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Angeli SI, Brown CS, Holcomb MA, Velandia SL, Eshraghi AA, Chiossone-Kerdel JA, Hoffer ME, Sanchez C, Telischi FF. Functional Hearing Preservation in Cochlear Implantation: The Miami Cocktail Effect. Otol Neurotol 2024; 45:376-385. [PMID: 38361325 DOI: 10.1097/mao.0000000000004134] [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: 02/17/2024]
Abstract
OBJECTIVE To investigate if pharmacological treatment with prednisone and L-N-acetylcysteine (STE + NAC) influence functional hearing preservation in cochlear implant (CI) surgery. STUDY DESIGNS Preimplantation and postimplantation longitudinal case-control study. SETTING Tertiary referral center. PATIENTS Pediatric and adult recipients of CI with preimplantation functional hearing defined as an average of air-conducted thresholds at 125, 250, and 500 Hz (low-frequency pure-tone average [LFPTA]) <80 dB. INTERVENTIONS Preimplantation and postimplantation audiometry. Weight-adjusted oral prednisone and L-N-acetylcysteine starting 2 days before surgery (Miami cocktail). Prednisone was continued for 3 days and L-N-acetylcysteine for 12 days after surgery, respectively. Cochlear implantation with conventional length electrodes. MAIN OUTCOME MEASURES Proportion of patients with LFPTA <80 dB, and LFPTA change at 1-year postimplantation. RESULTS All 61 patients received intratympanic and intravenous dexamethasone intraoperatively, with 41 patients receiving STE + NAC and 20 patients not receiving STE + NAC. At 1-year postimplantation, the proportion of functional hearing preservation was 83% in the STE + NAC group compared with 55% of subjects who did not receive STE + NAC ( p = 0.0302). The median LFPTA change for STE + NAC-treated and not treated subjects was 8.33 dB (mean, 13.82 ± 17.4 dB) and 18.34 dB (mean, 26.5 ± 23.4 dB), respectively ( p = 0.0401, Wilcoxon rank test). Perioperative STE + NAC treatment resulted in 10 dB of LFPTA better hearing than when not receiving this treatment. Better low-frequency preimplantation hearing thresholds were predictive of postimplantation functional hearing. No serious side effects were reported. CONCLUSION Perioperative STE + NAC, "The Miami Cocktail," was safe and superior to intraoperative steroids alone in functional hearing preservation 1-year after cochlear implantation.
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Affiliation(s)
| | | | - Meredith A Holcomb
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Sandra L Velandia
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Adrien A Eshraghi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | | | | | - Chrisanda Sanchez
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Fred F Telischi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Moore G, Barry A, Carter J, Ready J, Wan Y, Elsayed M, Haill C, Khashu M, Williams OM, Brown CS, Demirjian A, Ready D. Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England. J Hosp Infect 2023; 140:8-14. [PMID: 37487793 DOI: 10.1016/j.jhin.2023.06.030] [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] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The multidrug-resistant Staphylococcus capitis clone, NRCS-A, is increasingly associated with late-onset sepsis in low birthweight newborns in neonatal intensive care units (NICUs) in England and globally. Understanding where this bacterium survives and persists within the NICU environment is key to developing and implementing effective control measures. AIM To investigate the potential for S. capitis to colonize surfaces within NICUs. METHODS Surface swabs were collected from four NICUs with and without known NRCS-A colonizations/infections present at the time of sampling. Samples were cultured and S. capitis isolates analysed via whole-genome sequencing. Survival of NRCS-A on plastic surfaces was assessed over time and compared to that of non-NRCS-A isolates. The bactericidal activity of commonly used chemical disinfectants against S. capitis was assessed. FINDINGS Of 173 surfaces sampled, 40 (21.1%) harboured S. capitis with 30 isolates (75%) being NRCS-A. Whereas S. capitis was recovered from surfaces across the NICU, the NRCS-A clone was rarely recovered from outside the immediate neonatal bedspace. Incubators and other bedside equipment were contaminated with NRCS-A regardless of clinical case detection. In the absence of cleaning, S. capitis was able to survive for three days with minimal losses in viability (<0.5 log10 reduction). Sodium troclosene and a QAC-based detergent/disinfectant reduced S. capitis to below detectable levels. CONCLUSION S. capitis NRCS-A can be readily recovered from the NICU environment, even in units with no recent reported clinical cases of S. capitis infection, highlighting a need for appropriate national guidance on cleaning within the neonatal care environment.
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Affiliation(s)
- G Moore
- UK Health Security Agency, UK.
| | - A Barry
- UK Health Security Agency, UK
| | | | - J Ready
- UK Health Security Agency, UK
| | - Y Wan
- UK Health Security Agency, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK
| | - M Elsayed
- Royal United Hospital, Bath NHS Foundation Trust, Bath, UK; Southmead Hospital, North Bristol Trust, Bristol, UK
| | - C Haill
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - M Khashu
- University Hospitals Dorset, Poole, UK
| | - O M Williams
- UK Health Security Agency, UK; Bristol Royal Infirmary, Bristol NHS Foundation Trust, UK
| | - C S Brown
- UK Health Security Agency, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK
| | - A Demirjian
- UK Health Security Agency, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, London, UK; Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - D Ready
- UK Health Security Agency, UK; Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
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Taori SK, Rhodes J, Khonyongwa K, Szendroi A, Smith M, Borman AM, Kumarage J, Brown CS, Moore G, Desai N. First experience of implementing Candida auris real-time PCR for surveillance in the UK: detection of multiple introductions with two international clades and improved patient outcomes. J Hosp Infect 2022; 127:111-120. [PMID: 35753522 DOI: 10.1016/j.jhin.2022.06.009] [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: 02/02/2022] [Revised: 05/14/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Candida auris has been associated with rapid transmission and high mortality. A novel PCR-based surveillance programme was initiated at a London teaching hospital from January 2018. The results of this implementation until March 2019 are presented along with the clinical, transmission and phylogenetic characteristics encountered in that setting. METHODS A real-time PCR assay for C. auris was developed, validated, and implemented for direct use on skin swabs and urine. Environmental swabs were also tested by PCR as an emergency outbreak-control measure. Clinical risk factors and outcomes of patients were determined. Environmental dispersal was assessed using 24 h settle plate cultures around nine colonized patients followed by air sampling around one colonized patient during high- and low-turbulence activities. Sequencing was performed using Illumina HiSeq and maximum likelihood phylogenies were constructed using rapid bootstrap analysis. RESULTS Twenty-one C. auris colonized patients were identified. Median turnaround time of colonization detection reduced from 141 h (5.8 days) to approximately 24 h enabling rapid infection-control precautions. Settle plates detected 70-600 cfu/m2 around colonized patients over 24 h and air sampling suggested dispersal during turbulent activities. C. auris DNA was detected from 35.7% environmental swabs. Despite being in a high-risk setting, no patients developed invasive infection. Sequencing analysis of isolates from this centre identified two introductions of the South Asian (Clade I) and one of the South African (Clade III) strain. CONCLUSION The PCR offers a rapid, scalable method of screening and supports clinical risk reduction in settings likely to encounter multiple introductions.
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Affiliation(s)
- S K Taori
- Department of Medical Microbiology, NHS Lothian, Edinburgh, UK.
| | - J Rhodes
- Imperial College London, London, UK
| | - K Khonyongwa
- Information Services, UK Health Security Agency, London, UK
| | - A Szendroi
- Department of Infection Sciences, King's College Hospital NHS Foundation Trust, London, UK
| | - M Smith
- Department of Infection Sciences, King's College Hospital NHS Foundation Trust, London, UK
| | - A M Borman
- UK National Mycology Reference Laboratory, National Infection Service, UK Health Security Agency and Medical Research Council Centre for Medical Mycology at the University of Exeter, Exeter, UK
| | - J Kumarage
- Department of Infection Sciences, King's College Hospital NHS Foundation Trust, London, UK
| | - C S Brown
- HCAI/AMR, National Infection Service, UK Health Security Agency, London, UK
| | - G Moore
- Biosafety, Air and Water Microbiology Group, National Infection Service, UK Health Security Agency, London, UK
| | - N Desai
- Department of Infection Sciences, King's College Hospital NHS Foundation Trust, London, UK
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Lamagni T, Wloch C, Broughton K, Collin SM, Chalker V, Coelho J, Ladhani SN, Brown CS, Shetty N, Johnson AP. Assessing the added value of group B Streptococcus maternal immunisation in preventing maternal infection and fetal harm: population surveillance study. BJOG 2021; 129:233-240. [PMID: 34324252 PMCID: PMC9291181 DOI: 10.1111/1471-0528.16852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the incidence of maternal group B Streptococcus (GBS) infection in England. DESIGN Population surveillance augmented through data linkage. SETTING England. POPULATION All pregnant women accessing the National Health Service (NHS) in England. METHODS Invasive GBS (iGBS) infections during pregnancy or within 6 weeks of childbirth were identified by linking Public Health England (PHE) national microbiology surveillance data for 2014 to NHS hospital admission records. Capsular serotypes of GBS were determined by reference laboratory typing of clinical isolates from women aged 15-44 years. Post-caesarean section surgical site infection (SSI) caused by GBS was identified in 21 hospitals participating in PHE SSI surveillance (2009-2015). MAIN OUTCOME MEASURES iGBS rate per 1000 maternities; risk of GBS SSI per 1000 caesarean sections. RESULTS Of 1601 patients diagnosed with iGBS infections in England in 2014, 185 (12%) were identified as maternal infections, a rate of 0.29 (95% CI 0.25-0.33) per 1000 maternities and representing 83% of all iGBS cases in women aged 18-44 years. Seven (3.8%) were associated with miscarriage. Fetal outcome identified excess rates of stillbirth (3.4 versus 0.5%) and extreme prematurity (<28 weeks of gestation, 3.7 versus 0.5%) compared with national averages (P < 0.001). Caesarean section surveillance in 27 860 women (21 hospitals) identified 47 cases of GBS SSI, with an estimated 4.24 (3.51-5.07) per 1000 caesarean sections, a median time-to-onset of 10 days (IQR 7-13 days) and ten infections that required readmission. Capsular serotype analysis identified a diverse array of strains with serotype III as the most common (43%). CONCLUSIONS Our assessment of maternal GBS infection in England indicates the potential additional benefit of GBS vaccination in preventing adverse maternal and fetal outcomes.
