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Dwyer RH, Meaney KD, Geppert-Kleinrath H, Loomis EN, Robey HF, Mohamed ZL, Fry C, Kim Y. Optimization of the gamma reaction history diagnostic for double-shell pusher areal density and reaction history measurements on the National Ignition Facility. Rev Sci Instrum 2024; 95:033504. [PMID: 38497838 DOI: 10.1063/5.0189085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
The double-shell inertial confinement fusion campaign, which consists of an aluminum ablator, a foam cushion, a high-Z pusher (tungsten or molybdenum), and liquid deuterium-tritium (DT) fuel, aims for its first DT filled implosions on the National Ignition Facility (NIF) in 2024. The high-Z, high density pusher does not allow x-rays to escape the double-shell capsule. Therefore, nuclear diagnostics such as the Gamma Reaction History (GRH) diagnostic on the NIF are crucial for understanding high-Z implosion performance. To optimize the GRH measurement of fusion reaction history and the pusher's areal density, the MCNP6.3-based forward model of the detector was built. When calculating the neutron-induced inelastic gamma ray production, the interaction of neutrons with the compressed fuel was additionally included. By folding the calculated gamma ray spectrum output and the previously calibrated GRH detector responses, the optimum set of GRH energy thresholds for measuring the pusher areal density is determined to be 2.9 and 6.3 MeV for DT double-shell experiments. In addition, the effect of the down-scattering of neutrons on the gamma ray spectrum, the minimum required yield for measurements, and the attenuation of the gamma rays through the pusher are analyzed.
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Affiliation(s)
- R H Dwyer
- Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14627, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K D Meaney
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | | | - E N Loomis
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - H F Robey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z L Mohamed
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C Fry
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Y Kim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
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2
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Meyer J, Fry C, Turner A, Razavi H. Intravitreal dexamethasone versus bevacizumab in Aboriginal and Torres Strait Islander patients with diabetic macular oedema: The
OASIS
study (a randomised control trial). Clin Exp Ophthalmol 2022; 50:522-533. [DOI: 10.1111/ceo.14079] [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] [Received: 06/29/2021] [Revised: 02/07/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Joos Meyer
- Lions Eye Institute Perth Western Australia Australia
- Lions Outback Vision Lions Eye Institute Broome Werstern Australia Australia
| | - Carly Fry
- Lions Eye Institute Perth Western Australia Australia
| | - Angus Turner
- Lions Eye Institute Perth Western Australia Australia
- Lions Outback Vision Lions Eye Institute Broome Werstern Australia Australia
- Centre for Ophthalmology and Vision Sciences University of Western Australia Perth Western Australia Australia
| | - Hessom Razavi
- Lions Eye Institute Perth Western Australia Australia
- Lions Outback Vision Lions Eye Institute Broome Werstern Australia Australia
- Centre for Ophthalmology and Vision Sciences University of Western Australia Perth Western Australia Australia
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Gordon C, Fry C, Salman M, Desai N. Meningitis following cerebrospinal fluid-cutaneous fistula secondary to combined spinal-epidural anaesthesia for elective caesarean delivery. Int J Obstet Anesth 2021; 49:103241. [PMID: 34906428 DOI: 10.1016/j.ijoa.2021.103241] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/31/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
Cerebrospinal fluid-cutaneous fistula is a rare complication associated with neuraxial procedures. Here, we describe a case of fistula formation related to combined spinal-epidural anaesthesia for elective caesarean delivery, where the epidural catheter was removed only two hours later. The clear fluid leaking persistently from the site of the skin puncture associated with the epidural insertion site was confirmed to be cerebrospinal fluid with an increased beta-trace protein, and the fistula was closed with skin sutures. Subsequently, the patient presented with neurological signs and symptoms consistent with meningitis and she was treated empirically with intravenous antibiotics. Cerebrospinal fluid-cutaneous fistula formation with secondary meningitis is an exceptionally rare event in obstetric anaesthesia.
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Affiliation(s)
- C Gordon
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Fry
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Salman
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - N Desai
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK; King's College London, London, UK.
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Li Y, Ahmed H, Dall’ara E, Sullivan N, Liem Y, Tucker D, Fry C, Ooij BV, Blom A, Sharif M. AB0076 SPATIAL VARIATIONS OF BONE MICROARCHITECTURE AND MINERALIZATION IN HIP OSTEOARTHRITIS AND OSTEOPOROSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.703] [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: 11/04/2022]
Abstract
Background:The pattern of changes in bone microarchitecture and mineralisation are distinctly different in osteoarthritis (OA) and osteoporosis (OP). However, the pathogenesis of OA is closely related with OP, making subchondral bone a promising target for OA treatment [1]. A detailed comparison of subchondral bone in OA and OP may help understand the relationship of the two diseases.Objectives:To carry out a comprehensive analysis of regional and compartmental variations in subchondral bone architecture and mineralisation in OA and OP.Methods:Femoral heads were collected from patients undergoing hip arthroplasty surgeries for hip OA (N=16) or osteoporotic fracture (N=7). For OP group, osteochondral plugs were collected from fixed sites: anterior, posterior and superior. For OA group, an optimised sampling procedure, based on a new macroscopic grading method and modified OARSI microscopic grading system, was used to collect plugs from regions with varying severity of cartilage degradation. Plugs were scanned by micro CT (voxel size 4.88µm). Regions of interest for cortical plate (Ct) and trabecular bone (Tb) were segmented from reconstructed images using semi-automatic approach. Densitometric (tissue and bone mineral density: TMD and BMD) and architectural parameters (cortical plate thickness (Ct.Th), trabecular bone volume fraction (BV/TV), trabecular thickness (Tb.Th), etc.) were measured using commercially available software. Unmatched inter-group regional comparisons were made between OA microscopic grades (1 to 4) and OP. Matched intra-sample regional analysis was made between ‘mild’ (Grade 1 and/or 2) and ‘severe’ (Grade 3 and/or 4) OA. TMD was also subjected to paired comparison between cortical (Ct.TMD) and trabecular (Tb.TMD) compartments. Correlations between densitometric and architectural parameters were also explored.Results:Regional analysis showed that Tb.TMD in OA Grade 3 and 4 was significantly lower than in OP and Grade 1 and 2, while Tb.TMD in OP was not significantly different from OA Grade 1 and 2 (Fig 1A, F). Ct.TMD in OA Grade 4 was significantly lower than in OP, but no difference was found in other comparisons (Fig 1B, G). For BMD of trabecular bone (Tb.BMD) and architectural parameters including BV/TV and Ct.Th, values for OA Grade 3 and/or 4 were significantly higher than OP and Grade 1 and/or 2, but the difference between OP and Grade 1 and 2 was not significant (Fig 1C-E, H-J). Compartmental analysis showed that Ct.TMD was significantly lower than Tb.TMD in all groups (Table I). Tb.TMD was inversely correlated with Tb.BMD and BV/TV in both OA and OP; Ct.TMD and Tb.TMD were inversely associated with Ct.Th and Tb.Th respectively in OA (Table II).Conclusion:In both OA and OP, material density (TMD) of cortical plate was lower than trabecular bone. In hip OA, densitometric and architectural changes of subchondral cortical and trabecular bone were related to severity of cartilage degradation. In OA trabecular bone, the decrease in material density was compensated by increased bone volume, leading to higher apparent density (BMD); while in OP, loss of bone volume was correlated with, but not compensated by increased mineralisation, leading to lower apparent density.References:[1]Castaneda, S., et al. Biochem. Pharmacol., 2012Table 1.Compartmental comparison of TMDOPOA Grade1234Ct.TMD1.19±0.071.18±0.091.15±0.061.16±0.061.12±0.07Tb.TMD1.34±0.06****1.37±0.10****1.33±0.07****1.22±0.06*1.19±0.09*Table 2.Correlation analysisOPOAPR2SlopePR2SlopeTb.TMD - BV/TV< 0.00010.69-0.01< 0.00010.84-0.01Tb.BMD - BV/TV< 0.00010.950.02< 0.00010.960.01Tb.BMD - Tb.TMD< 0.00010.60-1.25< 0.00010.81-1.37Ct.TMD - Ct.Thns0.00090.19-0.33Tb.TMD - Tb.Thns< 0.00010.55-1.97Acknowledgments:China Scholarship CouncilDisclosure of Interests:None declared
