a high burden of depressive symptoms and depression among MSM/TGW in Kigali. Conceptually, stigma is a likely antecedent of mental health stress among MSM and TGW suggesting the potential utility of scaling up stigma mitigation interventions to improve the quality of life and mental health outcomes among sexual and gender minority communities in Rwanda.
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Affiliation(s)
- N. Okonkwo
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jean Olivier Twahirwa Rwema
- Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133 Baltimore, MD, 21205, USA
| | - C. Lyons
- Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133 Baltimore, MD, 21205, USA
| | - B. Liestman
- Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133 Baltimore, MD, 21205, USA
| | | | - O. Olawore
- Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133 Baltimore, MD, 21205, USA
| | - S. Nsanzimana
- Rwanda Biomedical Center, HIV and AIDS Division, Kigali, Rwanda
| | - P. Mugwaneza
- Rwanda Biomedical Center, HIV and AIDS Division, Kigali, Rwanda
| | - A. Kagaba
- Health Development Initiative, Kigali, Rwanda
| | - P. Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - S. Allen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - E. Karita
- Projet San Francisco, Kigali, Rwanda
| | - S. Baral
- Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E 7133 Baltimore, MD, 21205, USA
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8
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Butler E, Walsh JE, Grogan S, Lyons C, Whalley D, Fitzpatrick J, Gallagher L, Dockery F. 348 WHAT IS THE OLDER PATIENT’S VIEW ON RECEIVING DETAILED MEDICAL LETTERS? Age Ageing 2022. [DOI: 10.1093/ageing/afac218.305] [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: 11/12/2022] Open
Abstract
Abstract
Background
Sending copies of clinic letters to patients involves additional work for medical staff in formatting letters, administrative staff in printing and posting and is an added cost to the healthcare service. Though seen largely as good practice in some specialities, it is not done routinely in Geriatric medical services. We introduced this practice as standard in our service and wished to evaluate whether from the patient perspective, it is worthwhile.
Methods
We sent a questionnaire to n=80 older patients who were evaluated in the home setting (by the Integrated Care Team for Older People – ICTOP) or recently attended CGA (Comprehensive Geriatric Assessment) clinic or FLS (Fracture Liaison Service) clinic. We asked their opinion on the detailed medical letter sent to their General Practitioner (GP), which they received a copy of. The questionnaire could be completed by patient/carer/relative, and returned anonymously.
Results
N=30/80 were returned. Two said they found the letter difficult to understand; 1/30 said the letter caused them to worry but all said they still preferred that they had received it. N= 2 said they would like to have contributed to the letter for accuracy. All said they felt they should receive copies of all their medical correspondence. Free text comments showed overwhelming support for the process, in allowing them to self-manage their health, enhance communication with other healthcare professionals and was a useful document to refer back to when they are trying to process information during short consultations.
Conclusion
Though a small survey and limited by low response rate, older people expressed high levels of satisfaction in receiving copies of medical letters about their health. It supports the ongoing practice and should be adopted widely.
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Affiliation(s)
- E Butler
- Beaumont Hospital , Dublin, Ireland
| | - JE Walsh
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
| | - S Grogan
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
| | - C Lyons
- Beaumont Hospital , Dublin, Ireland
| | - D Whalley
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
| | | | | | - F Dockery
- Beaumont Hospital , Dublin, Ireland
- Integrated Care Team for Older People, North Dublin , Dublin, Ireland
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9
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McGettigan L, Abdullahi AS, Loughlin KM, Lyons C, Reddin C, Keane O. 35 GERIATRIC EMERGENCY MEDICINE (GEM) ’ PEARLS AND PITFALLS’- AN INTERDISCIPLINARY APPROACH TO EDUCATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.027] [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
Background
In recent years we have seen increased awareness of the terms ‘frailty’ and ‘GEM’ in many of our Emergency Departments (ED). A clear understanding of these terms within the context of ED is essential to provide a holistic care and to best meet the needs of older adults. It has been highlighted internationally that current training programmes do not sufficiently address learning needs of trainees to optimise care of this cohort of patients. The European Geriatric Medicine Society and the European Society for Emergency Medicine has attempted to address this gap through the introduction of a core GEM curriculum in 2016, however, at a local level many EDs are not utilising this resource for a number of reasons including lack of awareness and prioritisation of other local learning needs as determined by specialist training. To address the GEM learning needs at a local level an initiative idea was trialled in the form of a GEM teaching wall with dedicated monthly topics chosen from the above curriculum.
Methods
The initiative was led by a Senior Physiotherapist working on the Frailty Intervention Therapy Team and a Senior House Officer (SHO) working in ED with collaboration from other ED members as identified. A brainstorming session took place to identify potential topics. A poster was created by the project leads each month focusing on a core topic including an overview on the subject, national/international guidelines and top tips how to best manage in ED. Relevant team members contributed to different topics. Monthly posters were displayed in the ED.
Results
The project has been successfully running for 4 months with topics including Abdominal pain, Silver trauma Delirium and Falls.
Conclusion
GEM teaching is a cornerstone of successful management of older adults presenting to our EDs. Novel MDT teaching approaches can address the identified learning gap in this area and highlight international recommendations with minimum cost.