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Affiliation(s)
- T Lamagni
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - C Wloch
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - K Broughton
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - S M Collin
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - V Chalker
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - J Coelho
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - S N Ladhani
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - C S Brown
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - N Shetty
- Respiratory and Vaccine Preventable Reference Unit, Bacteriology Reference Department, National Infection Service, Public Health England, London, UK
| | - A P Johnson
- Healthcare-Associated Infection & Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
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Maynard-Smith L, Brown CS, Harris RJ, Hodkinson P, Tamne S, Anderson SR, Zenner D. Contact tracing following in-flight exposure to TB: why the 8-hour rule? Int J Tuberc Lung Dis 2021; 25:593-595. [PMID: 34183108 DOI: 10.5588/ijtld.21.0141] [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: 11/10/2022] Open
Affiliation(s)
- L Maynard-Smith
- National Infection Service, Public Health England, London, UK, Hospital for Tropical Diseases, London, UK
| | - C S Brown
- National Infection Service, Public Health England, London, UK, Department of Infection, Royal Free Hospital, London, UK
| | - R J Harris
- National Infection Service, Public Health England, London, UK
| | - P Hodkinson
- Aerospace Medicine Group, King´s College London, London, UK
| | - S Tamne
- National Infection Service, Public Health England, London, UK
| | - S R Anderson
- National Infection Service, Public Health England, London, UK
| | - D Zenner
- Institute for Global Health, University College London, London, UK
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Brown CS, Cunningham CD, Lee WT, Puscas L. Development of a Surgical Video Atlas for Resident Education: 3-Year Experience. OTO Open 2020; 4:2473974X20939067. [PMID: 32704610 PMCID: PMC7361475 DOI: 10.1177/2473974x20939067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022] Open
Abstract
Objective To create a high-quality annotated online surgical video atlas of key indicator otolaryngology cases and assess its use and overall journal trends over time. Methods Videos are recorded from multiple viewpoints within the operating room and compiled into a single stream. Postediting includes chaptering videos and overlaying relevant text annotations. Videos are published online and viewership trends analyzed. Results Over 3 years, 29 otolaryngology videos were published out of 161 journal publications (18%). Eight of the 14 key indicator procedures are included (57%). From the beginning of 2017 to the end of 2019, viewership of otolaryngology pages increased from 548 to 11,139 views per month, totaling >150,000 views. These now represent 10% of the total journal monthly views and 10% of the overall views. Users originate from the United States and from >10 other countries. Discussion Residents and faculty face challenges of providing the highest standard of clinical care, teaching, and learning in and out of the operating room. Inherent difficulties of surgical training, high-fidelity surgical simulation, and imposed work hour restrictions necessitate additional, more efficient and effective means of teaching and learning. Surgical videos demonstrating key anatomy, procedural steps, and surgical dexterity with hand positioning are increasing in their popularity among learners. Implications for Practice Surgical video atlases provide a unique adjunct for resident education. They are enduring and easily accessible. In a climate of work hour restrictions or elective case reduction, they may supplement how residents learn to operate outside the operating theater.
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Affiliation(s)
- C Scott Brown
- Department of Otolaryngology-Head and Neck Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Calhoun D Cunningham
- Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Walter T Lee
- Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Liana Puscas
- Department of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA
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Brown CS, Johnson LR, Visser LC, Chan JC, Pollard RE. Comparison of fluoroscopic cardiovascular measurements from healthy dogs obtained at end-diastole and end-systole. J Vet Cardiol 2020; 29:1-10. [PMID: 32348932 DOI: 10.1016/j.jvc.2020.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 02/04/2020] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Quantitative measurements are commonly implemented to objectively evaluate heart size in dogs. However, recent studies suggest that the phase of cardiac cycle can impact vertebral heart score, thereby potentially influencing clinical management. This study used fluoroscopy to assess the impact of the cardiac cycle on quantitative cardiovascular measurements in healthy dogs of various breeds. ANIMALS, MATERIALS, AND METHODS This was a prospective study. Multiple cardiac and respiratory cycles were recorded fluoroscopically. Peak inspiratory end-systole and end-diastole frames were captured from 49 dogs in right lateral recumbency. Vertebral heart score (VHS), cardiothoracic ratio (CTR), vertebral left atrial size (VLAS), and caudal vena cava diameter ratio (CVCDR) measurements were performed. Mean cardiac measurements were compared between cardiac cycle phases, and the impact of body condition score (BCS), weight, thoracic conformation, sex, and age was evaluated. RESULTS Cardiac cycle had a significant impact on VHS (mean difference: 0.36 ± 0.14 vertebral units between systole and diastole; p < 0.001) and CTR (mean difference: 2.2 ± 1.2% between systole and diastole; p < 0.001). Cardiac cycle had no significant impact on VLAS or CVCDR. Increasing BCS significantly increased variation between systole and diastole in CTR measurements (p = 0.024). CONCLUSIONS The cardiac cycle has a significant effect on VHS and CTR but does not impact VLAS or CVCDR. These findings should be taken into consideration during clinical use of these measurements, especially if a patient is being monitored for cardiac changes over time via serial radiographs.
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Affiliation(s)
- C S Brown
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA.
| | - L R Johnson
- William R. Pritchard Veterinary Medical Teaching Hospital, Department of Medicine and Epidemiology, University of California, Davis, CA 95616, USA
| | - L C Visser
- William R. Pritchard Veterinary Medical Teaching Hospital, Department of Medicine and Epidemiology, University of California, Davis, CA 95616, USA
| | - J C Chan
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA
| | - R E Pollard
- William R. Pritchard Veterinary Medical Teaching Hospital, Department of Surgical and Radiological Sciences, University of California, Davis, CA 95616, USA
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Risch AC, Zimmermann S, Ochoa-Hueso R, Schütz M, Frey B, Firn JL, Fay PA, Hagedorn F, Borer ET, Seabloom EW, Harpole WS, Knops JMH, McCulley RL, Broadbent AAD, Stevens CJ, Silveira ML, Adler PB, Báez S, Biederman LA, Blair JM, Brown CS, Caldeira MC, Collins SL, Daleo P, di Virgilio A, Ebeling A, Eisenhauer N, Esch E, Eskelinen A, Hagenah N, Hautier Y, Kirkman KP, MacDougall AS, Moore JL, Power SA, Prober SM, Roscher C, Sankaran M, Siebert J, Speziale KL, Tognetti PM, Virtanen R, Yahdjian L, Moser B. Soil net nitrogen mineralisation across global grasslands. Nat Commun 2019; 10:4981. [PMID: 31672992 PMCID: PMC6823350 DOI: 10.1038/s41467-019-12948-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 10/10/2019] [Indexed: 11/17/2022] Open
Abstract
Soil nitrogen mineralisation (Nmin), the conversion of organic into inorganic N, is important for productivity and nutrient cycling. The balance between mineralisation and immobilisation (net Nmin) varies with soil properties and climate. However, because most global-scale assessments of net Nmin are laboratory-based, its regulation under field-conditions and implications for real-world soil functioning remain uncertain. Here, we explore the drivers of realised (field) and potential (laboratory) soil net Nmin across 30 grasslands worldwide. We find that realised Nmin is largely explained by temperature of the wettest quarter, microbial biomass, clay content and bulk density. Potential Nmin only weakly correlates with realised Nmin, but contributes to explain realised net Nmin when combined with soil and climatic variables. We provide novel insights of global realised soil net Nmin and show that potential soil net Nmin data available in the literature could be parameterised with soil and climate data to better predict realised Nmin.
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Affiliation(s)
- A C Risch
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland.