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Graber T, Rawls B, Tian B, Durham W, Brasier A, Rasmussen B, Fry C. COPD CACHEXIA IN A MURINE MODEL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T. Graber
- University of Texas Medical Branch, Galveston, Texas
| | - B. Rawls
- University of Texas Medical Branch, Galveston, Texas
| | - B. Tian
- University of Texas Medical Branch, Galveston, Texas
| | - W. Durham
- University of Texas Medical Branch, Galveston, Texas
| | - A. Brasier
- University of Texas Medical Branch, Galveston, Texas
| | - B. Rasmussen
- University of Texas Medical Branch, Galveston, Texas
| | - C. Fry
- University of Texas Medical Branch, Galveston, Texas
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Pratt R, Morgan S, Hughes J, Mulhall A, Fry C, Perry C, Tew L. Healthcare governance and the modernisation of the NHS: infection prevention and control. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/175717740200300504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Q uality is central to the government's programme for modernising the NHS and clinical quality is at the heart of this agenda. The recent introduction of corporate governance with controls assurance and clinical governance in the NHS has established a framework for providing such excellence in clinical care. Governance applies to all healthcare activities and provides an ideal opportunity for infection prevention and control practitioners to improve the quality of their service and reduce the risk of patients acquiring preventable healthcare-associated infections (HAI). This paper will discuss the introduction of governance in the NHS, describe the key principles of clinical governance and relate these to infection prevention and control.
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Affiliation(s)
- R Pratt
- Professor of Nursing and Director, Richard Wells Research Centre, Thames Valley University London W5 2BS
| | - S Morgan
- Nurse Consultant in Infection Control, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN
| | - J Hughes
- Nurse Consultant Infection Control, University Hospital Aintree, Lower Lane, Liverpool L9 7AL
| | - A Mulhall
- Independent Training and Research Consultant, Ashmanhaugh, Norfolk
| | - C Fry
- Nurse Advisor, Communicable Diseases, Department of Health (England), 79 Whitehall, London SW1A 2NS
| | - C Perry
- Senior Infection Control Nurse, United Bristol Healthcare NHS Trust, Bristol BS2 8HW
| | - L Tew
- Infection Control Nurse Manager, Royal United Hospital Bath NHS Trust, Combe Park, Bath BA1 3NG
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Baxter M, Islam G, Parsons H, Enoch D, Fry C, Kiernan M, Mahida N. A new infection trainee education programme from the Healthcare Infection Society. J Hosp Infect 2016; 93:157-8. [DOI: 10.1016/j.jhin.2016.02.018] [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] [Received: 02/16/2016] [Accepted: 02/17/2016] [Indexed: 10/22/2022]
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Bennett MB, Wrede C, Brown BA, Liddick SN, Pérez-Loureiro D, Bardayan DW, Chen AA, Chipps KA, Fry C, Glassman BE, Langer C, Larson NR, McNeice EI, Meisel Z, Ong W, O'Malley PD, Pain SD, Prokop CJ, Schatz H, Schwartz SB, Suchyta S, Thompson P, Walters M, Xu X. Isospin Mixing Reveals ^{30}P(p,γ)^{31}S Resonance Influencing Nova Nucleosynthesis. Phys Rev Lett 2016; 116:102502. [PMID: 27015475 DOI: 10.1103/physrevlett.116.102502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Indexed: 06/05/2023]
Abstract
The thermonuclear ^{30}P(p,γ)^{31}S reaction rate is critical for modeling the final elemental and isotopic abundances of ONe nova nucleosynthesis, which affect the calibration of proposed nova thermometers and the identification of presolar nova grains, respectively. Unfortunately, the rate of this reaction is essentially unconstrained experimentally, because the strengths of key ^{31}S proton capture resonance states are not known, largely due to uncertainties in their spins and parities. Using the β decay of ^{31}Cl, we have observed the β-delayed γ decay of a ^{31}S state at E_{x}=6390.2(7) keV, with a ^{30}P(p,γ)^{31}S resonance energy of E_{r}=259.3(8) keV, in the middle of the ^{30}P(p,γ)^{31}S Gamow window for peak nova temperatures. This state exhibits isospin mixing with the nearby isobaric analog state at E_{x}=6279.0(6) keV, giving it an unambiguous spin and parity of 3/2^{+} and making it an important l=0 resonance for proton capture on ^{30}P.
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Affiliation(s)
- M B Bennett
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Wrede
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - S N Liddick
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Pérez-Loureiro
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - D W Bardayan
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - A A Chen
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - K A Chipps
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - C Fry
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - B E Glassman
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Langer
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - N R Larson
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, USA
| | - E I McNeice
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - Z Meisel
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - W Ong
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - P D O'Malley
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - S D Pain
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C J Prokop
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Schatz
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - S B Schwartz
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Geology and Physics, University of Southern Indiana, Evansville, Indiana 47712, USA
| | - S Suchyta
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, USA
| | - P Thompson
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M Walters
- Department of Physics and Astronomy, McMaster University, Hamilton, Ontario L8S 4M1, Canada
| | - X Xu
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
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Brown C, Livermore D, Otter J, Warren R, Jenks P, Enoch D, Newsholme W, Oppenheim B, Leanord A, McNulty C, Tanner G, Bennett S, Cann M, Bostock J, Collins E, Peckitt S, Ritchie L, Fry C, Hawkey P, Wilson A. Multidrug-resistant (MDR) Gram-negative bacteria information leaflets. J Hosp Infect 2016; 92:86-7. [DOI: 10.1016/j.jhin.2015.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fry C, Cawood A, Ashouri A. MON-PP019: Sensory Attributes and Preference of Low-Volume Oral Nutritional Supplements (ONS). Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30451-9] [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: 12/01/2022]
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Fraise A, Wilkinson M, Bradley C, Paton S, Walker J, Maillard JY, Wesgate R, Hoffman P, Coia J, Woodall C, Fry C, Wilcox M. Development of a sporicidal test method for Clostridium difficile. J Hosp Infect 2015; 89:2-15. [DOI: 10.1016/j.jhin.2014.09.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 09/22/2014] [Indexed: 01/19/2023]
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Howlett P, Morritt J, Greswell L, Findlay N, Mahmoudi M, Waheed A, Jabr R, Fry C, Leatham E. 81 * Symptom frequency is a poor predictor of onset of paroxysmal atrial fibrillation in a population presenting with palpitations. Europace 2014. [DOI: 10.1093/europace/euu244.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Antimicrobial resistance is a national and worldwide threat to the future of healthcare. Educating both healthcare staff and the public in the prudent use of antimicrobials is an essential part of antimicrobial stewardship programmes that aim to contain and control resistance and preserve the usefulness of currently available antibiotics. Using current available evidence, regulatory documents and national antimicrobial stewardship guidance for primary and secondary care, five dimensions for antimicrobial prescribing and stewardship competences have been developed in England, through an independent multiprofessional group led by the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) of the Department of Health (England). They are designed to complement the generic competency framework for all prescribers from the UK National Prescribing Centre (now part of National Institute for Health and Care Excellence) and are relevant to all independent prescribers, including doctors, dentists and non-medical practitioners. The antimicrobial prescribing and stewardship competences published jointly by ARHAI and PHE in 2013 are believed to be the first of their kind. Implementation of these competences will be an important contribution to the delivery of the UK government's 5 year Antimicrobial Resistance Strategy.