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Affiliation(s)
| | | | | | - C Lyons
- Beamount Hospital , Dublin, Ireland
| | - C Reddin
- Beamount Hospital , Dublin, Ireland
| | - O Keane
- Beamount Hospital , Dublin, Ireland
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10
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Peters N, Bambury RM, Power DG, McCarthy L, Lyons C, Kelly P, Jamaluddin MF. Radium-223 in the Treatment of Metastatic Castrate-Resistant Prostate Cancer. Ir Med J 2022; 115:536. [PMID: 35416462] [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: 06/14/2023]
Abstract
Background Radium 223 (Ra-223) has been successfully utilised for the treatment of men with metastatic castrate resistant prostate cancer (mCRPC). To date, no real world outcomes from its use in the Irish population have been described. Methods All men referred to our institution for Ra-223 from September 2016 to March 2019 were included. Patient demographics, treatments received, toxicities and outcomes were recorded. Overall survival (OS) and progression free survival (PFS) were analysed using the Kaplan-Meier method. Results Complete data was available for 54 men. Median age was 75 years (range 61-86 years). The median number of prior systemic treatments for mCRPC was 2 (range 0-4). Median ECOG performance status was 1 at the start of treatment and 2 at completion. The median number of Ra-223 cycles received was 4 with 37%(n=20) completing all 6 planned cycles. The most common treatment-related toxicity was fatigue seen in 52% of patients ( n=28). Improved pain scores were documented in 76% of men requiring opioid analgesia at the start of treatment. The median OS was 7 months. A good ECOG performance status, fewer than 6 bone metastases, normal alkaline phosphatase level at start of treatment and chemotherapy naivety were associated with improved OS. Conclusions Ra-223 is a moderately well tolerated palliative treatment amongst Irish men with mCRPC.
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Affiliation(s)
- N Peters
- Department of Medical Oncology, Cork University Hospital
| | - R M Bambury
- Department of Medical Oncology, Cork University Hospital
| | - D G Power
- Department of Medical Oncology, Cork University Hospital
| | - L McCarthy
- Department of Radiation Oncology, Cork University Hospital
| | - C Lyons
- Department of Radiation Oncology, Cork University Hospital
| | - P Kelly
- Department of Radiation Oncology, Cork University Hospital
- Department of Radiation Oncology, Bon Secours University Hospital
| | - M F Jamaluddin
- Department of Radiation Oncology, Cork University Hospital
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11
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Kearsley R, Lyons C, Daly Guris R. Case reports: invaluable learning from mistakes. Anaesth Rep 2021; 9:e12140. [PMID: 34881363 DOI: 10.1002/anr3.12140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- R Kearsley
- Imperial College Healthcare NHS Trust London UK
| | - C Lyons
- University Hospital Galway Galway Ireland
| | - R Daly Guris
- Department of Anaesthesiology and Critical Care Medicine Children's Hospital of Philadelphia Philadelphia PA USA.,Anaesthesiology and Critical Care University of Pennsylvania Philadelphia PA USA
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12
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Merron G, Lyons C, Dockery F. 114 FALLS AND SYNCOPE GUIDELINES APPLIED TO EMERGENCY DEPARTMENT ATTENDEES—HOW DO WE PERFORM? Age Ageing 2021. [DOI: 10.1093/ageing/afab219.114] [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
Falls and syncope are one of the most common presentations to emergency departments amongst older people. European Society of Cardiology (ESC) guidelines describe investigation of suspected syncope to assist care.
Methods
Following a previous audit we delivered an education program to Emergency Department (ED) staff, on assessment of fallers and syncope. This was a repeat cycle audit on consecutive patients aged who presented with a fall/faint/collapse/blackout/syncope, to assess impact of education sessions. We also conducted a survey of n = 23 ED staff members, on role of orthostatic blood pressures and ECGs in falls assessments.
Results
Of 80 consecutive attendees with a fall, n = 41 (51%) had possible syncope as documented in the history. ECG was done within the ED in 88% vs. 51% on baseline audit however only 14% (11/80) had lying and standing blood pressure checked vs. 15% on baseline audit. This is despite our survey showing that 17/23 (74%) of ED staff felt that orthostatic BP checks were essential in all fallers, and 44% stating they measure it themselves. Brain imaging was conducted in 44% vs. 40% in baseline audit, rationale for which was unclear in some. 31% (n = 25) were admitted compared to 42% previously. Of the n = 23 admitted, 24% (n = 6) had telemetry or Holter monitor, 20% had an echocardiogram.
Conclusion
Despite an education program on assessment of older fallers, embedding it to alter practice is challenging. While the education program resulted in some improvements, it supports a dedicated team for assessing fallers in the ED. Given the low rate of further investigations into causes for those admitted, a rapid access out patient pathway is warranted. Brain imaging is carried out relatively frequently though we cannot conclude on appropriateness in this limited audit.
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Affiliation(s)
- G Merron
- Beaumont Hospital , Dublin, Ireland
| | - C Lyons
- Beaumont Hospital , Dublin, Ireland
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13
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Loughlin KM, Lyons C, McGettigan L, Maloney P. 49 ASSESSING EFFECTIVENESS OF AN OUTREACH VISIT PATHWAY FROM ED & REQUIRING FURTHER FOLLOW UP IN THEIR OWN ENVIRONMENT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.49] [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
Falls are a leading cause of presentation to the Emergency Department for older adults. They often are at higher risk of admission to hospital which can lead to other complications of frailty such as development of delirium or deconditioning. The risks of admission were further complicated in the past year due to COVID and its adverse outcomes on our older frail population which further highlighted the need to manage their needs at home where possible.
These above changes have led to FITT reviewing the scope of our outreach service with a focus not just on facilitating discharge but preventing further presentation or deconditioning.
Methods
The aim of the project was to identify appropriate FITT patients to provide an Outreach visit from ED within 72 hours of discharge pending needs. This service was in conjunction with the existing Integrated Care Teams/community services but an outreach visit direct from ED may have been indicated due to; staffing levels, response time, catchment area or existing rapport with the individual patient. This was pending staffing levels with reconfiguration of existing staff to support the outreach therapist.
Appropriate patients included.
-Recurrent falls.
-Unresolved delirium/advanced dementia with ongoing therapy needs.—Bridging gap while awaiting community teams.
-Equipment provision.