| | - S Zimmermann
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - R Ochoa-Hueso
- Department of Biology, IVAGRO, University of Cádiz, Campus de Excelencia Internacional Agroalimentario (ceiA3), Campus Rio San Pedro, 11510, Puerto Real, Cádiz, Spain
| | - M Schütz
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - B Frey
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - J L Firn
- Queensland University of Technology (QUT), School of Earth, Environmental and Biological Sciences, Science and Engineering Faculty, Brisbane, QLD, 4001, Australia
| | - P A Fay
- USDA-ARS Grassland Soil, and Water Research Laboratory, Temple, TX, 76502, USA
| | - F Hagedorn
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
| | - E T Borer
- Department of Ecology, Evolution, and Behavior, University of Minnesota, St. Paul, MN, USA
| | - E W Seabloom
- Department of Ecology, Evolution, and Behavior, University of Minnesota, St. Paul, MN, USA
| | - W S Harpole
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Institute of Biology, Martin Luther University Halle-Wittenberg, Am Kirchtor 1, Halle (Saale), 06108, Germany
| | - J M H Knops
- School of Biological Sciences, University of Nebraska, 211A Manter Hall, Lincoln, NE, 68588, USA
- Department of Health and Environmental Sciences, Xi'an Jiaotong Liverpool University, Suzhou, 215213, China
| | - R L McCulley
- Department of Plant & Soil Sciences, University of Kentucky, Lexington, KY, 40546-0312, USA
| | - A A D Broadbent
- School of Earth and Environmental Sciences, Michael Smith Building, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK
- Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK
| | - C J Stevens
- Lancaster Environment Centre, Lancaster University, Lancaster, LA1 4YQ, UK
| | - M L Silveira
- University of Florida, Range Cattle Research and Education Center, Ona, FL, 33865, USA
| | - P B Adler
- Department of Wildland Resources and the Ecology Center, Utah State University, 5230 Old Main, Logan, UT, 84103, USA
| | - S Báez
- Departamento de Biología, Escuela Politécnica Nacional del Ecuador, Ladrón de Guevera E11-253 y Andalucía, Quito, Ecuador
| | - L A Biederman
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, 50011, USA
| | - J M Blair
- Division of Biology, Kansas State University, Manhattan, KS, 66502, USA
| | - C S Brown
- Department of Bioagricultural Sciences and Pest Management, Graduate Degree Program in Ecology, Colorado State University, 1177 Campus Delivery, Fort Collins, CO, USA
| | - M C Caldeira
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017, Lisboa, Portugal
| | - S L Collins
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - P Daleo
- Instituto de Investigaciones Marinas y Costeras (IIMyC), Universidad Nacional de Mar del Plata, CONICET, Mar del Plata, Argentina
| | - A di Virgilio
- INIBIOMA (CONICET-UNCOMA), Universidad Nacional del Comahue, Grupo de Investigaciones en Biología de la Conservación (GrInBiC) Laboratorio Ecotono, Quintral, 1250, Bariloche, Argentina
| | - A Ebeling
- Institute of Ecology and Evolution, Friedrich-Schiller-University Jena, Dornburger Str. 159, 07743, Jena, Germany
| | - N Eisenhauer
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Institute of Biology, Leipzig University, Deutscher Platz 5e, 04103, Leipzig, Germany
| | - E Esch
- University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92037, USA
| | - A Eskelinen
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Ecology and Genetics, University of Oulu, Pentti Kaiteran katu 1, 90014, Oulu, Finland
| | - N Hagenah
- Mammal Research Institute, Department of Zoology & Entomology, University of Pretoria, Pretoria, South Africa
| | - Y Hautier
- Ecology and Biodiversity Group, Department of Biology, Utrecht University, Padualaan 8, 3584 CH, Utrecht, The Netherlands
| | - K P Kirkman
- University of KwaZulu-Natal, Pietermaritzburg, Private Bag X01, Scottsville, 3209, South Africa
| | - A S MacDougall
- Department of Integrative Biology, University of Guelph, Guelph, N1G 2W1, ON, Canada
| | - J L Moore
- School of Biological Sciences, Monash University, Claytion, VIC, 3800, Australia
| | - S A Power
- Hawkesbury Institute for the Environment, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - S M Prober
- CSIRO Land and Water, Private Bag 5, Wembley, WA, 6913, Australia
| | - C Roscher
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
| | - M Sankaran
- National Centre for Biological Sciences, TIFR, Bangalore, 560065, India
- School of Biology, University of Leeds, Leeds, LS2 9JT, UK
| | - J Siebert
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Institute of Biology, Leipzig University, Deutscher Platz 5e, 04103, Leipzig, Germany
| | - K L Speziale
- INIBIOMA (CONICET-UNCOMA), Universidad Nacional del Comahue, Grupo de Investigaciones en Biología de la Conservación (GrInBiC) Laboratorio Ecotono, Quintral, 1250, Bariloche, Argentina
| | - P M Tognetti
- Universidad de Buenos Aires, Facultad de Agronomía, Instituto de Investigaciones Fisiológicas y Ecológicas vinculadas a la Agricultura (IFEVA), CONICET, Buenos Aires, Argentina
| | - R Virtanen
- Department of Physiological Diversity, Helmholtz Center for Environmental Research-UFZ, Permoserstrasse 15, Leipzig, 04318, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Ecology and Genetics, University of Oulu, Pentti Kaiteran katu 1, 90014, Oulu, Finland
| | - L Yahdjian
- Universidad de Buenos Aires, Facultad de Agronomía, Instituto de Investigaciones Fisiológicas y Ecológicas vinculadas a la Agricultura (IFEVA), CONICET, Buenos Aires, Argentina
| | - B Moser
- Swiss Federal Institute for Forest, Snow and Landscape Research WSL, Zuercherstrasse 111, 8903, Birmensdorf, Switzerland
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9
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Brown CS, Peskoe SB, Risoli T, Garrison DB, Kaylie DM. Associations of Video Head Impulse Test and Caloric Testing among Patients with Vestibular Schwannoma. Otolaryngol Head Neck Surg 2019; 161:324-329. [PMID: 30909803 DOI: 10.1177/0194599819837244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine relationships between caloric testing (CT) and video head impulse testing (vHIT) among patients with unilateral vestibular schwannoma (VS). To describe the distribution of CT and vHIT measurements and assess associations with tumor size and self-perceived handicapping effects. STUDY DESIGN Retrospective review. SETTING Tertiary referral hospital. SUBJECTS AND METHODS Subjects were adults with presumed unilateral VS between 2014 and 2017. Interventions were CT and vHIT. Primary outcomes were vHIT value (abnormal <0.8) and CT value (abnormal >25%). Secondary outcomes were tumor size and Dizziness Handicap Inventory scores. RESULTS Fifty-one individuals had complete data for CT and vHIT. The odds of abnormal gain increases by 2.18 for every 10% increase in unilateral weakness on CT (range, 1.44-3.34; P < .001). A significant negative correlation between CT and gain exists (rs = -0.64, P < .001). Odds of observing saccades increased by 2.68 for every 10% increase in unilateral weakness (range, 1.48-4.85; P = .001). This association was larger in magnitude for overt than covert saccades (odds ratios, 2.48 and 1.59, respectively). Tumor size was significantly associated with an increase in caloric weakness (β = 0.135, P < .001). With every 10-mm increase of tumor size, odds of abnormal gain on vHIT increased 4.13 (range, 1.46-11.66; P = .007). Mean Dizziness Handicap Inventory score was 19.7 (σ = 22), without association to caloric weakness, gain, or tumor size. CONCLUSION CT and vHIT both effectively assess vestibular function for patients with VS and correlate to tumor size. These findings are important as vHIT has a lower overall cost, improved patient tolerance, and demonstrated reliability.
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Affiliation(s)
- C Scott Brown
- 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Sarah B Peskoe
- 2 Biostatistics Core, Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Thomas Risoli
- 2 Biostatistics Core, Department of Biostatistics and Bioinformatics, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Douglas B Garrison
- 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - David M Kaylie
- 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
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10
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Brown CS, Abi Hachem R, Pendse A, Madden JF, Francis HW. Low-Grade Papillary Schneiderian Carcinoma of the Sinonasal Cavity and Temporal Bone. Ann Otol Rhinol Laryngol 2018; 127:974-977. [PMID: 30269519 DOI: 10.1177/0003489418803391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES: The aim of this study was to further characterize a newly described neoplasm, low-grade papillary Schneiderian carcinoma, occurring simultaneously in the sinonasal cavity and mastoid. Additionally, the authors review the only 2 similar cases within the literature and describe the common clinical features, radiographic findings, and pathologic characteristics of this exceptionally rare disease process. METHODS: Chart review for single patient, review of literature. RESULTS: The patient presented with bilateral nasal obstruction. Computed tomography revealed a left sinonasal mass with skull base hyperostosis, and follow-up magnetic resonance imaging showed a concomitant olfactory groove meningioma. Examination showed a bilateral, completely obstructing sinonasal mass with skip areas, and biopsy confirmed inverted papilloma (human papilloma virus strains 16 and 18 indeterminate). The patient underwent bilateral endoscopic sinus surgery, left medial maxillectomy, and left partial nasopharyngectomy. Given her multifocal disease, she was advised that she would require additional excision, but was lost to follow up. One year later she developed acute left facial paralysis. Magnetic resonance imaging demonstrated an enhancing mass in the left mastoid with enhancement along the Eustachian tube in addition to her known recurrent sinonasal disease. Simultaneous endoscopic sinus surgery and mastoidectomy were performed. Polypoid tissue was removed from the nasopharynx, mesotympanum, epitympanum, and retrofacial air cells. Immunohistochemistry showed that cells stained positive for p63 and dermCK and negative for synaptophysin. Morphologically, cells were bland, without classic stromal invasion, retaining their smooth, cystic, and papillary features, despite their increased depth within the tissue. Upon further review and consultation with an outside pathologist, a diagnosis of low-grade papillary Schneiderian carcinoma was made. The patient was referred for radiation therapy and is disease free at 3-month follow-up, with return of her facial function. CONCLUSIONS: This case represents the first report of concurrent low-grade papillary Schneiderian carcinoma of both the nasal cavity and mastoid. It emphasizes the importance of recognizing this new entity through pathologic analysis and suspecting it when the clinical course does not follow an expected pattern.
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Affiliation(s)
- C Scott Brown
- 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Ralph Abi Hachem
- 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Avani Pendse
- 2 Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - John F Madden
- 2 Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Howard W Francis
- 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
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11
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Ryan MA, Khoury T, Kaylie DM, Crowson MG, Brown CS, McClennen J, Raynor EM. Osseointegrated implants for auricular prostheses: An alternative to autologous repair. Laryngoscope 2018; 128:2153-2156. [PMID: 29481697 PMCID: PMC6109626 DOI: 10.1002/lary.27128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/27/2017] [Accepted: 01/22/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study compares the hospital cost of osseointegrated implants for retention of an auricular prosthesis to autologous ear reconstruction. STUDY DESIGN Retrospective review. METHODS This study includes patients who underwent reconstruction for either congenital or acquired ear defects at Duke University Medical Center during 2009 to 2015. RESULTS A total of nine patients had autologous repair representing nine operative ears, and 16 patients had an osseointegrated implant representing 18 operative ears (two bilateral). The average age for the autologous repair was 11.6 years with 56% male versus 40.7 years with 56% male for the osseointegrated implant patients. For autologous patients, indications for surgery were anotia/microtia in 8/9 (89%) and trauma in 1/9 (11%) versus 6/16 (387.5%) anotia/microtia, 8/16 (50%) cancer, and 2/16 (132.5%) trauma in the osseointegrated implant group. The mean number of surgeries was 3.1 for autologous repairs and 1.0 for osseointegrated repairs (mean difference confidence interval [CI]: -2.4 to -1.8, P < .001). The average cost to the hospital for an osseointegrated repair was $6,491.39 versus $10,047.93 for autologous repairs (CI: $6,496.38 to $-616.68, P = .02) CONCLUSIONS: Osseointegrated implants for retaining an auricular prosthesis has a similar cost to autologous repair of ear defects, but patients underwent an average of two more surgeries with autologous repair. Patients should be able to choose the reconstruction option that best suits their condition and preferences. LEVEL OF EVIDENCE 4. Laryngoscope, 128:2153-2156, 2018.