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Affiliation(s)
- D Ashiru-Oredope
- Antimicrobial Resistance, Stewardship and Healthcare Associated Infection (AMRS & HCAI) Programme, Public Health England, London, UK
| | - B Cookson
- Division of Infection and Immunity, University College London, London, UK
| | - C Fry
- Department of Health, London, UK
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McNulty C, Verlander NQ, Turner K, Fry C. Point prevalence survey of urinary catheterisation in care homes and where they were inserted, 2012. J Infect Prev 2014; 15:122-126. [PMID: 28989371 DOI: 10.1177/1757177414532507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2014] [Indexed: 11/15/2022] Open
Abstract
The extent to which the use of catheter care bundles and other interventions has led to a reduction in urinary catheterisation rates is unknown. We aimed to determine current urinary catheterisation rates in care homes with residents over 65 years old, and determine the extent to which residents are discharged from the hospital setting with urinary catheters. A point prevalence questionnaire survey was used in care homes that looked after residents over 65 years in six UK health boards or primary care trusts, to determine urinary catheterisation rates, and where these catheters were inserted. Questionnaires for 445 of 461 care homes (96.5%) were completed, 425 of 445 care homes cared for residents over 65 years; 888 (6.9%) of 12,827 residents had a urethral (82.5%) or supra-pubic (17.5%) urinary catheter. Over half of all catheters (both urethral and suprapubic, 57.4%, 509 of 888 catheters), and 3.1% of all residents had a catheter inserted while the residents were hospital inpatients, and then discharged back to the care home still catheterised. There was a significant variation in urinary catheterisation rates in the care homes surveyed, and rates remain similar to previous English surveys in 2003 and 2009. More still needs to be done to understand the variation in urinary catheterisation rates in care homes and reduce these rates, including the numbers of residents that are discharged from hospital with a urinary catheter.
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Affiliation(s)
- Cam McNulty
- Public Health England Primary Care Unit, and Cardiff University, UK
| | | | - K Turner
- Public Health England Primary Care Unit, UK
| | - C Fry
- Department of Health, London, UK
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15
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Coia JE, Ritchie L, Adisesh A, Makison Booth C, Bradley C, Bunyan D, Carson G, Fry C, Hoffman P, Jenkins D, Phin N, Taylor B, Nguyen-Van-Tam JS, Zuckerman M. Guidance on the use of respiratory and facial protection equipment. J Hosp Infect 2013; 85:170-82. [PMID: 24051190 PMCID: PMC7114842 DOI: 10.1016/j.jhin.2013.06.020] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 06/13/2013] [Indexed: 11/30/2022]
Abstract
Infectious micro-organisms may be transmitted by a variety of routes, and some may be spread by more than one route. Respiratory and facial protection is required for those organisms that are usually transmitted via the droplet/airborne route, or when airborne particles have been artificially created, such as during ‘aerosol-generating procedures’. A range of personal protective equipment that provides different degrees of facial and respiratory protection is available. It is apparent from the recent experiences with severe acute respiratory syndrome and pandemic (H1N1) 2009 influenza that healthcare workers may have difficulty in choosing the correct type of facial and respiratory protection in any given clinical situation. To address this issue, the Scientific Development Committee of the Healthcare Infection Society established a short-life working group to develop guidance. The guidance is based upon a review of the literature, which is published separately, and expert consensus.
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Affiliation(s)
- J E Coia
- Department of Clinical Microbiology, Glasgow Royal Infirmary, Glasgow, UK.
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Estryn-Behar M, Fry C, Guetarni K, Aune I, Machet G, Doppia MA, Lassaunière JM, Muster D, Pelloux P, Prudhomme C. Work week duration, work-family balance and difficulties encountered by female and male physicians: results from the French SESMAT study. Work 2013; 40 Suppl 1:S83-100. [PMID: 22112665 DOI: 10.3233/wor-2011-1270] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE France encounters difficulties attracting physicians to work in hospitals. Organisation at work and at home may be at the heart of the problem for female as well as for male physicians. PARTICIPANTS A comprehensive questionnaire was filled out online by a representative sample of 1924 French hospital physicians. METHODS We conducted gender bivariate and multivariate analysis of the risk factors for burnout and intent to leave the profession(ITL). RESULTS ITL was declared by 17.4% of physicians. According to 41.3% of female physicians (FP), their profession was an obstacle to having children (versus 19.3% for male physicians (MP)). Major factors linked with burnout were Effort/Reward imbalance (FP adjOR = 5.09, MP adjOR = 5.93), Work-family conflicts (FP adjOR = 2.97, MP adjOR = 3.04), and Low quality of teamwork (FP adjOR = 1.82, MP adjOR = 2.68). Major factors linked with ITL were Low quality of teamwork (FP adjOR = 4.49, MP adjOR = 3.03), Patient-related burnout (FP adjOR = 2.10, MP adjOR = 2.35) and General burnout (FP adjOR = 1.85, MP adjOR = 1.45). CONCLUSIONS Excessive job demands are linked with burnout and with work-family conflicts, conducting to difficulties in organising one's life in order to have and raise children. Potential solutions include facilitating teamwork in order to reduce departure, which increase workload on those who stay increasing their work family conflict.
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Affiliation(s)
- M Estryn-Behar
- Unité Presst/Sesmat Épidémiologie Ergonomie SCMT, Paris, France.
