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Medeiros PB, Bailey C, Pollock D, Liley H, Gordon A, Andrews C, Flenady V. Neonatal near-miss audits: a systematic review and a call to action. BMC Pediatr 2023; 23:573. [PMID: 37978460 PMCID: PMC10655277 DOI: 10.1186/s12887-023-04383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Neonatal near-miss (NNM) can be considered as an end of a spectrum that includes stillbirths and neonatal deaths. Clinical audits of NNM might reduce perinatal adverse outcomes. The aim of this review is to evaluate the effectiveness of NNM audits for reducing perinatal mortality and morbidity and explore related contextual factors. METHODS PubMed, Embase, Scopus, CINAHL, LILACS and SciELO were searched in February/2023. Randomized and observational studies of NNM clinical audits were included without restrictions on setting, publication date or language. PRIMARY OUTCOMES perinatal mortality, morbidity and NNM. SECONDARY OUTCOMES factors contributing to NNM and measures of quality of care. Study characteristics, methodological quality and outcome were extracted and assessed by two independent reviewers. Narrative synthesis was performed. RESULTS Of 3081 titles and abstracts screened, 36 articles had full-text review. Two studies identified, rated, and classified contributing care factors and generated recommendations to improve the quality of care. No study reported the primary outcomes for the review (change in perinatal mortality, morbidity and NNM rates resulting from an audit process), thus precluding meta-analysis. Three studies were multidisciplinary NNM audits and were assessed for additional contextual factors. CONCLUSION There was little data available to determine the effectiveness of clinical audits of NNM. While trials randomised at patient level to test our research question would be difficult or unethical for both NNM and perinatal death audits, other strategies such as large, well-designed before-and-after studies within services or comparisons between services could contribute evidence. This review supports a Call to Action for NNM audits. Adoption of formal audit methodology, standardised NNM definitions, evaluation of parent's engagement and measurement of the effectiveness of quality improvement cycles for improving outcomes are needed.
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Affiliation(s)
- P B Medeiros
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia.
- Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia.
| | - C Bailey
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - D Pollock
- JBI, School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - H Liley
- Mater Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - A Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- University of Sydney, Sydney, NSW, Australia
| | - C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
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Ward R, Obeid JS, Jennings L, Szwast E, Hayes WG, Pipaliya R, Bailey C, Faul S, Polyak B, Baker GH, McCauley JL, Lenert LA. Enhanced phenotypes for identifying opioid overdose in emergency department visit electronic health record data. JAMIA Open 2023; 6:ooad081. [PMID: 38486917 PMCID: PMC10938047 DOI: 10.1093/jamiaopen/ooad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 03/17/2024] Open
Abstract
Background Accurate identification of opioid overdose (OOD) cases in electronic healthcare record (EHR) data is an important element in surveillance, empirical research, and clinical intervention. We sought to improve existing OOD electronic phenotypes by incorporating new data types beyond diagnostic codes and by applying several statistical and machine learning methods. Materials and Methods We developed an EHR dataset of emergency department visits involving OOD cases or patients considered at risk for an OOD and ascertained true OOD status through manual chart reviews. We developed and validated prediction models using Random Forest, Extreme Gradient Boost, and Elastic Net models that incorporated 717 features involving primary and second diagnoses, chief complaints, medications prescribed, vital signs, laboratory results, and procedural codes. We also developed models limited to single data types. Results A total of 1718 records involving 1485 patients were manually reviewed; 541 (36.4%) patients had one or more OOD. Prediction performance was similar for all models; sensitivity varied from 94% to 97%; and area under the receiver operating characteristic curve (AUC) was 98% for all methods. The primary diagnosis and chief complaint were the most important contributors to AUC performance; primary diagnoses and medication class contributed most to sensitivity; chief complaint, primary diagnosis, and vital signs were most important for specificity. Models limited to decision support data types available in real time demonstrated robust prediction performance. Conclusions Substantial prediction performance improvements were demonstrated for identifying OODs in EHR data. Our e-phenotypes could be applied in surveillance, retrospective empirical applications, or clinical decision support systems.
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Affiliation(s)
- Ralph Ward
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Jihad S Obeid
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Lindsey Jennings
- Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Elizabeth Szwast
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - William Garrett Hayes
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Royal Pipaliya
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Cameron Bailey
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Skylar Faul
- School of Medicine, Mercer University, Macon, GA 31207, United States
| | - Brianna Polyak
- School of Medicine, University of Texas Rio Grande Valley, Edinburg, TX 78539, United States
| | - George Hamilton Baker
- Department of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Jenna L McCauley
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Leslie A Lenert
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29425, United States
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Uetsu Y, Houston D, Bailey C, Kilpatrick S. Association of the origin of contamination and species of microorganisms with short-term survival in dogs with septic peritonitis. Aust Vet J 2023; 101:83-89. [PMID: 36424833 DOI: 10.1111/avj.13220] [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: 11/10/2021] [Revised: 08/25/2022] [Accepted: 11/04/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the association between anatomical location of contamination and mortality in dogs with gastrointestinal and biliary origin of septic peritonitis. METHODS Medical records at two private referral hospitals between 2003 and 2020 were retrospectively reviewed. Cases were included if the origin of contamination was confirmed intraoperatively within the gastrointestinal or biliary tract. Cases were excluded if the dog died or was euthanized intraoperatively or where the data regarding the origin of contamination were not available. The association of anatomical origin with survival was assessed specifying the locations as stomach, small intestine, large intestine and biliary tract. The gastrointestinal tract origin was further subdivided into pylorus, nonpylorus, duodenum, jejunum, ileum, caecum and colon. RESULTS The overall survival rate was 75.9% (n = 44/58). There were no significant differences in survival among different anatomical origins of contaminations before or after subdivision (P = 0.349 and 0.832, respectively). Also, there was no association between isolated microorganism species in microbiological culture and the anatomical origin (P = 0.951) and the microorganism species was not associated with survival (P = 0.674). CONCLUSIONS There was no association between anatomical location of leakage, microorganism species and survival although further studies are warranted to analyse the relationships between anatomical leakage site and microorganism species as well as microorganism species and mortality.
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Affiliation(s)
- Y Uetsu
- North Shore Veterinary, Specialist & Emergency Centre, Artarmon, New South Wales, Australia
| | - D Houston
- Small Animal Specialist Hospital, Prospect, New South Wales, Australia
| | - C Bailey
- North Shore Veterinary, Specialist & Emergency Centre, Artarmon, New South Wales, Australia
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Crook B, Bailey C, Sykes A, Hoyle MC, Evans C, Poller B, Makison-Booth C, Pocock D, Tuudah C, Athan B, Hall S. Validation of personal protective equipment ensembles, incorporating powered air-purifying respirators protected from contamination, for the care of patients with high-consequence infectious diseases. J Hosp Infect 2023; 134:71-79. [PMID: 36716796 DOI: 10.1016/j.jhin.2023.01.005] [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: 10/24/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND The UK High-Consequence Infectious Diseases (HCID) Network of high-level isolation units provides care for patients with contact- or airborne-transmissible highly infectious and highly dangerous diseases. In most HCID units, the healthcare workers (HCWs) wear personal protective equipment (PPE) ensembles incorporating a powered air-purifying respirator (PAPR) for head and respiratory protection. Some PAPRs have components worn outside/over other PPE, necessitating decontamination of re-usable elements. Two alternative PAPRs, with all re-usable elements worn under PPE, were trialled in this study. AIM To undertake scenario-based testing of PAPRs and PPE to determine usability, comfort and ability to remove contaminated PPE without personal cross-contamination. METHODS Trained healthcare volunteers (N=20) wearing PAPR/PPE ensembles were sprayed with ultraviolet fluorescent markers. They undertook exercises to mimic patient care, and subsequently, after doffing the contaminated PPE following an established protocol, any personal cross-contamination was visualized under ultraviolet light. Participants also completed a questionnaire to gauge how comfortable they found the PPE. FINDINGS AND CONCLUSIONS The ensembles were tested under extreme 'worst case scenario' conditions, augmented by physical and manual dexterity tests. Participating volunteers considered the exercise to be beneficial in terms of training and PPE evaluation. Data obtained, including feedback from questionnaires and doffing buddy observations, supported evidence-based decisions on the PAPR/PPE ensemble to be adopted by the HCID Network. One cross-contamination event was recorded in the ensemble chosen; this could be attributed to doffing error, and could therefore be eliminated with further practice.
