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Currie E, Granata B, Goodman G, Rudd A, Wallace K, Rivkin A, Hart S, Porter CE, Harris S, Walker L, Lin F, Corduff N, Davies N, Roberts S, Clague M, Callan PP, McDonald C, Magnusson M, Tsirbas A, Gupta R, Bekhor P, Welsh B. The Use of Hyaluronidase in Aesthetic Practice: A Comparative Study of Practitioner Usage in Elective and Emergency Situations. Aesthet Surg J 2024:sjae009. [PMID: 38262634 DOI: 10.1093/asj/sjae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/25/2024] Open
Affiliation(s)
| | | | | | - Alice Rudd
- Alfred Hospital, Prahran, Victoria, Australia
| | | | | | | | | | | | | | - Frank Lin
- Monash University, Melbourne, Victoria, Australia
| | | | | | | | | | | | - Cara McDonald
- St. Vincent's Hospital Melbourne, Melbourne, Australia
| | | | | | | | - Philip Bekhor
- Department of Dermatology, Royal Children's Hospital, Parkville, Victoria, Australia
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Armitage KF, Porter CE, Ahmed S, Cook J, Boards J, Bongard E, Butler CC, Corfield K, Davoudianfar M, Galal U, Howard P, Mujica-Mota R, Saman R, Santillo M, Savic S, Shinkins B, Tonkin-Crine S, Wanat M, West RM, Yu LM, Pavitt S, Sandoe JAT. Penicillin allergy status and its effect on antibiotic prescribing, patient outcomes and antimicrobial resistance (ALABAMA): protocol for a multicentre, parallel-arm, open-label, randomised pragmatic trial. BMJ Open 2023; 13:e072253. [PMID: 37666558 PMCID: PMC10481831 DOI: 10.1136/bmjopen-2023-072253] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/07/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Incorrect penicillin allergy records are recognised as an important barrier to the safe treatment of infection and affect an estimated 2.7 million people in England. Penicillin allergy records are associated with worse health outcome and antimicrobial resistance. The ALlergy AntiBiotics And Microbial resistAnce (ALABAMA) trial aims to determine if an intervention package, centred around a penicillin allergy assessment pathway (PAAP) initiated in primary care, is safe and effective in improving patient health outcomes and antibiotic prescribing. METHODS AND ANALYSIS The ALABAMA trial is a multicentre, parallel-arm, open-label, randomised pragmatic trial with a nested pilot study. Adults (≥18 years) with a penicillin allergy record and who have received antibiotics in the previous 24 months will be eligible for participation. Between 1592 and 2090 participants will be recruited from participating National Health Service general practices in England. Participants will be randomised to either usual care or intervention to undergo a pre-emptive PAAP using a 1:1 allocation ratio. The primary outcome measure is the percentage of treatment response failures within 28 days of an index prescription. 2090 and 1592 participants are estimated to provide 90% and 80% power, respectively, to detect a clinically important absolute difference of 7.9% in primary outcome at 1 year between groups. The trial includes a mixed-methods process evaluation and cost-effectiveness evaluation. ETHICS AND DISSEMINATION This trial has been approved by London Bridge Research Ethics Committee (ref: 19/LO/0176). It will be conducted in compliance with Good Clinical Practice guidelines according to the Declaration of Helsinki. Informed consent will be obtained from all subjects involved in the study. The primary trial results will be submitted for publication to an international, peer-reviewed journal. TRIAL REGISTRATION ISRCTN20579216.
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Affiliation(s)
- Kelsey Fiona Armitage
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Catherine E Porter
- Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, West Yorkshire, UK
| | - Shadia Ahmed
- Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UK
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
| | - Johanna Cook
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Jenny Boards
- Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UK
| | - Emily Bongard
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Kate Corfield
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Mina Davoudianfar
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Ushma Galal
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Philip Howard
- School of Healthcare, University of Leeds, Leeds, UK
- NHS England, Leeds, UK
| | - Ruben Mujica-Mota
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Razan Saman
- Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, UK
| | - Marta Santillo
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Sinisa Savic
- Clinical Immunology and Allergy, University of Leeds Leeds Institute of Medical Research at St James's, Leeds, UK
| | - Bethany Shinkins
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ly-Mee Yu
- Nuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Sue Pavitt
- Dental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, West Yorkshire, UK
| | - Jonathan A T Sandoe
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
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Goodman GJ, McDonald CB, Lim A, Porter CE, Deva AK, Magnusson M, Patel A, Hart S, Callan P, Rudd A, Roberts S, Wallace K, Bekhor P, Clague M, Williams L, Corduff N, Wines N, Al-Niaimi F, Fabi SG, Studniberg HM, Smith S, Tsirbas A, Arendse S, Ciconte A, Poon T. Making Sense of Late Tissue Nodules Associated With Hyaluronic Acid Injections. Aesthet Surg J 2023; 43:NP438-NP448. [PMID: 36759325 PMCID: PMC10184938 DOI: 10.1093/asj/sjad028] [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] [Received: 01/15/2023] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The pathogenesis of delayed onset tissue nodules (DTNs) due to hyaluronic acid (HA) injections is uncertain. OBJECTIVES To formulate a rational theory for DTN development and their avoidance and treatment. METHODS A multi-disciplinary and multi country DTN consensus panel was established with 20 questions posed and consensus sought. Consensus was set at 75% agreement. RESULTS Consensus was reached in 16/20 questions regarding the pathogenesis of DTNs forming the basis of a classification and treatment guide. CONCLUSIONS The group believe that filler, pathogens and inflammation are all involved in DTNs and that DTNs most likely are infection initiated with a variable immune response. Injected filler may incorporate surface bacteria, either a commensal or a true pathogen if the skin barrier is altered. The initially High molecular weight HA (HMWHA) filler is degraded to Low molecular weight HA (LMWHA) at the edge of the filler. Commensals positioned within the filler bolus may be well tolerated until the filler is degraded and the commensal becomes visible to the immune system. LMWHA is particularly inflammatory in the presence of any local bacteria. Commensals may still be tolerated unless the immune system is generally heightened by viraemia, or vaccination. Systemic pathogenic bacteraemia may also interact with the filler peripheral LMWHA, activating Toll Like receptors inducing DTN formation. Given this scenario, attention to practitioner and patient hygiene and early systemic infection treatment deserve attention. Classification and treatment systems were devised by considering each of the 3 factors of filler, inflammation, and infection separately.