Results
Over 10 months 34 outreach visits completed.
Average CFS: 6.
Reasons for:
12 for safety checks.
15 equipment provision/fitting.
6 mobility reviews.
Onward referrals:
22 (PCCC OT, Physio, PHN & day hospital & ICT).
Represent within 7 days = 0.
Represent within 30 day = 14 (41%).
Conclusion
The provision of an outreach services allowed a swift therapy review in the patient’s own home & onwards referrals as indicated. Often these patients were likely to be admitted however the outreach provided a safety net to facilitate direct discharge from the ED with no representations within the first 7 days.
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Affiliation(s)
| | - C Lyons
- Beaumont Hospital , Dublin, Ireland
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14
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Loughlin KM, Lyons C, McGettigan L, Maloney P. 50 A COMPARISON OF FRAILTY SCREENING TOOLS WITHIN THE EMERGENCY DEPARTMENT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.50] [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
Increased awareness has been given to the value of identifying frail for risk stratification and to assist in providing frailty attuned care rather than disease specific input.
This increased awareness both nationally and internationally has led to many ED’s introducing the Clinical Frailty Scale (CFS) to triage however as a service we wanted to evaluate which tool would best meet our needs to screen appropriate patients and highlight the current level of frailty within the Emergency Department.
Methods
Over a 3 day period all patients over 75 who present during core hours were screened by a senior FITT member using a number of frailty tools (CFS, THINK frail, InterRai, PRIMSA 7 & compared against our own clinical reasoning if a FITT assessment was indicated).
Results
Total Patient’s over 75 screened by screener & FITT—48.
Average age: 82.
Sex: 51.62% male.
Discharges: 57% d/c’d.
Average CFS (Screener) = 5.
Average CFS (FITT) = 5.
28/48 CFS same = 58.33%.
15/48 CFS differ by 1 point = 31.25%.
Average THINK Frail (Screener): 3.
Average THINK Frail (FITT): 2.
17/47 THINK Frail same =36%.
21/47 THINK Frail differ by 1 point = 44%.
80.85% same or within 1 point difference.
Conclusion
The CFS score provided the most consistent when comparing scores by multiple disciplines/grades.
Although the majority of older adults who scored a CFS of 1–3 or deemed non frail at triage were unlikely to benefit from a CGA, those who presented with a new fall often did require FITT input.
This research has led us to move away from our current triage tool of THINK FRAIL to the CFS, whilst continuing to assess any new falls irrespective of score.
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Affiliation(s)
| | - C Lyons
- Beaumont Hospital , Dublin, Ireland
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15
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Lyons C, Moppett IK. Hypotension - what we say and what we do. Anaesthesia 2021; 77:132-134. [PMID: 34542906 DOI: 10.1111/anae.15584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 11/28/2022]
Affiliation(s)
- C Lyons
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
| | - I K Moppett
- Anaesthesia and Critical Care Section, Academic Unit of Injury, Inflammation and Recovery Science, Queen's Medical Centre, University of Nottingham, Nottingham, UK
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Lyons C, McElwain J, Coughlan MG, O'Gorman DA, Harte BH, Kinirons B, Laffey JG, Callaghan M. Pre-oxygenation with facemask oxygen vs high-flow nasal oxygen vs high-flow nasal oxygen plus mouthpiece: a randomised controlled trial. Anaesthesia 2021; 77:40-45. [PMID: 34402044 DOI: 10.1111/anae.15556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 12/18/2022]
Abstract
High-flow nasal oxygen used before and during apnoea prolongs time to desaturation at induction of anaesthesia. It is unclear how much oxygenation before apnoea prolongs this time. We randomly allocated 84 participants to 3 minutes of pre-oxygenation by one of three methods: 15 l.min-1 by facemask; 50 l.min-1 by high-flow nasal cannulae only; or 50 l.min-1 by high-flow nasal cannulae plus 15 l.min-1 by mouthpiece. We then anaesthetised and intubated the trachea of 79 participants and waited for oxygen saturation to fall to 92%. Median (IQR [range]) times to desaturate to 92% after pre-oxygenation with facemask oxygen, high-flow nasal oxygen only and high-flow nasal oxygen with mouthpiece, were: 309 (208-417 [107-544]) s; 344 (250-393 [194-585]) s; and 386 (328-498 [182-852]) s, respectively, p = 0.014. Time to desaturation after facemask pre-oxygenation was shorter than after combined nasal and mouthpiece pre-oxygenation, p = 0.006. We could not statistically distinguish high-flow nasal oxygen without mouthpiece from the other two groups for this outcome. Median (IQR [range]) arterial oxygen partial pressure after 3 minutes of pre-oxygenation by facemask, nasal cannulae and nasal cannulae plus mouthpiece, was: 49 (36-61 [24-66]) kPa; 57 (48-62 [30-69]) kPa; and 61 (55-64 [36-72]) kPa, respectively, p = 0.003. Oxygen partial pressure after 3 minutes of pre-oxygenation with nasal and mouthpiece combination was greater than after facemask pre-oxygenation, p = 0.002, and after high-flow nasal oxygen alone, p = 0.016. We did not reject the null hypothesis for the pairwise comparison of facemask pre-oxygenation and high-flow nasal pre-oxygenation, p = 0.14.