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Affiliation(s)
- B Crook
- Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK.
| | - C Bailey
- Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK
| | - A Sykes
- Infection Prevention and Control, Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - M C Hoyle
- ID/HCID Unit, Royal Liverpool Hospital, Royal Liverpool and Broad Green University Hospitals NHS Trust, Liverpool, UK
| | - C Evans
- Department of Virology, Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - B Poller
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK; Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - C Makison-Booth
- Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK; World Health Organization, Geneva, Switzerland
| | - D Pocock
- Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK; Cabinet Office, Kings Court, Sheffield, UK
| | - C Tuudah
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - B Athan
- High-Level Isolation Unit, Royal Free London NHS Foundation Trust, London, UK
| | - S Hall
- Health Capability Group, Science and Research Centre, Health and Safety Executive, Buxton, UK
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Freitag F, Valverde A, Jensen M, Sanchez A, Gomez D, Bailey C. Comparison of rostral spread of lumbosacral epidural volume calculated by body weight or length of the vertebral column in dogs. Vet Anaesth Analg 2023. [DOI: 10.1016/j.vaa.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Gallastegui N, Steiner BUK, Aguero P, Bailey C, Kruse-Jarres R, Quon DV, Hanacek C, Volland LM, Barnes RFW, von Drygalski A. The role of point-of-Care Musculoskeletal Ultrasound for Routine Joint evaluation and management in the Hemophilia Clinic - A Real World Experience. BMC Musculoskelet Disord 2022; 23:1111. [PMID: 36539778 PMCID: PMC9768915 DOI: 10.1186/s12891-022-06042-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The use of musculoskeletal ultrasound (MSKUS) for point-of-care (POC) evaluation of hemophilic arthropathy is growing rapidly. However, the extent to which MSKUS influences clinical treatment decisions is unknown. METHODS We conducted a three-year, prospective, multi-center study at three hemophilia treatment centers in the United States to evaluate the utilization of POC-MSKUS for routine clinical decision-making in adult persons with hemophilic arthropathy. Bilateral elbows, knees and ankles were assessed clinically [Hemophilia Joint Health Score (HJHS)] and with POC-MSKUS by the Joint TissueActivity and Damage Exam (JADE) protocol at baseline and approximately annually for two additional times. Treatment decisions, including physical therapy (PT) and "medical" (joint injections/aspirations, referrals to orthopedics, changes/adjustments of hemostatic plans, and use of oral anti-inflammatory medications) were recorded in relation to POC-MSKUS. RESULTS Forty-four persons [median age 37 years (IQR 29, 51)], mostly with severe Hemophilia A on clotting factor prophylaxis, completed 129 visits, yielding 792 joint exams by POC-MSKUS and HJHS [median at baseline 27 (IQR 18, 42)] over a median follow up of 584 days (range: 363 to 1072). Among 157 management decisions, 70% were related to PT plans (n = 110) and 30% were "medical". Point-of-care MSKUS influenced 47/110 (43%) PT plans, mostly informing treatment of specific arthropathic joints (45/47 plans) in patients with high HJHS. Physical therapy plans influenced by POC-MSKUS directed more manual therapy/therapeutic exercises, while plans based on physical exam were focused more on global exercises and wellness. Treatment decisions were mostly based on the identification of specific musculoskeletal abnormalities visualized by POC-MSKUS. Of note 20/47 (43%) POC-MSKUS plans included de-escalation strategies, thereby reducing exercise intensity, mostly for joint instability and subclinical hemarthroses. Point-of-care MSKUS also informed 68% (32/47) of "medical" decisions, surprisingly mostly for injections/aspirations and referrals to orthopedics, and not for adjustments of hemostatic treatment. Although not formally studied, ultrasound images were used frequently for patient education. CONCLUSION Routine joint evaluations with POC-MSKUS resulted in few changes regarding medical management decisions but had a profound effect on the formulation of PT plans. Based on these findings, new studies are essential to determine the benefit of MSKUS-informed management plans on joint health outcomes.
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Affiliation(s)
- N Gallastegui
- grid.266100.30000 0001 2107 4242Department of Medicine, Division of Hematology/Oncology, University of California San Diego, CA San Diego, USA ,grid.261331.40000 0001 2285 7943Department of Medicine, Division of Hematology, The Ohio State University, OH Columbus, USA
| | - BUK Steiner
- Washington Center for Bleeding Disorders, WA Seattle, USA
| | - P Aguero
- grid.266100.30000 0001 2107 4242Department of Medicine, Division of Hematology/Oncology, University of California San Diego, CA San Diego, USA
| | - C Bailey
- grid.489149.90000 0004 5900 1331The Orthopaedic Hemophilia Treatment Center, Orthopaedic Institute for Children, Los Angeles California, USA
| | - R Kruse-Jarres
- Washington Center for Bleeding Disorders, WA Seattle, USA
| | - DV Quon
- grid.489149.90000 0004 5900 1331The Orthopaedic Hemophilia Treatment Center, Orthopaedic Institute for Children, Los Angeles California, USA
| | - C Hanacek
- grid.266100.30000 0001 2107 4242Department of Medicine, Division of Hematology/Oncology, University of California San Diego, CA San Diego, USA ,Department of General Medical Education, KPC Health. Hemet, CA, USA 1810 Cannon Drive, Suite 1150E, OH Columbus, USA
| | - LM Volland
- grid.266100.30000 0001 2107 4242Department of Medicine, Division of Hematology/Oncology, University of California San Diego, CA San Diego, USA ,grid.422264.40000 0004 0542 3790National Hemophilia Foundation, NYC NY, USA
| | - RFW Barnes
- grid.266100.30000 0001 2107 4242Department of Medicine, Division of Hematology/Oncology, University of California San Diego, CA San Diego, USA
| | - A von Drygalski
- grid.266100.30000 0001 2107 4242Department of Medicine, Division of Hematology/Oncology, University of California San Diego, CA San Diego, USA
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7
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Sorensen A, Salas Atwell M, Koroukian S, Bailey C, Briggs F. A-44 Experiences of Adversity and Validity of Baseline Concussion Testing. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac32.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose: This study examined the relationship between individual-level experiences of social adversity and baseline computerized concussion testing validity (Immediate Post-Concussion Assessment and Cognitive Testing; ImPACT). Methods: This study involved 6495 student-athletes born between 1995 and 2005 who completed a baseline ImPACT test between 10 and 18 years old and could be identified in the Child-Household Integrated Longitudinal Data (CHILD) System, a continuously updated integrated and comprehensive data system that captures detailed individual-level demographic, social service usage, and educational outcomes on every child born or living in Cuyahoga County, Ohio from 1989 to present. Multivariable logistic regression models were conducted with experiences of SNAP/TANF enrollment, substantiated abuse or neglect incidents, and extreme neighborhood deprivation occurring in the sensitive developmental periods of early childhood and adolescence as key predictors of baseline test validity. Results: Our findings suggest that social mobility may play an important role in baseline validity. Youth with upward social mobility (poverty or neighborhood deprivation in early childhood only) were not significantly different than youth without such experiences (OR = 0.91, p = 0.74). Youth with persistent adversity across childhood or downward social mobility (poverty or high neighborhood deprivation in adolescence only) had 50–72% lower odds of achieving a valid baseline test (persistent poverty: OR = 0.59, p = 0.05; adolescent poverty only: OR = 0.50, p = 0.004; adolescent neighborhood deprivation only: OR = 0.28, p < 0.0001). Conclusions: These findings suggest certain patterns of social adversity may predispose youth to invalid computerized concussion baseline testing scores, potentially increasing their risk of inaccurate injury management and poor outcomes.