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Qasem A, Fry C, Jabr R. 206 ASSESSMENT OF GAP JUNCTION COMMUNICATION BETWEEN HUMAN UMBILICAL ENDOTHELIAL CELLS AND MONOCYTES IN RESPONSE TO TUMOUR NECROSIS FACTOR (TNF-Α). Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Howard P, Cooke J, Fry C, McNulty C, Khoda H, Wellstead S, Stockley J, Loveday H, Brown L. CPC-128 Start Smart Then Focus – a Survey of Antimicrobial Stewardship Guidelines Implementation in England. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.585] [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: 11/04/2022] Open
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Nagel M, Höpner D, Fry C, Siedentopf JP. Substitutionsbehandlung von Frauen. Suchttherapie 2011. [DOI: 10.1055/s-0031-1293196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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McNulty CAM, Lecky DM, Farrell D, Kostkova P, Adriaenssens N, Koprivova Herotova T, Holt J, Touboul P, Merakou K, Koncan R, Olczak-Pienkowska A, Brito Avo A, Campos J, Barbouni N, Benes J, Caballero CR, Cornaglia G, Davis C, De Corte S, de Quincey E, Dellamonica P, Gennimata D, Goossens H, Grzesiowski P, Jawaheer G, Kremastinou J, Lazareck L, Noer M, Nowakowska M, Weerasinghe D, Weinberg J, Fry C, Goossens H, Fisher I. Overview of e-Bug: an antibiotic and hygiene educational resource for schools. J Antimicrob Chemother 2011; 66 Suppl 5:v3-12. [DOI: 10.1093/jac/dkr119] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Levy BF, Scott MJ, Fawcett W, Fry C, Rockall TA. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery. Br J Surg 2011; 98:1068-78. [PMID: 21590762 DOI: 10.1002/bjs.7545] [Citation(s) in RCA: 170] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND Epidural analgesia is considered fundamental in enhanced recovery protocols (ERPs). However, its value in laparoscopic colorectal surgery is unclear. The aim of this study was to examine the effects of different analgesic regimens on outcomes following laparoscopic colorectal surgery in fluid-optimized patients treated within an ERP. METHODS Ninety-nine patients were randomized to receive epidural, spinal or patient-controlled (PCA) analgesia. The primary endpoints were time until medically fit for discharge and length of hospital stay. Secondary endpoints included return of bowel function, pain scores, and changes in pulmonary function and quality of life. RESULTS Ninety-one patients completed the study. The median length of hospital stay was 3.7 days following epidural analgesia, significantly longer than that of 2.7 and 2.8 days for spinal analgesia and PCA respectively (P = 0.002 and P < 0.001). There was also a slower return of bowel function with epidural analgesia than with spinal analgesia and PCA. Epidural analgesia did not offer better preservation of pulmonary function or quality of life, although pain scores were higher in the PCA group in the early postoperative period. CONCLUSION Many of the outcomes in the epidural analgesia group were significantly worse than those in the spinal analgesia and PCA groups, suggesting that either of these two modalities could replace epidural analgesia.
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Affiliation(s)
- B F Levy
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK.
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Estryn-Behar M, Doppia MA, Guetarni K, Fry C, Machet G, Pelloux P, Aune I, Muster D, Lassaunière JM, Prudhomme C. Emergency physicians accumulate more stress factors than other physicians-results from the French SESMAT study. Emerg Med J 2010; 28:397-410. [PMID: 21123828 DOI: 10.1136/emj.2009.082594] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION France is facing a shortage of available physicians due to a greying population and the lack of a proportional increase in the formation of doctors. Emergency physicians are the medical system's first line of defence. METHODS The authors prepared a comprehensive questionnaire using established scales measuring various aspects of working conditions, satisfaction and health of salaried physicians and pharmacists. It was made available online, and the two major associations of emergency physicians promoted its use. 3196 physicians filled out the questionnaire. Among them were 538 emergency physicians. To avoid bias, 1924 physicians were randomly selected from the total database to match the demographic characteristics of France's physician population: 42.5% women, 57.5% men, 8.2% < 35 years old, 33.8% 35-44 years old, 34.5% 45-54 years old and 23.6% ≥ 55 years old. The distribution of physicians in the 23 administrative regions and by speciality was also precisely taken into account. This representative sample was used to compare subgroups of physicians by speciality. RESULTS The outcomes indicate that the intent to leave the profession (ITL) was quite prevalent across French physicians and even more so among emergency physicians (17.4% and 21.4% respectively), and burnout was highly prevalent (42.4% and 51.5%, respectively). Among the representative sample and among emergency physicians, work-family conflict (OR=4.47 and OR=6.14, respectively) and quality of teamwork (OR=2.21 and OR=5.44, respectively) were associated with burnout in a multivariate analysis, and these risk factors were more prevalent among emergency physicians than other types. A serious lack of quality of teamwork appears to be associated with a higher risk of ITL (OR=3.92 among the physicians in the representative sample and OR=4.35 among emergency physicians), and burnout doubled the risk of ITL in multivariate analysis. CONCLUSIONS In order to prevent the premature departure of French doctors, it is important to improve work-family balance, working processes through collaboration, multidisciplinary teamwork and to develop team training approaches and ward design to facilitate teamwork.
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Affiliation(s)
- M Estryn-Behar
- Department of Occupational Medicine, SCMT, Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris, Parvis Notre-Dame, 75004 Paris, France.