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Affiliation(s)
- C Lyons
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
| | - J McElwain
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
| | - M G Coughlan
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
| | - D A O'Gorman
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
| | - B H Harte
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
| | - B Kinirons
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
| | - J G Laffey
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland.,Anaesthesia and Intensive Care Medicine, National University of Ireland, Galway, Ireland
| | - M Callaghan
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
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Fairmichael C, Redmond K, Osman S, Lyons C, Mitchell D, O’Sullivan J, Cole A, Giacometti V, Lundy G, Irvine D, McGarry C, Hounsell A, Jain S. OC-0510 SABR +/- pelvic nodal irradiation for higher risk prostate cancer. A randomized feasibility study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06936-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Apnoeic oxygenation refers to oxygenation in the absence of any patient or ventilator effort to move the lungs. This phenomenon was first described in humans in the mid-20th century but has seen renewed interest in the last decade following the demonstration of apnoeic oxygenation with low-flow, and subsequently high-flow, nasal oxygen. This narrative review summarises our understanding of apnoeic oxygenation in the paediatric population. We examine the evidence supporting oxygenation via tracheal tube, modified laryngoscopes and nasal cannulae. The evidence for prolongation of safe apnoea time at induction of anaesthesia is also appraised. We explore the capacity for carbon dioxide clearance, flow rate selection with high-flow nasal oxygen and complications associated with the technique. It remains uncertain whether apnoeic oxygenation in paediatric patients results in a meaningful clinical benefit compared with standard care for outcomes such as the number of tracheal intubation attempts or the incidence of hypoxaemia. In particular, the role of apnoeic oxygenation in paediatric difficult airway management is unclear as this has not been the targeted focus of any published research to date.
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Affiliation(s)
- C Lyons
- Department of Anaesthesia, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - M Callaghan
- Department of Anaesthesia, Galway University Hospitals, Galway, Ireland
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Affiliation(s)
- C Lyons
- Department of Anaesthesia and Intensive Care Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M Callaghan
- Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Galway, Ireland
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20
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Lyons C, O'Sullivan E. Videolaryngoscopy – Theory and practice. Trends in Anaesthesia and Critical Care 2019. [DOI: 10.1016/j.tacc.2019.05.001] [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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21
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Lyons C. Carbon dioxide clearance during apnoea. Anaesthesia 2019; 74:816-817. [DOI: 10.1111/anae.14689] [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] [Indexed: 11/27/2022]
Affiliation(s)
- C. Lyons
- Our Lady's Children's Hospital Dublin Ireland
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22
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Walls GM, Lyons C, Jellett LJ, Evans R, Bedair A, Brady D, McLaughlin LM, Reilly E, Reilly A, McAleer JJ, Stewart DP. Radiation Oncology: A Clinical Update from The North West Cancer Centre. Ulster Med J 2019; 88:91-97. [PMID: 31061556 PMCID: PMC6500407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 11/28/2022]
Affiliation(s)
- GM Walls
- The North West Cancer Centre, Western Health & Social Care Trust,Centre for Cancer Research & Cell Biology, Queen’s University Belfast
| | - C Lyons
- The North West Cancer Centre, Western Health & Social Care Trust
| | - LJ Jellett
- The North West Cancer Centre, Western Health & Social Care Trust
| | - R Evans
- The North West Cancer Centre, Western Health & Social Care Trust
| | - A Bedair
- The North West Cancer Centre, Western Health & Social Care Trust
| | - D Brady
- The North West Cancer Centre, Western Health & Social Care Trust
| | - LM McLaughlin
- The North West Cancer Centre, Western Health & Social Care Trust
| | - E Reilly
- The North West Cancer Centre, Western Health & Social Care Trust
| | - A Reilly
- The North West Cancer Centre, Western Health & Social Care Trust
| | - JJ McAleer
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust
| | - DP Stewart
- The North West Cancer Centre, Western Health & Social Care Trust
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McCauley S, O'Connell B, Lyons C, Evans R. EP-1309 Are OAR dose constraints for radical 3DCRT breast plans achievable? A one-year retrospective review. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31729-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Affiliation(s)
- C. Lyons
- Department of Anaesthesia; Mater Misericordiae University Hospital; Dublin Ireland
| | - M. Callaghan
- Department of Anaesthesia; Galway University Hospitals; Galway Ireland
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Cataldo Bascuñan LR, Lyons C, Bennet H, Artner I, Fex M. Serotonergic regulation of insulin secretion. Acta Physiol (Oxf) 2019; 225:e13101. [PMID: 29791774 DOI: 10.1111/apha.13101] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 05/14/2018] [Accepted: 05/17/2018] [Indexed: 12/13/2022]
Abstract
The exact physiological role for the monoamine serotonin (5-HT) in modulation of insulin secretion is yet to be fully understood. Although the presence of this monoamine in islets of Langerhans is well established, it is only with recent advances that the complex signalling network in islets involving 5-HT is being unravelled. With more than fourteen different 5-HT receptors expressed in human islets and receptor-independent mechanisms in insulin-producing β-cells, our understanding of 5-HT's regulation of insulin secretion is increasing. It is now widely accepted that failure of the pancreatic β-cell to release sufficient amounts of insulin is the main cause of type 2 diabetes (T2D), an ongoing global epidemic. In this context, 5-HT signalling may be of importance. In fact, 5-HT may serve an essential role in regulating the release of insulin and glucagon, the two main hormones that control glucose and lipid homoeostasis. In this review, we will discuss past and current understanding of 5-HT's role in the endocrine pancreas.