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Bailey C, Stumpf F, Raymond A, Richard H, Kim K, Fang A. Abstract No. 150 Retrospective comparative analysis of inferior vena cava filter retrieval in patients with and without filter strut arterial abutment/penetration. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bell SF, Collis RE, Bailey C, James K, John M, Kelly K, Kitchen T, Scarr C, Macgillivray E, Collins PW. Corrigendum to "The incidence, aetiology, and coagulation management of massive postpartum haemorrhage: a two-year national prospective cohort study" [Int J Obstet Anesth 2021;47:102983]. Int J Obstet Anesth 2022; 51:103549. [PMID: 35623997 DOI: 10.1016/j.ijoa.2022.103549] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S F Bell
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK.
| | - R E Collis
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - C Bailey
- Department of Anaesthetics, Intensive Care and Pain Medicine, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Bodelwyddan, UK
| | - K James
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - M John
- Department of Emergency Medicine, Aneurin Bevan University Health Board, Newport, UK
| | - K Kelly
- Department of Anaesthetics, Intensive Care and Pain Medicine, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Bodelwyddan, UK
| | - T Kitchen
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - C Scarr
- Department of Obstetrics and Gynaecology, Cardiff and Vale University Health Board, Cardiff, UK
| | | | - P W Collins
- Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Martel J, Addo K, Kim Y, Hamdan F, Demo H, Bonavita G, Li J, Ahmad S, Shah S, Delurgio D, Bailey C, Shim J. Impact of mapping technology on procedural characteristics during radiofrequency or cryoballoon pulmonary vein isolation for atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction: Cryoballoon ablation (CBA) is often associated with shorter procedure times along with tradeoffs such as increased fluoroscopy use compared to radiofrequency (RF) ablation of atrial fibrillation (AF), however the impact of mapping technology on these characteristics is not fully understood.
Purpose
To assess the effect of mapping technology on trends in fluoroscopy use and procedure times in AF pulmonary vein isolation (PVI) procedures with an RF or CBA catheter.
Methods
Acute procedure data from 210 de novo AF cases using a 3D mapping system was prospectively collected from 48 centers in eight countries. Choice of technology was left to physician discretion; a PVI only ablation strategy was utilized in all cases. Procedure data such as total procedure and fluoroscopy times from cases using either an RF or CBA catheter with either a grid-style mapping catheter (HD Grid) or circular mapping catheter (CMC) were compared.
Results
Of the 210 cases, RF ablation was used in 103 (49%), and CBA used in 107 (51%). In RF cases, a relatively even split between CMC and HD Grid use was observed (n=46, 45% vs. n=57, 55%), while a CMC was used in 100% of CBA cases (Figure 1). Across all cases, fluoroscopy and procedure times were significantly shorter when HD Grid was used (7.4±26.7 minutes; 108.2±46.3 minutes) compared to a CMC (20.4±17.6 minutes; 133.7±62.7) (p<0.001; p=0.003). A similar trend was also observed in RF cases using HD Grid (7.4±26.7 minutes; 108.2±46.3 minutes) compared to a CMC (17.9±12.3 minutes; 175.1±50.5) (p=0.01; p<0.001). Fluoroscopy times in RF cases with HD Grid (7.4±26.7 minutes) were significantly shorter compared to CBA cases with a CMC (21.5±19.4 minutes) (p<0.001), while procedure times were similar (108.2±46.3 minutes; 116.0±59.2 minutes, p=0.20).
Conclusion(s)
Use of HD Grid resulted in significantly shorter procedure and fluoroscopy times compared to a CMC across all cases, including those using RF ablation. Fluoroscopy times were also significantly shorter in RF cases using HD Grid compared to CBA cases using a CMC, with similar procedure times. These observations suggest that use of HD Grid may better enable safer and more efficient PVI, specifically when employing RF ablation, in addition to safer and equally efficient RF PVI compared to CBA with a CMC. Further study in in a larger, randomized cohort may be necessary.
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Affiliation(s)
- J Martel
- South Miami Hospital, Miami, United States of America
| | - K Addo
- Mount Carmel Health System, Columbus, United States of America
| | - Y Kim
- Korea University, Seoul, Korea (Republic of)
| | - F Hamdan
- Aultman Hospital, Canton, United States of America
| | - H Demo
- Swedish Hospital, Chicago, United States of America
| | - G Bonavita
- Aultman Hospital, Canton, United States of America
| | - J Li
- ProMedica Toledo Hospital, Toledo, United States of America
| | - S Ahmad
- Kettering Medical Center, Dayton, United States of America
| | - S Shah
- Virginia Arrhythmia Consultants, Richmond, United States of America
| | - D Delurgio
- Emory Saint Joseph’s Hospital, Atlanta, United States of America
| | - C Bailey
- Abbott, St. Paul, United States of America
| | - J Shim
- Korea University, Seoul, Korea (Republic of)
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Shah S, Shim J, Martel J, Addo K, Delurgio D, Demo H, Hamdan F, Bonavita G, Li J, Bailey C, Kim Y. Global preferences in mapping technology and its impact on fluoroscopy and procedure times during catheter ablation of atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Choice in mapping technology may play a critical role in reducing fluoroscopy and procedure times during atrial fibrillation (AF) ablation, however this relationship is not well studied.
Purpose
To assess the impact of mapping technology on trends in fluoroscopy use and procedure times in AF ablation procedures.
Methods
Acute procedure data from 525 AF cases was prospectively collected from 68 centers in nine countries. Choice of technology and ablation strategy, including PVI and substrate modification, were left to physician discretion. Procedure data such as total procedure and fluoroscopy times from cases using a grid-style mapping catheter (HD Grid) were compared to those using a circular mapping catheter (CMC).
Results
Of the 525 cases, HD Grid was used in 230 (44%), and CMC was used in 295 (56%). HD Grid was routinely used for both de novo and redo procedures while CMC was used predominantly for de novo procedures (Table 1). Similar procedure times were noted in redo PAF and redo PersAF procedures, while significantly shorter procedure times were observed for the HD Grid group in both de novo PAF and PersAF (113.9±48.8 vs. 125.9±56.3 minutes, p=0.04; and 142.8±53.2 vs. 169.8±52.2 minutes, p=0.001).
Overall fluoroscopy times were significantly shorter using HD Grid compared to a CMC (9.0±19.6 minutes vs. 19.8±16.4 minutes, p<0.001), including significantly shorter fluoroscopy times in de novo PAF, de novo PersAF, and redo PAF (Table 1). There were 155 cases completed without fluoroscopy use; zero fluoroscopy cases accounted for 50% (114/230) and 14% (41/295) of total cases completed with HD Grid and a CMC, respectively (p<0.001).
Conclusion(s)
Use of HD Grid was observed in a significantly higher portion of zero fluoroscopy cases and resulted in significantly shorter procedure and fluoroscopy times in both de novo PAF and de novo PersAF and significantly shorter fluoroscopy times in redo PAF. These observations suggest that use of HD Grid may better enable faster and safer procedures in these specific AF types compared to CMCs, although further analysis in a larger, randomized cohort may be warranted.
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Affiliation(s)
- S Shah
- Virginia Arrhythmia Consultants, Richmond, United States of America
| | - J Shim
- Korea University, Seoul, Korea (Republic of)
| | - J Martel
- South Miami Hospital, Miami, United States of America
| | - K Addo
- Mount Carmel Health System, Columbus, United States of America
| | - D Delurgio
- Emory Saint Joseph’s Hospital, Atlanta, United States of America
| | - H Demo
- Swedish Hospital, Chicago, United States of America
| | - F Hamdan
- Aultman Hospital, Canton, United States of America
| | - G Bonavita
- Aultman Hospital, Canton, United States of America
| | - J Li
- ProMedica Toledo Hospital, Toledo, United States of America
| | - C Bailey
- Abbott, St. Paul, United States of America
| | - Y Kim
- Korea University, Seoul, Korea (Republic of)
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Kottmaier M, Inaba O, Phillips K, Adsett M, Hayes J, Gkalapis C, Lengauer S, Clementy N, Bailey C, Kaneko S. Initial experience using a novel algorithm to calculate omnipolar electrograms using a high-density grid-style catheter. Europace 2022. [DOI: 10.1093/europace/euac053.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
A novel mapping algorithm recently became available in Europe and select countries in the Asia Pacific region. EnSite Omnipolar Technology (OT) utilizes the Advisor HD Grid Mapping Catheter, Sensor Enabled (HD Grid) to calculate electrograms in 360 degrees from two bipolar and three unipolar electrograms acquired from a triangular set of three electrodes. This software also enables calculation of wavefront characteristics including maximum voltage, activation direction and wave speed. Procedural characteristics and clinical utilization of this novel software have not yet been reported.