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Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 2010; 29:213-40. [PMID: 20025020 DOI: 10.1002/nau.20870] [Citation(s) in RCA: 704] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Chekanov S, Derrick M, Magill S, Musgrave B, Nicholass D, Repond J, Yoshida R, Mattingly MCK, Antonioli P, Bari G, Bellagamba L, Boscherini D, Bruni A, Bruni G, Cindolo F, Corradi M, Iacobucci G, Margotti A, Nania R, Polini A, Antonelli S, Basile M, Bindi M, Cifarelli L, Contin A, De Pasquale S, Sartorelli G, Zichichi A, Bartsch D, Brock I, Hartmann H, Hilger E, Jakob HP, Jüngst M, Nuncio-Quiroz AE, Paul E, Samson U, Schönberg V, Shehzadi R, Wlasenko M, Brook NH, Heath GP, Morris JD, Capua M, Fazio S, Mastroberardino A, Schioppa M, Susinno G, Tassi E, Kim JY, Ibrahim ZA, Kamaluddin B, Wan Abdullah WAT, Ning Y, Ren Z, Sciulli F, Chwastowski J, Eskreys A, Figiel J, Galas A, Gil M, Olkiewicz K, Stopa P, Zawiejski L, Adamczyk L, Bołd T, Grabowska-Bołd I, Kisielewska D, Lukasik J, Przybycień M, Suszycki L, Kotański A, Słomiński W, Behrens U, Blohm C, Bonato A, Borras K, Ciesielski R, Coppola N, Fang S, Fourletova J, Geiser A, Göttlicher P, Grebenyuk J, Gregor I, Haas T, Hain W, Hüttmann A, Januschek F, Kahle B, Katkov II, Klein U, Kötz U, Kowalski H, Lobodzinska E, Löhr B, Mankel R, Melzer-Pellmann IA, Miglioranzi S, Montanari A, Namsoo T, Notz D, Parenti A, Rinaldi L, Roloff P, Rubinsky I, Santamarta R, Schneekloth U, Spiridonov A, Szuba D, Szuba J, Theedt T, Wolf G, Wrona K, Yagües Molina AG, Youngman C, Zeuner W, Drugakov V, Lohmann W, Schlenstedt S, Barbagli G, Gallo E, Pelfer PG, Bamberger A, Dobur D, Karstens F, Vlasov NN, Bussey PJ, Doyle AT, Dunne W, Forrest M, Rosin M, Saxon DH, Skillicorn IO, Gialas I, Papageorgiu K, Holm U, Klanner R, Lohrmann E, Schleper P, Schörner-Sadenius T, Sztuk J, Stadie H, Turcato M, Foudas C, Fry C, Long KR, Tapper AD, Matsumoto T, Nagano K, Tokushuku K, Yamada S, Yamazaki Y, Barakbaev AN, Boos EG, Pokrovskiy NS, Zhautykov BO, Aushev V, Borodin M, Kadenko I, Kozulia A, Libov V, Lisovyi M, Lontkovskyi D, Makarenko I, Sorokin I, Verbytskyi A, Volynets O, Son D, de Favereau J, Piotrzkowski K, Barreiro F, Glasman C, Jimenez M, Labarga L, Del Peso J, Ron E, Soares M, Terrón J, Zambrana M, Corriveau F, Liu C, Schwartz J, Walsh R, Zhou C, Tsurugai T, Antonov A, Dolgoshein BA, Gladkov D, Sosnovtsev V, Stifutkin A, Suchkov S, Dementiev RK, Ermolov PF, Gladilin LK, Golubkov YA, Khein LA, Korzhavina IA, Kuzmin VA, Levchenko BB, Lukina OY, Proskuryakov AS, Shcheglova LM, Zotkin DS, Abt I, Caldwell A, Kollar D, Reisert B, Schmidke WB, Grigorescu G, Keramidas A, Koffeman E, Kooijman P, Pellegrino A, Tiecke H, Vázquez M, Wiggers L, Brümmer N, Bylsma B, Durkin LS, Lee A, Ling TY, Allfrey PD, Bell MA, Cooper-Sarkar AM, Devenish RCE, Ferrando J, Foster B, Korcsak-Gorzo K, Oliver K, Robertson A, Uribe-Estrada C, Walczak R, Bertolin A, Dal Corso F, Dusini S, Longhin A, Stanco L, Bellan P, Brugnera R, Carlin R, Garfagnini A, Limentani S, Oh BY, Raval A, Ukleja J, Whitmore JJ, Iga Y, D'Agostini G, Marini G, Nigro A, Cole JE, Hart JC, Abramowicz H, Ingbir R, Kananov S, Levy A, Stern A, Kuze M, Maeda J, Hori R, Kagawa S, Okazaki N, Shimizu S, Tawara T, Hamatsu R, Kaji H, Kitamura S, Ota O, Ri YD, Costa M, Ferrero MI, Monaco V, Sacchi R, Solano A, Arneodo M, Ruspa M, Fourletov S, Martin JF, Stewart TP, Boutle SK, Butterworth JM, Gwenlan C, Jones TW, Loizides JH, Wing M, Brzozowska B, Ciborowski J, Grzelak G, Kulinski P, Luzniak P, Malka J, Nowak RJ, Pawlak JM, Tymieniecka T, Ukleja A, Zarnecki AF, Adamus M, Plucinski P, Eisenberg Y, Hochman D, Karshon U, Brownson E, Danielson T, Everett A, Kçira D, Reeder DD, Ryan P, Savin AA, Smith WH, Wolfe H, Bhadra S, Catterall CD, Cui Y, Hartner G, Menary S, Noor U, Standage J, Whyte J. Inclusive K(S);(0)K(S);(0) resonance production in ep collisions at HERA. Phys Rev Lett 2008; 101:112003. [PMID: 18851276 DOI: 10.1103/physrevlett.101.112003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Indexed: 05/26/2023]
Abstract
Inclusive K_{S};{0}K_{S};{0} production in ep collisions at the DESY ep collider HERA was studied with the ZEUS detector using an integrated luminosity of 0.5 fb;{-1}. Enhancements in the mass spectrum were observed and are attributed to the production of f_{2}(1270)/a_{2};{0}(1320), f_{2};{'}(1525) and f_{0}(1710). Masses and widths were obtained using a fit which takes into account theoretical predictions based on SU(3) symmetry arguments, and are consistent with the Particle Data Group values. The f_{0}(1710) state, which has a mass consistent with a glueball candidate, was observed with a statistical significance of 5 standard deviations. However, if this state is the same as that seen in gammagamma-->K_{S};{0}K_{S};{0}, it is unlikely to be a pure glueball state.
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Affiliation(s)
- S Chekanov
- Argonne National Laboratory, Argonne, Illinois 60439-4815, USA
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Humphreys H, Newcombe R, Enstone J, Smyth E, McIlvenny G, Fitzpatrick F, Fry C, Spencer R. Four Country Healthcare Associated Infection Prevalence Survey 2006: risk factor analysis. J Hosp Infect 2008; 69:249-57. [DOI: 10.1016/j.jhin.2008.04.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Accepted: 04/18/2008] [Indexed: 10/22/2022]
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Fry C. Real world noise-induced hearing loss claims. Clin Otolaryngol 2008; 33:169-70. [DOI: 10.1111/j.1749-4486.2008.01610.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Increased gap junction expression in lamina propria myofibroblasts and urothelial cells may be involved in detrusor overactivity, leading to incontinence. Immunohistochemistry was used to compare connexin (Cx) 26, 43, and 45 expression in the bladders of neonatal, adult, and spinal cord-transected rats, while optical imaging was used to map the spread of spontaneous activity and the effects of gap junction blockade. Female adult Sprague-Dawley rats were deeply anesthetized, a laminectomy was performed, and the spinal cord was transected (T8/T9). After 14 days, their bladders and those of age-matched adults (4 mo old) and neonates (7-21 day old) were excised and studied immunohistochemically using frozen sections or optically using whole bladders stained with voltage- and Ca(2+)-sensitive dyes. The expression of Cx26 was localized to the urothelium, Cx43 to the lamina propria myofibroblasts, and Cx45 to the detrusor smooth muscle. While the expression of Cx45 was comparable in all bladders, the expression of Cx43 and Cx26 was increased in neonate and transected animals. In the bladders of adults, spontaneous activity was initiated at multiple sites, resulting in a lack of coordination. Alternatively, in neonate and transected animals spontaneous activity was initiated at a focal site near the dome and spread in a coordinated fashion throughout the bladder. Gap junction blockade (18beta-glycyrrhetinic acid, 1 microM) abolished this coordinated activity but had no effect on the uncoordinated activity in adult bladders. These data suggest that coordinated spontaneous activity requires gap junction upregulation in urothelial cells and lamina propria myofibroblasts.