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Affiliation(s)
- L. R. Cataldo Bascuñan
- Endocrine Cell Differentiation and Function Group; Stem Cell Centre; Lund University; Lund Sweden
| | - C. Lyons
- Department of Clinical Sciences in Malmö; Unit of Molecular Metabolism; Lund University Diabetes Centre; Lund University; Malmö Sweden
- Clinical Research Center; Lund University; Malmö Sweden
- Malmö University Hospital; Lund University; Malmö Sweden
| | - H. Bennet
- Department of Clinical Sciences in Malmö; Unit of Molecular Metabolism; Lund University Diabetes Centre; Lund University; Malmö Sweden
- Clinical Research Center; Lund University; Malmö Sweden
- Malmö University Hospital; Lund University; Malmö Sweden
| | - I. Artner
- Endocrine Cell Differentiation and Function Group; Stem Cell Centre; Lund University; Lund Sweden
| | - M. Fex
- Department of Clinical Sciences in Malmö; Unit of Molecular Metabolism; Lund University Diabetes Centre; Lund University; Malmö Sweden
- Clinical Research Center; Lund University; Malmö Sweden
- Malmö University Hospital; Lund University; Malmö Sweden
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Lyons C. Response to: Transnasal humidified rapid insufflation ventilatory exchange for oxygenation of children during apnoea: a prospective randomised controlled trial. Br J Anaesth 2018; 121:512-513. [DOI: 10.1016/j.bja.2018.05.053] [Citation(s) in RCA: 2] [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] [Received: 04/09/2018] [Accepted: 05/21/2018] [Indexed: 11/16/2022] Open
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Lyons C, Lawee MS, Aghassi P. 0560 A New Head Position Discovery and Reliable Treatment Methodology for Most OSA Sufferers. Sleep 2018. [DOI: 10.1093/sleep/zsy061.559] [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] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Lyons
- Sleep Systems, Tyngsboro, MA
| | - M S Lawee
- Mass Lung & Allergy P.C., Worcester, MA
| | - P Aghassi
- Mass Lung & Allergy P.C., Worcester, MA
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Lyons C, Callaghan M. Apnoeic oxygenation with high-flow nasal oxygen for laryngeal surgery: a case series. Anaesthesia 2017; 72:1379-1387. [DOI: 10.1111/anae.14036] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 12/16/2022]
Affiliation(s)
- C. Lyons
- Department of Anaesthesia; Galway University Hospitals; Galway Ireland
| | - M. Callaghan
- Department of Anaesthesia; Galway University Hospitals; Galway Ireland
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29
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Jain S, Lyons C, Walker S, McQuaid S, Hynes S, Mitchell D, Pang B, Logan G, McCavigan A, O'Rourke D, Davidson C, Knight L, Berge V, Neal D, Pandha H, Harkin P, James J, Kennedy R, O'Sullivan J, Waugh D. A Metastatic Biology Gene Expression Assay to Predict the Risk of Distant Metastases in Patients With Localized Prostate Cancer Treated With Primary Radical Treatment. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.234] [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: 11/26/2022]
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McCauley S, McCloskey P, Lyons C, Brown K, Rooney K, Houghton F. Should all oropharyngeal squamous cell carcinomas be stratified by HPV p16 status? Clin Oncol (R Coll Radiol) 2017. [DOI: 10.1016/j.clon.2017.04.017] [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: 11/30/2022]
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31
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Lyons C, Ellard R, McElnea E, Townley D. I Still Haven't Found What I'm Looking For... Bono, Google and Glaucoma Awareness. Ir Med J 2017; 110:568. [PMID: 28737309] [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: 06/07/2023]
Abstract
The effect of celebrity diagnosis on public awareness of health conditions has already been well documented. In October 2014, Bono, the lead singer with U2, revealed publicly for the first time that he has glaucoma. This study aimed to analyze the impact of Bono's announcement on public awareness of glaucoma using Google Search trends as an indicator of public interest in the disease. Google Trends was used to examine Google Search activity for the term 'Glaucoma' between 2009 and 2015 in both Ireland and the United Kingdom. Trend analyses were performed using Microsoft Excel Version 14.3.5. Increased Google Search activity for 'Glaucoma' in October 2014 was found in both Ireland and the United Kingdom. A five-fold increase from the mean Google Search activity for this term was found in Ireland and a two-fold increase from the mean Google Search activity for this term was found in the United Kingdom. No such increase in Google Search activity occurred during each country's 2014 Glaucoma Awareness week. Google Trends is useful in medical research as a means of assessing public awareness of, and/or interest in, health related topics. Current approaches to glaucoma related health promotion in both Ireland and the United Kingdom have failed to yield an increase in on-line Google Search activity. While there was an increase in interest in glaucoma it is unclear whether this led to an increase in health seeking behaviour.
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Affiliation(s)
- C Lyons
- Department of Ophthalmology, University Hospital Galway, University Road, Galway, Ireland
| | - R Ellard
- Department of Ophthalmology, University Hospital Galway, University Road, Galway, Ireland
| | - E McElnea
- Department of Ophthalmology, University Hospital Galway, University Road, Galway, Ireland
| | - D Townley
- Department of Ophthalmology, University Hospital Galway, University Road, Galway, Ireland
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Jain S, Lyons C, Walker S, McQuaid S, Hynes S, Mitchell D, Pang B, Logan G, McCavigan A, O'Rourke D, Davidson C, Knight L, Sheriff A, Berge V, Neal D, Pandha H, Watson R, Mason M, Kay E, Harkin D, James J, Salto-Tellez M, Kennedy R, O'Sullivan J, Waugh D. OC-0126: A gene expression assay to predict the risk of distant metastases in localized prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30569-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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33
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Lyons C, Lawee M, Sailer S. 0634 THE EFFECT OF HEAD PITCH AND ROLL ROTATION INDEPENDENT OF TORSO POSITION ON THE AHI. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.633] [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: 11/14/2022] Open
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34
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McCauley S, McCloskey P, Lyons C, Brown K, Rooney K, Houghton F. PO-105: Is there justification for age bias in HPV p16 testing for Oropharyngeal Squamous Cell Carcinoma? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30239-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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35
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Williams H, Jones SA, Lyons C, Wilson C, Ghandour A. Refractory patella tendinopathy with failed conservative treatment-shock wave or arthroscopy? J Orthop Surg (Hong Kong) 2017; 25:2309499016684700. [PMID: 28118806 DOI: 10.1177/2309499016684700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Indexed: 11/17/2022] Open
Abstract
AIM To identify whether the location of refractory patella tendinopathy (PT) has an effect on treatment modality (radial extracorporeal shock wave therapy (rESWT) or arthroscopic debridement). METHODS Between 2012 and 2014, 40 patients with PT underwent a magnetic resonance imaging (MRI) scan. This confirmed the diagnosis as either involving the tendon itself (group A, 20) or with retropatella fat pad extension (group B, 20). All patients underwent rESWT. If there was no improvement patients proceeded with surgery in the form of arthroscopic debridement (by senior authors CW and AG). Outcomes were assessed before and after treatment using the Victorian Institute of Sports Assessment-Patella (VISA-P) score. RESULTS There were 18 males and 2 females in group A and 15 males and 5 females in group B. The mean age was 41.4 years in group A (23-59) and 34.7 in group B (19-52). Seventeen of 20 in group A reported good or excellent outcomes and did not require surgical intervention (remaining three improved after second course of ESWT). All patients in group B failed to improve with rESWT, resulting in arthroscopic debridement and reported good or excellent outcomes. After 6 months, group A mean VISA-P score increased from 50.2 to 65.0 ( p = 0.01) and group B from 39.6 to 78.4 ( p = <0.001). CONCLUSION An MRI should be performed to determine the precise location of tendinosis in patients with refractory PT who fail standard conservative management. If the MRI scan shows intratendon changes only, ESWT should be performed and those with extension into the fat pad should proceed to arthroscopic debridement without rESWT.