Purpose
To examine the clinical utility and procedural characteristics associated with the use of this novel mapping algorithm among participating centers.
Methods
Acute procedural data were prospectively collected in 386 cases at 52 centers utilizing the newly approved mapping software in the initial phases of commercialization in Europe and the Asia Pacific region. Procedural characteristics recorded included indication for mapping/ablation, navigation mode, mapping reference, and maps and tools used to diagnose/locate ablation targets.
Results
A total of 14 indications for mapping and ablation were represented including AF, atypical flutter, and VT (Table 1). VoXel (magnetic primary) navigation mode was used in most cases (n=325, 84%). The CS catheter was used as the map reference in 280 cases (73%). A variety of workflows were used with OT to diagnose and locate ablation targets including voltage maps (n=275, 71%), LAT maps (n=226, 59%), OT activation vectors (n=124, 32%), propagation maps (n=94, 24%), and sparkle maps (n=69, 18%); note: total exceeds 100%, multiple workflows per case observed. EnSite LiveView Dynamic Display (LiveView) was used in 129 cases (33%) to diagnose and locate ablation targets, including 28 (22%) where OT activation vectors were used with LiveView. Several benefits of OT were reported including rapid identification of ablation target(s) (n=133, 35%), higher point density (n=82, 21%), better signals (n=69, 18%), and improved procedure efficiency (n=48, 12%).
Conclusion(s)
Initial experience with this novel mapping software in Europe and the Asia-Pacific region illustrated utility in a variety of arrhythmias to diagnose and locate ablation targets. The use of OT provided several benefits including rapid identification of ablation targets and higher point density, however further examination of its impact on procedural efficiencies and acute outcomes is likely warranted.
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Affiliation(s)
- M Kottmaier
- German Heart Center of Munich, Munich, Germany
| | - O Inaba
- Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - K Phillips
- Greenslopes Private Hospital, Brisbane, Australia
| | - M Adsett
- St Andrews War Memorial Hospital, Brisbane, Australia
| | - J Hayes
- St Andrews War Memorial Hospital, Brisbane, Australia
| | | | - S Lengauer
- German Heart Center of Munich, Munich, Germany
| | - N Clementy
- University Hospital of Tours, Tours, France
| | - C Bailey
- Abbott, St. Paul, United States of America
| | - S Kaneko
- Toyota Kosei Hospital, Toyota, Japan
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O’Sullivan G, Yu B, Bailey C, Velickovic Z, Rasko J. Regulatory Affairs, Quality Systems, Policy, and Ethics: HOW INSTITUTIONAL BIOSAFETY COMMITTEES CONTRIBUTE TO SAFETY, CAPACITY AND REGULATORY APPROVALS IN CELL AND GENE THERAPY TRIALS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00495-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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14
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Bailey C, Hilser H, Siwi Y, Lawe Z, Waterman J, Loffeld TAC, Sampson H, Tasirin J, Melfi V, Bowkett AE. Trends in the bushmeat market trade in North Sulawesi and conservation implications. Anim Conserv 2021. [DOI: 10.1111/acv.12723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Bailey
- Selamatkan Yaki Manado North Sulawesi Indonesia
| | - H. Hilser
- Selamatkan Yaki Manado North Sulawesi Indonesia
- College of Life and Environmental Sciences University of Exeter Exeter UK
| | - Y. Siwi
- Selamatkan Yaki Manado North Sulawesi Indonesia
| | - Z. Lawe
- Selamatkan Yaki Manado North Sulawesi Indonesia
| | - J. Waterman
- School of Biological and Environmental Science Liverpool John Moores University Liverpool UK
| | - T. A. C. Loffeld
- Durrell Institute of Conservation and Ecology (DICE) University of Kent Canterbury UK
| | - H. Sampson
- Selamatkan Yaki Manado North Sulawesi Indonesia
| | - J. Tasirin
- Selamatkan Yaki Manado North Sulawesi Indonesia
- Faculty of Agriculture Sam Ratulangi University Manado North Sulawesi Indonesia
| | - V. Melfi
- Hartpury University Gloucestershire UK
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Cushnie D, Fisher C, Hall H, Johnson M, Christie S, Bailey C, Phan P, Abraham E, Glennie A, Jacobs B, Paquet J, Thomas K. Mental health improvements after elective spine surgery: a Canadian Spine Outcome Research Network (CSORN) study. Spine J 2021; 21:1332-1339. [PMID: 33831545 DOI: 10.1016/j.spinee.2021.03.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/19/2021] [Accepted: 03/29/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Spine patients have a higher rate of depression then the general population which may be caused in part by levels of pain and disability from their spinal disease. PURPOSE Determination whether improvements in health-related quality of life (HRQOL) resulting from successful spine surgery leads to improvements in mental health. STUDY DESIGN/SETTING The Canadian Spine Outcome Research Network prospective surgical outcome registry. OUTCOME MEASURES Change between preoperative and postoperative SF12 Mental Component Score (MCS). Secondary outcomes include European Quality of Life (EuroQoL) Healthstate, SF-12 Physical Component Score (PCS), Oswestry Disability Index (ODI), Patient Health Questionaire-9 (PHQ9), and pain scales. METHODS The Canadian Spine Outcome Research Network registry was queried for all patients receiving surgery for degenerative thoracolumbar spine disease. Exclusion criteria were trauma, tumor, infection, and previous spine surgery. SF12 Mental Component Scores (MCS) were compared between those with and without significant improvement in postoperative disability (ODI) and secondary measures. Multivariate analysis examined factors predictive of MCS improvement. RESULTS Eighteen hospitals contributed 3222 eligible patients. Worse ODI, EuroQoL, PCS, back pain and leg pain correlated with worse MCS at all time points. Overall, patients had an improvement in MCS that occurred within 3 months of surgery and was still present 24 months after surgery. Patients exceeding Minimally Clinically Important Differences in ODI had the greatest improvements in MCS. Major depression prevalence decreased up to 48% following surgery, depending on spine diagnosis. CONCLUSIONS Large scale, real world, registry data suggests that successful surgery for degenerative lumbar disease is associated with reduction in the prevalence of major depression regardless of the specific underlaying diagnosis. Worse baseline MCS was associated with worse baseline HRQOL and improved postoperatively with coincident improvement in disability, emphasizing that mental wellness is not a static state but may improve with well-planned spine surgery.
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Affiliation(s)
- D Cushnie
- McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8.