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Affiliation(s)
- Marisa A. Ryan
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Hospital, Durham, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tawfiq Khoury
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Hospital, Durham, NC, USA
| | - David M. Kaylie
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Hospital, Durham, NC, USA
| | - Matthew G. Crowson
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Hospital, Durham, NC, USA
| | - C. Scott Brown
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Hospital, Durham, NC, USA
| | | | - Eileen M. Raynor
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Hospital, Durham, NC, USA
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12
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Brown CS, Choi KJ, Kaylie DM. Preoperative Imaging Findings and Cost in Adults With Postlingual Deafness Prior to Cochlear Implant. Ann Otol Rhinol Laryngol 2018; 127:270-274. [DOI: 10.1177/0003489418759114] [Citation(s) in RCA: 3] [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] [Indexed: 11/17/2022]
Affiliation(s)
| | - Kevin J. Choi
- Duke University Hospital, Durham, North Carolina, USA
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13
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Carpenter D, Shammas R, Honeybrook A, Brown CS, Chapurin N, Woodard CR. The Role of Postoperative Imaging after Orbital Floor Fracture Repair. Craniomaxillofac Trauma Reconstr 2018; 11:96-101. [PMID: 29892323 DOI: 10.1055/s-0038-1625949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022] Open
Abstract
Obtaining postoperative images of maxillofacial fractures does not affect the clinical management of asymptomatic patients; however, few studies have evaluated the role of postoperative imaging in the context of orbital floor fractures. In this study, we evaluate current practice techniques and the role of postoperative imaging in the management of orbital floor fractures in isolation and with concomitant facial fractures. Retrospective review of patients who underwent open reduction and internal fixation of orbital floor fractures between 2005 and 2015 at a single medical institution. Operative and perioperative records were reviewed to characterize postoperative imaging as routine or as indicated by concerning clinical symptoms, and to correlate clinical outcomes to postoperative imaging patterns across all identified orbital floor fractures. A total of 139 patients underwent open reduction and internal fixation of orbital floor fractures. Of these, 75 (54%) had zygomaticomaxillary (ZMC) involvement. The remaining 64 (46%) were isolated orbital floor fractures. Overall, 54 (39%) patients underwent postoperative imaging. Of these, 38 (70%) had postoperative imaging in the absence of concerning clinical symptoms. There was no observed difference in complication rates in those who underwent postoperative imaging, and those who did not. Patients with orbital + ZMC fractures underwent a significantly higher number of postoperative imaging studies ( p < 0.001); however, there was no observed difference in complications between isolated orbital and orbital + ZMC fractures. Routine postoperative imaging is not warranted in the absence of persistent clinical symptoms following open reduction and internal fixation of orbital floor fractures.
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Affiliation(s)
- David Carpenter
- Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina
| | - Ronnie Shammas
- Division of Plastic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Adam Honeybrook
- Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina
| | - C Scott Brown
- Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina
| | - Nikita Chapurin
- Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina
| | - Charles R Woodard
- Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina
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14
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Houlihan CF, Youkee D, Brown CS. Novel surveillance methods for the control of Ebola virus disease. Int Health 2017; 9:139-141. [PMID: 28582554 DOI: 10.1093/inthealth/ihx010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 02/23/2017] [Accepted: 04/07/2017] [Indexed: 11/14/2022] Open
Abstract
The unprecedented scale of the 2013-2016 West African Ebola virus disease (EVD) outbreak was in a large part due to failings in surveillance: contacts of confirmed cases were not systematically identified, monitored and diagnosed early, and new cases appearing in previously unaffected communities were similarly not rapidly identified, diagnosed and isolated. Over the course of this epidemic, traditional surveillance methods were strengthened and novel methods introduced. The wealth of experience gained, and the systems introduced in West Africa, should be used in future EVD outbreaks, as well as for other communicable diseases in the region and beyond.
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Affiliation(s)
- C F Houlihan
- London School of Hygiene & Tropical Medicine, London, UK.,University College London, London, UK
| | - D Youkee
- King´s Sierra Leone Partnership, King's Centre for Global Health, King's College London, London, UK
| | - C S Brown
- King´s Sierra Leone Partnership, King's Centre for Global Health, King's College London, London, UK.,National Infection Service, Public Health England, London, UK
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15
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Chan JC, Johnson LR, Brown CS, Pollard RE. Fluoroscopic Estimation of Thoracic Dimensional Changes in Healthy Dogs. J Vet Intern Med 2017; 31:1841-1848. [PMID: 28961336 PMCID: PMC5697204 DOI: 10.1111/jvim.14825] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/23/2017] [Accepted: 08/03/2017] [Indexed: 01/27/2023] Open
Abstract
Background Current methods available for assessing alterations in lung mechanics require sophisticated equipment and are of limited availability. A method that could assess lung area change with respiration might be a clinically useful surrogate for assessing lung compliance. Objective To use fluoroscopy to determine percent change in thoracic and lung areas in healthy dogs. Animals Forty‐four client‐owned dogs with no evidence of respiratory disease. Methods Prospective study. Resting respiration was recorded fluoroscopically, and peak inspiratory and expiratory frames were captured for 3 typical respiratory cycles. The number of intrathoracic pixels in the entire thoracic cavity was measured for both inspiration and expiration, and the average percent change in intrathoracic area was determined for each dog. This process was repeated by a hemithorax measurement of lung area that excluded the mediastinum and cardiac silhouette. Proposed reference ranges (and 95% confidence intervals [CI]) were computed by a nonparametric percentile distribution. Results Median percent change in thoracic dimension for the total thorax measurement was 12.5% (CI, 8.9–24.0%). Median percent change for the hemithorax measurement was significantly (P < 0.001) larger (20.8%, CI, 14.3–37.6%). Both measurement techniques were correlated with body weight but not with age, sex, thoracic conformation, body condition score (BCS), or breed. Conclusions and Clinical Importance Fluoroscopy allows a noninvasive and repeatable measure of lung area changes during respiration that must be corrected for body weight. Additional studies in dogs with respiratory diseases are needed to determine its utility in detecting clinically useful alterations in lung area changes.
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Affiliation(s)
- J C Chan
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - L R Johnson
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - C S Brown
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - R E Pollard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA
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16
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Brown CS, Ryan MA, Ramprasad VH, Karas AF, Raynor EM. Coblation of suprastomal granulomas in tracheostomy-dependent children. Int J Pediatr Otorhinolaryngol 2017; 96:55-58. [PMID: 28390614 PMCID: PMC5433249 DOI: 10.1016/j.ijporl.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Suprastomal granulomas pose a persistent challenge for tracheostomy-dependent children. They can limit phonation, cause difficulty with tracheostomy tube changes and prevent decannulation. We describe the use of the coblator for radiofrequency plasma ablation of suprastomal granulomas in five consecutive children from September 2012 to January 2016. METHOD Retrospective case series at a tertiary medical center. RESULTS The suprastomal granuloma could be removed with the coblator in all 5 cases. Three were removed entirely endoscopically and 2 required additional external approach through the tracheal stoma for complete removal. There were no intraoperative or postoperative complications. One patient was subsequently decannulated and 2 patients have improved tolerance of their speaking valves. Two patients remain ventilator dependent, but their bleeding and difficulty with tracheostomy tube changes resolved. Three of the patients have had subsequent re-evaluation with bronchoscopy, demonstrating resolution or markedly decreased size of the granuloma. This technique is time efficient, simple and minimizes risks associated with other techniques. The relatively low temperature and use of continuous saline irrigation with the coblator device minimizes the risk of airway fires. Additionally, the risk of hypoxia from keeping a low fractional inspiratory oxygen level (FIO2) to prevent fire is avoided. The concurrent suction in the device decreases blood and tissue displacement into the distal airway. CONCLUSION Coblation can be used safely and effectively with an endoscopic or external approach to remove suprastomal granulomas in tracheostomy-dependent children. More studies that are larger and have longer follow-up are needed to evaluate the use of this technique.
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Affiliation(s)
- C Scott Brown
- Duke University Medical Center, Division of Otolaryngology-Head and Neck Surgery & Communication Sciences, Department of Surgery, 40 Duke Medicine Circle, DUMC 3805, Durham, NC 27710, USA.
| | - Marisa A. Ryan
- Duke University Medical Center, Division of Otolaryngology-Head and Neck Surgery & Communication Sciences, Department of Surgery. 40 Duke Medicine Circle, DUMC 3805, Durham, NC 27710, USA
| | - Vaibhav H. Ramprasad
- Duke University School of Medicine, 8 Duke University Medical Center Greenspace, Durham, NC 27703, USA
| | - Anatoli F. Karas
- Duke University Medical Center, Division of Otolaryngology-Head and Neck Surgery & Communication Sciences, Department of Surgery. 40 Duke Medicine Circle, DUMC 3805, Durham, NC 27710, USA
| | - Eileen M. Raynor
- Duke University Medical Center, Division of Otolaryngology-Head and Neck Surgery & Communication Sciences, Department of Surgery. 40 Duke Medicine Circle, DUMC 3805, Durham, NC 27710, USA
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17
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Lewis SM, Treacher DF, Edgeworth J, Mahalingam G, Brown CS, Mare TA, Stacey M, Beale R, Brown KA. Expression of CD11c and EMR2 on neutrophils: potential diagnostic biomarkers for sepsis and systemic inflammation. Clin Exp Immunol 2015; 182:184-94. [PMID: 26153037 DOI: 10.1111/cei.12679] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2015] [Indexed: 12/26/2022] Open
Abstract
There is a need for cellular biomarkers to differentiate patients with sepsis from those with the non-infectious systemic inflammatory response syndrome (SIRS). In this double-blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)-like molecule containing mucin-like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non-infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0.001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0.05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively.
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Affiliation(s)
- S M Lewis
- Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.,Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London
| | - D F Treacher
- Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London
| | - J Edgeworth
- Department of Infection, Guy's and St Thomas' NHS Foundation Trust, University of Leeds, London, UK
| | - G Mahalingam
- Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London
| | - C S Brown
- Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London
| | - T A Mare
- Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.,Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London
| | - M Stacey
- School of Molecular and Cellular Biology, University of Leeds, London, UK
| | - R Beale
- Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.,Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London
| | - K A Brown
- Intensive Care Unit, Guy's and St Thomas' NHS Foundation Trust, London.,Department of Vascular Immunology, Division of Asthma, Allergy and Lung Biology, King's College London
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18
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Wood JW, Thornton B, Brown CS, McLevy JD, Thompson JW. Traumatic tracheal injury in children: a case series supporting conservative management. Int J Pediatr Otorhinolaryngol 2015; 79:716-20. [PMID: 25792031 DOI: 10.1016/j.ijporl.2015.02.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 02/20/2015] [Accepted: 02/20/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Injuries to the tracheobronchial region are rare, but have the potential for rapid progression and can become life-threatening. Etiologies of non-penetrating tracheobronchial injuries include blunt cervical trauma, endotracheal intubation, and other iatrogenic causes. Several options for treatment ranging from conservative to surgical exist, but no single treatment has been implemented with consensus. While early surgical repair was once considered the cornerstone of therapy, evidence supporting conservative treatment continues to gain strength. METHODS All pediatric patients who suffered from non-penetrating injuries to the tracheobronchial tree who were treated by the Otolaryngology Service at a tertiary children's hospital from May 2012 through March 2014 were recorded. A total of 8 patients were identified. The cases were collected from the patients treated by the Otolaryngology Department based on retrospective review. The available electronic medical records were reviewed for each patient. Data including type of injury, endoscopic assessment of injury, treatment received, and follow-up were collected. RESULTS The ages ranged from 2 to 15 years old, with a mean of 9.25 years old. Six of the eight patients had injuries related to endotracheal intubation. Each patient was taken to the operating suite for diagnostic direct laryngoscopy and bronchoscopy, and treated with initial conservative management. All but one of the patients was treated with endotracheal intubation, and the average length of intubation was 11.71 days. All of the injuries healed spontaneously without requiring initial open surgery. Five patients (62.5%) developed some degree of tracheal stenosis. Three patients (37.5%) required further surgery; one received a tracheostomy and two patients required balloon dilation. CONCLUSIONS This case series is the largest to date documenting the outcomes of conservative treatment of non-penetrating traumatic tracheal injuries in children. By using initial conservative therapy, we were able to avoid open surgical procedures in many of our patients. We believe that this case series provides further support for conservative management for children with tracheobronchial injuries.