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Affiliation(s)
- Hlm Williams
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
| | - S A Jones
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
| | - C Lyons
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
| | - C Wilson
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
| | - A Ghandour
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
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Donoghue M, Conor P, Lyons C, Corcoran G, Moore A, Sinclair O. MON-P132: Using Quality Improvement Methods to Improve Malnutrition Screening Rates on a Frail Elderly Ward in Beaumont Hospital, Dublin, Ireland. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30766-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Welinder L, Robitaille J, Boerkoel C, Rupps R, Lyons C. Two Sisters with Congenital Blindness caused by Osteoporosis-pseudoglioma Syndrome due to new Mutations in the LPR5 Gene. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1628] [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] [Indexed: 11/29/2022]
Affiliation(s)
- L. Welinder
- Ophthalmology; Aalborg University Hospital; Aalborg Denmark
| | - J.M. Robitaille
- Department of Ophthalmology and Visual Sciences; Dalhousie University and IWK Health Centre; Halifax NS Canada
| | - C.F. Boerkoel
- BC Childrens Hospital; Genetics; University of British Columbia; Vancouver BC Canada
| | - R. Rupps
- BC Childrens Hospital; Genetics; University of British Columbia; Vancouver BC Canada
| | - C. Lyons
- BC Childrens Hospital; Pediatric Ophthalmology; University of British Columbia; Vancouver BC Canada
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Welinder L, Robitaille J, Boerkoel C, Rupps R, Lyons C. Two Sisters with Congenital Blindness caused by Osteoporosis-pseudoglioma Syndrome due to new Mutations in the LPR5 Gene. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0628] [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] [Indexed: 11/28/2022]
Affiliation(s)
- L. Welinder
- Ophthalmology; Aalborg University Hospital; Aalborg Denmark
| | - J.M. Robitaille
- Department of Ophthalmology and Visual Sciences; Dalhousie University and IWK Health Centre; Halifax Canada
| | - C.F. Boerkoel
- Genetics; University of British Columbia- BC childrens Hospital; Vancouver Canada
| | - R. Rupps
- Genetics; University of British Columbia- BC childrens Hospital; Vancouver Canada
| | - C. Lyons
- Pediatric Ophthalmology; University of British Columbia- BC childrens Hospital; Vancouver Canada
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O'Reilly M, Dillon E, Finucane O, McMorrow A, Murphy A, Lyons C, de la Llera Moya M, Reilly M, Roche H, McGillicuddy F. HDL proteomic quality, and not efflux capacity, reflects differential modulation of reverse cholesterol transport by saturated and monounsaturated fat diets. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.029] [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: 11/27/2022]
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40
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O'Callaghan G, Ronan N, Foley N, Lyons C, O'Driscoll A, Ni Chroinin M, Mullane D, Murphy D, Shanahan F, Eustace J, Houston A, Plant B. WS13.2 The role of PGE 2 in cystic fibrosis (CF) lung inflammation and the potential association with ivacaftor therapy and treatment response. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30080-1] [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]
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41
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Roche H, Finucane O, Lyons C, Murphy A, Reynolds C, Healy N, Tierney A, Morine M, Alcala‐Diaz J, Lopez‐Miranda J, O'Neill L, McGillicuddy F. Monounsaturated Fatty Acid High‐Fat Diets Impede Adipose IL‐1β Secretion and Insulin Resistance. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.602.7] [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] [Indexed: 11/11/2022]
Affiliation(s)
- H Roche
- NutrigenomicsResearch Group UCDIreland
| | | | - C Lyons
- NutrigenomicsResearch Group UCDIreland
| | - A Murphy
- NutrigenomicsResearch Group UCDIreland
| | | | - N Healy
- NutrigenomicsResearch Group UCDIreland
| | - A Tierney
- Department of Dietetics and Human Nutrition La Trobe UniversityAustralia
| | - M Morine
- Microsoft Research and University of Trento Centre for Computational and Systems Biology University of TrentoItaly
| | - J Alcala‐Diaz
- Lipids and Atherosclerosis Research Unit University of CordobaSpain
| | - J Lopez‐Miranda
- Lipids and Atherosclerosis Research Unit University of CordobaSpain
| | - L O'Neill
- InflammatoryResearch Group TCDIreland