| | - C Fisher
- University of British Columbia, 6th floor, 818 West 10th Avenue, Vancouver, British Columbia, Canada, V5Z 1M9
| | - H Hall
- University of Toronto, 494851 Traverston Road, Markdale, Ontario, Canada, N0C 1H0
| | - M Johnson
- University of Manitoba, AD401 - 820 Sherbrook Street, Winnipeg, Manitoba, Canada, R3A 1R9
| | - S Christie
- Dalhousie University, Department of Surgery (Neurosurgery), Halifax, Nova Scotia, Canada, B3H 4R2
| | - C Bailey
- Western University, 800 Commissioners Rd. E., E1-317London, Ontario, Canada, N6A 5W9
| | - P Phan
- University of Ottawa, 1053 Carling Ave, Ottawa, Ontario, Canada, K1Y 4E9
| | - E Abraham
- Dalhousie University, 555 Somerset St, Suite 200, Saint John, New Brunswick, Canada, E2K 4X2
| | - A Glennie
- Dalhousie University, Department of Surgery (Neurosurgery), Halifax, Nova Scotia, Canada, B3H 4R2
| | - B Jacobs
- University of Calgary, Foothills Medical Centre, 1403 - 29th Street NW Calgary, AB, Canada T2N 2T9
| | - J Paquet
- CHU de Québec-Université Laval, 1401 18e rue, Québec City, Quebec, Canada, G1J 1Z4
| | - K Thomas
- University of Calgary, Foothills Medical Centre, 1403 - 29th Street NW Calgary, AB, Canada T2N 2T9
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Yuan F, Gong A, Farhan A, Gowda P, Bailey C, Latif M, Shafaat O, Fu Y, Mitchell S, Holly B, Weiss C. Abstract No. 197 Using intraoperative neurophysiologic monitoring to prevent peripheral nerve injury during embolization of low-flow vascular malformations. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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17
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Hafezi Nejad N, Bailey C, Lyons G, Liddell R. Abstract No. 464 Peripheral endovascular interventions: national burden, regional variations, disparities, direct and indirect costs in the United States. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Esfandiary T, Bailey C, Liddell R, Singh H, Lyons G. Abstract No. 193 Vascular sequelae of COVID-19: interventional radiology in the management of coronavirus-associated angiopathy. J Vasc Interv Radiol 2021. [PMCID: PMC8079608 DOI: 10.1016/j.jvir.2021.03.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Latif M, Motaghi M, Abou Areda M, Bailey C, Mitchell S, Weiss C. Abstract No. 66 Predictors of reperfusion in treated pulmonary arteriovenous malformation: a retrospective single-center study. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hafezi Nejad N, Gowda P, Bailey C, Weiss C. Abstract No. 47 Recurrent bleeding and post-procedural complications following bronchial artery embolization for hemoptysis: a meta-analysis of 2661 patients. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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O’Sullivan G, Yu B, Bailey C, Velickovic Z, Rasko J. How institutional biosafety committees contribute to safety, capacity and regulatory approvals in cell and gene therapy trials. Cytotherapy 2021. [DOI: 10.1016/s146532492100640x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Quick A, Martin B, Bailey C, Covington K, Cook R. 297 Risk stratification of patients with stage I cutaneous melanoma (CM) using 31-gene expression profiling (GEP). J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yuan F, Latif M, Shafaat O, Fu Y, Gowda P, Gong A, Farhan A, Bailey C, Mitchell S, Weiss C. Abstract No. 598 Clinical manifestations of patients with novel mutations associated with hereditary hemorrhagic telangiectasia and related vascular anomalies. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Hafezi Nejad N, Abou Areda M, Bailey C, Solomon A, Weiss C. Abstract No. 463 Percutaneous vertebral augmentation in the oldest old: comparative evaluation of comorbidities, outcomes and disparities. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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25
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Bell SF, Collis RE, Bailey C, James K, John M, Kelly K, Kitchen T, Scarr C, Macgillivray E, Collins PW. The incidence, aetiology, and coagulation management of massive postpartum haemorrhage: a two-year national prospective cohort study. Int J Obstet Anesth 2021; 47:102983. [PMID: 33994274 DOI: 10.1016/j.ijoa.2021.102983] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/23/2021] [Accepted: 03/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Between 2017 and 2018 a national quality improvement initiative was introduced incorporating point-of-care viscoelastic haemostatic assays (VHA) to guide blood product transfusion. Laboratory coagulation profiles, use and results of VHA, and administration of blood products were investigated. METHODS A two-year prospective cohort study of maternal outcomes of women experiencing massive postpartum haemorrhage (PPH) >1000 mL in Wales. In this study, cases of massive PPH (≥2500 mL and/or ≥5 units red blood cell (RBC) transfusion) were identified. RESULTS Massive PPH occurred in 349 of 60 914 maternities (rate 5.7 per 1000). There were no deaths from PPH. Intensive care unit admission and/or hysterectomy occurred in 34/311 (10.9%) and 16/347 (4.6%), respectively. The leading cause of massive PPH was genital tract trauma (107/349, 30.6%). Two hundred and seventy-nine (80.6%) required RBC transfusion and 79/345 (22.9%) received at least one blood coagulation product. Results of VHA were recorded in 245/349 (70.2%), with 44/98 (44.9%) women tested in the first six months vs 63/77 (81.8%) in the final six months. Hypofibrinogenaemia (Clauss fibrinogen <2 g/L or FIBTEM A5 <12 mm) was observed in 56/328 (17.1%) of women, thrombocytopaenia (count <75 × 109/L) in 17/334 (5.1%) and either PT or aPTT >1.5×reference range in 10/293 (3.4%). CONCLUSION In Wales, the use of VHA in cases of massive PPH increased over time, enabling clinicians to adopt a targeted, patient-specific approach to blood product administration, with only 22.9% of women receiving blood coagulation products and 17.1% having a documented clotting abnormality.
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Affiliation(s)
- S F Bell
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK.
| | - R E Collis
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - C Bailey
- Department of Anaesthetics, Intensive Care and Pain Medicine, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Bodelwyddan, UK
| | - K James
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - M John
- Department of Emergency Medicine, Aneurin Bevan University Health Board, Newport, UK
| | - K Kelly
- Department of Anaesthetics, Intensive Care and Pain Medicine, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Bodelwyddan, UK
| | - T Kitchen
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - C Scarr
- Department of Obstetrics and Gynaecology, Cardiff and Vale University Health Board, Cardiff, UK
| | | | - P W Collins
- Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Bailey C, Meyer J, Tangen C, Deane R, Briskin S, Gunstad J, Fastenau P, Smith P, Solomon M, Kelly AW. A-03 SCAT5 Cognitive Screening Normative Data and Reliable Change Indices. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
This study provides normative data on the SCAT5 Cognitive Screening, establishes test-retest reliability, and creates clinically relevant cut points for low performance.
Method
The multisport baseline sample was composed of 727 uninjured college athletes (52% female) at a Division I university who were administered the SCAT5 before the 2017–2018 season. Descriptive statistics, including base rates of low performance, were calculated for SCAT5 indices. Repeat baseline testing was completed by 325 athletes (48% female) at 1 year (days M = 352.56;SD = 56.03) who were included in the test-retest reliability and practice effect analyses. Reliable change indices were calculated.
Results
Descriptive statistics for SCAT5 were computed for both baselines (Baseline 1: SAC total M = 35.15,SD = 4.93; immediate recall total M = 20.01,SD = 3.46; delayed recall total M = 6.43,SD = 1.75). A difference in descriptive statistics and practice effects by sex on the SCAT5 Cognitive Screening has been demonstrated (Bailey, Meyer, Tangen et al., under review). For female athletes, the 1st administration cutoff scores for abnormal performance (<10th%ile) included SAC total score = 33, immediate recall score = 18, and delayed recall score = 6. For male athletes, the 1st administration cutoff scores for abnormal performance (<10th%ile) included SAC total score = 30, immediate recall score = 17, and delayed recall score = 5. Test-retest reliability of the SAC was similar to previous versions but varied by sex. Reliable change indices (RCI) were created with cut points for significant change.
Conclusions
The present study provides clinically relevant normative data for the SCAT5 Cognitive Screening. Cut points for low performance on both reliable chance indices (RCIs) and normative performance reflected meaningful sex differences that could influence clinical interpretation.
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Bailey C, Shoura MJ, Mischel PS, Swanton C. Extrachromosomal DNA-relieving heredity constraints, accelerating tumour evolution. Ann Oncol 2020; 31:884-893. [PMID: 32275948 DOI: 10.1016/j.annonc.2020.03.303] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 02/21/2020] [Accepted: 03/26/2020] [Indexed: 12/31/2022] Open
Abstract
Oncogene amplification on extrachromosomal DNA (ecDNA) provides a mechanism by which cancer cells can rapidly adapt to changes in the tumour microenvironment. These circular structures contain oncogenes and their regulatory elements, and, lacking centromeres, they are subject to unequal segregation during mitosis. This non-Mendelian mechanism of inheritance results in increased tumour heterogeneity with daughter cells that can contain increasingly amplified oncogene copy number. These structures also contain favourable epigenetic modifications including transcriptionally active chromatin, further fuelling positive selection. ecDNA drives aggressive tumour behaviour, is related to poorer survival outcomes and provides mechanisms of drug resistance. Recent evidence suggests one in four solid tumours contain cells with ecDNA structures. The concept of tumour evolution is one in which cancer cells compete to survive in a diverse tumour microenvironment under the Darwinian principles of variation and fitness heritability. Unconstrained by conventional segregation constraints, ecDNA can accelerate intratumoral heterogeneity and cellular fitness. In this review, we highlight some of the recent discoveries underpinning this process.