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Affiliation(s)
- Y Ikeda
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
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Kanai A, Roppolo J, Ikeda Y, Zabbarova I, Tai C, Birder L, Griffiths D, de Groat W, Fry C. Origin of spontaneous activity in neonatal and adult rat bladders and its enhancement by stretch and muscarinic agonists. Am J Physiol Renal Physiol 2006; 292:F1065-72. [PMID: 17107944 PMCID: PMC3033037 DOI: 10.1152/ajprenal.00229.2006] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study examined the origin of spontaneous activity in neonatal and adult rat bladders and the effect of stretch and muscarinic agonists and antagonists on spontaneous activity. Rats were anesthetized and their bladders were excised, cannulated, and loaded with voltage- and Ca(2+)-sensitive dyes. Intracellular Ca(2+) and membrane potential transients were mapped using photodiode arrays in whole bladders, bladder sheets, or cross-section preparations at 37 degrees C. Intravesical pressure was recorded from whole bladders. In neonatal bladders and sheets, spontaneous Ca(2+) and electrical signals arose at a site near the dome and spread in a coordinated manner throughout the bladder with different dome-to-neck conduction velocities (Ca(2+): 3.7 +/- 0.4 mm/s; membrane potential: 46.2 +/- 3.1 mm/s). In whole bladders, optical signals were associated with spontaneous contractions (10-20 cmH(2)O). By contrast, in adult bladders spontaneous Ca(2+) and electrical activity was uncoordinated, originating at multiple sites and was associated with smaller (2-5 cmH(2)O) contractions. Spontaneous contractions and optical signals were insensitive to tetrodotoxin (2 muM) but were blocked by nifedipine (10 muM). Stretch or low carbachol concentrations (50 nM) applied to neonatal whole bladders enhanced the amplitude (to 20-35 cmH(2)O) of spontaneous activity, which was blocked by atropine. Bladder cross sections revealed that Ca(2+) and membrane potential transients produced by stretch or carbachol began near the urothelial-suburothelial interface and then spread to the detrusor. In conclusion, spontaneous activity in neonatal bladders, unlike activity in adult bladders, is highly organized, originating in the urothelium-suburothelium near the dome. Activity is enhanced by stretch or carbachol and this enhancement is blocked by atropine. It is hypothesized that acetylcholine is released from the urothelium during bladder filling to enhance spontaneous activity.
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Affiliation(s)
- A Kanai
- Department of Medicine, University of Pittsburgh School of Medicine, A1224 Scaife Hall, Pittsburgh, PA 15261, USA.
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Coia J, Duckworth G, Edwards D, Farrington M, Fry C, Humphreys H, Mallaghan C, Tucker D. Erratum to “Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities [Journal of Hospital Infection 2006;63:S1–S44]”. J Hosp Infect 2006. [DOI: 10.1016/j.jhin.2006.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kanai A, de Groat W, Birder L, Chai T, Hultgren S, Fowler C, Fry C. Symposium Report on Urothelial Dysfunction: Pathophysiology and Novel Therapies. J Urol 2006; 175:1624-9. [PMID: 16600715 DOI: 10.1016/s0022-5347(05)00977-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Indexed: 02/06/2023]
Abstract
PURPOSE The basic premise of this symposium (Workshop 7) at the 2004 International Continence Society meeting in Paris was to elucidate different mechanisms of urothelial cell pathology, explore their impact on bladder function and discuss novel therapeutic interventions. RESULTS The topics included 1) urothelial structure and function, 2) the role of adenosine triphosphate in urothelial signaling and cystitis, 3) lamina propria myofibroblasts and purinergic receptors, 4) antiproliferative factor involvement in interstitial cystitis, 5) the urothelium as a reservoir for bacterial infections, 6) radiation cystitis, nitric oxide and gene therapy, and 7) intravesical treatments. DISCUSSION It was agreed that the urothelium can no longer be regarded merely as a passive barrier separating urine from the underlying tissues. The epithelial cells of the urothelium form part of an integrated network that also includes afferent and possibly efferent nerves, and suburothelial myofibroblasts. It has a central role in several functions, including bladder wall sensation, local blood flow modulation, pathogen removal and active barrier provision. These functions are achieved through several autocrine and paracrine pathways that involve transmitter release from the urothelium and its ability to integrate incoming signals through its battery of membrane receptors. Several pathological processes were discussed using this knowledge, including the role of small glycoproteins released during interstitial cystitis, the molecular basis of radiation induced urothelial damage, the origin of recurrent urinary tract infections and the mode of action of potential intravesical treatments for overactive bladder. CONCLUSIONS Overall it was concluded that the urothelium has a key role in regulating lower urinary tract physiology and pathology.
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Affiliation(s)
- A Kanai
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
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Coia JE, Duckworth GJ, Edwards DI, Farrington M, Fry C, Humphreys H, Mallaghan C, Tucker DR. Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect 2006; 63 Suppl 1:S1-44. [PMID: 16581155 DOI: 10.1016/j.jhin.2006.01.001] [Citation(s) in RCA: 388] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2005] [Indexed: 01/01/2023]
Abstract
Meticillin-resistant Staphylococcus aureus (MRSA) remains endemic in many UK hospitals. Specific guidelines for control and prevention are justified because MRSA causes serious illness and results in significant additional healthcare costs. Guidelines were drafted by a multi-disciplinary group and these have been finalised following extensive consultation. The recommendations have been graded according to the strength of evidence. Surveillance of MRSA should be undertaken in a systematic way and should be fed back routinely to healthcare staff. The inappropriate or unnecessary use of antibiotics should be avoided, and this will also reduce the likelihood of the emergence and spread of strains with reduced susceptibility to glycopeptides, i.e. vancomycin-intermediate S. aureus/glycopeptide-intermediate S. aureus (VISA/GISA) and vancomycin-resistant S. aureus (VRSA). Screening for MRSA carriage in selected patients and clinical areas should be performed according to locally agreed criteria based upon assessment of the risks and consequences of transmission and infection. Nasal and skin decolonization should be considered in certain categories of patients. The general principles of infection control should be adopted for patients with MRSA, including patient isolation and the appropriate cleaning and decontamination of clinical areas. Inadequate staffing, especially amongst nurses, contributes to the increased prevalence of MRSA. Laboratories should notify the relevant national authorities if VISA/GISA or VRSA isolates are identified.
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Affiliation(s)
- J E Coia
- Department of Bacteriology, Glasgow Royal Infirmary, Glasgow, UK
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Morgan M, Black J, Bone F, Fry C, Harris S, Hogg S, Holmes A, Hughes S, Looker N, McIlvenny G, Nixon J, Nolan J, Noone A, Reilly J, Richards J, Smyth E, Howard A. Clinician-led surgical site infection surveillance of orthopaedic procedures: a UK multi-centre pilot study. J Hosp Infect 2005; 60:201-12. [PMID: 15949611 DOI: 10.1016/j.jhin.2004.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Accepted: 11/18/2004] [Indexed: 11/21/2022]
Abstract
The UK Department of Health established the Healthcare-associated Infection (HAI) Surveillance Steering Group in 2000 to develop a strategy for implementing a national programme for HAI surveillance in National Health Service trusts. A subgroup of this committee examined the surveillance of surgical site infections following orthopaedic surgery. This group oversaw a pilot scheme that was set up in 12 hospitals around the UK to explore the feasibility of implementing a system of surveillance that engaged clinical staff in its operation, provided a process for continuous data collection and could be maintained as part of routine hospital operation over time. A minimum data set was established by the subgroup, and Centers for Disease Control and Prevention (CDC) definitions of infection were used. By March 2003, the surveillance had been undertaken continuously in 11 sites for one to two years, depending on the date of implementation. Only one hospital had ceased data collection. The information was collected mainly by clinical staff, with support and co-ordination usually provided by infection control teams. Data on more than 5400 procedures were available for analysis for four core procedures: arthroplasty of the hip and knee; hemi-arthroplasty of the hip; and internal fixation of trochanteric fractures of the femur. The data set permitted the calculation of risk-adjusted rates, allowing comparisons between hospitals and within a hospital over time. The methodology enhanced clinical ownership of the surveillance process, re-inforced infection control as the responsibility of all staff, and provided timely feedback and local data analysis. The use of CDC definitions permitted international comparisons of the data.