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O'Reilly M, Finucane O, Jones D, Murphy A, Lyons C, de la Llera Moya M, Reilly M, Roche H, McGillicuddy F. Fatty acid manipulation of obesity – consequences for high-density lipoprotein protein composition and macrophage-to-feces reverse cholesterol transport (rct). Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.110] [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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Thirion P, Mihai A, Lyons C, Wynn R, Armstrong J, Rock L, Heron D. Implementation of LINAC-based Stereotactic Ablative Radiation Therapy (SABR) for Early-Stage Nonoperable Non-small Cell Lung Cancer (NSCLC) in Community-based Radiation Therapy Practice: A Transatlantic Hub-and-Spoke Experience. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1596] [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: 10/27/2022]
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Giaschi D, Narasimhan S, Lo R, Lyons C, Gardiner J, Aroichane M, Wilcox L. Sparing of coarse stereopsis in children with amblyopia. J Vis 2012. [DOI: 10.1167/12.9.1364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Brimer N, Lyons C, Wallberg AE, Vande Pol SB. Cutaneous papillomavirus E6 oncoproteins associate with MAML1 to repress transactivation and NOTCH signaling. Oncogene 2012; 31:4639-46. [PMID: 22249263 PMCID: PMC3330202 DOI: 10.1038/onc.2011.589] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Papillomavirus E6 oncoproteins associate with LXXLL motifs on target cellular proteins to alter their function. Using a proteomic approach, we found the E6 oncoproteins of cutaneous papillomaviruses Bovine Papillomavirus Type 1 (BE6) and HPV types 1 and 8 (1E6 and 8E6) associated with the MAML1 transcriptional co-activator. All three E6 proteins bind to an acidic LXXLL motif at the carboxy-terminus of MAML1 and repress transactivation by MAML1. MAML1 is best known as the co-activator and effector of NOTCH induced transcription, and BPV-1 E6 represses synthetic NOTCH responsive promoters, endogenous NOTCH responsive promoters, and is found in a complex with MAML1 in stably transformed cells. BPV-1 induced papillomas show characteristics of repressed NOTCH signal transduction, including suprabasal expression of integrins, talin, and basal type keratins, and delayed expression of the NOTCH dependent HES1 transcription factor. These observations give rise to a model whereby papillomavirus oncoproteins including BPV-1 E6 and the cancer associated HPV-8 E6 repress Notch induced transcription, thereby delaying keratinocyte differentiation.
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Affiliation(s)
- N Brimer
- Department of Pathology, University of Virginia, Charlottesville, VA 22908-0904, USA
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Pavel H, Ajeawung N, Faure R, Poirier D, Kamnasaran D, Ajeawung N, Joshi H, Kamnasaran D, Poirier D, Ajeawung N, Kamnasaran D, Lun X, Zemp F, Sun B, Stechishin O, Luchman A, Kelly JJ, Weiss S, Hamilton MG, Cairncross G, Senger DL, Bell J, McFadden G, Forsyth PA, Tzeng SY, Guerrero-Cazares H, Martinez EE, Young NP, Sunshine JC, Quinones-Hinojosa A, Green JJ, Lei L, D'Amico R, Sisti J, Leung R, Sonabend AM, Guarnieri P, Rosenfeld SS, Bruce JN, Canoll P, Baichwal VR, Reeves L, Chad BL, Zavitz KH, Beelen AP, Mather GG, Carlson RO, Manton C, Chandra J, Keir ST, Reardon DA, Saling JR, Gray LS, Bigner DD, Friedman HS, Zhang J, Brun J, Ogbomo H, Zemp F, Wang Z, Stojdl DJ, Lun X, Forsyth PA, Kong LY, Hatiboglu MA, Wei J, Wang Y, McEnery KA, Fuller GN, Qiao W, Davies MA, Priebe W, Heimberger AB, Amendolara B, Gil O, Lei L, Ivkovic S, Bruce J, Canoll P, Rosenfeld S, Finniss S, Perlstein B, Miller C, Okhrimenko H, Kazimirsky G, Cazacu S, Lemke N, Brodie S, Rempel SA, Rosenblum M, Mikkelsen T, Margel S, Brodie C, Guvenc H, Demir H, Gupta S, Mazumder S, Ray-Chaundhury A, Li T, Li C, Nakano I, Rahman R, Rahman C, Smith S, Macarthur D, Rose F, Shakesheff K, Grundy RG, Brenner AJ, Goins B, Bao A, Miller J, Trevino A, Zuniga R, Phillips WT, Gilg AG, Bowers KG, Toole BP, Maria BL, Leung GK, Sun S, Wong ST, Zhang XQ, Pu JK, Lui WM, Marino AM, Hussaini IM, Amos S, Simpson K, Redpath GT, Lyons C, Dipierro C, Grant GA, Wilson C, Salami S, Macaroni P, Li S, Park JY, Needham D, Bigner D, Dewhirst M, Ohlfest J, Gallardo J, Argawal S, Mittapalli R, Donelson R, Elmquist WF, Nicolaides T, Hariono S, Barkovich K, Hashizume R, Rowitch D, Weiss W, Sheer D, Baker S, Paugh B, Waldman T, Li H, Jones C, Forshew T, James D, Caroline H, Patrick R, Katrin L, Karl F, Ghazaleh T, Michael W, Albrecht V, Thorsteinsdottir J, Wagner E, Tonn JC, Ogris M, Schichor C, Charest G, Paquette B, Sanche L, Mathieu D, Fortin D, Qi X, Cuttitta F, Chu Z, Celerier J, Pakradouni J, Rixe O, Hashizume R, Gragg A, Muller S, Banerjee A, Phillips J, Prados M, Haas-Kogan D, Gupta N, James D, Florence