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Affiliation(s)
- C Bailey
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - M J Shoura
- Department of Pathology, Stanford University School of Medicine, Stanford, USA
| | - P S Mischel
- Ludwig Institute for Cancer Research, University of California at San Diego, San Diego, USA; San Diego Moores Cancer Center, University of California, La Jolla, USA; Department of Pathology, University of California San Diego, La Jolla, USA
| | - C Swanton
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK; Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
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Hafezi Nejad N, Bailey C, Weiss C. Abstract No. 580 Overweight, obesity, and unfavorable outcomes after percutaneous biliary interventions: a national study. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Patel K, Maxwell A, Bailey C. 3:54 PM Abstract No. 361 Safety and efficacy of central venous line placement via internal jugular vein in patients with total artificial hearts. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Hafezi Nejad N, Bailey C, Weiss C. Abstract No. 581 Percutaneous biliary interventions: national trends, patient characteristics, clinical indications, and outcomes in the United States, 1993 to 2015. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Hafezi Nejad N, Bailey C, Weiss C. Abstract No. 621 Vertebroplasty and kyphoplasty in the United States, 2004 to 2015: national trends, short-term outcomes, and regional disparities in cost of care. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Williams H, Tarallo C, Tran L, Griswold L, Bailey C, Patel K, Ghamande S, Rungruang B. Factors Influencing Survival and Survivorship Outcomes in Vulvar Cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bailey C, Nejad NH, Weiss C. Abstract No. 417 Arteriography of pulmonary arteries for pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: national trends, patient characteristics, and outcomes. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Meyer J, Briskin S, Tangen C, Hoffer S, Dundr J, Brennan B, Smith P, Lissemore F, Bailey C. B-48 Effects of Anxiety on Response to a Subsymptom Threshold Exercise Program for Treatment of Persistent Post-Concussive Symptoms: A Pilot Randomized Clinical Trial. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
There is a growing literature to support the use of subsymptom threshold exercise for treatment of both acute and chronic post-concussion symptoms. The present study aimed to explore the influence of anxiety on response to exercise intervention for patients with persistent post-concussive symptoms.
Methods
Sixteen adolescents (ages 14-18) with persistent (>1 month) concussion symptoms were randomized into a light, home exercise group and a subsymptom threshold exercise group performed by PT’s (modeled after Leddy et al.,2019). Participants underwent intervention for 6 weeks and completed evaluations at Baseline, Mid-Point, and Follow-up after treatment; evaluations included State-Trait Anxiety Inventory (STAI), the Post-Concussive Scale-Revised (PCS-R), as well as additional measures of emotional functioning, balance disturbance, and neuropsychological functioning.
Results
Average PCS-R endorsement improved by 21 points from Baseline to Follow-up across treatment groups (PCS-R Total Change M = -21.29,SD = 13.54). There were meaningful Baseline differences between intervention groups in STAI state anxiety (p < .05) and STAI trait anxiety (p = 0.51); STAI variables were used as covariates in an ANOVA comparing mean PCS-R Percent Change between treatment and control groups. After removing the influence of anxiety, the intervention groups significantly differed and showed large effect (F(3,13) = 6.94,p < .05,partial eta2 = .41), with the intervention group improving (PCS-R Percent Change M = -63.3,SD = 17.4) more than the control group (PCS-R Percent Change M = -56.8,SD = 27.8).
Conclusion
Exercise intervention appears to be more effective than standard-of-care light activity in the treatment of persistent symptoms in adolescents; however, anxiety may alter response to intervention. Complimentary mental health treatment may augment response to exercise intervention and optimize concussion recovery trajectory in patients with persisting symptoms.
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Hafezi Nejad N, Bailey C, Weiss C. Abstract No. 492 Uterine artery embolization in the United States, 2012–2015: a population-based analysis of costs based on hospital characteristics. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Hinerfeld D, Fuhrman K, Church S, Zollinger D, Reeves J, Bailey C, Warren S. Differential analysis of complex immune biology in MSI and MSS colorectal tumor microenvironments using high-plex spatial resolution. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nejad NH, Bailey C, Weiss C. 03:27 PM Abstract No. 338 Transcatheter and endoscopic treatment of gastric and duodenal bleeding: population-based analysis of national inpatient trends and outcomes in the United States 1993–2015. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Linton E, Walkden A, Steeples LR, Bhargava A, Williams C, Bailey C, Quhill FM, Kelly SP. Retinal burns from laser pointers: a risk in children with behavioural problems. Eye (Lond) 2019; 33:492-504. [PMID: 30546136 PMCID: PMC6460723 DOI: 10.1038/s41433-018-0276-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/21/2018] [Accepted: 11/04/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To explore self-inflicted retinal burns from laser pointers in children. METHODS Literature review of laser pointer retinal injuries in childhood and online survey of UK Consultant Ophthalmologists. A cohort of local children with self-inflicted injury is described. The matter is topical. We review progress in recent legislation and policy change in the UK. RESULTS Four of 77 case reports of laser burns in childhood analysed reported psychological or behavioural issues. Three of four children in our cohort had such issues. Delay in diagnosis occurred in two of our patients. Structural retinal damage persisted for over 12 months in all four children (seven eyes). Our survey of UK ophthalmologists found 159 cases of injury (85% male), 80% under 20 years of age. The majority of the laser pointers were purchased online. Many patients (36%) suffered moderate vision loss (6/18 to 6/60 Snellen), while 17% (at least 11 patients) suffered severe vision loss (<6/60 Snellen). CONCLUSION We highlight the risk of macular damage and vision loss from handheld lasers specifically in children with behavioural, learning or mental health issues. The diagnosis may be difficult or delayed in such children. In children with uncertain macular changes, ophthalmologists should explore the history for possible instances of exposure to handheld lasers pointers. Regulatory authorities and manufacturers of handheld lasers need to be aware of the risk to children. Furthermore, there is a need to better inform parents, carers and teachers of the risk of ocular self-injury from such lasers pointers.
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Affiliation(s)
- E Linton
- Department of Ophthalmology, Bolton Hospitals NHS Foundation Trust, Bolton, UK
| | - A Walkden
- Department of Ophthalmology, Lancashire Teaching Hospitals NHS Foundation Hospital, Preston, UK
| | - L R Steeples
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A Bhargava
- Department of Ophthalmology, Lancashire Teaching Hospitals NHS Foundation Hospital, Preston, UK
| | - C Williams
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - C Bailey
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - F M Quhill
- Department of Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S P Kelly
- Department of Ophthalmology, Bolton Hospitals NHS Foundation Trust, Bolton, UK.
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Townsend M, Karthigan R, Kaderbhai H, Bailey C, Panchalingam D, Keane A, Nehra D, Burney K. Gastric ulceration causing thoracic spondylodiscitis: a first case of a rare complication post oesophagectomy. BJR Case Rep 2019; 5:20170074. [PMID: 31131113 PMCID: PMC6519485 DOI: 10.1259/bjrcr.20170074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 06/22/2018] [Accepted: 07/04/2018] [Indexed: 11/05/2022] Open
Abstract
We report the case of an 84-year-old male, who presented with septicaemia, abdominal and back pain. The patient had a background of oesophageal carcinoma and had undergone previous oesophagectomy and gastric pull-up operation 10 years ago. A computerised topography scan demonstrated a probable gastro-vertebral communication with a destructive process at the T8/T9 vertebral level. Further evaluation with MRI clearly showed the tract between the two structures and confirmed the diagnosis of spondylodiscitis at the adjacent spinal level. The patient was resuscitated, treated with intravenous antibiotics and kept nil by mouth. A subsequent gastroscopy demonstrated an eroding gastric ulcer at the enteric opening of the tract between the tubal stomach and the spinal column. The diagnosis was discussed with the patient, his family and the surgical multidisciplinary team. Given the extent of disease and his multiple medical co-morbidities, the decision was made for conservative management and symptom control. This is the first case of a gastro-vertebral communication causing spondylodiscitis to be described in the literature.