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Affiliation(s)
- Joshua W Wood
- University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, Memphis, TN, United States.
| | - Blakely Thornton
- University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, Memphis, TN, United States
| | - C Scott Brown
- University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, Memphis, TN, United States
| | - Jennifer D McLevy
- University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, Memphis, TN, United States
| | - Jerome W Thompson
- University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, Memphis, TN, United States
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19
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Walker NF, Brown CS, Youkee D, Baker P, Williams N, Kalawa A, Russell K, Samba AF, Bentley N, Koroma F, King MB, Parker BE, Thompson M, Boyles T, Healey B, Kargbo B, Bash-Taqi D, Simpson AJ, Kamara A, Kamara TB, Lado M, Johnson O, Brooks T. Evaluation of a point-of-care blood test for identification of Ebola virus disease at Ebola holding units, Western Area, Sierra Leone, January to February 2015. ACTA ACUST UNITED AC 2015; 20. [PMID: 25846490 DOI: 10.2807/1560-7917.es2015.20.12.21073] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Current Ebola virus disease (EVD) diagnosis relies on reverse transcription-PCR (RT-PCR) technology, requiring skilled laboratory personnel and technical infrastructure. Lack of laboratory diagnostic capacity has led to diagnostic delays in the current West African EVD outbreak of 2014 and 2015, compromising outbreak control. We evaluated the diagnostic accuracy of the EVD bedside rapid diagnostic antigen test (RDT) developed by the United Kingdom's Defence Science and Technology Laboratory, compared with Ebola virus RT-PCR, in an operational setting for EVD diagnosis of suspected cases admitted to Ebola holding units in the Western Area of Sierra Leone. From 22 January to 16 February 2015, 138 participants were enrolled. EVD prevalence was 11.5%. All EVD cases were identified by a positive RDT with a test line score of 6 or more, giving a sensitivity of 100% (95% confidence interval (CI): 78.2-100). The corresponding specificity was high (96.6%, 95% CI: 91.3-99.1). The positive and negative predictive values for the population prevalence were 79.0% (95% CI: 54.4-93.8) and 100% (95% CI: 96.7-100), respectively. These results, if confirmed in a larger study, suggest that this RDT could be used as a 'rule-out' screening test for EVD to improve rapid case identification and resource allocation.
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Affiliation(s)
- N F Walker
- King s Sierra Leone Partnership, King's Centre for Global Health, King's College London, and King s Health Partners, London, United Kingdom
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Pereyaslov D, Rosin P, Palm D, Zeller H, Gross D, Brown CS, Struelens MJ. Laboratory capability and surveillance testing for Middle East respiratory syndrome coronavirus infection in the WHO European Region, June 2013. ACTA ACUST UNITED AC 2014; 19:20923. [PMID: 25323078 DOI: 10.2807/1560-7917.es2014.19.40.20923] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since September 2012, over 90 cases of respiratory disease caused by a novel coronavirus, now named Middle East respiratory syndrome coronavirus (MERSCoV), have been reported in the Middle East and Europe. To ascertain the capabilities and testing experience of national reference laboratories across the World Health Organization (WHO) European Region to detect this virus, the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe conducted a joint survey in November 2012 and a follow-up survey in June 2013. In 2013, 29 of 52 responding WHO European Region countries and 24 of 31 countries of the European Union/European Economic Area (EU/EEA) had laboratory capabilities to detect and confirm MERS-CoV cases, compared with 22 of 46 and 18 of 30 countries, respectively, in 2012. By June 2013, more than 2,300 patients had been tested in 23 countries in the WHO European Region with nine laboratory-confirmed MERS-CoV cases. These data indicate that the Region has developed significant capability to detect this emerging virus in accordance with WHO and ECDC guidance. However, not all countries had developed capabilities, and the needs to do so should be addressed. This includes enhancing collaborations between countries to ensure diagnostic capabilities for surveillance of MERS-CoV infections across the European Region.
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Affiliation(s)
- D Pereyaslov
- World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
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21
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Hall JA, Brown CS, Pettigrew L, Malik ANJ, Watson J, Topiwala A, McGregor L, Ramsay R. Fit for the future? The place of global health in the UK's postgraduate medical training: a review. JRSM Short Rep 2013; 4:19. [PMID: 23560218 PMCID: PMC3616298 DOI: 10.1177/2042533313476421] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES That health is now global is increasingly accepted. However, a 'mismatch between present professional competencies and the requirements of an increasingly interdependent world' has been identified. Postgraduate training should take account of the increasingly global nature of health; this paper examines the extent to which they currently do. DESIGN Trainees across 11 medical specialties reviewed the content of their postgraduate curriculum. SETTING Not relevant. PARTCIPANTS: None. MAIN OUTCOME MEASURES Competencies were coded as 'UK' (statement only relevant to UK work), 'global' (statement with an explicit reference to aspects of health outside the UK) or generic (relevant both to the UK and international settings). RESULTS Six of the 11 curricula reviewed contained global health competencies. These covered the global burden or determinants of disease and appropriate policy responses. Only one College required trainees to 'be aware of the World Health Organization', or 'know the local, national and international structures for health care'. These cross-cutting competencies have applicability to all specialties. All 11 curricula contained generic competencies where a global health perspective and/or experience could be advantageous, e.g. caring for migrant or culturally different patients. CONCLUSION Trainees in all specialties should achieve a minimum requirement of global health awareness. This can be achieved through a small number of common competencies that are consistent across core curricula. These should lead on from equivalent undergraduate competencies. Addressing the current gap in the global health content of postgraduate medical curricula will ensure that the UK has health professionals that are trained to meet the health challenges of the future.
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Affiliation(s)
- JA Hall
- FPH Global Health Specialty Registrar's Group, Chair, London SE22 9DB, UK
| | - CS Brown
- Alma Mata Global Health Graduates’ Network, London, UK
| | | | | | - J Watson
- RCGP Junior International Committee, Education and Training Lead, London, UK
| | - A Topiwala
- Royal College of Psychiatrists’ International Advisory Committee, London, UK
| | | | - R Ramsay
- RCGP Junior International Committee Chair, London, UK
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22
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Brown CS. The role of the WHO Regional Office for Europe in response to seasonal, avian, and pandemic influenza. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:47-55. [PMID: 23275956 PMCID: PMC7080048 DOI: 10.1007/s00103-012-1587-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Between 2005 and 2011, the WHO Regional Office for Europe assisted the member states of the WHO European Region to prepare and respond to outbreaks of avian influenza H5N1, the 2009 pandemic, and to enhance their capacities for the prevention and control of seasonal influenza. It did this through conducting a combination of regional and subregional meetings and trainings, establishing a regional network for influenza surveillance, providing operational guidance for implementing influenza surveillance and strengthening the capacities of National Influenza Centers, and through assistance at the country-level where needed. In all, close to 60 country-missions or country-level activities were conducted. These activities were conducted in close coordination with WHO headquarters, WHO European Region Country Offices, the European Commission, the European Centre for Disease Prevention and Control, and with other partner organizations, and were in line with the implementation of the International Health Regulations (2005). The results of activities as well as guidance documents were disseminated to a wide audience through publication on the WHO Regional Office for Europe Influenza website, on the EuroFlu website, and through peer-reviewed publications.
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Affiliation(s)
- C S Brown
- WHO Regional Office for Europe, Scherfigsvej 8, 2100, Copenhagen, Denmark.
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23
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Palm D, Pereyaslov D, Vaz J, Broberg E, Zeller H, Gross D, Brown CS, Struelens MJ. Laboratory capability for molecular detection and confirmation of novel coronavirus in Europe, November 2012. ACTA ACUST UNITED AC 2012; 17. [PMID: 23231892 DOI: 10.2807/ese.17.49.20335-en] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A rapid survey by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe ascertained the availability of national reference laboratory testing for a recently detected novel coronavirus as of 28 November 2012. Screening by internal quality controlled upE-RT-PCR assay was available in 23/46 of responding countries in the WHO European Region, of which 19/30 in European Union (EU) and European Economic Area (EEA) countries. Confirmation of positive screened samples by either ORF1b - RT-PCR, or other target RT-PCR assays with sequence analysis or whole-genome sequence analysis was available in 22/46 responding countries of which 18/30 in EU/EEA countries.
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Affiliation(s)
- D Palm
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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24
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Bermingham A, Chand MA, Brown CS, Aarons E, Tong C, Langrish C, Hoschler K, Brown K, Galiano M, Myers R, Pebody RG, Green HK, Boddington NL, Gopal R, Price N, Newsholme W, Drosten C, Fouchier RA, Zambon M. Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.40.20290-en] [Citation(s) in RCA: 268] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coronaviruses have the potential to cause severe transmissible human disease, as demonstrated by the severe acute respiratory syndrome (SARS) outbreak of 2003. We describe here the clinical and virological features of a novel coronavirus infection causing severe respiratory illness in a patient transferred to London, United Kingdom, from the Gulf region of the Middle East.