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Affiliation(s)
- M Morgan
- NPHS Communicable Disease Surveillance Centre, Cardiff, UK
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Abstract
Using a randomized, controlled study, the investigators evaluated and compared the effects of local anesthesia versus no anesthesia on pain associated with peripherally inserted central catheter (PICC) insertion. A sample of 42 subjects was selected and divided into three groups. Group 1 received EMLA cream. Group 2 received buffered lidocaine. Group 3 (the control group) did not receive a local anesthetic. The short form of the McGill Pain Questionnaire was used to measure pain quality and intensity. A numerical Visual Analogue Scale accompanied the questionnaire and measured overall pain intensity. Results showed that buffered lidocaine was statistically superior to EMLA cream or no anesthetic in relieving pain associated with PICC insertion.
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Abstract
AIMS To examine injecting drug user (IDU) motivations as research participants. DESIGN Convenience sampling facilitated by recruitment notices distributed through needle and syringe programmes (NSPs), and snowballing within peer networks. SETTING NSPs in six suburbs throughout the Melbourne metropolitan area. PARTICIPANTS One hundred and fifty-four current IDUs. The mean age was 28 years, 62% were male, and 80% nominated heroin as preferred drug. MEASUREMENTS Interviewer-administered survey including questions about socio-demographics, drug use and main reasons for participating in research. FINDINGS IDU research participation reasons were consistent with motivational themes such as economic gain (46%), expression of citizenship (38%), altruism (19%), personal satisfaction (17%), drug user activism (16%) and seeking information or assistance (5%). Most respondents (58%) cited reasons where the primary beneficiaries of participation were other individuals or groups (citizenship, altruism, drug user activism) or both self and others. CONCLUSIONS IDU motivations for research involvement appear to be multi-dimensional, rarely motivated by economic gain alone, and not necessarily defined by direct benefits or gains to themselves. These findings are relevant to the question of IDU research payment ethics.
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Affiliation(s)
- C Fry
- Turning Point Alcohol and Drug Centre Inc., Melbourne, Australia.
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Brown J, Byrne R, Fry C, Henderson S, Ivanski F, Liddell M, Skae K, Connell N, Beith C, Bryce B, Livingston A, Kneale V. PDSA review. Vet Rec 2001; 149:32. [PMID: 11486778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Abstract
This paper examines the relationship between urinary pH, infection and urinary catheter encrustation and discusses the current management and problems of catheter associated urinary infection and encrustation.
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Affiliation(s)
- S Choong
- Institute of Urology and Nephrology, London, UK.
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Fry C, Dietze P, Crofts N. Naloxone distribution: remembering hepatitis C transmission as an issue. Addiction 2000; 95:1865-6. [PMID: 11218366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Abstract
OBJECTIVE To investigate the attitudes of injecting drug users (IDUs) towards the establishment of safe injecting rooms (SIRs) in Melbourne, Australia. METHODS Multi-site convenience sampling at Needle and Syringe Exchange Programs (NSEPs) within six Melbourne suburbs. Four hundred current IDUs were recruited directly through NSEP and participant snowballing. Respondents completed either a semi-structured interview, anonymous self-report questionnaire, face-to-face interview or participated in a focus group. Participants were asked to report on their knowledge and attitudes about SIR, their experiences and concerns as participants of street-based illicit drug markets, and their willingness to use SIRs if established. RESULTS Participants (91%) were knowledgeable about the SIR issue and thought such a strategy had potential to address both personal and wider community harms associated with public injecting. Most (77%) indicated they would be willing to use a SIR if established in Melbourne. Gender, lifetime non-fatal overdose episodes and frequency of heroin use were all significantly related to a person's willingness to use SIRs. A significant number also reported a preference for injecting at their own place of residence due to concerns regarding privacy, safety and police presence within street-based market places. CONCLUSIONS This study has identified a number of important issues relating to the likely demand and uptake of SIRs that should be addressed when considering the feasibility of establishing SIRs within Australia.
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Affiliation(s)
- C Fry
- Turning Point Alcohol & Drug Centre Inc., Fitzroy, Victoria.
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Farrell AM, Shanson DC, Ross JS, Roberts NM, Fry C, Cream JJ, Staughton RC, Bunker CB. An outbreak of methicillin-resistant staphylococcus aureus (MRSA) in a dermatology day-care unit. Clin Exp Dermatol 1998; 23:249-53. [PMID: 10233618 DOI: 10.1046/j.1365-2230.1998.00382.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a dermatology day-care unit and the methods used to determine the mechanism of spread and control it. The epidemic strain had a characteristic sensitivity pattern and was typeable with phages 29, 80, 95, 47, 54 and 77, which was of considerable value in interpreting the epidemiological data. The method of spread was studied by examination of the medical and nursing records of patients who had acquired MRSA (to determine which members of staff they had encountered and which other MRSA-positive patients had been present in the department at the same time) and by the microbiological screening of all patients and staff. However, screening of all staff by nasal swabbing failed to identify carriage of the epidemic strain, while extensive swabbing of surfaces on the day-care unit also failed to show any evidence of MRSA in the environment. This suggests that the MRSA was most probably spread from patient to patient via the hands of staff, although there was also the possibility of direct transmission from patient to patient. Nine patients acquired the unique strain of MRSA and once acquired it proved difficult to eradicate, although in the majority, the infection did not appear to be clinically significant. However, in two patients MRSA contributed to a fatal outcome: these were the two most elderly patients and were the only two who were receiving systemic corticosteroids. The outbreak was brought under control with rigorous hygienic measures and the decision to discharge all patients with MRSA from the day-care unit. Repeat screening (swabs of nose, axilla and groin) of all day-care unit and in-patients 11 months after the last MRSA case showed no evidence of any residual MRSA infection in the day-care unit.