L, Gwendoline VG, Veronique M, Robert K, Agarwal S, Mittapalli RK, Cen L, Carlson BL, Elmquist WF, Sarkaria JN, Sengupta S, Weeraratne SD, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Rotenberg A, Cook J, Pomeroy SL, Jenses F, Cho YJ, Hjouj M, Last D, Guez D, Daniels D, Lavee J, Rubinsky B, Mardor Y, Serwer LP, Noble CO, Michaud K, Drummond DC, Ozawa T, Zhou Y, Marks JD, Bankiewicz K, Park JW, James D, Wang W, Cho H, Weintraub M, Jhaveri N, Torres S, Petasis N, Schonthal AH, Louie SG, Hofman FM, Chen TC, Grada Z, Hegde M, Schaffer DR, Ghazi A, Byrd T, Dotti G, Wels W, Heslop HE, Gottschalk S, Baker M, Ahmed N, Hamblett KJ, Kozlosky CJ, Liu H, Siu S, Arora T, Retter MW, Matsuda K, Hill JS, Fanslow WC, Diaz RJ, Etame A, Meaghan O, Mainprize T, Smith C, Hynynen K, Rutka J, Pradarelli J, Yoo JY, Kaka A, Alvarez-Breckenridge C, Pan Q, Chiocca EA, Teknos T, Kaur B, Lee SY, Slagle-Webb B, Sheehan JM, Connor JR, Cote J, Lepage M, Gobeil F, Fortin D, Kleijn A, Balvers R, Kloezeman J, Dirven C, Lamfers M, Leenstra S, See W, Tan IL, Nicolaides T, Pieper R, Jiang H, White E, Rios-Vicil CI, Yung WKA, Gomez-Manzano C, Fueyo J, Zemp FJ, McKenzie BA, Lun X, McFadden G, Forsyth PA, Mueller S, Yang X, Hashizume R, Gragg A, Smirnov I, Prados M, James DC, Phillips JJ, Berger MS, Rowitch DH, Gupta N, Haas-Kogan DH, D'Amico R, Lei L, Kennedy B, Rosenfeld SS, Canoll P, Bruce JN, Gopalakrishnan V, Das C, Taylor P, Kommagani R, Su X, Aguilera D, Thomas A, Wolff J, Flores E, Kadakia M, Alkins R, Broderson P, Sodhi R, Hynynen K, Chung SA, McDonald KL, Shen H, Day BW, Stringer BW, Johns T, Decollogne S, Teo C, Hogg PJ, Dilda PJ, Patel TR, Zhou J, Piepmeier JM, Saltzman WM, Vogelbaum MA, Agarwal S, Manchanda P, Ohlfest JR, Elmquist WF, Kitange GJ, Mladek AC, Carlson BL, Schroeder MA, Pokorny JL, Sarkaria JN, Ogbomo H, Lun X, Zhang J, McFadden G, Mody C, Forsyth P, Dasgupta T, Yang X, Hashizume R, Gragg A, Prados M, Nicolaides T, James CD, Haas-Kogan D, Madhankumar AB, Webb BS, Park A, Harbaugh K, Sheehan J, Connor JR. PRECLINICAL EXPERIMENTAL THERAPEUTICS AND PHARMACOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Barry A, Lyons C, Dunne M, Thirion P, Armstrong J. Temporal Patterns Of Bowel And Bladder Toxicity In A Randomized Controlled Trial Assessing Duration Of Neoadjuvant Hormones In Prostate Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.685] [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: 11/26/2022]
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Duane F, Gillham C, Rangaswamy G, Walsh L, Lyons C, Dunne M, Langan B, Walker C, McArdle O. 645 poster IMPACT OF DELINEATION ERROR ON DOSE TO ORGANS AT RISK IN IMAGE-GUIDED BRACHYTHERAPY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70767-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Paul A, John H, Oakley L, Deeley D, Samaranayaka M, Klocke R, Murley A, Webb E, Al-Allaf A, Panchal S, Moorthy A, Samanta A, Rajak R, Zaman M, Camilleri J, Nash J, Negi A, Jones S, Hull DN, Smith AS, Taylor PC, Hughes L, Done J, Young A, Colijn E, Franssen M, Rabsztyn PRI, van den Ende CHM, Williams A, Graham A, Davies S, Longrigg K, Dagg A, Lyons C, Bowen C, Wright S, Cornell P, Richards S. BHPR - audit/service delivery: 93. Taking Care of the Foot Health of Rheumatology Patients: Where Do We Stand Now? Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ward HK, Lyons C. STUDIES ON THE HEMOLYTIC STREPTOCOCCUS OF HUMAN ORIGIN : I. OBSERVATIONS ON THE VIRULENT, ATTENUATED, AND AVIRULENT VARIANTS. ACTA ACUST UNITED AC 2010; 61:515-30. [PMID: 19870376 PMCID: PMC2133238 DOI: 10.1084/jem.61.4.515] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
1. Four common variants of the hemolytic streptococcus of human origin have been described. These have been designated the F, M, attenuated M, and C variants. 2. The F and M variants only have been isolated from the blood stream in streptococcal infections. Only the M, however, has any primary virulence for the mouse. 3. Both these variants resist phagocytosis in human blood under suitable conditions, and this appears to be a reliable test for human virulence. 4. The attenuated M variant, found only in laboratory cultures, has a capsule as well developed as that of the virulent variants, and yet does not resist phagocytosis. 5. The C variant has no capsule and is readily phagocyted. It appears to correspond to the avirulent variant in other species. 6. An attempt has been made to correlate these four variants with those already described in the literature. 7. The application of these findings to the problem of virulence has been discussed.
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Affiliation(s)
- H K Ward
- Department of Bacteriology and Immunology of The Harvard Medical School, Boston
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