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Affiliation(s)
- A Bermingham
- Health Protection Agency (HPA), London, United Kingdom
| | - M A Chand
- Health Protection Agency (HPA), London, United Kingdom
| | - C S Brown
- Centre for Clinical Infection and Diagnostics Research, King’s College London, London, England
- Health Protection Agency (HPA), London, United Kingdom
| | - E Aarons
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Tong
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Langrish
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - K Hoschler
- Health Protection Agency (HPA), London, United Kingdom
| | - K Brown
- Health Protection Agency (HPA), London, United Kingdom
| | - M Galiano
- Health Protection Agency (HPA), London, United Kingdom
| | - R Myers
- Health Protection Agency (HPA), London, United Kingdom
| | - R G Pebody
- Health Protection Agency (HPA), London, United Kingdom
| | - H K Green
- Health Protection Agency (HPA), London, United Kingdom
| | | | - R Gopal
- Health Protection Agency (HPA), London, United Kingdom
| | - N Price
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - W Newsholme
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Drosten
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
| | - R A Fouchier
- Department of Virology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - M Zambon
- Health Protection Agency (HPA), London, United Kingdom
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Pebody RG, Chand MA, Thomas HL, Green HK, Boddington NL, Carvalho C, Brown CS, Anderson SR, Rooney C, Crawley-Boevey E, Irwin DJ, Aarons E, Tong C, Newsholme W, Price N, Langrish C, Tucker D, Zhao H, Phin N, Crofts J, Bermingham A, Gilgunn-Jones E, Brown KE, Evans B, Catchpole M, Watson JM. The United Kingdom public health response to an imported laboratory confirmed case of a novel coronavirus in September 2012. Euro Surveill 2012. [DOI: 10.2807/ese.17.40.20292-en] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
On 22 September 2012, a novel coronavirus, very closely related to that from a fatal case in Saudi Arabia three months previously, was detected in a previously well adult transferred to intensive care in London from Qatar with severe respiratory illness. Strict respiratory isolation was instituted. Ten days after last exposure, none of 64 close contacts had developed severe disease, with 13 of 64 reporting mild respiratory symptoms. The novel coronavirus was not detected in 10 of 10 symptomatic contacts tested.
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Affiliation(s)
- R G Pebody
- Health Protection Agency (HPA), London, United Kingdom
| | - M A Chand
- Health Protection Agency (HPA), London, United Kingdom
| | - H L Thomas
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
- Field Epidemiology Training Programme (FETP), Health Protection Agency, London, United Kingdom
- Health Protection Agency (HPA), London, United Kingdom
| | - H K Green
- Health Protection Agency (HPA), London, United Kingdom
| | | | - C Carvalho
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
- Health Protection Agency (HPA), London, United Kingdom
| | - C S Brown
- Centre for Clinical Infection and Diagnostics Research, King’s College London, London, England
- Health Protection Agency (HPA), London, United Kingdom
| | - S R Anderson
- Health Protection Agency (HPA), London, United Kingdom
| | - C Rooney
- Health Protection Agency (HPA), London, United Kingdom
| | | | - D J Irwin
- Health Protection Agency (HPA), London, United Kingdom
| | - E Aarons
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Tong
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - W Newsholme
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - N Price
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - C Langrish
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - D Tucker
- Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, United Kingdom
| | - H Zhao
- Health Protection Agency (HPA), London, United Kingdom
| | - N Phin
- Health Protection Agency (HPA), London, United Kingdom
| | - J Crofts
- Health Protection Agency (HPA), London, United Kingdom
| | - A Bermingham
- Health Protection Agency (HPA), London, United Kingdom
| | | | - K E Brown
- Health Protection Agency (HPA), London, United Kingdom
| | - B Evans
- Health Protection Agency (HPA), London, United Kingdom
| | - M Catchpole
- Health Protection Agency (HPA), London, United Kingdom
| | - J M Watson
- Health Protection Agency (HPA), London, United Kingdom
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26
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Pebody RG, Chand MA, Thomas HL, Green HK, Boddington NL, Carvalho C, Brown CS, Anderson SR, Rooney C, Crawley-Boevey E, Irwin DJ, Aarons E, Tong C, Newsholme W, Price N, Langrish C, Tucker D, Zhao H, Phin N, Crofts J, Bermingham A, Gilgunn-Jones E, Brown KE, Evans B, Catchpole M, Watson JM. The United Kingdom public health response to an imported laboratory confirmed case of a novel coronavirus in September 2012. Euro Surveill 2012; 17:20292. [PMID: 23078799] [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: 06/01/2023] Open
Abstract
On 22 September 2012, a novel coronavirus, very closely related to that from a fatal case in Saudi Arabia three months previously, was detected in a previously well adult transferred to intensive care in London from Qatar with severe respiratory illness. Strict respiratory isolation was instituted. Ten days after last exposure, none of 64 close contacts had developed severe disease, with 13 of 64 reporting mild respiratory symptoms. The novel coronavirus was not detected in 10 of 10 symptomatic contacts tested.
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Affiliation(s)
- R G Pebody
- Health Protection Agency (HPA), London, UK.
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27
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Bermingham A, Chand MA, Brown CS, Aarons E, Tong C, Langrish C, Hoschler K, Brown K, Galiano M, Myers R, Pebody RG, Green HK, Boddington NL, Gopal R, Price N, Newsholme W, Drosten C, Fouchier RA, Zambon M. Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012. Euro Surveill 2012; 17:20290. [PMID: 23078800] [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: 06/01/2023] Open
Abstract
Coronaviruses have the potential to cause severe transmissible human disease, as demonstrated by the severe acute respiratory syndrome (SARS) outbreak of 2003. We describe here the clinical and virological features of a novel coronavirus infection causing severe respiratory illness in a patient transferred to London, United Kingdom, from the Gulf region of the Middle East.
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28
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Brown CS, Chand MA, Hoffman P, Woodford N, Livermore DM, Brailsford S, Gharbia S, Small N, Billingham E, Zambon M, Grant K. Possible contamination of organ preservation fluid with Bacillus cereus: the United Kingdom response. ACTA ACUST UNITED AC 2012; 17. [PMID: 22587955 DOI: 10.2807/ese.17.18.20165-en] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe here the United Kingdom (UK) response following the recent international recall of an organ preservation fluid owing to potential Bacillus cereus contamination. This fluid is used for the transport of solid organs and pancreatic islet cells for transplant. We detail the response mechanisms, including the initial risk stratification, investigatory approaches, isolate analysis and communications to professional bodies. This report further lays out the potential need for enhanced surveillance in UK transplant patients.
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Affiliation(s)
- C S Brown
- Microbiology Services Division, Health Protection Agency, London, United Kingdom.
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29
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Brown GK, Canfield PJ, Dunstan RH, Roberts TK, Martin AR, Brown CS, Irving R. Detection of Anaplasma platys and Babesia canis vogeli and their impact on platelet numbers in free-roaming dogs associated with remote Aboriginal communities in Australia. Aust Vet J 2006; 84:321-5. [PMID: 16958629 DOI: 10.1111/j.1751-0813.2006.00029.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To detect Anaplasma platys and Babesia canis vogeli infection, using polymerase chain reaction (PCR)-based assays, in free-roaming dogs associated with eight Aboriginal communities in remote areas of Australia and to determine the impact of infection through the assessment of platelet numbers. PROCEDURES Blood samples from 215 dogs were screened by PCR for A platys and B canis vogeli using established genus-specific DNA primers for the 16S and 18S rRNA genes respectively. Both A platys DNA and B canis vogeli DNA were confirmed from the screening PCR either by sequencing or by the use of species-specific primers. Peripheral blood films from 92 of the 215 dogs were used to estimate platelet numbers through an indirect method. RESULTS Of 215 dogs, 69 (32%) were positive for A platys, 22 (10%) for B canis vogeli and 24 (11%) for both. The two organisms were detected singularly and as coinfection in all communities. For the 92 dogs in which peripheral blood films were examined, the mean estimated platelet counts for the non-infected dogs was 318 x 10(9)/L, those infected with A platys alone was 256 x 10(9)/L, those with B canis vogeli alone was 276 x 10(9)/L and those infected with both parasites was 169 x 10(9)/L. In young dogs, infection produced significantly decreased mean platelet counts when compared to uninfected dogs. Thrombocytopenia (< 200 x 10(9)/L) was detected in 18 (51%) dogs infected with A platys alone, 3 (33%) dogs infected with B canis vogeli alone, 13 (72%) dogs coinfected, and 8 (27%) uninfected dogs. CONCLUSIONS A platys and B canis vogeli infection, either singularly or together, was widespread in free roaming dogs associated with remote Aboriginal communities in the Northern Territory and north-western New South Wales. Moreover, both A platys and B canis vogeli infections were associated with a reduction in mean platelet numbers in dog populations, particularly in young dogs. The fact that 51% of dogs infected with A platys alone and 72% dogs coinfected were thrombocytopenic compared to 27% of uninfected dogs suggests that the organism alone or in combination with B canis vogeli has the potential to cause thrombocytopenia and perhaps contribute to a clinical bleeding disorder in infected dogs.
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Affiliation(s)
- G K Brown
- Discipline of Biological Sciences, School of Environmental and Life Sciences, University of Newcastle, Callaghan NSW 2308, Australia
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30
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Meijer A, Paget WJ, Meerhoff TJ, Brown CS, Meuwissen LE, Van Der Velden J, European Influenza Surveillance Scheme (EISS) C. Epidemiological and virological assessment of influenza activity in Europe, during the 2004-2005 winter. Euro Surveill 2006; 11:9-10. [DOI: 10.2807/esm.11.05.00623-en] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 2004-2005 influenza season in Europe started in late December 2004 and the first influenza activity occurred in the west and southwest (Spain, United Kingdom and Ireland). Influenza activity then moved gradually east across Europe during January and early February 2005, and from late February until late March, most movement was south to north. The intensity of clinical influenza activity in ten out of 23 countries was higher than during the 2003-2004 season, and lower or equal to the 2003-2004 season in the other 13 countries. The highest consultation rates were generally observed among children aged 0-14 years. However, the peak consultation rates due to influenza-like illness or acute respiratory infection were not especially high when compared with historical data. The predominant virus strain was influenza A (83% of total detections) of the H3 subtype (85% of H-subtyped A viruses), with fewer influenza B (17% of total detections) or A(H1) viruses (15 % of H-subtyped A viruses) detected. The vast majority of A(H3) viruses were similar to the reference strains A/Wellington/1/2004 (H3N2) and, subsequently, A/California/7/2004 (H3N2) that are closely related drift variants of the A/Fujian/411/2002 (H3N2) prototype vaccine strain. The B viruses co-circulated with A viruses during the whole influenza season in 11 out of 24 countries.