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Affiliation(s)
- A M Farrell
- Departments of Dermatology, Churchill Hospital, Oxford, UK
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Braden TD, Fry C, Sartin JL. Effects of interleukins on secretion of luteinizing hormone from ovine pituitary cells. Am J Vet Res 1998; 59:1488-93. [PMID: 9829412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To determine whether cytokines of homologous species might mediate the stimulatory effects of endotoxin on release of luteinizing hormone (LH) from pituitary cells. SAMPLE POPULATION Cells from pituitary glands collected from 8- to 14-month-old wethers. PROCEDURE Cells from the anterior pituitary gland were cultured in the presence of recombinant ovine or bovine cytokines (interleukin [IL]-1alpha, IL-1beta, and IL-2), tumor necrosis factor-alpha (TNF), and interferon-gamma (IFN-gamma). Luteinizing hormone that was released into the medium was measured. Cells were also cultured with modulators of signal transduction pathways to evaluate the second messenger system used by IL-1 alpha and IL-1beta. RESULTS Similar to effects of endotoxin, IL-1alpha and IL-1beta stimulated release of LH. Interleukin 2, TNF, and IFN-gamma did not have a detectable effect on release of LH. Stimulation of LH release by IL-1alpha and IL-1beta required activation of voltage-dependent Ca2+ channels and appeared to involve protein kinase C. CONCLUSIONS IL-1alpha and IL-1beta may mediate the direct stimulatory effect of endotoxin on release of LH in vitro. Interleukin 2, TNF, and IFN-gamma do not have a direct effect on release of LH; therefore, they do not mediate this effect of endotoxin. CLINICAL RELEVANCE Stressors, including infection, are often associated with reduced fertility. Infection resulting in endotoxin release, production of interleukins, or both, can lead to direct stimulation of LH release from the pituitary gland. Inopportune release of LH via cytokines may interfere with normal pulsatile release of LH, thereby suppressing gonadal function.
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Affiliation(s)
- T D Braden
- Department of Anatomy, Physiology, and Pharmacology, College of Veterinary Medicine, Auburn University, AL 36849, USA
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Abstract
Previous studies have demonstrated that intravenous lipopolysaccharide (LPS) will increase concentrations of growth hormone (GH). One possible explanation for this may reside in the response of the pituitary to specific cytokines. This study sought to determine the effects of recombinant bovine tumor necrosis factor alpha (TNF), recombinant ovine (ro) interleukin-1alpha (IL-1alpha), roIL-1beta, ro interleukin-2 (IL-2), and ro gamma-interferon (INT) on GH release from cultured sheep pituitary cells. Sheep were sacrificed and pituitary cells cultured in DMEM with 10% fetal bovine serum for 3 days. On day 4, cells were washed and serum-free DMEM added to cells. IL-1alpha and IL-1beta were used at 0.2, 2 and 20 ng/ml and the remaining cytokines at 2, 20 and 200 ng/ml. Neither IL-2 nor INT had effects on basal or on GH-releasing hormone (GRH)-stimulated GH release. TNF inhibited GRH-stimulated GH release (p < 0.05). Both IL-1alpha and IL-1beta stimulated GH release from cultured pituitary cells at all doses tested (p < 0.01). Neither IL-1alpha nor IL-1beta had an effect on GRH-stimulated GH release. IL-1 effects were inhibited by H-89 (p < 0.05; a protein kinase A inhibitor) and by nifedipine (p < 0.05; a calcium channel blocker). Both of these mechanisms are central signal transduction mechanisms mediating GRH-stimulated GH release. IL-1-stimulated GH release is partially inhibited (p < 0.05) by lipoxygenase pathway blockers. Phorbol myristate acetate downregulation of protein kinase C did not alter IL-1-stimulated GH release. IL-1beta increased the content of both GH and GH mRNA in cultured sheep pituitary cells. We conclude that IL-1 produces a strong stimulus to GH release, which is mediated by calcium entry and protein kinase A activation. IL-1 also activates lipoxygenase pathways. This latter pathway as well as calcium entry were shown to mediate LPS stimulation of GH release from cultured pituitary cells. The similarity between IL-1 and LPS signal transduction suggests that LPS may activate pituitary production of IL-1 to produce the stimulus to GH. The lack of inhibitory effects of INT, TNF and IL-2 as opposed to what is seen in the rat may suggest a partial mechanism to explain the different effects of LPS on GH release between sheep and that seen in cattle and rats.
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Affiliation(s)
- C Fry
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, Ala., USA
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Gray R, McIntyre H, Fry C, Malone-Lee J. Contractile Function in Hypertrophied Myocardium. Age Ageing 1997. [DOI: 10.1093/ageing/26.suppl_1.p4-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Austin L, Fry C, Shropshire C. Mandatory education: a successful, creative approach. J Nurs Staff Dev 1993; 9:200-1. [PMID: 8366379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Affiliation(s)
- N E White
- School of Nursing, University of Northern Colorado, Greeley
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Buck-Gramcko D, Fry C. [Ischemic contracture of the forearm and hand. Staging and indications for surgical treatment]. HANDCHIR MIKROCHIR P 1991; 23:128-43. [PMID: 1869108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Results of long-term follow up of 66 patients with ischemic contracture of the forearm and hand, all surgically treated in the "Unfallkrankenhaus Hamburg)) between 1961 and 1982, are presented. Whereas ischemic contracture of the forearm flexors resulted mainly from fractures, ischemic contracture of the intrinsic muscles of the hand was most often seen after pressure injuries. All patients in this study presented to us with fully established ischemic contractures. Muscle and nerve damage was retrospectively evaluated according to operative notes, and the degree of damage could be classified into four groups. Most frequently, neurolysis, scar excision and muscle-sliding operations were performed; furthermore, tendon lengthening, tendon transpositions, wrist arthrodesis and nerve grafting were indicated. Results were judged according to twelve separately measured functions, each measurement giving a possible score of three to six points. Muscle-sliding operations result in an improved score regardless of ischemic contracture stage. For a stage 2 contracture, a 20 point improvement can be expected. In stage 1 contracture--presenting with extension deficiency of four or more points--, complete recovery can be expected following a muscle-sliding operation. For isolated muscle injuries, tendon lengthening is recommended. For stage 2 contracture, the transposition of superficial to deep flexor tendons results in the same score as a muscle-sliding operation; however, the transposition procedure should be reserved for special indications. In stage 3 contracture, the muscle-sliding operation is the treatment of choice, with secondary procedures such as tendon transpositions and nerve grafts often being necessary. In stage 4 ischemic contracture, muscle-sliding operations may improve extension deficiency; however, wrist arthrodesis, especially in combination with extensor tendon transpositions, may be beneficial. No experience with free muscle transplantation was made during the study period.
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Affiliation(s)
- D Buck-Gramcko
- Abteilung für Handchirurgie und Plastische Chirurgie, Berufsgenossenschaftlichen Unfallkrankenhauses Hamburg
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Fry C, Korndorfeer M. Publisher's introduction. Clin Biomech (Bristol, Avon) 1988; 3:3. [PMID: 23915806 DOI: 10.1016/0268-0033(88)90117-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
The effect of a change in temperature on net mitochondrial Ca2+ exchange has been investigated in a suspension of adult rat ventricular myocytes. Temperature was varied between 42 degrees C and 15 degrees C. Hypothermia reduced the initial rate of respiration-dependent Ca2+ uptake and reduced the Na+-sensitivity of Ca2+ efflux. The net result of these alterations is that at low temperatures, the Ca2+ level at which a steady-state between mitochondria and sarcoplasm is maintained, will be raised.
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Akasofu SI, Fillius W, Sun W, Fry C, Dryer M. A simulation study of two major events in the heliosphere during the present sunspot cycle. ACTA ACUST UNITED AC 1985. [DOI: 10.1029/ja090ia09p08193] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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