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Affiliation(s)
- M Townsend
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - R Karthigan
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - H Kaderbhai
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - C Bailey
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | | | - A Keane
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - D Nehra
- Epsom and St Helier’s NHS Trust, Carshalton, UK
| | - K Burney
- Epsom and St Helier’s NHS Trust, Carshalton, UK
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Izumi N, Meezan NB, Johnson S, Woodworth BN, Woods T, Jones OS, Landen OL, Kroll JJ, Vonhof S, Nikroo A, Jaquez J, Kangas K, Bailey C, Hardy M, Ehrlich R, Ralph J, Town RP, Bradley DK, Hinkel DE, Moore AS, Divol L, Young C, Moody JD. Simultaneous visualization of wall motion, beam propagation, and implosion symmetry on the National Ignition Facility (invited). Rev Sci Instrum 2018; 89:10K111. [PMID: 30399855 DOI: 10.1063/1.5039364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/21/2018] [Indexed: 06/08/2023]
Abstract
Achieving a symmetric implosion in National Ignition Facility indirect drive targets requires understanding and control of dynamic changes to the laser power transport in the hohlraum. We developed a new experimental platform to simultaneously visualize wall-plasma motion and dynamic laser power transport in the hohlraum and are using it to investigate correlations of these measurements with the imploded capsule symmetry. In a series of experiments where we made one single parameter variation, we show the value of this new platform in developing an understanding of laser transport and implosion symmetry. This platform also provides a new way to evaluate dynamic performance of advanced hohlraum designs.
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Affiliation(s)
- N Izumi
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - N B Meezan
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - S Johnson
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - B N Woodworth
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - T Woods
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - O S Jones
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - O L Landen
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J J Kroll
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - S Vonhof
- General Atomics, San Diego, California 92121, USA
| | - A Nikroo
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J Jaquez
- General Atomics, San Diego, California 92121, USA
| | - K Kangas
- General Atomics, San Diego, California 92121, USA
| | - C Bailey
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - M Hardy
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - R Ehrlich
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J Ralph
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - R Pj Town
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D K Bradley
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - D E Hinkel
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - A S Moore
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - L Divol
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - C Young
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
| | - J D Moody
- Lawrence Livermore National Laboratory, Livermore, California 94551, USA
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Shakoor Z, Tang S, Case C, Sinclair M, Muscat E, Bailey C, Sharma A, Betembeau N, Reddy M, Khoo L, Wilkinson L, Banerjee D, Chauhan R, Shrestha A. Patient satisfaction and re-audit of the vacuum excision (VACE) pathway for the management of breast lesions of uncertain malignant potential (B3). Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.02.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Bailey C, Choi P, Betz J, Duvvuri M, Towsley M, Mitchell S, Weiss C. 3:45 PM Abstract No. 106 Comparing solid embolic devices for the embolization of pulmonary arteriovenous malformations: an update. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kocharyan H, Rastegarpour A, Loveridge K, Bailey C, Sucher A, Intikhab O, Kannab-Aida S, Aoun H, Critchfield J. Abstract No. 498 CT-guided lung mass biopsy: reduced incidence of pneumothorax with tract injection. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Kocharyan H, Rastegarpour A, Bailey C, Sucher A, Karapetyan L, Intikhab O, Critchfield J. Abstract No. 542 Survival analysis of 79 patients with advanced hepatocellular carcinoma treated with Y90. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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45
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Zhou JY, Rappazzo KC, Volland L, Barnes RFW, Brackman M, Steiner B, Kruse-Jarres R, Quon DV, Bailey C, Chang EY, von Drygalski A. Pocket handheld ultrasound for evaluation of the bleeding haemophilic joint: A novel and reliable way to recognize joint effusions. Haemophilia 2018; 24:e77-e80. [PMID: 29436079 DOI: 10.1111/hae.13429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/28/2022]
Affiliation(s)
- J Y Zhou
- Division of Hematology/Oncology, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - K C Rappazzo
- Division of Hematology/Oncology, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - L Volland
- Division of Hematology/Oncology, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - R F W Barnes
- Division of Hematology/Oncology, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - M Brackman
- Division of Hematology/Oncology, Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - B Steiner
- Washington Center for Bleeding Disorders at BloodWorks NW, Seattle, WA, USA
| | - R Kruse-Jarres
- Washington Center for Bleeding Disorders at BloodWorks NW, Seattle, WA, USA
| | - D V Quon
- Orthopaedic Hemophilia Treatment Center, Orthopaedic Institute for Children, Los Angeles, CA, USA
| | - C Bailey
- Orthopaedic Hemophilia Treatment Center, Orthopaedic Institute for Children, Los Angeles, CA, USA
| | - E Y Chang
- VA San Diego Healthcare System, Radiology Service, San Diego, CA, USA
| | - A von Drygalski
- Division of Hematology/Oncology, Department of Medicine, University of California, San Diego, San Diego, CA, USA.,Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
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46
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Poller B, Hall S, Bailey C, Gregory S, Clark R, Roberts P, Tunbridge A, Poran V, Crook B, Evans C. 'VIOLET': a fluorescence-based simulation exercise for training healthcare workers in the use of personal protective equipment. J Hosp Infect 2018; 99:229-235. [PMID: 29421340 PMCID: PMC7133760 DOI: 10.1016/j.jhin.2018.01.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/30/2018] [Indexed: 01/06/2023]
Abstract
Background Healthcare workers caring for patients with high-consequence infectious diseases (HCIDs) require protection from pathogen exposure, for example by wearing personal protective equipment (PPE). Protection is acquired through the inherent safety of the PPE components, but also their safe and correct use, supported by adequate training and user familiarity. However, the evidence base for HCID PPE ensembles and any associated training is lacking, with subsequent variation between healthcare providers. Aim To develop an evidence-based assessment and training tool for evaluating PPE ensembles and doffing protocols, in the assessment of patients with suspected HCIDs. Methods VIOLET (Visualising Infection with Optimised Light for Education and Training) comprises a healthcare mannequin adapted to deliver simulated bodily fluids containing UV-fluorescent tracers. On demand and remotely operated, the mannequin projectile vomits (blue), coughs (red), has diarrhoea (yellow) and is covered in sweat (orange). Wearing PPE, healthcare staff participate in an HCID risk assessment and examination of the ‘patient’, thereby becoming exposed to these bodily fluids. Contamination of PPE is visualized and body-mapped under UV light before and after removal. Observational findings and participant feedback, around its use as a training exercise, is also recorded. Findings Significant contamination from different exposure events was seen, enabling evaluation of PPE and doffing procedures used. Observational data and participant feedback demonstrated its strengths and success as a training technique. Conclusion Simulation exercises using VIOLET provide evidence-based assessment of PPE ensembles, and are a valuable resource for training of healthcare staff in wearing and safe doffing of PPE.
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Affiliation(s)
- B Poller
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | - S Hall
- Health and Safety Executive, Buxton, UK
| | - C Bailey
- Health and Safety Executive, Buxton, UK
| | - S Gregory
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - R Clark
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - P Roberts
- Health and Safety Executive, Buxton, UK
| | - A Tunbridge
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - V Poran
- Health and Safety Executive, Leeds, UK
| | - B Crook
- Health and Safety Executive, Buxton, UK
| | - C Evans
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Bailey C, Schmidt-Posthaus H, Segner H, Wahli T, Strepparava N. Are brown trout Salmo trutta fario and rainbow trout Oncorhynchus mykiss two of a kind? A comparative study of salmonids to temperature-influenced Tetracapsuloides bryosalmonae infection. J Fish Dis 2018; 41:191-198. [PMID: 28914447 DOI: 10.1111/jfd.12694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 05/24/2023]
Abstract
Proliferative kidney disease (PKD) of salmonids caused by Tetracapsuloides bryosalmonae causes high mortalities of wild brown trout (Salmo trutta fario) and farmed rainbow trout (Oncorhynchus mykiss) at elevated water temperatures. Here the aim was to compare the temperature-dependent modulation of T. bryosalmonae in the two salmonid host species, which display different temperature optima. We used a novel experimental set-up in which we exposed brown trout and rainbow trout to an identical quantified low concentration of T. bryosalmonae for a short time period (1 hr). We followed the development of the parasite in the fish hosts for 70 days. PKD prevalence and parasite kinetics were assessed using qPCR. Exposures were performed at temperatures (12°C and 15°C) that reflect an environmental scenario that may occur in the natural habitat of salmonids. T. bryosalmonae infection was confirmed earliest in brown trout kept at 15°C (day 7 post-exposure) while, in all other groups, T. bryosalmonae was not confirmed until day 15 post-exposure. Moreover, significantly greater infection prevalence and a faster increase of parasite intensity were observed in brown trout kept at 15°C than in all other groups. These results indicate that PKD is differentially modulated by water temperature in related host species.