Seven of these were located in the northeast of Europe and in these countries the proportion of B viruses was higher (range: 31-60%) than in the rest of Europe (range: 6-26%). In 13 out of 24 countries the B viruses circulated relatively late in the season. About 43% of all antigenically characterised B viruses were B/Hong Kong/330/2001-like (B/Victoria/2/87 lineage), a strain that is distinguishable from the vaccine influenza B strain, which was a B/Yamagata/16/88 lineage virus. Based on the viruses detected worldwide until February 2005, the World Health Organization modified the composition of the 2005-2006 influenza vaccine from the 2004-2005 season vaccine to include a new A(H3N2) component: an A/California/7/2004 (H3N2)-like virus.
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Affiliation(s)
- A Meijer
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - W J Paget
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - T J Meerhoff
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - C S Brown
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
- Current affiliation: WHO Regional Office for Europe, Copenhagen, Denmark
| | - L. E. Meuwissen
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - J Van Der Velden
- Radboud University Medical Center, Nijmegen, The Netherlands
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
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31
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Meijer A, Paget WJ, Meerhoff TJ, Brown CS, Meuwissen LE, van der Velden J. Epidemiological and virological assessment of influenza activity in Europe, during the 2004-2005 winter. Euro Surveill 2006; 11:111-8. [PMID: 16757850] [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: 05/10/2023] Open
Abstract
The 2004-2005 influenza season in Europe started in late December 2004 and the first influenza activity occurred in the west and southwest (Spain, United Kingdom and Ireland). Influenza activity then moved gradually east across Europe during January and early February 2005, and from late February until late March, most movement was south to north. The intensity of clinical influenza activity in ten out of 23 countries was higher than during the 2003-2004 season, and lower or equal to the 2003-2004 season in the other 13 countries. The highest consultation rates were generally observed among children aged 0-14 years. However, the peak consultation rates due to influenza-like illness or acute respiratory infection were not especially high when compared with historical data. The predominant virus strain was influenza A (83% of total detections) of the H3 subtype (85% of H-subtyped A viruses), with fewer influenza B (17% of total detections) or A(H1) viruses (15 % of H-subtyped A viruses) detected. The vast majority of A(H3) viruses were similar to the reference strains A/Wellington/1/2004 (H3N2) and, subsequently, A/California/7/2004 (H3N2) that are closely related drift variants of the A/Fujian/411/2002 (H3N2) prototype vaccine strain. The B viruses co-circulated with A viruses during the whole influenza season in 11 out of 24 countries. Seven of these were located in the northeast of Europe and in these countries the proportion of B viruses was higher (range: 31-60%) than in the rest of Europe (range: 6-26%). In 13 out of 24 countries the B viruses circulated relatively late in the season. About 43% of all antigenically characterised B viruses were B/Hong Kong/330/2001-like (B/Victoria/2/87 lineage), a strain that is distinguishable from the vaccine influenza B strain, which was a B/Yamagata/16/88 lineage virus. Based on the viruses detected worldwide until February 2005, the World Health Organization modified the composition of the 2005-2006 influenza vaccine from the 2004-2005 season vaccine to include a new A(H3N2) component: an A/California/7/2004 (H3N2)-like virus.
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Affiliation(s)
- A Meijer
- European Influenza Surveillance Scheme Co-ordination Centre, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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32
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Brown CS, Rudkjøbing A. Smoke-free medical students' meetings. Lancet 2005; 366:893-4. [PMID: 16154011 DOI: 10.1016/s0140-6736(05)67315-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Franssila R, Söderlund M, Brown CS, Spaan WJ, Seppälä I, Hedman K. IgG subclass response to human parvovirus B19 infection. ACTA ACUST UNITED AC 2005; 6:41-9. [PMID: 15566889 DOI: 10.1016/0928-0197(96)00156-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/1995] [Accepted: 09/25/1995] [Indexed: 11/21/2022]
Abstract
BACKGROUND IgG antibodies are essential to immunity against human parvovirus B19 and can neutralize infection both in bone marrow cell cultures infected in vitro and in chronically infected immunosuppressed individuals. OBJECTIVES To assess the levels and response kinetics of IgG subclasses towards individual structural proteins of human parvovirus B19. STUDY DESIGN Subclasses of IgG for capsid proteins VP1 or VP2 were quantified by EIA using monoclonal antibodies in 30 acutely infected and 30 convalescent patients, as well as in 32 remotely infected and 20 non-infected controls. RESULTS In all groups of seropositive individuals the predominant subclass for either structural protein was IgG1. Subclass IgG3 was associated with acute infection. By contrast, IgG4 appeared months after infection, and occurred specifically towards VP1. The ratio of VP1-specific subclasses IgG3 and IgG4 provided a diagnostic test for recent infection with a specificity of 98% and a sensitivity of 97%. CONCLUSIONS Comparative measurement of VP1-specific IgG3 and IgG4 is useful in diagnosis. The IgG4 results point to long-term expression of immunologically active VP1 and to T-cell help of T(h)2 type for B-cells recognizing VP1.
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Affiliation(s)
- R Franssila
- Department of Virology, Haartman Institute, P.O. Box 21, FIN-00014, University of Helsinki, Helsinki, Finland
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Klymchuk DO, Kordyum EL, Vorobyova TV, Chapman DK, Brown CS. Changes in vacuolation in the root apex cells of soybean seedlings in microgravity. Adv Space Res 2003; 31:2283-8. [PMID: 14686444 DOI: 10.1016/s0273-1177(03)00256-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Changes in the vacuolation in root apex cells of soybean (Glycine max L. [Merr.]) seedlings grown in microgravity were investigated. Spaceflight and ground control seedlings were grown in the absence or presence of KMnO4 (to remove ethylene) for 6 days. After landing, in order to study of cell ultrastructure and subcellular free calcium ion distribution, seedling root apices were fixed in 2.5% (w/v) glutaraldehyde in 0.1 M cacodylate buffer and 2% (w/v) glutaraldehyde, 2.5% (w/v) formaldehyde, 2% (w/v) potassium antimonate K[Sb(OH)6] in 0.1 M K2HPO4 buffer with an osmolarity (calculated theoretically) of 0.45 and 1.26 osmol. The concentrations of ethylene in all spaceflight canisters were significantly higher than in the ground control canisters. Seedling growth was reduced in the spaceflight-exposed plants. Additionally, the spaceflight-exposed plants exhibited progressive vacuolation in the root apex cells, particularly in the columella cells, to a greater degree than the ground controls. Plasmolysis was observed in columella cells of spaceflight roots fixed in solutions with relatively high osmolarity (1.26 osmol). The appearance of plasmolysis permitted the evaluation of the water status of cells. The water potential of the spaceflight cells was higher than the surrounding fixative solution. A decrease in osmotic potential and/or an increase in turgor potential may have induced increases in cell water potential. However, the plasmolysed (i.e. non-turgid) cells implied that increases in water potential were accompanied with a decrease in osmotic potential. In such cells changes in vacuolation may have been involved to maintain turgor pressure or may have been a result of intensification of other vacuolar functions like digestion and storage.
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Affiliation(s)
- D O Klymchuk
- Institute of Botany, National Academy Sciences of Ukraine, Kyiv, Ukraine.
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Abstract
This study described the efficacy of various strategies for the recruitment of women with female sexual arousal disorder (FSAD) and matched controls in an obstetrics and gynecology clinic. During both phases of the study, actual recruitment time exceeded expectations. Clinical screening was the most effective recruitment strategy, accounting for one half of the enrolled subjects. Mass media advertising proved effective in recruiting up to one third of subjects. Control subjects were easily enrolled using all recruitment methods. Future reports should compare the efficiency and cost-benefit strategies for the recruitment of women with FSAD.
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Affiliation(s)
- C S Brown
- Departments of Pharmacy Practice, Psychiatry, and Obstetrics and Gynecology, University of Tennessee, 847 Monroe Avenue, Room 205, Memphis, TN, USA.
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Gallegos GL, Peterson BV, Brown CS, Guikema JA. Effects of stress ethylene inhibitors on sweet clover (Melilotus alba L.) seedling growth in microgravity. J Gravit Physiol 2001; 2:P151-2. [PMID: 11538907] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- G L Gallegos
- Division of Biology, Kansas State University, Manhattan 66506-4901, USA
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Brown CS, Tibbitts TW, Croxdale JG, Wheeler RM. Potato tuber formation in the spaceflight environment. Life Support Biosph Sci 2001; 4:71-6. [PMID: 11540455] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Five potato (Solanum tuberosum L.) leaf cuttings were flown on STS-73 in late October, 1995 as part of the 16-day USML-2 mission. Preflight studies were conducted to study tuber growth, determine carbohydrate concentrations, and examine the developing starch grains within the tuber. In these tests, tubers attained a fresh weight of 1.4 g tuber-1 after 13 days. Tuber fresh mass was significantly correlated to tuber diameter. Greater than 60% of the tuber dry mass was starch and the starch grains varied in size from 2 to 40 micrometers in the long axis. For the flight experiment, cuttings were obtained from 7-week-old Norland potato plants, kept at 5 degrees C for 12 h then planted into arcillite in the ASTROCULTURE(TM) flight hardware. The flight package was loaded on-board the orbiter 22 h prior to launch. During the mission, the flight hardware maintained an environment around the cuttings of 22 +/- 2 degrees C, 81 +/- 7% RH, and a 12-h photoperiod using red and blue light-emitting diodes at a photosynthetic photon flux of 150 micromol m-2 s-1. CO2 concentration exceeded 4000 ppm during the dark period and was controlled during the light period to approximately 400 ppm. Video downlinking of images of the plants and CO2 exchange data during the flight demonstrated plant vitality for the first 12 days of the mission followed by senescence of the leaves. The flight package was received 4 h after landing at the Kennedy Space Center and postflight processing of the samples was completed within 3 h. Four out of the five space-grown cuttings produced tubers that were similar in appearance and dimension to the ground control tubers. This is an important finding if potatoes are to be used as part of a bioregenerative life support system for long-term space exploration.