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Affiliation(s)
- Greg J Goodman
- Honorary professor at the University College of London, London, United Kingdom
| | - Cara B McDonald
- Dermatologist, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Adrian Lim
- Practicing dermatologist, Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Catherine E Porter
- Cosmetic physician in private practice in Sydney, New South Wales, Australia
| | - Anand K Deva
- Professor, Department of Plastic and Reconstructive Surgery, Macquarie University, Sydney, Australia
| | - Mark Magnusson
- Associate professor, Department of Plastic and Reconstructive Surgery, Griffiths University Southport, Queensland, Australia
| | - Anita Patel
- Dermatologist in Private practice in Bondi Junction, New South Wales, Australia
| | - Sarah Hart
- Aesthetic physician in private practice in Auckland, the North Island, New Zealand
| | - Peter Callan
- Specialist plastic surgeon in private practice in Geelong, Victoria, Australia
| | - Alice Rudd
- Dermatologist, Department of Dermatology, Alfred Hospital Prahran Victoria, Victoria, Australia
| | - Stefania Roberts
- Aesthetic physician in private practice in Melbourne, Victoria, Australia
| | - Katy Wallace
- Nurse practitioner at a private dermatology practice in South Yarra, Victoria, Australia
| | - Philip Bekhor
- Dermatologist, Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Clague
- Cosmetic nurse in private practice in South Yarra, Victoria, Australia
| | - Linda Williams
- Cosmetic physician in private practice in East Brisbane, Queensland, Australia
| | - Niamh Corduff
- Plastic surgeon in private practice in Geelong, Victoria, Australia
| | - Nina Wines
- Principal dermatologist in private practice in Sydney, New South Wales, Australia
| | - Firas Al-Niaimi
- Dermatologist, Department of Dermatology, Aalborg University, Aalborg, Denmark
| | - Sabrina G Fabi
- Dermatologist, Department of Dermatology, University of California San Diego, La Jolla, CA, USA
| | | | - Saxon Smith
- Dermatologist at the Sydney Clinical School, ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Angelo Tsirbas
- Oculoplastic surgeon in Sydney, New South Wales, Australia
| | - Sean Arendse
- Cosmetic physician in private practice in Melbourne, Victoria, Australia
| | - Antoinette Ciconte
- Dermatologist at Eastern Health Hospital, Box Hill and Canterbury, Victoria, Australia
| | - Terence Poon
- Dermatologist in private practice in Sydney, New South Wales, Australia
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Oganessian YT, Abdullin FS, Bailey PD, Benker DE, Bennett ME, Dmitriev SN, Ezold JG, Hamilton JH, Henderson RA, Itkis MG, Lobanov YV, Mezentsev AN, Moody KJ, Nelson SL, Polyakov AN, Porter CE, Ramayya AV, Riley FD, Roberto JB, Ryabinin MA, Rykaczewski KP, Sagaidak RN, Shaughnessy DA, Shirokovsky IV, Stoyer MA, Subbotin VG, Sudowe R, Sukhov AM, Tsyganov YS, Utyonkov VK, Voinov AA, Vostokin GK, Wilk PA. Synthesis of a new element with atomic number Z = 117. Phys Rev Lett 2010; 104:142502. [PMID: 20481935 DOI: 10.1103/physrevlett.104.142502] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Indexed: 05/29/2023]
Abstract
The discovery of a new chemical element with atomic number Z=117 is reported. The isotopes (293)117 and (294)117 were produced in fusion reactions between (48)Ca and (249)Bk. Decay chains involving 11 new nuclei were identified by means of the Dubna gas-filled recoil separator. The measured decay properties show a strong rise of stability for heavier isotopes with Z > or = 111, validating the concept of the long sought island of enhanced stability for superheavy nuclei.
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Affiliation(s)
- Yu Ts Oganessian
- Joint Institute for Nuclear Research, RU-141980 Dubna, Russian Federation.
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