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Affiliation(s)
- C Bailey
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Berne, Bern, Switzerland
| | - H Schmidt-Posthaus
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Berne, Bern, Switzerland
| | - H Segner
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Berne, Bern, Switzerland
| | - T Wahli
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Berne, Bern, Switzerland
| | - N Strepparava
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Berne, Bern, Switzerland
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Hall S, Poller B, Bailey C, Gregory S, Clark R, Roberts P, Tunbridge A, Poran V, Evans C, Crook B. Use of ultraviolet-fluorescence-based simulation in evaluation of personal protective equipment worn for first assessment and care of a patient with suspected high-consequence infectious disease. J Hosp Infect 2018; 99:218-228. [PMID: 29325871 DOI: 10.1016/j.jhin.2018.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 11/20/2017] [Accepted: 01/03/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Variations currently exist across the UK in the choice of personal protective equipment (PPE) used by healthcare workers when caring for patients with suspected high-consequence infectious diseases (HCIDs). AIM To test the protection afforded to healthcare workers by current PPE ensembles during assessment of a suspected HCID case, and to provide an evidence base to justify proposal of a unified PPE ensemble for healthcare workers across the UK. METHODS One 'basic level' (enhanced precautions) PPE ensemble and five 'suspected case' PPE ensembles were evaluated in volunteer trials using 'Violet'; an ultraviolet-fluorescence-based simulation exercise to visualize exposure/contamination events. Contamination was photographed and mapped. FINDINGS There were 147 post-simulation and 31 post-doffing contamination events, from a maximum of 980, when evaluating the basic level of PPE. Therefore, this PPE ensemble did not afford adequate protection, primarily due to direct contamination of exposed areas of the skin. For the five suspected case ensembles, 1584 post-simulation contamination events were recorded, from a maximum of 5110. Twelve post-doffing contamination events were also observed (face, two events; neck, one event; forearm, one event; lower legs, eight events). CONCLUSION All suspected case PPE ensembles either had post-doffing contamination events or other significant disadvantages to their use. This identified the need to design a unified PPE ensemble and doffing procedure, incorporating the most protective PPE considered for each body area. This work has been presented to, and reviewed by, key stakeholders to decide on a proposed unified ensemble, subject to further evaluation.
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Affiliation(s)
- S Hall
- Health and Safety Executive, Buxton, UK.
| | - B Poller
- Sheffield Teaching Hospitals NHS Trusts, Sheffield, UK
| | - C Bailey
- Health and Safety Executive, Buxton, UK
| | - S Gregory
- Sheffield Teaching Hospitals NHS Trusts, Sheffield, UK
| | - R Clark
- Sheffield Teaching Hospitals NHS Trusts, Sheffield, UK
| | - P Roberts
- Health and Safety Executive, Buxton, UK
| | - A Tunbridge
- Sheffield Teaching Hospitals NHS Trusts, Sheffield, UK
| | - V Poran
- Health and Safety Executive, Leeds, UK
| | - C Evans
- Sheffield Teaching Hospitals NHS Trusts, Sheffield, UK
| | - B Crook
- Health and Safety Executive, Buxton, UK
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Bailey C, Segner H, Wahli T. What goes around comes around: an investigation of resistance to proliferative kidney disease in rainbow trout Oncorhynchus mykiss (Walbaum) following experimental re-exposure. J Fish Dis 2017; 40:1599-1612. [PMID: 28429822 DOI: 10.1111/jfd.12628] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 06/07/2023]
Abstract
Rainbow trout Oncorhynchus mykiss surviving proliferative kidney disease (PKD) are reported not to develop the disease upon re-exposure. However, the mechanisms involved in the immune response to re-exposure are unknown. We examined disease susceptibility and the immune response of naive 1+ rainbow trout when first exposed to Tetracapsuloides bryosalmonae in comparison with that of 1+ rainbow trout re-exposed to T. bryosalmonae. PKD pathogenesis, parasite burden and transcriptional signatures of the host immune response were assessed at 10, 25 and 40 d.p.e (days post-exposure). In addition, we evaluated the presence of IgM+ B cells in the blood and the posterior kidney. The exposure of 1+ rainbow trout to T. bryosalmonae for the first time resulted in 100% infection prevalence, high parasite burdens and severe clinical PKD, while re-exposed fish were either able to avoid reinfection completely or mount an earlier and more efficient adaptive-type immune response. This response was characterized by a greater amount of IgM+ B cells in the blood and elevated mRNA levels of secretory IgM in the posterior kidney which minimized pathogen burden and kidney inflammation. Our findings suggest that rainbow trout is able to develop immune protection against T. bryosalmonae.
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Affiliation(s)
- C Bailey
- Vetsuisse Faculty, Centre for Fish and Wildlife Health, University of Berne, Berne, Switzerland
| | - H Segner
- Vetsuisse Faculty, Centre for Fish and Wildlife Health, University of Berne, Berne, Switzerland
| | - T Wahli
- Vetsuisse Faculty, Centre for Fish and Wildlife Health, University of Berne, Berne, Switzerland
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Burke TR, Chu CJ, Salvatore S, Bailey C, Dick AD, Lee RWJ, Ross AH, Carreño E. Application of OCT-angiography to characterise the evolution of chorioretinal lesions in acute posterior multifocal placoid pigment epitheliopathy. Eye (Lond) 2017; 31:1399-1408. [PMID: 28983094 PMCID: PMC5639187 DOI: 10.1038/eye.2017.180] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 06/06/2017] [Indexed: 11/08/2022] Open
Abstract
PurposeThe aim of this study was to determine a sequence of structural changes in acute posterior multifocal placoid pigment epitheliopathy (APMPPE) using optical coherence tomography-angiography (OCT-A) and comparing with other imaging modalities.Patients and methodsPatients with a new diagnosis of acute-onset APMPPE referred to a regional specialist centre from October 2015 to October 2016 were included. Multimodal imaging employed on all patients from diagnosis included the following: fundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence, spectral domain-OCT (SD-OCT), and OCT-A. All non-invasive imaging processes were repeated during follow-up.ResultsTen eyes of five patients were included in the study, three males and two females, with a mean age of 26.2 years (range: 21-32) and a mean follow-up of 6.4 months (range: 2.6-13.3). All patients presented with bilateral disease and macular involving lesions. OCT-A imaging of the choriocapillaris was supportive of hypoperfusion at the site of APMPPE lesions during the acute phase of this condition with normalisation of choroidal vasculature during follow-up. Multimodal imaging consistently highlighted four sequential phases from presentation to resolution of active disease.ConclusionsMultimodal imaging in patients with APMPPE in acute and long-term follow-up demonstrates a reversible choroidal hypoperfusion supporting the primary inciting pathology as a choriocapillaritis. The evolution shows resolution of the ischaemia through a defined sequence that results in persistent changes at the level of the retinal pigment epithelium and outer retina. OCT-A was able to detect preclinical changes and chart resolution at the level of the choriocapillaris.
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Affiliation(s)
- T R Burke
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - C J Chu
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - S Salvatore
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - C Bailey
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - A D Dick
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK
| | - R W J Lee
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London, UK
| | - A H Ross
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - E Carreño
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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