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Affiliation(s)
- C S Brown
- Dynamac Corporation, Durham, NC 27713, USA
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Gallegos GL, Hilaire EM, Peterson BV, Brown CS, Guikema JA. Effects of microgravity and clinorotation on stress ethylene production in two starchless mutants of Arabidopsis thaliana. J Gravit Physiol 2001; 2:P153-4. [PMID: 11538908] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- G L Gallegos
- Kansas State University, Division of Biology, Manhattan 66506-4901, USA
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Hilaire E, Brown CS, Guikema JA. The Fluid Processing Apparatus: from flight hardware to electron micrographs. J Gravit Physiol 2001; 2:P165-6. [PMID: 11538914] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- E Hilaire
- Kansas State University, Division of Biology, Manhattan 66506-4901, USA
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Goins GD, Yorio NC, Sanwo-Lewandowski MM, Brown CS. Life cycle experiments with Arabidopsis grown under red light-emitting diodes (LEDs). Life Support Biosph Sci 2001; 5:143-9. [PMID: 11541670] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Light-emitting diodes (LEDS) are a potential lighting source for space-based plant growth systems because of their small mass, operational longevity, and spectral quality. However, the vegetative and reproductive growth and development of plants grown under narrow spectrum LEDs must be characterized before acceptance of LEDS as an alternative light source for growing plants. The objectives of this study were 1) to determine the feasibility of using red LEDS for growing Arabidopsis thaliana L. through a full seed-bearing generation, and 2) to determine if supplemental blue radiation is necessary for growth and seed production. Arabidopsis grown under red LEDS alone produced viable seed, but these plants had abnormal leaf morphology and delayed flowering in comparison to control plants grown under broad spectrum white light or red LEDS supplemented with blue light.
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Affiliation(s)
- G D Goins
- Dynamac Corporation, Advanced Life Support and Space Biology, Kennedy Space Center, FL 32899, USA.
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Tibbitts TW, Croxdale JC, Brown CS, Wheeler RM, Goins GD. Ground-based studies and space experiment with potato leaf explants. Life Support Biosph Sci 2001; 6:97-106. [PMID: 11542246] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
This article details the extensive preflight research required to make a plant experiment conform to the constraints imposed by the spaceflight system. Potato explants, each consisting of a leaf, an axillary bud, and small stem section, were flown on USML-2 in the ASTROCULTURE (TM) flight hardware to study tuber formation from the axillary bud during the 16 days of flight. To obtain acceptable explant materials: 1) parent plants had to be grown under reduced light (150 micromoles m-2 s-1 PPF) to ensure uniform bud and tuber development, 2) leaves had to be trimmed to fit the small size of the flight growth chamber, and 3) only young, fully expanded leaves from plants 5-7 weeks old could be used. After six scrubs, the experiment was flown successfully October 20 to November 5 and produced tubers and accumulated starch similar to that produced on ground controls.
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Brown CS, Goodwin PC, Sorger PK. Image metrics in the statistical analysis of DNA microarray data. Proc Natl Acad Sci U S A 2001; 98:8944-9. [PMID: 11481466 PMCID: PMC55353 DOI: 10.1073/pnas.161242998] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [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] [Received: 10/28/2000] [Accepted: 05/15/2001] [Indexed: 11/18/2022] Open
Abstract
DNA microarrays represent an important new method for determining the complete expression profile of a cell. In "spotted" microarrays, slides carrying spots of target DNA are hybridized to fluorescently labeled cDNA from experimental and control cells and the arrays are imaged at two or more wavelengths. In this paper, we perform statistical analysis on images of microarrays and show that quantitating the amount of fluorescent DNA bound to microarrays is subject to considerable uncertainty because of large and small-scale intensity fluctuations within spots, nonadditive background, and fabrication artifacts. Pixel-by-pixel analysis of individual spots can be used to estimate these sources of error and establish the precision and accuracy with which gene expression ratios are determined. Simple weighting schemes based on these estimates are effective in improving significantly the quality of microarray data as it accumulates in a multiexperiment database. We propose that error estimates from image-based metrics should be one component in an explicitly probabilistic scheme for the analysis of DNA microarray data.
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Affiliation(s)
- C S Brown
- Biotechnology Group, Applied Precision, Inc., 1040 12th Avenue Northwest, Issaquah, WA 98027, USA
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Abstract
This study was designed to examine whether the presence of implicit links between social groups and high versus low status attributes affects the formation of intergroup attitudes. Elementary school children aged 7 to 12 years (N = 91) were given measures of classification skill and self-esteem, and assigned to one of three types of summer school classrooms in which teachers made (1) functional use of novel ("blue" and "yellow") social groups that were depicted via posters as varying in status, (2) no explicit use of novel social groups that were, nonetheless, depicted as varying in status, or (3) functional use of novel social groups in the absence of information about status. After 6 weeks, children completed measures of intergroup attitudes. Results indicated that children's intergroup attitudes were affected by the status manipulation when teachers made functional use of the novel groups. Children who were members of high-status (but not low-status) groups developed in-group biased attitudes.
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Affiliation(s)
- R S Bigler
- Department of Psychology, University of Texas at Austin, 78712, USA.
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Amin K, Ng KY, Brown CS, Bruno MS, Heath TD. LDL induced association of anionic liposomes with cells and delivery of contents as shown by the increase in potency of liposome dependent drugs. Pharm Res 2001; 18:914-21. [PMID: 11496949 DOI: 10.1023/a:1010971808006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE To establish whether anionic liposomes interact with the low-density lipoprotein (LDL) receptor, to determine the role of lipoproteins in this interaction, and whether the association causes functional delivery of encapsulated drugs. METHODS The cell lines used were CV1-P and CHO wild type, both of which express the LDL receptor, and CHOldlA7, which lacks the LDL receptor. Cellular association of encapsulated methotrexate and fluorescein, labeled phosphatidylethanolamine in the lipid bilayer, was measured. Potency of three liposome dependent drugs (N-phosphonacetyl-L-aspartic acid, fluoroorotic acid, and methotrexate-gamma-aspartate) was also measured by growth inhibition. RESULTS Association of liposomes containing at least 75 mol egg phosphatidylglycerol (ePG)/100 mol phospholipid with cells grown in defined medium supplemented with 1.0 mg/ml LDL was up to 30-fold higher with CV1-P or CHO wild type cells than with CHOldlA7, and 5-fold higher than association in defined medium lacking LDL. The addition of LDL did not yield any elevation of cellular association of distearoylphosphatidylglycerol liposomes. Increased association was paralleled by a corresponding increase in potency of all three liposome dependent drugs tested. CONCLUSIONS ePG liposomes interact with the LDL receptor in an LDL-dependent fashion, and the interaction results in the delivery of contents to cells.
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Affiliation(s)
- K Amin
- University of Wisconsin-Madison, School of Pharmacy, 53706, USA
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Abstract
Depressive and anxiety disorders are common problems facing obstetrician-gynecologists. Although psychiatric disorders are equally common in men and women, women are at least twice as likely to present with depressive disorders and most anxiety disorders. The depressive disorders include major depression, dysthymia, seasonal affective disorder, and premenstrual dysphoric disorder. The anxiety disorders are panic disorder (with and without agoraphobia), generalized anxiety disorder, social phobia, obsessive compulsive disorder, and PTSD. One must diagnose and manage depressive and anxiety disorders during pregnancy, the purpureum, and while breastfeeding. General treatment principles include assessing suicide risk, psychotherapy, pharmacologic treatment, and an appropriate medical work-up for depressive and anxiety disorders. The SSRIs are the first-line treatment for most depressive and anxiety disorders because of data supporting their efficacy, the minimal need for dosage titration, the overall favorable side-effect profile, and the length of available clinical experience. Newer antidepressants, such as venlafaxine, bupropion, nefazodone, and mirtazapine, are options for patients unresponsive to, or intolerant of, the SSRIs. Treatment considerations include acute, maintenance, and continuation therapy, dosage regimens, adverse effects, and drug interactions. Specific guidelines are available for referring patients to a mental health specialist.
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Affiliation(s)
- C S Brown
- Departments of Pharmacy Practice and Pharmacoeconomics, Obstetrics and Gynecology, and Psychiatry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Kuznetsov OA, Brown CS, Levine HG, Piastuch WC, Sanwo-Lewandowski MM, Hasenstein KH. Composition and physical properties of starch in microgravity-grown plants. Adv Space Res 2001; 28:651-8. [PMID: 11803968 DOI: 10.1016/s0273-1177(01)00374-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The effect of spaceflight on starch development in soybean (Glycine max L., BRIC-03) and potato (Solanum tuberosum, Astroculture-05) was compared with ground controls by biophysical and biochemical measurements. Starch grains from plants from both flights were on average 20-50% smaller in diameter than ground controls. The ratio delta X/delta rho (delta X --difference of magnetic susceptibilities, delta rho--difference of densities between starch and water) of starch grains was ca. 15% and 4% higher for space-grown soybean cotyledons and potato tubers, respectively, than in corresponding ground controls. Since the densities of particles were similar for all samples (1.36 to 1.38 g/cm3), the observed difference in delta X/delta rho was due to different magnetic susceptibilities and indicates modified composition of starch grains. In starch preparations from soybean cotyledons (BRIC-03) subjected to controlled enzymatic degradation with alpha-amylase for 24 hours, 77 +/- 6% of the starch from the flight cotyledons was degraded compared to 58 +/- 12% in ground controls. The amylose content in starch was also higher in space-grown tissues. The good correlation between the amylose content and delta X/delta rho suggests, that the magnetic susceptibility of starch grains is related to their amylose content. Since the seedlings from the BRIC-03 experiment showed elevated post-flight ethylene levels, material from another flight experiment (GENEX) which had normal levels of ethylene was examined and showed no difference to ground controls in size distribution, density, delta X/delta rho and amylose content. Therefore the role of ethylene appears to be more important for changes in starch metabolism than microgravity.
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Affiliation(s)
- O A Kuznetsov
- Biology Dept., University of Louisiana at Lafayette, LA 70504-2451, USA
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Abstract
Admissions and discharges from a 30-bed regional secure unit (RSU) were surveyed over a 15-year period. In the last five years there has been a significant increase in the average length of stay of patients and a marked decrease in the number of admissions and discharges. The reasons for this 'silting up' of the RSU by longer-term patients and the consequences for an effective forensic psychiatric service are discussed.
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Affiliation(s)
- C S Brown
- Department of Mental Health, University of Exeter, Wonford House, Dryden Road, Exeter EX2 5AF
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